Coronavirus Disease 2019 Outbreak in a San Francisco Homeless Shelter

Imbert, Elizabeth; Kinley, Patrick M.; Scarborough, Alexander; Cawley, Caroline; Sankaran, Madeline; Cox, Sarah N; Kushel, Margot; Stoltey, Juliet; Cohen, Stéphanie; Fuchs, Jonathan

doi:10.1093/cid/ciaa1071

Cited by 79 publications

(98 citation statements)

References 6 publications

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“…Eight of the cross-sectional quantitative studies were conducted in the USA [18][19][20][21][22][23][24][25] , one in Canada 26 and one in France 27 . All studies collected data from March to early May 2020 during the first wave of the SARS-Cov-2 pandemic, except one 20 , conducted from April to August 2020.…”

Section: Resultsmentioning

confidence: 99%

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

Mohsenpour

Bozorgmehr

Rohleder

et al. 2021

Preprint

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Background: People experiencing homelessness (PEH) may be at particular risk for COVID19. We synthesised the evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of targeted strategies for infection prevention and control (IPC). Methods: Systematic review of articles, reports and grey-literature indexed in electronic databases (EMBASE, WHO-Covid19, Web of Science), pre-print repositories, institutional websites, and handsearching. Empirical papers of any study design addressing Covid-19 in PEH or homeless shelters' staff in English were included. (PROSPERO 2020 CRD42020187033) Findings: Of 194 publications, 13 studies were included (two modelling, ten observational and one qualitative study). All were conducted in high-income countries. Random-effect meta-analysis of prevalence estimates yields a baseline SARS-Cov-2 prevalence of 2.14% (95% Confidence-Interval, 95%CI=1.02-3.27) in PEH and 1.72 % (95%CI=0.31-3.12) in staff. In outbreaks, the pooled prevalence increases to 29.49% (95%CI=16.44-29.55) in PEH and 15.18% (95%CI=8.95-21.42) in staff. Main IPC strategies were universal and rapid testing, expansion of non-congregate housing support, and individual measures in shelters (bed spacing, limited staff rotation). Interpretation: Up to 30% PEH and 17% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found on health-related outcomes or health effects of NPI. An overview and evaluation of IPC strategies for PEH, including a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems is needed. Qualitative studies may serve to voice PEH experiences and guide future evaluations and IPC strategies. Funding: No source of funding.

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Section: Resultsmentioning

confidence: 99%

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

Mohsenpour

Bozorgmehr

Rohleder

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Also, homeless persons have more physical and mental comorbidities, usually undiagnosed and uncontrolled, that may worsen the disease's course. In these congregated living settings, asymptomatic cases represent the most common means of contagion, as reported by Baggett in Boston ( Baggett et al, 2020 ), Tobolowsky in Seattle and King County ( Tobolowsky et al, 2020 ), and Imbert in San Francisco ( Imbert et al, 2020 ) ( Table 1 ).…”

mentioning

confidence: 87%

Asymptomatic patients as a source of transmission of COVID-19 in homeless shelters

Ralli¹,

Morrone²,

Arcangeli³

et al. 2021

International Journal of Infectious Diseases

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“…For instance, Arcadepani et al (2020) highlight the challenges of COVID-19 prevention in public and open-air drug scenes, focusing on a case study in São Paulo, Brazil. A particular challenge is delivering COVID-19 prevention and quarantine services to homeless populations ( Banerjee and Bhattacharya, 2020 , Lenhard, 2020 , Marcus et al, 2020 ), particularly in settings where outbreaks have been observed ( Baggett et al, 2020 , Imbert et al, 2020 , Mosites et al, 2020 , Tobolowsky et al, 2020 ). This special issue highlights some of the specific challenges in providing COVID-19 prevention services among homeless people who use drugs in Iran ( Deilamizade & Moghanibashi-Mansourieh, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and the health of people who use drugs: What is and what could be?

Grebely

Cerdá

Rhodes

2020

International Journal of Drug Policy

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SARS-CoV-2, the virus that causes COVID-19, has changed the world as we know it, and continues to do so. How COVID-19 affects people who use drugs, the environments in which they live, and capacities of response, warrants immediate attention. This special issue begins to map how COVID-19 is altering the health of people who use drugs, including in relation to patterns of drug use, service responses, harms that may relate to drug use, interventions to reduce risk of harms, COVID-19 health, and drug policies. We emphasise the need to envisage COVID-19 and its effects as a matter of intersecting ‘complex adaptive systems’: that is, the impacts of COVID-19 extend beyond the virus and related illness conditions to encompass multiple social, cultural, economic, policy and political effects; and these affect the health of people who use drugs directly as well as indirectly by altering the risk and enabling environments in which they live. We synthesize emergent evidence on the impact of COVID-19 on the health of people who use drugs. A key concern we identify is how to sustain policy and service delivery improvements prompted by COVID-19. We need to maintain an ethos of emergent adaptation and experimentation towards the creation of safer environments in relation to the health of people who use drugs.

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Coronavirus Disease 2019 Outbreak in a San Francisco Homeless Shelter

Cited by 79 publications

References 6 publications

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

Asymptomatic patients as a source of transmission of COVID-19 in homeless shelters

COVID-19 and the health of people who use drugs: What is and what could be?

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