National Health Care for the Homeless Council, Nashville, TN, USA.
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2022 Jul-Aug;137(4):764-773. doi: 10.1177/00333549221086514. Epub 2022 Apr 9.
SARS-CoV-2 testing is a critical component of preventing the spread of COVID-19. In the United States, people experiencing homelessness (PEH) have accessed testing at health clinics, such as those provided through Health Care for the Homeless (HCH) clinics or through community-based testing events at homeless service sites or encampments. We describe data on SARS-CoV-2 testing among PEH in US clinic- and community-based settings from March through November 2020.
We conducted a descriptive analysis of data from HCH clinics and community testing events. We used a standardized survey to request data from HCH clinics. We developed and made publicly available an online data entry portal to collect data from community-based organizations that provided testing for PEH. We assessed positivity rates across clinics and community service sites serving PEH and used generalized linear mixed models to account for clustering.
Thirty-seven HCH clinics reported providing 280 410 tests; 3.2% (n = 8880) had positive results (range, 1.6%-4.9%). By race, positivity rates were highest among people who identified as >1 race (11.6%; < .001). During the reporting period, 22 states reported 287 community testing events and 14 116 tests; 7.1% (n = 1004) had positive results. Among facility types, day shelters (380 of 2697; 14.1%) and inpatient drug/alcohol rehabilitation facilities (32 of 251; 12.7%) reported the highest positivity rates.
While HCH clinic data provided results for a larger number of patients, community-based testing data showed higher positivity rates. Clinic data demonstrated racial disparities in positivity. Community-based testing data provided information about SARS-CoV-2 transmission settings. Although these data provide information about testing, standard surveillance systems are needed to better understand the incidence of disease among PEH.
SARS-CoV-2 检测是预防 COVID-19 传播的关键组成部分。在美国，无家可归者（PEH）在卫生诊所接受了检测，例如在无家可归者健康诊所（HCH）或在无家可归者服务场所或营地的社区检测活动中提供的检测。我们描述了 2020 年 3 月至 11 月期间美国诊所和社区环境中 PEH 的 SARS-CoV-2 检测数据。
我们对 HCH 诊所和社区检测活动的数据进行了描述性分析。我们使用标准化调查从 HCH 诊所请求数据。我们开发了一个在线数据输入门户并公开提供，以收集为 PEH 提供检测的社区组织的数据。我们评估了为 PEH 提供服务的诊所和社区服务站点的阳性率，并使用广义线性混合模型来解释聚类。
37 家 HCH 诊所报告提供了 280410 次检测；3.2%（n=8880）的检测结果为阳性（范围为 1.6%-4.9%）。按种族划分，阳性率最高的是身份认同为多种族的人群（11.6%；<0.001）。在报告期内，22 个州报告了 287 次社区检测活动和 14116 次检测；7.1%（n=1004）的检测结果为阳性。在设施类型中，日间庇护所（2697 个中的 380 个；14.1%）和住院药物/酒精康复设施（251 个中的 32 个；12.7%）报告的阳性率最高。
虽然 HCH 诊所的数据为更多的患者提供了结果，但社区检测数据显示了更高的阳性率。诊所数据显示阳性率存在种族差异。社区检测数据提供了有关 SARS-CoV-2 传播环境的信息。尽管这些数据提供了有关检测的信息，但需要标准监测系统来更好地了解无家可归者中疾病的发病率。
