Researchers explore rapid outbreak of COVID-19 in U.S. detention facility

Throughout the coronavirus disease 2019 (COVID-19) pandemic, many outbreaks have been observed among people in enclosed and close-quarters living environments, such as nursing homes and detention facilities.

Caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the disease is easily transmissible, particularly in crowded areas or places where people congregate.

To assess the transmission of SARS-CoV-2 in a detention facility experiencing a COVID-19 outbreak, researchers at the U.S. Centers for Disease Control and Prevention (CDC) conducted testing for detained individuals in six quarantined dormitories at various time points.

Detention and correctional facilities

Like in nursing and retirement facilities, social distancing practices are difficult to effectively implement in detention and correctional facilities.

These facilities face challenges in controlling viral spread, including the close-quarters nature of their living environments – making it difficult for detained people to socially distance – and the high risk of virus introduction by staff movement outside and inside the facilities.

These challenges may have fueled the increased rates of SARS-CoV-2 infections and deaths among these individuals compared with the general population. By October 2020, 146,472 cases and 1,122 deaths in the U.S. were made up by detained individuals.

The CDC released interim guidance for managing COVID-19 in correctional facilities, which notes that detained persons should undergo testing and contact tracing. Also, the guidance recommends considering testing and a 14-day quarantine for people preparing for release or transfer to another facility.

Cohorting was also implemented, wherein infected individuals should be isolated individually. The timely testing and isolation of cases can help reduce transmission of the virus.

For staff working with infected individuals, they should properly wear personal protective equipment (PPE).

The study

In the study, which appeared in CDC’s journal Emerging Infectious Diseases, the researchers investigated a COVID-19 outbreak in a detention center in Louisiana, USA, and utilized serial testing to detect infections and contain the viral spread.

Everyone in the detention facility was tested for SARS-CoV-2 to identify infected individuals and to cohort them based on their test result. This can help prevent transmission and, at the same time, evaluate the efficacy of serial testing in this setting.

When the COVID-19 pandemic reached the United States and caused the spread of the virus in numerous states, the facility in Louisiana stopped the travels of detained individuals outside the facility, halted visitors, and banned the movement of detained persons within the facility.

However, on March 29, a staff member manifested COVID-19 symptoms and later tested positive for SARS-CoV-2 infection. By April 7, the first COVID-19 case in a detained person was reported. The staff monitored all detained individuals by actively checking for fever daily and blood oxygen saturation levels to detect suspected cases.

Two days after, more cases were detected, and the virus had spread even to other dormitories. In an attempt to curb the spread of SARS-CoV-2, the Louisiana Department of Health asked for CDC assistance. On May 7, CDC officials started to investigate the outbreak.

The CDC researchers conducted testing for detained persons in six quarantined dormitories. Of the 143 persons, 53 tested positive at the initial test, and an additional 58 persons tested positive at later time points.

Among the positive SARS-CoV-2 individuals, nearly half were asymptomatic and 14 had replication-competent virus isolated. The team also found that there was rapid and widespread SARS-CoV2 transmission and a high proportion of asymptomatic infections.

The study highlights the importance of testing at multiple time points to identify infections and contain transmission. Serial testing has identified 52 percent of the COVID-19 cases.

To increase the sensitivity of symptom screening, screenings should use an expanded COVID-19 symptom list based on the latest evidence and guidance, and barriers to symptom reporting, such as medical care costs or concerns over medical isolation, should be minimized,” the researchers explained.

The team also recommends that using multiple rounds of widespread testing for detained individuals and staff members is essential for the early detection of virus introduction. The early and timely detection and isolation of cases are effective in fighting the pandemic, as infected individuals will be isolated.

Journal reference:
Angela Betsaida B. Laguipo

Written by

Angela Betsaida B. Laguipo

Angela is a nurse by profession and a writer by heart. She graduated with honors (Cum Laude) for her Bachelor of Nursing degree at the University of Baguio, Philippines. She is currently completing her Master's Degree where she specialized in Maternal and Child Nursing and worked as a clinical instructor and educator in the School of Nursing at the University of Baguio.

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