Assessment of contact tracing for COVID-19 among people experiencing homelessness, Salt Lake County Health Department, March-May 2020

Ann Epidemiol. 2021 Jul;59:50-55. doi: 10.1016/j.annepidem.2021.04.002. Epub 2021 Apr 22.

Abstract

Purpose: Contact tracing is intended to reduce the spread of coronavirus disease 2019 (COVID-19), but it is difficult to conduct among people who live in congregate settings, including people experiencing homelessness (PEH). This analysis compares person-based contact tracing among two populations in Salt Lake County, Utah, from March-May 2020.

Methods: All laboratory-confirmed positive cases among PEH (n = 169) and documented in Utah's surveillance system were included in this analysis. The general population comparison group (n = 163) were systematically selected from all laboratory-confirmed cases identified during the same period.

Results: Ninety-three PEH cases (55%) were interviewed compared to 163 (100%) cases among the general population (P < .0001). PEH were more likely to be lost to follow-up at end of isolation (14.2%) versus the general population (0%; P-value < .0001) and provided fewer contacts per case (0.3) than the general population (4.7) (P-value < .0001). Contacts of PEH were more often unreachable (13.0% vs. 7.1%; P-value < .0001).

Conclusions: These findings suggest that contact tracing among PEH should include a location-based approach, along with a person-based approach when resources allow, due to challenges in identifying, locating, and reaching cases among PEH and their contacts through person-based contact tracing efforts alone.

Keywords: Covid-19; Epidemiology; People experiencing homelessness, Contact tracing; Public health; RT-PCR= reverse transcription-polymerase chain reaction; SARS-COV-2; list of abbreviations and acronyms PEH = people experiencing homelessness.

MeSH terms

  • COVID-19*
  • Contact Tracing
  • Humans
  • Ill-Housed Persons*
  • SARS-CoV-2
  • Utah / epidemiology