Objectives: Identifying factors that can lead to an outbreak in an orphanage is important. This study describes a COVID-19 outbreak in an orphanage in the Philippines. The clinicodemographic profile of the children and employees, safety protocols implemented and outbreak response are reported. Methodology: This is a descriptive study of the COVID-19 outbreak which occurred at a local orphanage in Metro Manila. The clinicodemographic profile of children and employees were obtained from the orphanage’s health records. Interview of employees and administrators and focused group discussions (FDG) were done. A questionnaire on how the orphanage dealt with the COVID-19 pandemic was administered. Results: A total of 128 children and 34 staff were in the orphanage during the COVID-19 outbreak. Majority (96%) of children were symptomatic and 15% of them have co-morbidities. While 82% of the employees were symptomatic, majority had a positive rapid antigen test or RT-PCR for SARS-CoV2. All the children and employees had mild illness and recovered with no complications. The orphanage implemented strict infection control measures when the COVID-19 pandemic was declared. There was a halt in the adoption processes and in the movement of persons in the orphanage. With the decline of COVID-19 cases in Metro Manila, the orphanage resumed accepting new admissions and processing adoption papers. A few weeks later, a child became symptomatic but was not immediately considered as a case of COVID-19. This was followed by the majority of the children and the employees becoming symptomatic, thus the COVID-19 outbreak was called. Foremost in the response was to attend to the medical needs of the children. Strict lockdown was enforced by the City Health Office until all cases were deemed not contagious. Conclusion Factors that can lead to an outbreak in an orphanage include missed opportunities for early diagnosis, contact tracing and intervention. Despite strict infection control measures, a single breach undermined all the efforts done to prevent an outbreak in a closed community.
COVID-19 ; Orphanages