Projecting COVID-19 isolation bed requirements for people experiencing homelessness.

Tanvi A Ingle,Vella Karman,Spencer Fox,Lauren Ancel Meyers,Maike Morrison,Xutong Wang,Timothy Mercer,Martial L Ndeffo Mbah

doi:10.1371/journal.pone.0251153

Abstract

As COVID-19 spreads across the United States, people experiencing homelessness (PEH) are among the most vulnerable to the virus. To mitigate transmission, municipal governments are procuring isolation facilities for PEH to utilize following possible exposure to the virus. Here we describe the framework for anticipating isolation bed demand in PEH communities that we developed to support public health planning in Austin, Texas during March 2020. Using a mathematical model of COVID-19 transmission, we projected that, under no social distancing orders, a maximum of 299 (95% Confidence Interval: 223, 321) PEH may require isolation rooms in the same week. Based on these analyses, Austin Public Health finalized a lease agreement for 205 isolation rooms on March 27th 2020. As of October 7th 2020, a maximum of 130 rooms have been used on a single day, and a total of 602 PEH have used the facility. As a general rule of thumb, we expect the peak proportion of the PEH population that will require isolation to be roughly triple the projected peak daily incidence in the city. This framework can guide the provisioning of COVID-19 isolation and post-acute care facilities for high risk communities throughout the United States.

Highlights

As of December 16th 2020, a new coronavirus (SARS-CoV-2) has emerged into a global pandemic, with more than 16,519,668 confirmed cases of the disease (COVID-19) and 302,992 COVID-19 deaths reported in the United States [1]
In Austin, Texas, the Parks and Recreation Department partnered with Austin Public Health to open personal hygiene stations around the city, the Office of Sustainability established a micro-food distribution system to prevent long lines at soup kitchens, homeless shelters have instituted CDC-recommended infection screening and prevention protocols, and community outreach partners are leading initiatives to educate people experiencing homelessness (PEH) about COVID-19 prevention strategies and implement ongoing symptom-based and surveillance testing among this population [25, 26]
In March 2020, the Homeless Services Division of the Austin Public Health Department sought to project the number of rooms that would be needed to isolate potentially exposed members of the PEH community while they waited for test results and, if positive, throughout their infectious period

Summary

Introduction

As of December 16th 2020, a new coronavirus (SARS-CoV-2) has emerged into a global pandemic, with more than 16,519,668 confirmed cases of the disease (COVID-19) and 302,992 COVID-19 deaths reported in the United States [1]. 42 states and the District of Columbia imposed stay-at-home orders, with the earliest beginning in mid-March [2]. All have since begun relaxing these orders, with great heterogeneity in duration and the details of continued restrictions across states [3]. During even the strictest stay-home measures, some populations have difficulty avoiding contacts and reducing transmission risks, including those. The specific roles of these authors are articulated in the ‘author contributions’ section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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Results

Conclusion