Background People experiencing homelessness are at increased risk of COVID-19, but little is known about specific risk factors for infection within homeless shelters. Methods We performed widespread SARS-CoV-2 PCR testing and collected risk factor information at all homeless shelters in Chicago with at least one reported case of COVID-19 (n=21). Multivariable, mixed-effects log-binomial models were built to estimate adjusted prevalence ratios (aPRs) for SARS-CoV-2 infection for both individual and facility-level risk factors. Results During March 1 to May 1, 2020, 1717 shelter residents and staff were tested for SARS-CoV-2; 472 (27%) persons tested positive. Prevalence of infection was higher for residents (431/1435, 30%) than for staff (41/282, 15%) (prevalence ratio [PR] =2.52, 95% CI 1.78–3.58). The majority of residents with SARS-CoV-2 infection (293/406 with available information about symptoms, 72%) reported no symptoms at the time of specimen collection or within the following two weeks.Among residents, sharing a room with a large number of people was associated with increased likelihood of infection (aPR for sharing with >20 people compared to single rooms = 1.76, 95% CI 1.11–2.80), and current smoking was associated with reduced likelihood of infection (aPR=0.71, 95% CI 0.60–0.85). At the facility-level, a higher proportion of residents leaving and returning each day was associated with increased prevalence (aPR=1.08, 95% CI 1.01–1.16), while an increase in the number of private bathrooms was associated with reduced prevalence (aPR for one additional private bathroom per 100 people = 0.92, 95% CI 0.87–0.98). Conclusions We identified a high prevalence of SARS-CoV-2 infections in homeless shelters. Reducing the number of residents sharing dormitories might reduce the likelihood of SARS-CoV-2 infection. When community transmission is high, limiting movement of persons experiencing homelessness into and out of shelters might also be beneficial.

No abstract

Key Points Question Was a hotel-based protective housing intervention associated with reduced incidence of SARS-CoV-2 infection among persons experiencing homelessness (PEH) in Chicago, Illinois? Findings In this cohort study of 259 PEH, a significant reduction in SARS-CoV-2 incidence was observed during the study period among PEH provided with protective housing compared with PEH in shelters citywide. Improvements in hypertension and glycemic control were also observed; 51% were successfully housed at departure. Meaning These findings suggest that protective housing interventions may reduce SARS-CoV-2 incidence among PEH at increased risk for severe COVID-19.

In Camden, New Jersey--as in many urban areas--health care costs are concentrated in a disproportionately small number of patients. These "super-utilizers" typically have multiple chronic conditions combined with social barriers that make it hard to access and coordinate the care they need to manage these conditions and stay healthy. Launched in 2002, the Camden Coalition of Healthcare Providers strives to reform the quality, capacity, and accessibility of the health care system for the city's vulnerable populations.

Quick and effective screening measures are needed for detecting Autism Spectrum Disorder (ASD). Thirty typically developing children and 30 children with ASD aged 24-68 months were used. This study explored if the ASD group would exhibit less object exploration, diversity of play, and turn-taking than the typically developing group. Older children with ASD performed less turn-taking. On all other measures, IQ accounted for more of the difference between groups than diagnosis. Implications of these results for future research are discussed.