Abstract
Preventing SARS-CoV-2 transmission and protecting people from COVID-19 is the most significant public health challenge faced in recent years. COVID-19 outbreaks are occurring in workplaces and evidence is needed to support effective strategies to prevent and control these outbreaks. Investigations into these outbreaks are routinely undertaken by public health bodies and regulators in the United Kingdom (UK); however, such investigations are typically disparate in nature with a lack of consistency across all investigations, preventing meaningful analysis of the data collected. The COVID-OUT (COVID-19 Outbreak investigation to Understand Transmission) study aims to collect a consistent set of data in a systematic way from workplaces that are experiencing outbreaks, to understand SARS-CoV-2 transmission risk factors, transmission routes, and the role they play in the COVID-19 outbreaks. Suitable outbreak sites are identified from public health bodies. Following employer consent to participate, the study will recruit workers from workplaces where there are active outbreaks. The study will utilise data already collected as part of routine public health outbreak investigations and collect additional data through a comprehensive questionnaire, viral and serologic testing of workers, surface sampling, viral genome sequencing, and an environmental assessment of building plans, ventilation and current control measures. At each site, a detailed investigation will be carried out to evaluate transmission routes. A case-control approach will be used to compare workers who have and have not had SARS-CoV-2 infections during the outbreak period to assess transmission risk factors. Data from different outbreaks will be combined for pooled analyses to identify common risk factors, as well as factors that differ between outbreaks. The COVID-OUT study can contribute to a better understanding of why COVID-19 outbreaks associated with workplaces occur and how to prevent these outbreaks from happening in the future.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that has caused a pandemic of the “coronavirus disease 2019” (COVID-19)[1]
This study is coordinated by the Health and Safety Executive (HSE) in collaboration with Public Health England (PHE), the University of Manchester (UoM) and the London School of Hygiene & Tropical Medicine (LSHTM)
The COVID-OUT study has been designed using a set of relevant World Health Organization (WHO) COVID-19 Early Investigation Protocols, including the protocol for the assessment of risk factors for COVID-19 in health workers[8], the investigation protocol for the first few cases and contacts[9], the seroepidemiological investigation protocol[10] and the protocol for surface sampling[11]
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that has caused a pandemic of the “coronavirus disease 2019” (COVID-19)[1]. The COVID-OUT study has been designed using a set of relevant World Health Organization (WHO) COVID-19 Early Investigation Protocols, including the protocol for the assessment of risk factors for COVID-19 in health workers[8], the investigation protocol for the first few cases and contacts[9], the seroepidemiological investigation protocol[10] and the protocol for surface sampling[11] These protocols have been combined and adapted for the investigation of workplace outbreaks in the UK. Data at the workplace environmental level ○ Influencing factors of viral exposure and transmission will be measured, including building layout, ventilation, temperature, humidity, air movement and noise level through environmental assessment These will provide opportunities to link laboratoryconfirmed cases with potential sources of infection. These will provide opportunities to link laboratoryconfirmed cases with potential sources of infection. ○ The work environment will be sampled to measure the quantity of viral RNA from high-risk environments, in particular those linked to work areas from recent positive cases and communal areas. ○ Any environmental samples producing high levels of viral RNA will be further assessed by whole genome sequencing and viral isolation
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