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The CDC has recommended steps that homeless shelters should take to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission after studying outbreaks at several facilities across the United States.
Among the US shelters that accommodate an estimated 1.4 million individuals annually, recent CDC investigations have shown that transmission is prevalent at some facilities but may occur undetected in others.
In late March and early April, CDC teams responded to clusters of coronavirus disease 2019 (COVID-19) cases at 5 homeless shelters in 3 cities: Boston, San Francisco, and Seattle. Teams carried out SARS-CoV-2 testing at these shelters and others in Seattle and Atlanta. Results for 1192 residents and 313 staff at 19 shelters showed that at sites with 2 or more cases, between 17% and 66% of residents and between 16% and 30% of staff tested positive. At a Seattle shelter with 1 reported case, 5% of residents and 1% of staff tested positive, while 4% of residents and 2% of staff tested positive at 2 shelters in Atlanta with no previously reported cases.
“Homelessness poses multiple challenges that can exacerbate and amplify the spread of COVID-19,” the investigators wrote. “Homeless shelters are often crowded, making social distancing difficult. Many persons experiencing homelessness are older or have underlying medical conditions,” which increases their risk of severe disease.
To protect residents and staff, the CDC has recommended that shelters implement infection control practices, apply social distancing measures such as ensuring residents sleep 6 feet apart, and encourage residents and staff to wear masks. The CDC also has advised shelters to encourage residents to shelter in place, test staff and residents, and promptly isolate those who are symptomatic or test positive.
Kuehn BM. Homeless Shelters Face High COVID-19 Risks. JAMA. 2020;323(22):2240. doi:10.1001/jama.2020.8854
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