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

Background - People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). - Met...

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Hauptverfasser: Mohsenpour, Amir (VerfasserIn) , Bozorgmehr, Kayvan (VerfasserIn) , Rohleder, Sven (VerfasserIn) , Stratil, Jan (VerfasserIn) , Costa, Diogo (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 23 July 2021
In: EClinicalMedicine
Year: 2021, Jahrgang: 38, Pages: 1-20
ISSN:2589-5370
DOI:10.1016/j.eclinm.2021.101032
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.eclinm.2021.101032
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S2589537021003126
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Verfasserangaben:Amir Mohsenpour, Kayvan Bozorgmehr, Sven Rohleder, Jan Stratil, Diogo Costa

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520 |a Background - People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). - Methods - Systematic review of articles, indexed in electronic databases (EMBASE, WHOCovid19, Web of Science), institutional websites and the Norwegian Institute of Public Health's live map of COVID-19 evidence, and published from December 1st, 2019, to March 3rd, 2021. Empirical papers of any study design addressing Covid-19 and health(-related) outcomes in PEH or shelters’ staff were included. (PROSPERO-2020-CRD42020187033) - Findings - Of 536 publications, 37 studies were included (two modelling, 31 observational, four qualitative studies). Random-effect meta-analysis yields a baseline SARS-Cov-2 prevalence of 2•32% (95% Confidence-Interval, 95%CI=1•30-3•34) in PEH and 1•55% (95%CI=0•79-2•31) in staff. In outbreaks, the pooled prevalence increases to 31•59% (95%CI=20•48-42•71) in PEH and 14•80% (95%CI=10•73-18•87) in staff. Main IPC strategies were universal rapid testing, expansion of non-congregate housing, and in-shelter measures (bed spacing, limited staff rotation, reduction in number of residents). - Interpretation - 32% of PEH and 15% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found quantifying health-related outcomes of NPI. Overview and evaluation of IPC strategies for PEH, a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems are needed. Qualitative studies may serve to voice PEH and shelter staff experiences, and guide future evaluations and IPC strategies. - Funding - None. 
650 4 |a COVID-19 
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700 1 |a Stratil, Jan  |e VerfasserIn  |4 aut 
700 1 |a Costa, Diogo  |e VerfasserIn  |4 aut 
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