Assessment of SARS-CoV-2 Infection Prevalence in Homeless Shelters — Four U.S. Cities, March 27–April 15, 2020
Emily Mosites, Erin Parker, Kristie E.N. Clarke, Jessie M. Gaeta, Travis P. Baggett, Elizabeth Imbert, Madeline Sankaran, Ashley Scarborough, Karin Huster, Matt Hanson, Elysia Gonzales, Jody Rauch, Libby C. Page, Temet M. McMichael, Ryan Keating, Grace E. Marx, Tom Andrews, Kristine M Schmit, Sapna Bamrah Morris, Nicole F. Dowling, Georgina Peacock, COVID-19 Homelessness Team, COVID-19 Homelessness Team, Ann M. Buff, Calla Jamison, Ruthanne Marcus, Carol Y. Rao, Julie L. Self, Farrell Tobolowsky, Samantha Williams, Meagan Kay, Naveena Bobba, Stephanie E. Cohen, Jonathan D. Fuchs, Trang Nguyen, Julie Stoltey
Abstract
In the United States, approximately 1.4 million persons access emergency shelter or transitional housing each year (1). These settings can pose risks for communicable disease spread. In late March and early April 2020, public health teams responded to clusters (two or more cases in the preceding 2 weeks) of coronavirus disease 2019 (COVID-19) in residents and staff members from five homeless shelters in Boston, Massachusetts (one shelter); San Francisco, California (one); and Seattle, Washington (three). The investigations were performed in coordination with academic partners, health care providers, and homeless service providers. Investigations included reverse transcription-polymerase chain reaction testing at commercial and public health laboratories for SARS-CoV-2, the virus that causes COVID-19, over approximately 1-2 weeks for residents and staff members at the five shelters. During the same period, the team in Seattle, Washington, also tested residents and staff members at 12 shelters where a single case in each had been identified. In Atlanta, Georgia, a team proactively tested residents and staff members at two shelters with no known COVID-19 cases in the preceding 2 weeks. In each city, the objective was to test all shelter residents and staff members at each assessed facility, irrespective of symptoms. Persons who tested positive were transported to hospitals or predesignated community isolation areas.