• CMAJ open · Oct 2020

    Outbreak of SARS-CoV-2 infection at a large refugee shelter in Toronto, April 2020: a clinical and epidemiologic descriptive analysis.

    • Vanessa Redditt, Vanessa Wright, Meb Rashid, Roy Male, and Isaac Bogoch.
    • Crossroads Clinic (Redditt, Wright, Rashid, Male), Women's College Hospital; Department of Family & Community Medicine (Redditt, Rashid), and Lawrence S. Bloomberg Faculty of Nursing (Wright), University of Toronto; Divisions of General Internal Medicine and Infectious Diseases (Bogoch), University Health Network; Faculty of Medicine (Bogoch), University of Toronto, Toronto, Ont.
    • CMAJ Open. 2020 Oct 1; 8 (4): E819-E824.

    BackgroundThere is high risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in congregate settings, including shelters. This study describes a coronavirus disease 2019 (COVID-19) outbreak and corresponding reported symptomatology at a shelter in Toronto.MethodsThis clinical and epidemiologic analysis focuses on a COVID-19 outbreak at a dedicated refugee shelter in downtown Toronto. All adult residents on site at the shelter were offered SARS-CoV-2 testing on Apr. 20, 2020. At the time of testing, residents were screened for 3 typical COVID-19 symptoms (fever, cough and shortness of breath). Among those who tested positive, a more comprehensive clinical assessment was conducted 1 day after testing and a standardized 15-item symptom screen was administered by telephone 14 days after testing. We report rates of positive test results and clinical symptoms with each assessment interval.ResultsOf the 63 adult residents on site at the shelter, 60 agreed to be tested. Among those tested, 41.7% (n = 25) were positive for SARS-CoV-2 infection. Of those who tested positive (n = 25), 20.0% (n = 5) reported fever, cough or shortness of breath at the time of testing. On more detailed assessment 1 day later, 70.8% (17/24) reported a broader range of symptoms. During the 14 days after testing, 87.5% (21/24) reported symptoms of infection.InterpretationWe found a high rate of SARS-CoV-2 infection in this shelter population. Our study underscores the high risk of SARS-CoV-2 transmission in congregate living settings and the importance of mobilizing timely testing and management of symptomatic, paucisymptomatic and asymptomatic residents in shelters.Copyright 2020, Joule Inc. or its licensors.

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