Coronavirus Disease 2019 (COVID-19) Prevalences 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 BixlerSean Cavanaugh, Nicole Flowers, Nicholas Gaffga, Jean Y. Ko, Heather N. Paulin, Mark K. Weng, Emily Mosites, Sapna Bamrah Morris

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: In response to reported coronavirus disease 2019 (COVID-19) outbreaks among people experiencing homelessness (PEH) in other US cities, we conducted multiple, proactive, facility-wide testing events for PEH living sheltered and unsheltered and homelessness service staff in Atlanta, Georgia. We describe the severe acute respiratory syndrome coronavirus 2 (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 7 April-6 May 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, 2875 individuals at 24 shelters and 9 unsheltered outreach events underwent SARS-CoV-2 testing, and 2860 (99.5%) had conclusive test results. The SARS-CoV-2 prevalences were 2.1% (36/1684) 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. Prevalences by shelter ranged 0-27.6%. Repeat testing 3-4 weeks later at 4 shelters documented decreased SARS-CoV-2 prevalences (0-3.9%). Of 24 shelters, 9 completed shelter assessments and implemented IPC measures as part of the COVID-19 response. Conclusions: PEH living in shelters experienced a higher SARS-CoV-2 prevalence compared with PEH living unsheltered. Facility-wide testing in congregate settings allowed for the identification and isolation of COVID-19 cases, and is an important strategy to interrupt SARS-CoV-2 transmission.

Original languageEnglish (US)
Pages (from-to)E2978-E2984
JournalClinical Infectious Diseases
Volume73
Issue number9
DOIs
StatePublished - Nov 1 2021
Externally publishedYes

Keywords

  • COVID-19
  • homeless persons
  • prevalence
  • SARS-CoV-2
  • universal testing

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Coronavirus Disease 2019 (COVID-19) Prevalences among People Experiencing Homelessness and Homelessness Service Staff during Early Community Transmission in Atlanta, Georgia, April-May 2020'. Together they form a unique fingerprint.

Cite this