436 - Assessing SARS-CoV-2 Infection among Persons Experiencing Homelessness — Atlanta, GA, 2020

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Presenting Author(s)

Jane C. Yoon

Infectious Diseases Fellow
Emory University
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

Sapna Morris

Medical Officer
CDC
Atlanta, GA
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KS

Kristine Schmit

Medical Officer
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AH

Alfonso Hernandez

Infectious Diseases Fellow
Emory University
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MM

Martha Montgomery

Medical Officer, Epidemiologist
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JK

Jean Ko

Epidemiologist
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AB

Andrew T. Boyd

Medical Officer
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AB

Ann Buff

Medical Officer
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NF

Nicole Flowers

Medical Officer
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CJ

Calla Jamison

Evaluation Fellow
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Emily Mosites

Epidemiolgist
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HP

Heather Paulin

Medical Officer
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SA

Sophia Ajoku

Health Outreach Supervisor
Fulton County Board of Health
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MS

Mark Swancutt

Physician
Fulton County Board of Health
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
DH

David P. Holland

Associate Professor
Emory University
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KT

Kim Turner

Director of Clinical Services
Fulton County Board of Health
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TA

Tom Andrews

CEO
Mercy Care Atlanta
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SS

Sarita Shah

Associate Professor
Emory University
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JP

Juliana Prieto

District Epidemiologist
Fulton County Board of Health
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SS

Sasha Smith

Epidemiologist
Fulton County Board of Health
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NG

Nicholas Gaffga

Medical Epidemiologist
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JC

Joseph Cavanaugh

Medical Epidemiologist
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CM

Cathryn Marchman

Executive Director
Partners for Home
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Persons experiencing homelessness (PEH) often do not have sufficient resources to practice public health interventions. PEH may reside at overcrowded shelters, have poor access to health care, and often suffer from significant co-morbid conditions. In this study, we describe prevalence of COVID-19 amongst PEH and homeless service staff in Atlanta, Georgia, as well as demographic data, underlying conditions, and symptoms.

Methods: In response to the COVID-19 pandemic in Atlanta, PEH and homeless service providers were offered PCR testing for SARS-CoV-2 via nasopharyngeal, nasal mid-turbinate, and oropharyngeal swabs. Shelters identified as having a higher number of COVID-19 infections underwent re-testing 3-4 weeks after initial testing. Demographic information was collected, and individuals were screened for symptoms and underlying conditions.

Results: A total of 2,294 PEH and 544 staff underwent SARS-CoV-2 PCR testing from April 8 - May 6, 2020. 24 homeless shelters were included in this study. The majority of individuals were male (66.3% sheltered, 85.5% unsheltered, 55.3% staff), and 2,192 of 2,838 (78.3%) persons identified as black. Approximately half of individuals had no known underlying conditions (51.5% sheltered, 47.7% unsheltered, 55.5% staff). Cardiovascular disease was the most frequently reported condition (32.0%), followed by chronic lung disease (14.8%). In total, 45 of 2,823 (1.6%) individuals had detectable PCR results for SARS-CoV-2, including 35 of 1,666 (2.1%) sheltered clients, 3 of 614 (0.5%) unsheltered clients, and 7 of 543 (1.3%) staff. Among individuals with detectable SARS-CoV-2, 5 of 20 (25%) reported at least one symptom in the last week. Most shelters (16 of 24) had at least one individual with detectable SARS-CoV-2. The prevalence of SARS-CoV-2 in the majority of shelters (19 of 24) was < 3%, with a median prevalence of 0.2% across all shelters. Upon retesting 4 shelters with a higher number of COVID-19 infections, only 3 individuals from 2 shelters tested positive out of 357 total retested (0.8%).TABLE 1. Demographic and background characteristics of homeless shelter clients, unsheltered clients, and staff tested for SARS-CoV-2 — Atlanta, Georgia, United States, April—May 2020

Table 2. SARS-CoV-2 test result by shelter and collection date—Atlanta, Georgia, United States, April—May 2020

Conclusion: We identified a low prevalence of SARS-CoV-2 infection among PEH in Atlanta, which was influenced by a pre-emptive testing strategy. Continued vigilance is necessary to limit spread in this vulnerable population.