COVID-19 Screening in Homeless Shelters: A Study Overview
Background
This study aimed to evaluate four different strategies for early COVID-19 case detection among people in homeless shelters in Hamilton, Ontario. We wanted to see how effective these methods were and how well participants kept up with them over time.
Methods
The research was carried out from April 2020 to January 2021 in eleven shelters. Participants who agreed to join could self-swab for testing. The main focus was to find out how often SARS-CoV-2 was detected, how many outbreaks occurred, and how well participants adhered to the testing methods. All participants, including staff and residents, went through daily symptom checks. Shelters were divided into three groups for different testing methods:
- Once weekly, self-collected oral swabs (OS)
- Once-weekly self-collected oral-nasal swab (ONS)
- Once-weekly nurse-collected nasopharyngeal swab (NPS)
Results
A total of 9,747 SARS-CoV-2 tests were completed on 1,570 participants. The testing outcomes were:
- OS identified 5 new cases (1.1 per 1000).
- ONS identified 15 new cases (3.0 per 1000).
This showed that ONS was more effective than OS. However, both self-collection methods were preferred over NPS, which had lower adherence and detected no cases. During the study, three outbreaks occurred with a total of 7 positive cases.
Conclusions
The study found that self-collection methods (OS and ONS) were the most effective and had better adherence. We plan to explore a larger-scale ONS strategy in ongoing research with more shelters.
Trial Registration
This trial was officially registered on ClinicalTrials.gov on June 18, 2020, under the identifier NCT04438070.
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