Imperial College London
Alternate

ProfessorMarie-ClaudeBoily

Faculty of Medicine, School of Public Health

Professor of Mathematical Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3263mc.boily

 
 
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Location

 

LG26Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wang:2020:10.9778/cmajo.20200213,
author = {Wang, L and Ma, H and Yiu, KCY and Calzavara, A and Landsman, D and Luong, L and Chan, AK and Kustra, R and Kwong, JC and Boily, M-C and Hwang, S and Straus, S and Baral, SD and Mishra, S},
doi = {10.9778/cmajo.20200213},
journal = {CMAJ Open},
pages = {E627--E636},
title = {Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study.},
url = {http://dx.doi.org/10.9778/cmajo.20200213},
volume = {8},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Congregate settings have been disproportionately affected by coronavirus disease 2019 (COVID-19). Our objective was to compare testing for, diagnosis of and death after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across 3 settings (residents of long-term care homes, people living in shelters and the rest of the population). METHODS: We conducted a population-based prospective cohort study involving individuals tested for SARS-CoV-2 in the Greater Toronto Area between Jan. 23, 2020, and May 20, 2020. We sourced person-level data from COVID-19 surveillance and reporting systems in Ontario. We calculated cumulatively diagnosed cases per capita, proportion tested, proportion tested positive and case-fatality proportion for each setting. We estimated the age- and sex-adjusted rate ratios associated with setting for test positivity and case fatality using quasi-Poisson regression. RESULTS: Over the study period, a total of 173 092 individuals were tested for and 16 490 individuals were diagnosed with SARS-CoV-2 infection. We observed a shift in the proportion of cumulative cases from all cases being related to travel to cases in residents of long-term care homes (20.4% [3368/16 490]), shelters (2.3% [372/16 490]), other congregate settings (20.9% [3446/16 490]) and community settings (35.4% [5834/16 490]), with cumulative travel-related cases at 4.1% (674/16490). Cumulatively, compared with the rest of the population, the diagnosed cases per capita was 64-fold and 19-fold higher among long-term care home and shelter residents, respectively. By May 20, 2020, 76.3% (21 617/28 316) of long-term care home residents and 2.2% (150 077/6 808 890) of the rest of the population had been tested. After adjusting for age and sex, residents of long-term care homes were 2.4 (95% confidence interval [CI] 2.2-2.7) times more likely to test positive, and those who received a diagnosis of COVID-19 were 1.4-fold (95% CI 1.1-1.8) more likely to die than
AU  - Wang,L
AU  - Ma,H
AU  - Yiu,KCY
AU  - Calzavara,A
AU  - Landsman,D
AU  - Luong,L
AU  - Chan,AK
AU  - Kustra,R
AU  - Kwong,JC
AU  - Boily,M-C
AU  - Hwang,S
AU  - Straus,S
AU  - Baral,SD
AU  - Mishra,S
DO  - 10.9778/cmajo.20200213
EP  - 636
PY  - 2020///
SN  - 2291-0026
SP  - 627
TI  - Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study.
T2  - CMAJ Open
UR  - http://dx.doi.org/10.9778/cmajo.20200213
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33037070
UR  - http://cmajopen.ca/content/8/4/E627
UR  - http://hdl.handle.net/10044/1/83553
VL  - 8
ER  -
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