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SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis
Open accessPreprint — published as 10.1016/j.eclinm.2021.101032 · Paper page
Abstract
Background: People experiencing homelessness (PEH) may be at particular risk for COVID19. We synthesised the evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of targeted strategies for infection prevention and control (IPC). Methods: Systematic review of articles, reports and grey-literature indexed in electronic databases (EMBASE, WHO-Covid19, Web of Science), pre-print repositories, institutional websites, and handsearching. Empirical papers of any study design addressing Covid-19 in PEH or homeless shelters' staff in English were included. (PROSPERO 2020 CRD42020187033) Findings: Of 194 publications, 13 studies were included (two modelling, ten observational and one qualitative study). All were conducted in high-income countries. Random-effect meta-analysis of prevalence estimates yields a baseline SARS-Cov-2 prevalence of 2.14% (95% Confidence-Interval, 95%CI=1.02-3.27) in PEH and 1.72 % (95%CI=0.31-3.12) in staff. In outbreaks, the pooled prevalence increases to 29.49% (95%CI=16.44-29.55) in PEH and 15.18% (95%CI=8.95-21.42) in staff. Main IPC strategies were universal and rapid testing, expansion of non-congregate housing support, and individual measures in shelters (bed spacing, limited staff rotation). Interpretation: Up to 30% PEH and 17% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found on health-related outcomes or health effects of NPI. An overview and evaluation of IPC strategies for PEH, including a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems is needed. Qualitative studies may serve to voice PEH experiences and guide future evaluations and IPC strategies. Funding: No source of funding.
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Beijer, U., Wolf, A., & Fazel, S. (2012) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70177-9 · Cited by 357
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Metadata
- Authors
- Mohsenpour, A. M., Bozorgmehr, K., Rohleder, S., Stratil, J., & Costa, D.
- Affiliations
- Bielefeld University (DE)
- Ludwig-Maximilians-Universität München (DE)
- Corresponding author
- Mohsenpour, Amir Mohsen
- Venue
- medRxiv
- Publisher
- openRxiv
- Published
- 2021-01-15
- OpenAlex
- W3119714240
- Cited by
- 5
- References
- 1
- Citations by year
- 2024: 2 · 2023: 2 · 2021: 1
- Type
- posted content
- Language
- en
- Open access
- green
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion)
- Publikationen an der Universität Bielefeld (Universität Bielefeld) (submittedVersion)
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- SARS-CoV-2, COVID-19 pandemic, homelessness, homeless shelters, infection prevalence, disease transmission, infection control, non-pharmaceutical interventions, shelter staff, outbreak, rapid testing, job rotation
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