Vanessa Redditt1, Vanessa Wright2, Meb Rashid1, Roy Male1, Isaac Bogoch1. 1. 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. 2. 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. vanessa.redditt@wchospital.ca.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: Of the 63 adult residents on site at the shelter, 60 agreed to be tested. Among those tested, 41.7% (n = 25) were positive for SARS-CoV-2 infection. Of those who tested positive (n = 25), 20.0% (n = 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. INTERPRETATION: 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. Copyright 2020, Joule Inc. or its licensors.
BACKGROUND: 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. METHODS: 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. RESULTS: Of the 63 adult residents on site at the shelter, 60 agreed to be tested. Among those tested, 41.7% (n = 25) were positive for SARS-CoV-2 infection. Of those who tested positive (n = 25), 20.0% (n = 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. INTERPRETATION: 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. Copyright 2020, Joule Inc. or its licensors.
Authors: Farrell A Tobolowsky; Elysia Gonzales; Julie L Self; Carol Y Rao; Ryan Keating; Grace E Marx; Temet M McMichael; Margaret D Lukoff; Jeffrey S Duchin; Karin Huster; Jody Rauch; Hedda McLendon; Matthew Hanson; Dave Nichols; Sargis Pogosjans; Meaghan Fagalde; Jennifer Lenahan; Emily Maier; Holly Whitney; Nancy Sugg; Helen Chu; Julia Rogers; Emily Mosites; Meagan Kay Journal: MMWR Morb Mortal Wkly Rep Date: 2020-05-01 Impact factor: 17.586
Authors: Melissa M Arons; Kelly M Hatfield; Sujan C Reddy; Anne Kimball; Allison James; Jesica R Jacobs; Joanne Taylor; Kevin Spicer; Ana C Bardossy; Lisa P Oakley; Sukarma Tanwar; Jonathan W Dyal; Josh Harney; Zeshan Chisty; Jeneita M Bell; Mark Methner; Prabasaj Paul; Christina M Carlson; Heather P McLaughlin; Natalie Thornburg; Suxiang Tong; Azaibi Tamin; Ying Tao; Anna Uehara; Jennifer Harcourt; Shauna Clark; Claire Brostrom-Smith; Libby C Page; Meagan Kay; James Lewis; Patty Montgomery; Nimalie D Stone; Thomas A Clark; Margaret A Honein; Jeffrey S Duchin; John A Jernigan Journal: N Engl J Med Date: 2020-04-24 Impact factor: 91.245
Authors: Robert W Aldridge; Alistair Story; Stephen W Hwang; Merete Nordentoft; Serena A Luchenski; Greg Hartwell; Emily J Tweed; Dan Lewer; Srinivasa Vittal Katikireddi; Andrew C Hayward Journal: Lancet Date: 2017-11-12 Impact factor: 79.321
Authors: Anne Kimball; Kelly M Hatfield; Melissa Arons; Allison James; Joanne Taylor; Kevin Spicer; Ana C Bardossy; Lisa P Oakley; Sukarma Tanwar; Zeshan Chisty; Jeneita M Bell; Mark Methner; Josh Harney; Jesica R Jacobs; Christina M Carlson; Heather P McLaughlin; Nimalie Stone; Shauna Clark; Claire Brostrom-Smith; Libby C Page; Meagan Kay; James Lewis; Denny Russell; Brian Hiatt; Jessica Gant; Jeffrey S Duchin; Thomas A Clark; Margaret A Honein; Sujan C Reddy; John A Jernigan Journal: MMWR Morb Mortal Wkly Rep Date: 2020-04-03 Impact factor: 17.586
Authors: Zelalem Mengesha; Esther Alloun; Danielle Weber; Mitchell Smith; Patrick Harris Journal: Int J Environ Res Public Health Date: 2022-05-29 Impact factor: 4.614
Authors: Kevin Escandón; Angela L Rasmussen; Isaac I Bogoch; Eleanor J Murray; Karina Escandón; Saskia V Popescu; Jason Kindrachuk Journal: BMC Infect Dis Date: 2021-07-27 Impact factor: 3.090
Authors: Gage K Moreno; Katarina M Braun; Ian W Pray; Hannah E Segaloff; Ailam Lim; Keith Poulsen; Jonathan Meiman; James Borcher; Ryan P Westergaard; Michael K Moll; Thomas C Friedrich; David H O'Connor Journal: Clin Infect Dis Date: 2021-07-15 Impact factor: 9.079
Authors: Gage K Moreno; Katarina M Braun; Ian W Pray; Hannah E Segaloff; Ailam Lim; Keith Poulson; Jonathan Meiman; James Borcher; Ryan P Westergaard; Michael K Moll; Thomas C Friedrich; David H O'Connor Journal: medRxiv Date: 2021-03-06
Authors: Linh Luong; Michaela Beder; Rosane Nisenbaum; Aaron Orkin; Jonathan Wong; Cynthia Damba; Ryan Emond; Suvendrini Lena; Vanessa Wright; Mona Loutfy; Cindy Bruce-Barrett; Wilfred Cheung; Yick Kan Cheung; Victoria Williams; Miriam Vanmeurs; Andrew Boozary; Harvey Manning; Joe Hester; Stephen W Hwang Journal: Can J Public Health Date: 2021-12-17
Authors: Soroush Moallef; Becky L Genberg; Kanna Hayashi; Shruti H Mehta; Gregory D Kirk; JinCheol Choi; Kora DeBeck; Michele Kipke; Richard D Moore; Marianna K Baum; Steven Shoptaw; Pamina M Gorbach; Brian Mustanski; Marjan Javanbakht; Susanne Siminski; M-J Milloy Journal: Drug Alcohol Depend Date: 2022-09-15 Impact factor: 4.852
Authors: Crista E Johnson-Agbakwu; Cortney M Eakin; Celeste V Bailey; Shelly Sood; Nyima Ali; Pooja Doehrman; Bikash Bhattarai; Linda Chambliss; Dean V Coonrod Journal: AJOG Glob Rep Date: 2021-03-21
Authors: Julia Corey; James Lyons; Austin O'Carroll; Richie Stafford; Jo-Hanna Ivers Journal: Int J Environ Res Public Health Date: 2022-03-09 Impact factor: 3.390