Your browser doesn't support javascript.
Assessment of a Hotel-Based Protective Housing Program for Incidence of SARS-CoV-2 Infection and Management of Chronic Illness Among Persons Experiencing Homelessness.
Huggett, Thomas D; Tung, Elizabeth L; Cunningham, Megan; Ghinai, Isaac; Duncan, Heather L; McCauley, Maura E; Detmer, Wayne M.
  • Huggett TD; Lawndale Christian Health Center, Chicago, Illinois.
  • Tung EL; Section of General Internal Medicine and Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois.
  • Cunningham M; Chicago Department of Public Health, Chicago, Illinois.
  • Ghinai I; Chicago Department of Public Health, Chicago, Illinois.
  • Duncan HL; Lawndale Christian Health Center, Chicago, Illinois.
  • McCauley ME; Department of Nursing, North Park University, Chicago, Illinois.
  • Detmer WM; Chicago Department of Family and Support Services, Chicago, Illinois.
JAMA Netw Open ; 4(12): e2138464, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1567894
ABSTRACT
Importance Persons experiencing homelessness (PEH) are at higher risk for SARS-CoV-2 infection and severe illness due to COVID-19 because of a limited ability to physically distance and a higher burden of underlying health conditions.

Objective:

To describe and assess a hotel-based protective housing intervention to reduce incidence of SARS-CoV-2 infection among PEH in Chicago, Illinois, with increased risk of severe illness due to COVID-19. Design, Setting, and

Participants:

This retrospective cohort study analyzed PEH who were provided protective housing in individual hotel rooms in downtown Chicago during the COVID-19 pandemic from April 2 through September 3, 2020. Participants were PEH at increased risk for severe COVID-19, defined as (1) aged at least 60 years regardless of health conditions, (2) aged at least 55 years with any underlying health condition posing increased risk, or (3) aged less than 55 years with any underlying health condition posing substantially increased risk (eg, HIV/AIDS). Exposures Participants were housed in individual hotel rooms to reduce the risk of SARS-CoV-2 infection; on-site health care workers provided daily symptom monitoring, regular SARS-CoV-2 testing, and care for chronic health conditions. Additional on-site services included treatment of mental health and substance use disorders and social services. Main Outcomes and

Measures:

The main outcome measured was SARS-CoV-2 incidence, with SARS-Cov2 infection defined as a positive upper respiratory specimen using any polymerase chain reaction diagnostic assay authorized for emergency use by the Food and Drug Administration. Secondary outcomes were blood pressure control, glycemic control as measured by hemoglobin A1c, and housing placements at departure.

Results:

Of 259 participants from 16 homeless shelters in Chicago, 104 (40.2%) were aged at least 65 years, 190 (73.4%) were male, 185 (71.4%) were non-Hispanic Black, and 49 (18.9%) were non-Hispanic White. There was an observed reduction in SARS-CoV-2 incidence during the study period among the protective housing cohort (54.7 per 1000 people [95% CI, 22.4-87.1 per 1000 people]) compared with citywide rates for PEH residing in shelters (137.1 per 1000 people [95% CI, 125.1-149.1 per 1000 people]; P = .001). There was also an adjusted change in systolic blood pressure at a rate of -5.7 mm Hg (95% CI, -9.3 to -2.1 mm Hg) and hemoglobin A1c at a rate of -1.4% (95% CI, -2.4% to -0.4%) compared with baseline. More than half of participants (51% [n = 132]) departed from the intervention to housing of some kind (eg, supportive housing). Conclusions and Relevance This cohort study found that protective housing was associated with a reduction in SARS-CoV-2 infection among high-risk PEH during the first wave of the COVID-19 pandemic in Chicago. These findings suggest that with appropriate wraparound supports (ie, multisector services to address complex needs), such housing interventions may reduce the risk of SARS-CoV-2 infection, improve noncommunicable disease control, and provide a pathway to permanent housing.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Homeless Persons / Program Evaluation / Delivery of Health Care / Noncommunicable Diseases / COVID-19 / Housing Type of study: Diagnostic study / Evaluation study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Homeless Persons / Program Evaluation / Delivery of Health Care / Noncommunicable Diseases / COVID-19 / Housing Type of study: Diagnostic study / Evaluation study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article