Background Long-term care facilities (LTCF) worldwide have suffered high rates of COVID-19, reflecting the vulnerability of the persons who live there and the institutional nature of care delivered. This study describes the impact of the pandemic on incidences and deaths in LTCF across England. Methods Laboratory-confirmed SARS-CoV-2 cases in England, notified to Public Health England from 01 Jan to 25 Dec 2020, were address-matched to an Ordnance Survey reference database to identify residential property classifications. Data were analysed to characterize cases and identify clusters. Associated deaths were defined as death within 60 days of diagnosis or certified as cause of death. Results Of 1 936 315 COVID-19 cases, 81 275 (4.2%) and 10 050 (0.52%) were identified as resident or staff in an LTCF, respectively, with 20 544 associated deaths in residents, accounting for 31.3% of all COVID-19 deaths. Cases were identified in 69.5% of all LTCFs in England, with 33.1% experiencing multiple outbreaks. Multivariable analysis showed a 67% increased odds of death in residents [adjusted odds ratio (aOR): 1.67, 95% confidence interval (CI): 1.63–1.72], compared with those not residing in LTCFs. A total of 10 321 outbreaks were identified at these facilities, of which 8.2% identified the first case as a staff member. Conclusions Over two-thirds of LTCFs have experienced large and widespread outbreaks of COVID-19, and just under one-third of all COVID-19 deaths occurring in this setting in spite of early policies. A key implication of our findings is upsurges in community incidences seemingly leading to increased outbreaks in LTCFs; thus, identifying and shielding residents from key sources of infection are vital to reduce the number of future outbreaks.

中文翻译：

---

英国长期护理机构中 COVID-19 的渗透率和影响：人口监测研究

背景 世界各地的长期护理机构 (LTCF) 感染 COVID-19 的比例很高，反映出居住在那里的人的脆弱性以及所提供护理的机构性质。这项研究描述了大流行对英格兰各地 LTCF 发病率和死亡的影响。方法 将 2020 年 1 月 1 日至 12 月 25 日期间向英格兰公共卫生部门通报的英格兰实验室确诊的 SARS-CoV-2 病例与英国地形测量局参考数据库进行地址匹配，以确定住宅物业分类。分析数据以表征病例并识别集群。相关死亡被定义为诊断或被证实为死因后 60 天内死亡。结果 在 1 936 315 例 COVID-19 病例中，分别有 81 275 例 (4.2%) 和 10 050 例 (0.52%) 被确定为 LTCF 的居民或工作人员，其中 20 544 例居民相关死亡，占所有 COVID-19 病例的 31.3% -19人死亡。英格兰 69.5% 的 LTCF 中发现了病例，其中 33.1% 经历了多次疫情爆发。多变量分析显示，与非长期居住社区居民相比，居民的死亡几率增加了 67% [调整后优势比 (aOR)：1.67，95% 置信区间 (CI)：1.63–1.72]。这些设施共发现 10 321 起疫情，其中 8.2% 的首例病例为工作人员。结论 尽管采取了早期政策，但超过三分之二的 LTCF 经历了大规模且广泛的 COVID-19 疫情爆发，并且只有不到三分之一的 COVID-19 死亡发生在这种情况下。我们的研究结果的一个关键含义是，社区发病率的激增似乎导致了 LTCF 疫情的增加；因此，识别并保护居民免受主要感染源的侵害对于减少未来疫情爆发的数量至关重要。