Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 infection, spreads swiftly in nursing homes and assisted living facilities, leading to a high degree of lethality. The data generated by an epidemiological surveillance program allow for obtaining valid information on the diseases' epidemiology and possible prevention methods. OBJECTIVE: This work aims to analyze COVID-19 epidemiology among healthcare staff based in the Seville healthcare district (Spain) and evaluate its role in outbreaks in nursing homes. METHODS: This is an observational, descriptive study of 88 assisted living facilities located in the city of Seville from March 1 to May 23, 2020. Data were obtained via epidemiological surveys on staff at centers where there were outbreaks (n = 732 in 14 nursing homes). The cumulative incidence, epidemic curves, sociodemographic and clinical characteristics, and delays in isolation and notification of cases were calculated. For the statistical analysis, measures of central tendency and dispersion were used as well as confidence intervals and statistical hypothesis tests. RESULTS: There were 124 cases in staff members (cumulative incidence 16.9%), 79.0% of which were in women. The majority presented with mild symptoms (87.1%). The most common symptoms were fever (31.5%) and cough (49.2%). The median number of days from onset of symptoms to isolation was three. CONCLUSIONS: A high incidence in nursing home staff along with delays in isolation were observed, which could affect the dynamics of transmission in outbreaks. It is necessary to review disease identification and isolation practices among staff as well as emphasize rapid implementation of prevention measures.