Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Homeless Shelters in Chicago, Illinois-March-May, 2020.
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Ghinai Isaac, Davis Elizabeth S, Mayer Stockton, Toews Karrie-Ann, Huggett Thomas D, Snow-Hill Nyssa, Perez Omar, Hayden Mary K, Tehrani Seena, Landi A Justine, Crane Stephanie, Bell Elizabeth, Hermes Joy-Marie, Desai Kush, Godbee Michelle, Jhaveri Naman, Borah Brian, Cable Tracy, Sami Sofia, Nozicka Laura, Chang Yi-Shin, Jagadish Aditi, Chee Mark, Thigpen Brynna, Llerena Christopher, Tran Minh, Surabhi Divya Meher, Smith Emilia D, Remus Rosemary G, Staszcuk Roweine, Figueroa Evelyn, Leo Paul, Detmer Wayne M, Lyon Evan, Carreon Sarah, Hoferka Stacey, Ritger Kathleen A, Jasmin Wilnise, Nagireddy Prathima, Seo Jennifer Y, Fricchione Marielle J, Kerins Janna L, Black Stephanie R, Butler Lisa Morrison, Howard Kimberly, McCauley Maura, Fraley Todd, Arwady M Allison, Gretsch Stephanie, Cunningham Megan, Pacilli Massimo, Ruestow Peter S, Mosites Emily, Avery Elizabeth, Longcoy Joshua, Lynch Elizabeth B, Layden Jennifer E
Аннотация
METHODS: We performed widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction testing and collected risk factor information at all homeless shelters in Chicago with at least 1 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 of 1435, 30%) than for staff (41 of 282, 15%) (prevalence ratio = 2.52; 95% confidence interval [CI], 1.78-3.58). The majority of residents with SARS-CoV-2 infection (293 of 406 with available information about symptoms, 72%) reported no symptoms at the time of specimen collection or within the following 2 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 with 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), whereas an increase in the number of private bathrooms was associated with reduced prevalence (aPR for 1 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.