Infection and transmission of SARS-CoV-2 in London care homes reporting no cases or outbreaks of COVID-19: Prospective observational cohort study, England 2020

Jeffery-Smith, Anna; Dun-Campbell, Kate; Janarthanan, Roshni; Fok, Jonathan; Crawley-Boevey, Emma; Vusirikala, Amoolya; Olano, Elena Fernandez Ruiz De; Perez, Marina Sanchez; Tang, Suzanne; Rowland, Thomas A.J.; Wynne-Evans, Edward; Bell, Anita; Patel, Bharat; Amin-Chowdhury, Zahin; Aiano, Felicity; Paranthaman, Karthik; Ma, Thomas; Saavedra-Campos, María; Ellis, Joanna; Lackenby, Angie; Whitaker, Heather; Myers, Richard; Höschler, Katja; Brown, Kevin E.; Ramsay, Mary; Shetty, Nandini; Chow, Ji‐Jian; Ladhani, Shamez; Zambon, Maria

doi:10.1016/j.lanepe.2021.100038

Cited by 30 publications

(30 citation statements)

References 22 publications

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“…Because of the speed with which the assays have been developed, limited validation has been conducted by the manufacturers. We therefore used panels created by PHE and managed by the SEU to validate the assays ( 7 , 8 )…”

Section: Methodsmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 among Blood Donors and Changes after Introduction of Public Health and Social Measures, London, UK

Amirthalingam¹,

Whitaker²,

Brooks³

et al. 2021

Emerg. Infect. Dis.

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T he fi rst confi rmed cases of coronavirus disease (COVID-19) in the United Kingdom were identifi ed at the end of January 2020. As cases increased across all regions, surveillance data indicated that the epidemic was progressing more rapidly in London than the rest of the United Kingdom. In response to the increase in cases, hospitalizations, and deaths, the United Kingdom introduced a series of measures to limit transmission, beginning March 12, 2020 (week 11); persons with a continuous cough or fever were advised to self-isolate for 7 days, school trips abroad were cancelled, and at-risk groups were advised to avoid cruises. These measures culminated in the implementation of legally enforceable public health and social measures (i.e., lockdown) beginning March 23 (week 13) (1).Despite the reporting of a range of surveillance data in England, including laboratory-confi rmed cases, primary-care consultations, hospital and intensive care unit (ICU) admissions, and deaths (2), much remains unknown about the magnitude of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in the population, the key drivers of transmission, and the incidence of asymptomatic or mildly symptomatic infection within the UK population thus far.Serologic estimates are critical to better understand epidemiologic trends and help inform policy options to control disease. These estimates also provide a denominator for estimating severity measures, such as infection fatality and infection hospitalization ratios, and to help clarify the epidemiology of COV-ID-19 in the population.Early in the pandemic, data from populationbased seroepidemiologic studies were limited (N. Bobrovitz et al., unpub. data,

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Section: Methodsmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 among Blood Donors and Changes after Introduction of Public Health and Social Measures, London, UK

Amirthalingam¹,

Whitaker²,

Brooks³

et al. 2021

Emerg. Infect. Dis.

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“…To study the role of MBC, we obtained PBMC from a subset (n=32) of a large cohort who survived COVID-19 with mild/asymptomatic infection after outbreaks in three care homes in April 2020 (Methods and Table S1). 21,22 The care home cohort subset was selected to have a wide range of nAb titres detectable against live virus at the first sampling timepoint (T1, May 2020, Fig.1). By end September 2020 (T2, five months), 32% of all participants sampled had stable or increasing nAb to live virus.…”

Section: Resultsmentioning

confidence: 99%

“…21,22 Briefly, a native virus lysate assay (PHE) and/or receptor binding domain assay (RBD, PHE) determined seropositivity, and a live virus neutralising antibody assay to prototype England.2 SARS-CoV-2 virus was used to determine neutralising antibody titres. 21,22…”

Section: Methodsmentioning

confidence: 99%

“…1,21 Serostatus of individuals within these homes at one month and five months after the outbreaks (T1 and T2 respectively) was established using binding and functional assays as previously described. 21,22 Briefly, a native virus lysate assay (PHE) and/or receptor binding domain assay (RBD, PHE) determined seropositivity, and a live virus neutralising antibody assay to prototype England.2 SARS-CoV-2 virus was used to determine neutralising antibody titres. 21,22 A total of 32 SARS-CoV-2 individuals (22 residents; 10 staff) were recruited, all of whom were seropositive by the binding assays described above at both sampling time points (T1: May 2020, T2: September 2020), alongside 11 SARS-CoV-2 seronegative control individuals from three of the care homes.…”

Section: Methodsmentioning

confidence: 99%

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SARS-CoV-2-specific memory B cells can persist in the elderly despite loss of neutralising antibodies

Jeffery-Smith

Burton

Lens

et al. 2021

Preprint

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Memory B cells (MBC) can provide a recall response able to supplement waning antibodies with an affinity-matured response better able to neutralise variant viruses. We studied a cohort of vulnerable elderly care home residents and younger staff, a high proportion of whom had lost neutralising antibodies (nAb), to investigate their reserve immunity from SARS-CoV-2-specific MBC. Class-switched spike and RBD-tetramer-binding MBC with a classical phenotype persisted five months post-mild/asymptomatic SARS-CoV-2 infection, irrespective of age. Spike/RBD-specific MBC remained detectable in the majority who had lost nAb, although at lower frequencies and with a reduced IgG/IgA isotype ratio. Functional spike/S1/RBD-specific recall was also detectable by ELISpot in some who had lost nAb, but was significantly impaired in the elderly, particularly to RBD. Our findings demonstrate persistence of SARS-CoV-2-specific MBC beyond loss of nAb, but highlight the need for careful monitoring of functional defects in RBD-specific B cell immunity in the elderly.

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“…The support care homes received from local NHS services ranged from brilliant to patchy and unreliable. And many care home outbreaks were seeded not by hospital discharges but by staff who were infected without knowing it, or were unable to self-isolate, or worked on multiple sites 1516. Hancock and other ministers played down all of this publicly—and, if Cummings is to be believed, privately too.…”

mentioning

confidence: 99%

David Oliver: The story of covid in care homes—neither mystery nor melodrama

Oliver

2021

BMJ

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Infection and transmission of SARS-CoV-2 in London care homes reporting no cases or outbreaks of COVID-19: Prospective observational cohort study, England 2020

Cited by 30 publications

References 22 publications

Seroprevalence of SARS-CoV-2 among Blood Donors and Changes after Introduction of Public Health and Social Measures, London, UK

Seroprevalence of SARS-CoV-2 among Blood Donors and Changes after Introduction of Public Health and Social Measures, London, UK

SARS-CoV-2-specific memory B cells can persist in the elderly despite loss of neutralising antibodies

David Oliver: The story of covid in care homes—neither mystery nor melodrama

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