Abstract
Objectives: Prisons are high-risk settings for infectious disease outbreaks because of their highly dynamic and crowded nature. During late 2020, prisons in England observed a surge in COVID-19 infection. This study describes the emergence of the Alpha variant in prisons during this period.
Methods: Alpha and non-Alpha variant COVID-19 cases were identified in prisoners in England using address-matched laboratory notifications and genomic information from COG-UK.
Results: Of 14,094 COVID-19-positive prisoner cases between 1 October 2020 and 28 March 2021, 11.5% (n = 1621) had sequencing results. Of these, 1082 (66.7%) were identified as the Alpha variant. Twenty-nine (2.7%) Alpha cases required hospitalisation compared with only five (1.0%; P = 0.02) non-Alpha cases. A total of 14 outbreaks were identified with the median attack rate higher for Alpha (17.9%, interquartile range [IQR] 3.2%-32.2%; P = 0.11) than non-Alpha outbreaks (3.5%, IQR 2.0%-10.2%).
Conclusion: Higher attack rates and increased likelihood of hospitalisations were observed for Alpha cases compared with non-Alpha. This suggests a key contribution to the rise in cases, hospitalisations and outbreaks in prisons in the second wave. With prisons prone to COVID-19 outbreaks and the potential to act as reservoirs for variants of concern, sequencing of prison-associated cases alongside whole-institution vaccination should be prioritised.
Keywords: COVID-19; England; Outbreaks; Prisons; Severe acute respiratory syndrome coronavirus 2; Whole-genome sequencing.
【저자키워드】 COVID-19, severe acute respiratory syndrome coronavirus 2, whole-genome sequencing, Outbreaks, England, prisons, 【초록키워드】 severe acute respiratory syndrome coronavirus 2, whole-genome sequencing, coronavirus, vaccination, Sequencing, variant, variants of concern, Infectious disease, severe acute respiratory syndrome Coronavirus, variants, Laboratory, COVID-19 outbreak, COVID-19 infection, outbreak, attack rate, Alpha, second wave, Alpha variant, infectious disease outbreak, England, prison, hospitalisation, interquartile range, hospitalisations, acute respiratory syndrome, acute respiratory syndrome coronavirus, COVID-19 case, reservoirs, reservoir, COG-UK, genomic information, FIVE, likelihood, required, IQR, the median, 【제목키워드】 SARS-CoV-2, B.1.1.7, Impact,