Abstract
BACKGROUND: Early Years' Settings (EYSs) provide childcare and education for children 0-5 years old. They remained fully open in England during the third National lockdown when other educational settings were only open for selected children. EYSs are generally considered to be low-risk settings for transmission of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). METHODS: An observational study describing a large outbreak of SARS CoV-2 within an EYS in Cambridgeshire, United Kingdom. RESULTS: Overall 45 cases of SARS-CoV-2 were identified; 24 adults (71% of staff members) and 21 children (25% of nursery attendees). One case was identified as the alpha variant (B.1.1.7 [VOC-20-DEC-01]). One staff member became critically unwell. CONCLUSIONS: Transmission of SARS-CoV-2 occurred quickly, with a high attack rate; likely a consequence of a variant with enhanced transmissibility and an inability of the setting to adhere to infection control measures.