COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020

Background: During the coronavirus disease 2019 (COVID-19) pandemic, Ontario created a three-phase reopening framework for the economy. Outbreaks were expected at each phase. One week after Phase Two of reopening in the provincial public health administration region of Kingston, Frontenac, Lennox an...

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Main Authors: Anthony Li, Stéphanie Parent, Azim Kasmani, T Hugh Guan, Kieran Moore
Format: Article
Language:English
Published: Public Health Agency of Canada 2021-04-01
Series:Canada Communicable Disease Report
Subjects:
Online Access:https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-4-april-2021/covid-19-outbreak-kingston-ontario-2020.html
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author Anthony Li
Stéphanie Parent
Azim Kasmani
T Hugh Guan
Kieran Moore
author_facet Anthony Li
Stéphanie Parent
Azim Kasmani
T Hugh Guan
Kieran Moore
author_sort Anthony Li
collection DOAJ
description Background: During the coronavirus disease 2019 (COVID-19) pandemic, Ontario created a three-phase reopening framework for the economy. Outbreaks were expected at each phase. One week after Phase Two of reopening in the provincial public health administration region of Kingston, Frontenac, Lennox and Addington (KFL&A), a positive case was reported after three weeks of zero new COVID-19 cases. The objective of this report is to describe this COVID-19 outbreak, linked to a personal service setting (PSS), and the public health response to contain the outbreak. Methods: The outbreak investigation included all COVID-19 cases in KFL&A between June 20, 2020 and July 3, 2020. Public health inspectors and nurses were rapidly deployed to inspect the PSS. A multimodal approach to high-volume testing involved fixed assessment centres, drive-through testing capacity and targeted testing at the outbreak site. Testing was conducted through a real-time polymerase chain reaction assay at the local Public Health Ontario laboratory. Results: Thirty-seven cases were associated with the outbreak: 38% through direct PSS exposure; 32% through household contact; and 30% through social and workplace contact. A superspreading event contributed to 38% of total cases. The majority of cases were in the low to mid-quintiles when analyzed for material deprivation. Testing rates increased four-fold compared to the prior baseline weeks in response to media attention and public health messaging, resulting in a low percent positivity. Conclusion: The interplay of aggressive accessible testing, quick lab turnaround time, contact tracing within 24 hours of positive laboratory results as per provincial standards, frequent public communication, rapid inspections, mandatory self-isolation and face coverings were measures successful in halting the outbreak. Inspections or self-audits should be required at all PSSs prior to reopening and outbreak management must work with PSSs to reduce the possibility of superspreading events.
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spelling doaj.art-85046e324c43475fb55012d70cea4bab2022-12-21T20:06:12ZengPublic Health Agency of CanadaCanada Communicable Disease Report1481-85312021-04-0147421622310.14745/ccdr.v47i04a06COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020Anthony Li0Stéphanie Parent1Azim Kasmani2T Hugh Guan3Kieran Moore4Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON; School of Medicine, Queen’s University, Kingston, ONKingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON; School of Medicine, Queen’s University, Kingston, ONKingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON; Public Health and Preventive Medicine Residency Program, Queen’s University, Kingston, ONKingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON; Public Health and Preventive Medicine Residency Program, Queen’s University, Kingston, ONKingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON; Public Health and Preventive Medicine Residency Program, Queen’s University, Kingston, ONBackground: During the coronavirus disease 2019 (COVID-19) pandemic, Ontario created a three-phase reopening framework for the economy. Outbreaks were expected at each phase. One week after Phase Two of reopening in the provincial public health administration region of Kingston, Frontenac, Lennox and Addington (KFL&A), a positive case was reported after three weeks of zero new COVID-19 cases. The objective of this report is to describe this COVID-19 outbreak, linked to a personal service setting (PSS), and the public health response to contain the outbreak. Methods: The outbreak investigation included all COVID-19 cases in KFL&A between June 20, 2020 and July 3, 2020. Public health inspectors and nurses were rapidly deployed to inspect the PSS. A multimodal approach to high-volume testing involved fixed assessment centres, drive-through testing capacity and targeted testing at the outbreak site. Testing was conducted through a real-time polymerase chain reaction assay at the local Public Health Ontario laboratory. Results: Thirty-seven cases were associated with the outbreak: 38% through direct PSS exposure; 32% through household contact; and 30% through social and workplace contact. A superspreading event contributed to 38% of total cases. The majority of cases were in the low to mid-quintiles when analyzed for material deprivation. Testing rates increased four-fold compared to the prior baseline weeks in response to media attention and public health messaging, resulting in a low percent positivity. Conclusion: The interplay of aggressive accessible testing, quick lab turnaround time, contact tracing within 24 hours of positive laboratory results as per provincial standards, frequent public communication, rapid inspections, mandatory self-isolation and face coverings were measures successful in halting the outbreak. Inspections or self-audits should be required at all PSSs prior to reopening and outbreak management must work with PSSs to reduce the possibility of superspreading events.https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-4-april-2021/covid-19-outbreak-kingston-ontario-2020.htmlcovid-19sars-cov-2outbreakpersonal service settingpublic healthinfection prevention and controlcase and contact managementsuperspreading event
spellingShingle Anthony Li
Stéphanie Parent
Azim Kasmani
T Hugh Guan
Kieran Moore
COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020
Canada Communicable Disease Report
covid-19
sars-cov-2
outbreak
personal service setting
public health
infection prevention and control
case and contact management
superspreading event
title COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020
title_full COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020
title_fullStr COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020
title_full_unstemmed COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020
title_short COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020
title_sort covid 19 outbreak in a personal service setting in kingston ontario 2020
topic covid-19
sars-cov-2
outbreak
personal service setting
public health
infection prevention and control
case and contact management
superspreading event
url https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-4-april-2021/covid-19-outbreak-kingston-ontario-2020.html
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AT thughguan covid19outbreakinapersonalservicesettinginkingstonontario2020
AT kieranmoore covid19outbreakinapersonalservicesettinginkingstonontario2020