Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Homeless Shelters in Chicago, Illinois—March–May, 2020
Author:
Ghinai Isaac12ORCID, Davis Elizabeth S3, Mayer Stockton4, Toews Karrie-Ann12, Huggett Thomas D5, Snow-Hill Nyssa4, Perez Omar4, Hayden Mary K3, Tehrani Seena3, Landi A Justine3, Crane Stephanie3, Bell Elizabeth3, Hermes Joy-Marie3, Desai Kush3, Godbee Michelle3, Jhaveri Naman4, Borah Brian4, Cable Tracy4, Sami Sofia4, Nozicka Laura4, Chang Yi-Shin4, Jagadish Aditi14, Chee Mark16, Thigpen Brynna1, Llerena Christopher14, Tran Minh14, Surabhi Divya Meher14, Smith Emilia D14, Remus Rosemary G1, Staszcuk Roweine1, Figueroa Evelyn4, Leo Paul4, Detmer Wayne M5, Lyon Evan7, Carreon Sarah8, Hoferka Stacey9, Ritger Kathleen A1, Jasmin Wilnise1, Nagireddy Prathima1, Seo Jennifer Y1, Fricchione Marielle J1, Kerins Janna L1, Black Stephanie R1, Butler Lisa Morrison10, Howard Kimberly10, McCauley Maura10, Fraley Todd1, Arwady M Allison1, Gretsch Stephanie1, Cunningham Megan1, Pacilli Massimo1ORCID, Ruestow Peter S1, Mosites Emily2, Avery Elizabeth3, Longcoy Joshua3, Lynch Elizabeth B3, Layden Jennifer E1
Affiliation:
1. Chicago Department of Public Health, Chicago, Illinois, USA 2. Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3. Rush University Medical Center, Chicago, Illinois, USA 4. University of Illinois at Chicago, Chicago, Illinois, USA 5. Lawndale Christian Health Center, Chicago, Illinois, USA 6. University of Chicago, Chicago, Illinois, USA 7. Heartland Alliance Health, Chicago, Illinois, USA 8. PCC Wellness, Chicago, Illinois, USA 9. Illinois Department of Public Health, Springfield, Illinois, USA 10. Chicago Department of Family & Support Services, Chicago, Illinois, USA
Abstract
Abstract
Background
People experiencing homelessness are at increased risk of coronavirus disease 2019 (COVID-19), but little is known about specific risk factors for infection within homeless shelters.
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.
Funder
Chicago Department of Public Health
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Reference30 articles.
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