COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Montgomery, Paulin, Boyd, Buff, Gaffga, Bamrah Morris, and Cavanaugh); Partners for HOME, Atlanta, Georgia (Mr Morris and Ms Marchman); Fulton County Board of Health, Atlanta, Georgia (Ms Cotton); Georgia Department of Public Health, Atlanta, Georgia (Ms Speers); Darlene Mathews, Incorporated, Atlanta, Georgia (Ms Mathews); and Mercy Care, Atlanta, Georgia (Ms Wells).
J Public Health Manag Pract. 2021;27(3):285-294. doi: 10.1097/PHH.0000000000001349.
Local agencies across the United States have identified public health isolation sites for individuals with coronavirus disease 2019 (COVID-19) who are not able to isolate in residence.
We describe logistics of establishing and operating isolation and noncongregate hotels for COVID-19 mitigation and use the isolation hotel as an opportunity to understand COVID-19 symptom evolution among people experiencing homelessness (PEH).
Multiple agencies in Atlanta, Georgia, established an isolation hotel for PEH with COVID-19 and noncongregate hotel for PEH without COVID-19 but at risk of severe illness. PEH were referred to the isolation hotel through proactive, community-based testing and hospital-based testing. Daily symptoms were recorded prospectively. Disposition location was recorded for all clients.
During April 10 to September 1, 2020, 181 isolation hotel clients (77 community referrals; 104 hospital referrals) were admitted a median 3 days after testing. Overall, 32% of community referrals and 7% of hospital referrals became symptomatic after testing positive; 83% of isolation hotel clients reported symptoms at some point; 93% completed isolation. Among 302 noncongregate hotel clients, median stay was 18 weeks; 61% were discharged to permanent housing or had a permanent housing discharge plan.
Overall, a high proportion of PEH completed isolation at the hotel, suggesting a high level of acceptability. Many PEH with COVID-19 diagnosed in the community developed symptoms after testing, indicating that proactive, community-based testing can facilitate early isolation. Noncongregate hotels can be a useful COVID-19 community mitigation strategy by bridging PEH at risk of severe illness to permanent housing.
美国各地的地方机构已经确定了公共卫生隔离点，用于那些无法在家中隔离的 2019 年冠状病毒病（COVID-19）患者。
我们描述了为减轻 COVID-19 而建立和运营隔离和非集体酒店的后勤工作，并利用隔离酒店的机会了解无家可归者（PEH）中 COVID-19 症状的演变。
佐治亚州亚特兰大的多个机构为有 COVID-19 的 PEH 建立了隔离酒店，为没有 COVID-19 但有患重病风险的 PEH 建立了非集体酒店。PEH 通过主动的社区检测和医院检测被转介到隔离酒店。每天的症状都被前瞻性地记录下来。所有客户的处置地点都被记录下来。
在 2020 年 4 月 10 日至 9 月 1 日期间，181 名隔离酒店客户（77 名社区转介；104 名医院转介）在检测后平均 3 天入住。总体而言，32%的社区转介者和 7%的医院转介者在检测呈阳性后出现症状；83%的隔离酒店客户在某个时候报告有症状；93%的人完成了隔离。在 302 名非集体酒店客户中，中位停留时间为 18 周；61%的人出院到永久性住房或有永久性住房出院计划。
总体而言，酒店内有相当比例的 PEH 完成了隔离，这表明接受度很高。许多在社区中确诊的 COVID-19 的 PEH 在检测后出现症状，这表明主动的社区检测可以促进早期隔离。非集体酒店可以通过将有患重病风险的 PEH 与永久性住房联系起来，成为 COVID-19 社区缓解策略的有用工具。
