Abstract
Objectives: Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection. Methods: Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched. Results: Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts. Conclusion: Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.
Highlights
The SARS-CoV-2 virus has inflicted a global health crisis, infecting at least 271 million individuals and causing over 5.3 million deaths as of December 18, 2021 [1]
This review aims to systematically examine the pattern of SARS-CoV-2 outbreaks in hospitals and identify vulnerable aspects of our preparedness against future outbreaks
The following keywords were used in combination: (SARS-CoV-2 OR COVID-19 OR 2019-nCoV OR 2019 AND ncov) AND AND outbreak
Summary
The SARS-CoV-2 virus has inflicted a global health crisis, infecting at least 271 million individuals and causing over 5.3 million deaths as of December 18, 2021 [1]. Despite causing a largely asymptomatic and mild disease, COVID-19 infection could lead to multi-organ damage, pneumonia and death, especially among unvaccinated elderly individuals with multiple comorbidities [4]. During this pandemic, uncertainties surrounding the mode of transmission and scarcity in personal protective equipment (PPE) supplies [5] contributed to high rates of infections in countries worldwide. A resurgence of SARS-CoV-2 infection was observed among healthcare workers at the University of California San Diego Health [12], coinciding with the emergence of the more transmissible variants of concern [13]
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