COVID-19 Prevalence among People Experiencing Homelessness and Homelessness Service Staff during Early Community Transmission in Atlanta, Georgia, April–May 2020

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Abstract

Background

In response to reported COVID-19 outbreaks among people experiencing homelessness (PEH) in other U.S. cities, we conducted multiple, proactive, facility-wide testing events for PEH living sheltered and unsheltered and homelessness service staff in Atlanta, Georgia. We describe SARS-CoV-2 prevalence and associated symptoms and review shelter infection prevention and control (IPC) policies

Methods

PEH and staff were tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) during April 7–May 6, 2020. A subset of PEH and staff was screened for symptoms. Shelter assessments were conducted concurrently at a convenience sample of shelters using a standardized questionnaire

Results

Overall, 2,875 individuals at 24 shelters and nine unsheltered outreach events underwent SARS-CoV-2 testing and 2,860 (99.5%) had conclusive test results. SARS-CoV-2 prevalence was 2.1% (36/1,684) among PEH living sheltered, 0.5% (3/628) among PEH living unsheltered, and 1.3% (7/548) among staff. Reporting fever, cough, or shortness of breath in the last week during symptom screening was 14% sensitive and 89% specific for identifying COVID-19 cases compared with RT-PCR. Prevalence by shelter ranged 0%–27.6%. Repeat testing 3–4 weeks later at four shelters documented decreased SARS-CoV-2 prevalence (0%–3.9%). Nine of 24 shelters completed shelter assessments and implemented IPC measures as part of the COVID-19 response

Conclusions

PEH living in shelters experienced higher SARS-CoV-2 prevalence compared with PEH living unsheltered. Facility-wide testing in congregate settings allowed for identification and isolation of COVID-19 cases and is an important strategy to interrupt SARS-CoV-2 transmission

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Author and article information

Journal

Journal ID (nlm-ta): Clin Infect Dis

Journal ID (iso-abbrev): Clin. Infect. Dis

Journal ID (publisher-id): cid

Title: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: Oxford University Press (US )

ISSN (Print): 1058-4838

ISSN (Electronic): 1537-6591

Publication date (Electronic): 08 September 2020

Electronic Location Identifier: ciaa1340

Affiliations

[1 ] Division of Infectious Diseases, Emory University School of Medicine , Atlanta, GA, USA

[2 ] COVID-19 Emergency Response, Centers for Disease Control and Prevention , Atlanta, GA, USA

[3 ] Rollins School of Public Health, Emory University , Atlanta, GA, USA

[4 ] Fulton County Board of Health , Atlanta, GA, USA

[5 ] Mercy Care , Atlanta, GA, USA

[6 ] Partners for HOME , Atlanta, GA, USA

[7 ] Emory University School of Medicine , Atlanta, GA, USA

Author notes

Corresponding Author: Sapna Bamrah Morris, MD, MBA, FIDSA, Centers for Disease Control & Prevention, 1600 Clifton Rd NE, MS US 12-4, Atlanta, GA 30329, Work: (404) 639-8289 / Mobile: (404) 388-3073 / Fax: (404) 718-8308, Email: feu3@ 123456cdc.gov

Author information

Jane C Yoon http://orcid.org/0000-0002-3039-2661

Article

Publisher ID: ciaa1340

DOI: 10.1093/cid/ciaa1340

PMC ID: 7499502

PubMed ID: 32898272

SO-VID: 1c31e3a1-cbe5-4261-8ca0-15c7ff9e8e0b

License:

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

History

Date received : 04 August 2020

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article-lifecycle PAP

edited-state accepted-manuscript

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: covid-19,sars-cov-2,prevalence,homeless persons,universal testing

Data availability:

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: covid-19, sars-cov-2, prevalence, homeless persons, universal testing

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