Lessons from a COVID-19 outbreak in the disability support sector, Australian Capital Territory, August 2021
DOI:
https://doi.org/10.33321/cdi.2023.47.34Keywords:
COVID-19, people with disabilities, SARS-CoV-2, disability support, vaccination, Canberra, Australian Capital Territory, ACTAbstract
People with disability are at higher risk of severe outcomes from SARS-CoV-2 infection. Due to complex client needs and available staffing, disability support providers (DSP) were limited in their ability to mitigate the introduction of SARS-CoV-2 into disability support settings. This report describes the characteristics of a Delta variant outbreak associated with a single DSP in Canberra, Australian Capital Territory (ACT), in August 2021. We calculated attack rates for workplace exposure sites and households, using the number of people present at workplaces and households as the denominator.
Thirty confirmed cases were identified, comprised of 13 support workers, six clients, and 11 household and other contacts. The median age of cases was 30.5 years (range 1 to 80 years) and 5 cases (17%) were hospitalised. No cases were admitted to an intensive care unit (ICU) or died. Twenty-two percent of people in close contact with confirmed SARS-CoV-2 cases in this cluster (23/103) subsequently tested positive to SARS-CoV-2. Investigations identified multiple primary cases, with one primary case the likely infection source for at least 17 other cases. Despite the majority being eligible for vaccination, only two cases were fully vaccinated (two doses > 14 days before exposure). The mean secondary attack rate at workplace sites (15% or 12/80 close contacts infected) was lower than the tertiary attack rate (47.8% or 11/23 close contacts infected). The overall risk of contracting SARS-CoV-2 in DSP-related work sites was lower than for household settings (relative risk: 0.42; 95% confidence interval: 0.21–0.82).
These findings demonstrate the importance of ongoing collaboration between governments and the disability support sector. Development and delivery of targeted health messaging to people with disability and to disability support workers, regarding infection control in the home setting, and identification of enablers for vaccination, should be the highest priorities from this collaboration.
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References
Australian Bureau of Statistics. Disability, Ageing and Carers, Australia: Summary of Findings. Reference period: 2018. [Webpage.] Canberra: Australian Bureau of Statistics; 24 October 2019. Available from: https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/latest-release.
Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (Disability Royal Commission). The impact of and responses to the Omicron wave of the COVID-19 pandemic for people with disability Issues paper . Canberra: Disability Royal Commission; 25 March 2022. Available from: https://disability.royalcommission.gov.au/publications/impact-and-responses-omicron-wave-covid-19-pandemic-people-disability-issues-paper.
Boyle CA, Fox MH, Havercamp SM, Zubler J. The public health response to the COVID-19 pandemic for people with disabilities. Disabil Health J . 2020;13(3):100943. doi: https://doi.org/10.1016/j.dhjo.2020.100943.
Schott W, Tao S, Shea L. COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions. Autism . 2022;26(4):975–87. doi: https://doi.org/10.1177/13623613211039662.
Lunsky Y, Durbin A, Balogh R, Lin E, Palma L, Plumptre L. COVID-19 positivity rates, hospitalizations and mortality of adults with and without intellectual and developmental disabilities in Ontario, Canada. Disabil Health J . 2022;15(1):e101174. doi: https://doi.org/10.1016/j.dhjo.2021.101174.
Henderson A, Fleming M, Cooper SA, Pell JP, Melville C, Mackay DF et al. COVID-19 infection and outcomes in a population-based cohort of 17 203 adults with intellectual disabilities compared with the general population. J Epidemiol Community Health . 2022;76(6):550–5. doi: https://doi.org/10.1136/jech-2021-218192.
Kavanagh A, Dimov S, Dickinson H, McAllister A, Shields M, Alex S. Disability support workers: COVID-19 vaccine hesitancy and communication needs . [Online document.] Melbourne: University of Melbourne; 26 May 2021. [Accessed on 23 March 2022.] doi: https://doi.org/10.26188/14456577.
Australian Government Department of Health. Management and Operational Plan for People with Disability: Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) . Canberra: Australian Government Department of Health; September 2020. [Accessed on 23 December 2021.] Available from: https://www.health.gov.au/sites/default/files/documents/2020/09/management-and-operational-plan-for-people-with-disability.pdf.
Sheel M, Voo TV, Pingault N, Sloan-Gardner TS, Marmor A, Kirk MD et al. Vaccine breakthrough infections in a highly vaccinated Australian population during a SARS-CoV-2 Delta outbreak. Commun Dis Intell (2018) . 2022;46. doi: https://doi.org/10.33321/cdi.2022.46.32.
Australian Capital Territory (ACT) Government. Seven-day lockdown for the ACT. [Internet.] Canberra: ACT Government; 12 August 2021. [Accessed on 23 December 2021.] Available from: https://www.covid19.act.gov.au/news-articles/seven-day-lockdown-for-the-act.
Australian Government. Australia’s COVID-19 vaccine national roll-out strategy . Canberra: Australian Government; 2021. [Accessed on 23 December 2021.] Available from: https://www.health.gov.au/sites/default/files/documents/2021/01/covid-19-vaccination-australia-s-covid-19-vaccine-national-roll-out-strategy.pdf.
Australian Government Department of Health and Aged Care. COVID-19 vaccine rollout update – 31 July 2021 . Canberra: Australian Government Department of Health and Aged Care; 31 July 2021. Available from: https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-31-july-2021.
ACT Government. Public Health Act 1997 . [Legislation.] Canberra: ACT Government, ACT Legislation Register; 2022. Available from: https://www.legislation.act.gov.au/a/1997-69.
Australian Government Department of Health. Coronavirus Disease 2019 (COVID-19). CDNA National guidelines for public health units. Version 4.7. [Internet.] Canberra: Australian Government Department of Health; 2021. [Accessed on 23 December 2021.] Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-novel-coronavirus.htm.
Madewell ZJ, Yang Y, Longini IM, Halloran ME, Dean NE. Factors associated with household transmission of SARS-CoV-2: an updated systematic review and meta-analysis. JAMA Netw Open . 2021;4(8):e2122240. doi: https://doi.org/10.1001/jamanetworkopen.2021.22240.
Denford S, Morton K, Horwood J, de Garang R, Yardley L. Preventing within household transmission of Covid-19: is the provision of accommodation to support self-isolation feasible and acceptable? BMC Public Health . 2021;21(1):e1641. doi: https://doi.org/10.1186/s12889-021-11666-z.
Lunsky Y, Kithulegoda N, Thai K, Benham JL, Lang R, Desveaux L et al. Beliefs regarding COVID-19 vaccines among Canadian workers in the intellectual disability sector prior to vaccine implementation. J Intellect Disabil Res . 2021;65(7):617–25. doi: https://doi.org/10.1111/jir.12838.
Kavanagh A, Dickinson H, Dimov S, Shields M, McAllister A. The COVID-19 vaccine intentions of Australian disability support workers. Aust N Z J Public Health . 2022;46(3):314–21. doi: https://doi.org/10.1111/1753-6405.13226.
ACT Government. Public Health (Health Care and Support Workers COVID-19 Vaccination) Emergency Direction 2022 . [Legislation.] Canberra: ACT Government, ACT Legislation Register; 4 April 2022. Available from: https://legislation.act.gov.au/ni/2022-171/.
Rotenberg S, Downer MB, Cooper J. Making COVID-19 vaccinations accessible for people with disabilities. Vaccine . 2021;39(40):5727–8. doi: https://doi.org/10.1016/j.vaccine.2021.08.062.
Ryerson AB, Rice CE, Hung MC, Patel SA, Weeks JD, Kriss JL et al. Disparities in COVID-19 vaccination status, intent, and perceived access for noninstitutionalized adults, by disability status – National Immunization Survey Adult COVID Module, United States, May 30-June 26, 2021. MMWR Morb Mortal Wkly Rep . 2021;70(39):1365–71. doi: https://doi.org/10.15585/mmwr.mm7039a2.
ACT Government. COVID-19: Information for people with disability and their carers. [Internet.] Canberra: ACT Government; 2021. [Accessed on 25 March 2022.] Available from: https://www.covid19.act.gov.au/services-and-support/disability/information-for-people-with-disability.
Myers A, Ipsen C, Lissau A. COVID-19 vaccination hesitancy among Americans with disabilities aged 18-65: an exploratory analysis. Disabil Health J . 2022;15(1):101223. doi: https://doi.org/10.1016/j.dhjo.2021.101223.
Aitken Z, Emerson E, Kavanagh AM. COVID-19 vaccination coverage and vaccine hesitancy among Australians with disability and long-term health conditions. Health Promot J Austr . 2022;10.1002/hpja.691. doi: https://doi.org/10.1002/hpja.691.
Hatton C, Bailey T, Bradshaw J, Caton S, Flynn S, Gillooly A et al. The willingness of UK adults with intellectual disabilities to take COVID-19 vaccines. J Intellect Disabil Res . 2021;65(11):949–61. doi: https://doi.org/10.1111/jir.12884.
Iadarola S, Siegel JF, Gao Q, McGrath K, Bonuck KA. COVID-19 vaccine perceptions in New York State’s intellectual and developmental disabilities community. Disabil Health J . 2022;15(1):e101178. doi: https://doi.org/10.1016/j.dhjo.2021.101178.
Australian Government Department of Health and Aged Care. COVID-19 vaccine rollout update – 31 March 2022 . Canberra: Australian Government Department of Health and Aged Care; 31 March 2021. Available from: https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-31-march-2022.
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