Understanding Early Pandemic Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in a Medical Center by Incorporating Public Sequencing Databases to Mitigate Bias

Jacquelyn Turcinovic, Beau Schaeffer, Bradford P. Taylor, Tara C. Bouton, Aubrey R. Odom-Mabey, Sarah E. Weber, Sara Lodi, Elizabeth J. Ragan, John H. Connor, Karen R. Jacobson, William P. Hanage

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background. Throughout the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, healthcare workers (HCWs) have faced risk of infection from within the workplace via patients and staff as well as from the outside community, complicating our ability to resolve transmission chains in order to inform hospital infection control policy. Here we show how the incorporation of sequences from public genomic databases aided genomic surveillance early in the pandemic when circulating viral diversity was limited. Methods. We sequenced a subset of discarded, diagnostic SARS-CoV-2 isolates between March and May 2020 from Boston Medical Center HCWs and combined this data set with publicly available sequences from the surrounding community deposited in GISAID with the goal of inferring specific transmission routes. Results. Contextualizing our data with publicly available sequences reveals that 73% (95% confidence interval, 63%–84%) of coronavirus disease 2019 cases in HCWs are likely novel introductions rather than nosocomial spread. Conclusions. We argue that introductions of SARS-CoV-2 into the hospital environment are frequent and that expanding public genomic surveillance can better aid infection control when determining routes of transmission.

Original languageEnglish (US)
Pages (from-to)1704-1711
Number of pages8
JournalJournal of Infectious Diseases
Volume226
Issue number10
DOIs
StatePublished - Nov 15 2022
Externally publishedYes

Keywords

  • COVID-19
  • genomic epidemiology
  • infection control
  • nosocomial infection
  • SARS-CoV-2

ASJC Scopus subject areas

  • General Medicine

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