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Understanding the Impact of Hospital-Based Transmission in SARS-CoV-2 Pandemic: Implications for Infection Control

Research underscores the pivotal role of hospital-based transmission in the spread of the SARS-CoV-2 pandemic. In fact, hospital-based transmission was central to the epidemics of Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV). Large-scale studies focusing on its role in the SARS-CoV-2 pandemic are however limited – a gap that this research aims to fill. The consequential impact of such transmission is multi-faceted – it risks disseminating the virus to some of the most susceptible individuals, can compromise the delivery of healthcare services, puts healthcare professionals at risk and, importantly, it can influence wider-scale dynamics through hospital-community interactions.

This study uses data from acute hospitals in England to assess the scale of within-hospital transmission, examine potential pathways of spread and factors that increased transmission risk. The wider dynamics consequences of such transmissions are also evaluated. Between the time period of June 2020 and March 2021, it is estimated that between 95,000 and 167,000 inpatients contracted the SARS-CoV-2 virus within hospitals. This equates to approximately 1% to 2% of all hospital admissions during this period. The main sources of in-hospital transmission were patients who themselves were infected with the SARS-CoV-2 virus within the hospital. Hospitals with fewer single rooms and lower heated volume per bed were associated with increased transmission to inpatients. The research found that a reduction in hospital transmission could profoundly enhance the efficiency of punctuated lockdown measures, thus helping to suppress community transmission. The findings of this study highlight the importance of focusing on hospital control measures and the need to design hospitals that are better equipped to limit the transmission of high-consequence pathogens in future.


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