Establishment of Isolation and Noncongregate Hotels During COVID-19 and Symptom Evolution Among People Experiencing Homelessness—Atlanta, Georgia, 2020. Issue 3 (May 2021)

• Record Type: Journal Article
• Authors: Montgomery, Martha P.; Paulin, Heather N.; Morris, Asher; Cotton, Afrika; Speers, Austin; Boyd, Andrew T.; Buff, Ann M.; Mathews, Darlene; Wells, Alyssa; Marchman, Cathryn; Gaffga, Nicholas; Bamrah Morris, Sapna; Cavanaugh, Sean S.
• Is Part Of: Journal of public health management and practice. Volume 27:Issue 3(2021)
• Publication Date: 2021-05
• Subjects: COVID-19 -- homeless persons -- housing -- patient isolation; Public health administration -- United States -- Periodicals; 253.6
• DOI: 10.1097/PHH.0000000000001349
• Languages: English
• ISSNs: 1078-4659

Abstract

Abstract : Context: 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. Program: 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). Implementation: 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. Evaluation: 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. Discussion: 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.