Assessment of SARS-CoV-2 Infection Prevalence in Homeless Shelters - Four U.S. Cities, March 27-April 15, 2020.

Emily Mosites,Madeline Sankaran,Tom Andrews,Travis P Baggett,Nicole F Dowling,Georgina Peacock,Elysia Gonzales,Elizabeth Imbert,Sapna Bamrah Morris,Jody Rauch,Temet M Mcmichael,Ryan Keating,Jessie M Gaeta,Karin Huster,Matthew Hanson ,Kristie E N Clarke ,Alexander Scarborough ,Erin Parker ,Libby C Page ,Grace E Marx ,Kristine M Schmit

doi:10.15585/mmwr.mm6917e1

Abstract

In the United States, approximately 1.4 million persons access emergency shelter or transitional housing each year (1). These settings can pose risks for communicable disease spread. In late March and early April 2020, public health teams responded to clusters (two or more cases in the preceding 2 weeks) of coronavirus disease 2019 (COVID-19) in residents and staff members from five homeless shelters in Boston, Massachusetts (one shelter); San Francisco, California (one); and Seattle, Washington (three). The investigations were performed in coordination with academic partners, health care providers, and homeless service providers. Investigations included reverse transcription-polymerase chain reaction testing at commercial and public health laboratories for SARS-CoV-2, the virus that causes COVID-19, over approximately 1-2 weeks for residents and staff members at the five shelters. During the same period, the team in Seattle, Washington, also tested residents and staff members at 12 shelters where a single case in each had been identified. In Atlanta, Georgia, a team proactively tested residents and staff members at two shelters with no known COVID-19 cases in the preceding 2 weeks. In each city, the objective was to test all shelter residents and staff members at each assessed facility, irrespective of symptoms. Persons who tested positive were transported to hospitals or predesignated community isolation areas.

Highlights

Overall, 1,192 residents and 313 staff members were tested in 19 homeless shelters (Table)
To protect homeless shelter residents and staff members, CDC recommends that homeless service providers implement recommended infection control practices, apply social distancing measures including ensuring residents’ heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents.† These measures become especially important once ongoing COVID-19 transmission is identified within communities where shelters are located
Travis Baggett reports receipt of royalties from UpToDate for authorship of a topic review on health care of homeless persons in the United States

Summary

Introduction

1,192 residents and 313 staff members were tested in 19 homeless shelters (Table). Testing all residents and staff members at each shelter was the objective, some were not available or declined (e.g., in San Francisco 143 of an estimated 255 residents at risk were tested).

Results

Conclusion