On March 30, 2020, Public Health – Seattle and King County (PHSKC) was notified of a proven case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and drop-in center. shelter (AT shelter). Residents of two other homeless shelters (B and C) used shelter A’s half-day services. Testing for SARS-CoV-2, the virus that causes COVID-19, was presented to citizens and the public. staff of the 3 shelters from March 30 to April 1, 2020. Of the 181 people most consulted, 19 (10. 5%) had positive effects. check effects (15 citizens and 4 officials). On April 1, PHSKC and CDC collaborated to conduct on-site testing and symptom screening, isolate sick citizens and staff, reinforce infection prevention and control practices, provide masks, and donate shelter-in-place recommendations. Repeat screening was presented on April 7 and 8 to all citizens and staff who were not tested in the first place or had negative screening effects. Of the other 118 people verified at the time of verification, 18 (15. 3%) had positive verification effects (16 citizens and two officials). In addition to the 31 citizens and six staff members known through screening at shelters, two other resident cases were learned at separate symptom screening events, and 4 were learned after two citizens and two staff members searched physical care independently. In total, 35 of 195 (18%) citizens and 8 of 38 (21%) staff members who were checked at the shelter or tested elsewhere were diagnosed with COVID-19. COVID-19 can temporarily spread in homeless shelters; Immediate interventions that add verification and isolation are needed to identify instances and minimize transmission. The CDC recommends that homeless service providers implement proper infection control practices, enforce physical distancing measures, and ensure that citizens’ heads are at least 6 feet (2 meters) apart from each other. yes while they sleep, and advertise the use of cloth. face masks among all citizens. [1]
The first case of COVID-19 in the United States was shown in Snohomish County, Washington on January 20, 2020. The Governor of Washington issued stay-at-home orders on March 23; as of March 28, a total of 2,307 cases showed that cases of COVID-19 had been reported in neighboring King County. [2,3] On March 30, PHSKC was notified that a resident of the homeless shelter A had tested positive for SARS-CoV-2. (Figure). The resident, a 67-year-old man with underlying medical conditions, was hospitalized on March 29 with acute encephalopathy. He reported 2 days of cough, shortness of breath, fever, sore throat, and runny nose. A nasopharyngeal swab taken on admission tested positive for SARS-CoV-2 via real-time reverse transcription and polymerase chain reaction testing. The patient remained clinically healthy without the need for an intensive care unit and was discharged after five days to isolation accommodation (i. e. , bachelor room with clinic) provided by the County Department of Social and Community Services. of king.
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Testing events and adjustments in response to a COVID-19 outbreak at 3 affiliated homeless shelters: King County, Washington, March 27 – April 11, 2020 Abbreviation: COVID-19 = coronavirus disease 2019.
A CDC team arrived on PHSKC first responders April 1. Teams tested 122 citizens and staff over 3 days for COVID-19-like illness (c. assessments at each shelter and recommendations to restrict transmission at all 3 shelters). .
Shelter A is a 24-hour shelter that has housed up to 40 men and 10 women; Sleeping mats (not assigned to individual citizens) were placed in two rooms overnight and stacked during the day. Shelter B housed up to 110 men in two main rooms; Shelter C housed up to a hundred men in two main halls. To decrease overcrowding and the threat of COVID-19 transmission, approximately a portion of Shelter B’s citizens were moved to Vault C on March thirteen. Sleeping mats and shelter spaces B and C were also located for individual citizens and returned to their posts on the day. Shelters B and C were converted into 24-hour shelters on March 13 and 26, respectively. All shelters had indoor restrooms on-site with sinks and soap. All shelters served people older than five0 ≥and were located 2 to 5 miles (3 to 8 kilometers) apart.
Site trials knew several spaces to improve on-site housing and infection prevention and practices. Staff members rotated between the 3 shelters. Residents can simply leave shelters if they returned after curfew. The sleeping mats in each of the shelters were separated by ≤ 3 feet. Shelter C had no alcohol-based hand sanitizer or on-site showers; Residents used the shelter’s shuttle services or public transportation to access public showers. Staff members wore cloth face coverings or face masks intermittently; however, they were not provided to residents.
As a result of the assessment, recommendations were implemented to decrease the threat of COVID-19 transmission. On April 5, to address staff shortages, PHSKC completed Shelter A and moved the citizens of Shelter A to an isolation unit with singles rooms and moving. the men to Shelter C, where PHSKC provided thermometers to monitor temperature and arranged portable showers to avoid the need for public showers (Figure). For all shelters, the immediate reaction groups provided recommendations to restrict staff turnover, inspire physical distancing, restrict movement in and out of the shelter, exercise staff in cleaning and disinfection, and move mattresses so that citizens’ heads are ≥ 6 feet (≥2 meters) from each other. Disposable masks were provided to all citizens and staff to facilitate origin control.
Morbidity and Mortality Weekly Report. 2020;69(17):523-526. © 2020 Centers for Disease Control and Prevention (CDC)
Abbreviation: N/A = not applicable. * Residents and staff who had negative or non-test event verification effects were verified at Event 2. † Residents were eligible to check if they had spent the last night at the shelter. . §The total number of staff active on the day of the check must not be held. ¶Residents of Shelter A who were screened in isolation housing after the closure of Shelter A on 5 April 2020. **Shelter closed.
Abbreviation: COVID-19 = coronavirus 2019.
Farrell A. Tobolowsky, DO1,2, Elysia Gonzales, MPH3, Julie L. Self, PhD2, Carol Y. Rao, ScD2, Ryan Keating, MPH2, Grace E. Marx, MD2, Temet M. McMichael, PhD1,3, Margaret D. Lukoff, MD3, Jeffrey S. Duchin, MD3, Karin Huster, MPH3,4, Jody Rauch, MA3, Hedda McLendon, MPH5, Matthew Hanson, MD3, Dave Nichols3, Sargis Pogosjans, MPH3, Meaghan Fagalde, MPH3, Jennifer Lenahan, MPH3, Emily Maier, MPH3, Holly Whitney, MPH3, Nancy Sugg, MD4, Helen Chu, MD4, Julia Rogers, MPH4, Emily Mosites, PhD2 and Meagan Kay, DVM3 1Epidemic Intelligence Service, CDC; 2CDC COVID-19 Emergency Response; 3Public Health: Seattle and King County, Washington; 4University of Washington, Seattle, Washington; 5King County Department of Community and Human Services, Seattle, Washington.
Correspondent Farrell A. Tobolowsky, oqk3@cdc. gov, 404-718-3635.
All authors completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Helen Chu reports fees from non-public representatives of Merck and GlaxoSmithKline and a scholarship from Sanofi Pasteur. No other potential conflicts of interest were disclosed.
What do we already know about this topic?
COVID-19 can spread temporarily within and between multifamily housing, such as homeless shelters. However, COVID-19 in homeless shelters has been well described.
What does this bring?
On April 1, 2020, an outbreak of COVID-19 was detected in 3 affiliated homeless shelters. SARS-CoV-2 tests were promptly presented to all citizens and staff. COVID-19 in another 43 people at those sites.
What are the implications for public practice?
Interrupting COVID-19 transmission in homeless shelters is challenging. In contexts where COVID-19 outbreaks are known, assistance with compliance with shelter-in-place orders, assessment of citizens and staff, and timely isolation of symptomatic or sick citizens. They are needed to save you additional transmission in homeless shelters.
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Testing events and adjustments in response to a COVID-19 outbreak at 3 affiliated homeless shelters: King County, Washington, March 27 – April 11, 2020 Abbreviation: COVID-19 = coronavirus disease 2019.
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