Redditt Vanessa, Wright Vanessa, Rashid Meb, Male Roy, Bogoch Isaac
Crossroads Clinic (Redditt, Wright, Rashid, Male), Women's College Hospital; Department of Family & Community Medicine (Redditt, Rashid), and Lawrence S. Bloomberg Faculty of Nursing (Wright), University of Toronto; Divisions of General Internal Medicine and Infectious Diseases (Bogoch), University Health Network; Faculty of Medicine (Bogoch), University of Toronto, Toronto, Ont.
CMAJ Open. 2020 Dec 8;8(4):E819-E824. doi: 10.9778/cmajo.20200165. Print 2020 Oct-Dec.
There is high risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in congregate settings, including shelters. This study describes a coronavirus disease 2019 (COVID-19) outbreak and corresponding reported symptomatology at a shelter in Toronto.
This clinical and epidemiologic analysis focuses on a COVID-19 outbreak at a dedicated refugee shelter in downtown Toronto. All adult residents on site at the shelter were offered SARS-CoV-2 testing on Apr. 20, 2020. At the time of testing, residents were screened for 3 typical COVID-19 symptoms (fever, cough and shortness of breath). Among those who tested positive, a more comprehensive clinical assessment was conducted 1 day after testing and a standardized 15-item symptom screen was administered by telephone 14 days after testing. We report rates of positive test results and clinical symptoms with each assessment interval.
Of the 63 adult residents on site at the shelter, 60 agreed to be tested. Among those tested, 41.7% ( = 25) were positive for SARS-CoV-2 infection. Of those who tested positive ( = 25), 20.0% ( = 5) reported fever, cough or shortness of breath at the time of testing. On more detailed assessment 1 day later, 70.8% (17/24) reported a broader range of symptoms. During the 14 days after testing, 87.5% (21/24) reported symptoms of infection.
We found a high rate of SARS-CoV-2 infection in this shelter population. Our study underscores the high risk of SARS-CoV-2 transmission in congregate living settings and the importance of mobilizing timely testing and management of symptomatic, paucisymptomatic and asymptomatic residents in shelters.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在包括避难所在内的集体环境中有很高的传播风险。本研究描述了多伦多一个避难所的2019冠状病毒病（COVID-19）疫情及相应报告的症状。
这项临床和流行病学分析聚焦于多伦多市中心一个专门的难民避难所的COVID-19疫情。2020年4月20日，为该避难所所有成年居民提供了SARS-CoV-2检测。检测时，对居民进行了3种典型COVID-19症状（发热、咳嗽和呼吸急促）的筛查。在检测呈阳性者中，检测后1天进行了更全面的临床评估，并在检测后14天通过电话进行了标准化的15项症状筛查。我们报告了每个评估间隔的阳性检测结果率和临床症状。
该避难所63名成年居民中，60人同意接受检测。在接受检测者中，41.7%（n = 25）SARS-CoV-2感染呈阳性。在检测呈阳性者（n = 25）中，20.0%（n = 5）在检测时报告有发热、咳嗽或呼吸急促症状。在检测后1天进行的更详细评估中，70.8%（17/24）报告了更广泛的症状。在检测后的14天内，87.5%（21/24）报告了感染症状。
我们发现该避难所人群中SARS-CoV-2感染率很高。我们的研究强调了SARS-CoV-2在集体生活环境中的高传播风险，以及对避难所中有症状、症状轻微和无症状居民及时进行检测和管理的重要性。
