Rapid increase of Care Homes reporting outbreaks a sign of eventual substantial disease burden

Enclosed societies (i.e. locations that are connected to wider community only by subgroups of their population and that are dominated by within society transmission) have the potential, upon establishment of a respiratory disease, to suffer a large proportion of the population within becoming infected. Care homes are particularly susceptible to COVID19 outbreaks and suffer high mortality due to vulnerable population within. Recent data on the number of new outbreak reports in care homes to Public Health England shows an initial increase then plateau perhaps associated with an SIS model dynamic. Without change in policy moving forward a high prevalence in such setting is predicted of around 75%. Action is needed to support staff in such settings. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement LP is funded by the Wellcome Trust and the Royal Society (grant 202562/Z/16/Z). TH is supported by the Royal Society (Grant Number INF\R2\180067) and Alan Turing Institute for Data Science and Artificial Intelligence. IH is supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response and the National Institute for Health Research Policy Research Programme in Operational Research (OPERA) and Alan Turing Institute for Data Science and Artificial Intelligence. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data is being published online on weekly basis.