• Clin. Infect. Dis. · Sep 2020

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

    • Jane C Yoon, Martha P Montgomery, Ann M Buff, Andrew T Boyd, Calla Jamison, Alfonso Hernandez, Kristine Schmit, Sarita Shah, Sophia Ajoku, David P Holland, Juliana Prieto, Sasha Smith, Mark A Swancutt, Kim Turner, Tom Andrews, Kevin Flowers, Alyssa Wells, Cathryn Marchman, Emaline Laney, Danae Bixler, Sean Cavanaugh, Nicole Flowers, Nicholas Gaffga, Jean Y Ko, Heather N Paulin, Mark K Weng, Emily Mosites, and Sapna Bamrah Morris.
    • Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
    • Clin. Infect. Dis. 2020 Sep 8.

    BackgroundIn 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.MethodsPEH 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.ResultsOverall, 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.ConclusionsPEH 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.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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