Impact of SARS-CoV-2 Alpha variant (B.1.1.7) on prisons, England

Vusirikala, Amoolya, Flannagan, Joe, Czachorowski, Maciej, Zaidi, Asad, Twohig, Kate A., Plugge, Emma, Ellaby, Nicholas, Rice, Wendy, Dabrera, Gavin, Chudasama, Dimple Y. and Lamagni, Theresa (2022) Impact of SARS-CoV-2 Alpha variant (B.1.1.7) on prisons, England. Public Health, 204, 21-24. (doi:10.1016/j.puhe.2021.12.018).

Abstract

Objectives: prisons are high-risk settings for infectious disease outbreaks because of their highly dynamic and crowded nature. During late 2020, prisons in England observed a surge in COVID-19 infection. This study describes the emergence of the Alpha variant in prisons during this period.

Methods: Alpha and non-Alpha variant COVID-19 cases were identified in prisoners in England using address-matched laboratory notifications and genomic information from COG-UK.

Results: of 14,094 COVID-19-positive prisoner cases between 1 October 2020 and 28 March 2021, 11.5% (n = 1621) had sequencing results. Of these, 1082 (66.7%) were identified as the Alpha variant. Twenty-nine (2.7%) Alpha cases required hospitalisation compared with only five (1.0%; P = 0.02) non-Alpha cases. A total of 14 outbreaks were identified with the median attack rate higher for Alpha (17.9%, interquartile range [IQR] 3.2%-32.2%; P = 0.11) than non-Alpha outbreaks (3.5%, IQR 2.0%-10.2%).

Conclusion: higher attack rates and increased likelihood of hospitalisations were observed for Alpha cases compared with non-Alpha. This suggests a key contribution to the rise in cases, hospitalisations and outbreaks in prisons in the second wave. With prisons prone to COVID-19 outbreaks and the potential to act as reservoirs for variants of concern, sequencing of prison-associated cases alongside whole-institution vaccination should be prioritised.

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Contributors

Author: Emma Plugge

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