A recent pre-print (therefore, not yet peer-reviewed) led by CITF-funded researcher Dr. Stephen Hwang from the University of Toronto and Unity Health, explored the prevalence of SARS-CoV-2 among people experiencing homelessness in Toronto during the first wave of the pandemic. They observed that the overall prevalence of SARS-CoV-2 was higher among populations experiencing homelessness compared to the general population and that the rates varied greatly between different sites serving this population, indicating the need for a multifaceted response strategy when addressing the needs of this community.

People experiencing homelessness are particularly vulnerable to infectious diseases – and thus, COVID-19 – due to existing complex health concerns, a lack of resources, and access to health care, as well as the need to navigate crowded and poorly-ventilated shelters.

In this Toronto-based study, the research team recruited participants from various sites serving this specific population (shelters, informal encampments, COVID-19 physical distancing sites, drop-in services) to better understand differences in prevalence rates in diverse settings. Data were collected at 97 identified sites between April 17 and July 31, 2020.

Key points:

  • The overall prevalence of SARS-CoV-2 infection in this specific population was 8.5% (394/4657), lower than in the general Toronto population, for the same time period.
  • Infection rates at the sites studied varied from 0% to 70.6%, indicating the wide variability in rates of infection across different shelters and settings.
  • Data were collected at three different time periods showed that positivity rates declined over time. This may be due to coordination between shelter providers and health providers to test and isolate infected residents from others.
  • Most cases (97.5%) were detected during identified outbreaks rather than during screening activities.

Given the high prevalence of COVID-19 among this population, Dr. Hwang and his co-authors emphasize the need for appropriate measures to support individuals experiencing homelessness and to implement measures to decrease COVID transmission risk in high-volume settings such as shelters.

Luong L, Beder M, Nisenbaum R, Orkin A, Wong J, Damba C, Emond R, Lena S, Wright V, Loutfy M, Bruce-Barrett C, Cheung W, Cheung YK, Williams V, Vanmeurs M, Boozary A, Manning H, Hester J, Hwang SW, 2021. Prevalence of SARS-CoV-2 infection among people experiencing homelessness in Toronto during the first wave of the COVID-19 pandemic. medRxiv, September 26, 2021. doi:10.1101/2021.09.21.21263713