What settings have been linked to SARS-CoV-2 transmission clusters?
What settings have been linked to SARS-CoV-2 transmission clusters?
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DOI：
10.12688/wellcomeopenres.15889.1
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Knight, Gwenan M
中科院分区：
文献类型：
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作者：
Leclerc, Quentin J;Fuller, Naomi M;Knight, Gwenan M
背景资料：由于担心新型冠状病毒SARS-CoV-2对健康的影响，人们普遍强制减少人员流动（“封锁”）。然而，人们越来越担心这些措施的严重经济和更广泛的社会后果。一些国家已开始逐步取消一些关于实际距离的规则，但这些“退出战略”的内容和时限各不相同。这项工作的目的是通过探索据报告发生SARS-CoV-2传播并导致病例聚集的室内和室外环境类型，为此类退出战略提供信息。确定导致传播集群的潜在环境，使这些环境能够受到密切监视和/或保持关闭，作为旨在避免解除封锁措施后传播死灰复燃的战略的一部分。研究方法：我们对现有文献和媒体报道进行了系统性综述，以发现具有这些特征的同行评审文章和媒体中报道的设置。这些资料来源经过整理，可在一个可编辑的在线数据库中查阅。结果：我们发现许多SARS-CoV-2集群的例子与广泛的室内环境有关。来自学校的报告很少，许多来自家庭，越来越多的报告来自欧洲各地的医院和老年人护理机构。结论：我们识别出可能与COVID-19病例集群相关的场所，并可在逐步取消封锁限制后首先予以密切监控及╱或继续关闭。然而，部分由于在许多情况下的监测能力的限制，收集信息，如集群大小和攻击率是有限的几个方面：固有的回忆偏见，有偏见的媒体报道和缺失的数据。
Background: Concern about the health impact of novel coronavirus SARS-CoV-2 has resulted in widespread enforced reductions in people's movement ("lockdowns"). However, there are increasing concerns about the severe economic and wider societal consequences of these measures. Some countries have begun to lift some of the rules on physical distancing in a stepwise manner, with differences in what these "exit strategies" entail and their timeframes. The aim of this work was to inform such exit strategies by exploring the types of indoor and outdoor settings where transmission of SARS-CoV-2 has been reported to occur and result in clusters of cases. Identifying potential settings that result in transmission clusters allows these to be kept under close surveillance and/or to remain closed as part of strategies that aim to avoid a resurgence in transmission following the lifting of lockdown measures. Methods: We performed a systematic review of available literature and media reports to find settings reported in peer reviewed articles and media with these characteristics. These sources are curated and made available in an editable online database. Results: We found many examples of SARS-CoV-2 clusters linked to a wide range of mostly indoor settings. Few reports came from schools, many from households, and an increasing number were reported in hospitals and elderly care settings across Europe. Conclusions: We identified possible places that are linked to clusters of COVID-19 cases and could be closely monitored and/or remain closed in the first instance following the progressive removal of lockdown restrictions. However, in part due to the limits in surveillance capacities in many settings, the gathering of information such as cluster sizes and attack rates is limited in several ways: inherent recall bias, biased media reporting and missing data.