Dataset Information

Implementation of rapid and frequent SARS-CoV2 antigen testing and response in congregate homeless shelters.

ABSTRACT:

Background

People experiencing homelessness who live in congregate shelters are at high risk of SARS-CoV2 transmission and severe COVID-19. Current screening and response protocols using rRT-PCR in homeless shelters are expensive, require specialized staff and have delays in returning results and implementing responses.

Methods

We piloted a program to offer frequent, rapid antigen-based tests (BinaxNOW) to residents and staff of congregate-living shelters in San Francisco, California, from January 15th to February 19th, 2021. We used the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework to evaluate the implementation.

Results

Reach: We offered testing at ten of twelve eligible shelters. Shelter residents and staff had variable participation across shelters; approximately half of eligible individuals tested at least once; few tested consistently during the study. Effectiveness: 2.2% of participants tested positive. We identified three outbreaks, but none exceeded 5 cases. All BinaxNOW-positive participants were isolated or left the shelters. Adoption: We offered testing to all eligible participants within weeks of the project's initiation. Implementation: Adaptations made to increase reach and improve consistency were promptly implemented. Maintenance: San Francisco Department of Public Health expanded and maintained testing with minimal support after the end of the pilot.

Conclusion

Rapid and frequent antigen testing for SARS-CoV2 in homeless shelters is a viable alternative to rRT-PCR testing that can lead to immediate isolation of infectious individuals. Using the RE-AIM framework, we evaluated and adapted interventions to enable the expansion and maintenance of protocols.

SUBMITTER: Aranda-Diaz A

PROVIDER: S-EPMC8912252 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Implementation of rapid and frequent SARS-CoV2 antigen testing and response in congregate homeless shelters.

Aranda-Díaz Andrés A Imbert Elizabeth E Strieff Sarah S Graham-Squire Dave D Evans Jennifer L JL Moore Jamie J McFarland Willi W Fuchs Jonathan J Handley Margaret A MA Kushel Margot M

PloS one 20220310 3

<h4>Background</h4>People experiencing homelessness who live in congregate shelters are at high risk of SARS-CoV2 transmission and severe COVID-19. Current screening and response protocols using rRT-PCR in homeless shelters are expensive, require specialized staff and have delays in returning results and implementing responses.<h4>Methods</h4>We piloted a program to offer frequent, rapid antigen-based tests (BinaxNOW) to residents and staff of congregate-living shelters in San Francisco, Califor ...[more]

PMID: 35271622

Similar Datasets

Project description:IntroductionCOVID-19 surveillance in congregate settings is important to mitigating disease, but the health and economic impact of testing remains unclear.MethodsThe authors developed a Markov model to project the cost-utility of COVID-19 testing strategies in homeless shelters from the healthcare payer and societal perspective over 1 year. Model inputs utilized data from residents aged ≥18 years across 23 Seattle shelters from January 1, 2020, to May 31, 2021. No in-shelter surveillance was compared with scenarios of 2 COVID-19 testing strategies implemented monthly: polymerase chain reaction (PCR) testing and rapid antigen testing; scenarios in which only PCR testing was available were also evaluated. The primary health outcome was quality-adjusted life years. Interventions were considered cost-effective if the incremental cost-effectiveness ratio was ≤$150,000 per quality-adjusted life year and dominant if they saved costs and provided health effects.ResultsWhen assuming the availability of both antigen and PCR tests, most rapid antigen testing strategies were cost-effective, whereas PCR testing was dominated by antigen testing. Compared with no in-shelter surveillance, antigen testing increased mean quality-adjusted life years by 0.0009 (0.03% infections averted) at an incremental cost of $97/resident from the healthcare perspective (incremental cost-effectiveness ratio=$112,352/quality-adjusted life year gained) and $8/resident from the societal perspective (incremental cost-effectiveness ratio=$9,627/quality-adjusted life year gained) at 75% vaccination coverage. PCR testing was not cost-effective when antigen testing was available but was cost-effective compared with no surveillance at low vaccination coverage levels (<30% coverage from the healthcare perspective and ≤48% coverage from the societal perspective). Probabilistic sensitivity analysis showed that antigen testing was cost-effective in 62% and 86% of simulations from the healthcare and societal perspectives, respectively.ConclusionsModeled findings show that COVID-19 testing in shelters can be a cost-effective pandemic response. Antigen testing remained cost-effective at high vaccination levels, whereas PCR testing was most effective at low vaccination levels if antigen testing was not available.

Dataset Information

Implementation of rapid and frequent SARS-CoV2 antigen testing and response in congregate homeless shelters.

Background

Methods

Results

Conclusion

Publications

Implementation of rapid and frequent SARS-CoV2 antigen testing and response in congregate homeless shelters.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets