Download This Paper
Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.
The Pandemic Contagion. COVID-19 Clusters in Thuringia: An Population Based Analysis of the Infection Locations and Patterns in Germany
23 Pages Posted: 3 Aug 2022
More...Abstract
Background: Routine data from official sources report aggregated data. Most public health interventions are based on evidence from mandatory reporting sources to tailor response strategies. We complemented the less granular legal reporting with granular data from the federal state of Thuringia, Germany, to better understand the infection dynamics and to improve the evidence base for decision-making.
Methods: This study uses in-depth analyses of multiple data sources of infections, morbidity, and mortality, combining mandatory regional-level less granular data and granular data at the district level according to age, place, and time of infection reports in relation to infection control policies implemented in the state of Thuringia (March 2020 until December 2021).
Findings: Large numbers of cases were reported in private environments. Schools followed by nurseries or kindergartens reported many small clusters (schools: 1.8 to 6.3; nurseries: 2.3 to 7.5 cases per outbreak). Despite having professional infection control policies, hospitals and care facilities experienced much larger cluster sizes (mean: 4.4 to 12.6; care homes: 6.9 to 29.6 cases per outbreak). Clusters in these settings and age groups greatly impact morbidity and mortality.
Interpretation: Hospitals and senior facilities were places with significant clusters and should be the least likely places for such, as professional infection control strategies should be in place. School surveillance has been controversially discussed, yet its benefits in infection control strategies are inconclusive.
Conclusion: We suggest reconceptualising infection control policies in the most vulnerable settings and refocusing surveillance activities to high-risk (hospitals, care facilities) and high-impact settings (social gatherings).
Funding Information: The research was funded through a grant from the federal state of Thuringia; grant number #5575/2-1 63952/2020 (April 2020 to June 2022).
Declaration of Interests: The authors declare no competing interests.
Suggested Citation: Suggested Citation