RT Journal Article
SR Electronic
T1 Development and assessment of a hospital-led, community-partnering COVID-19 testing and prevention program for homeless and congregate living services in Toronto, Canada: a descriptive feasibility study
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E483
OP E490
DO 10.9778/cmajo.20210105
VO 10
IS 2
A1 Loutfy, Mona
A1 Kennedy, V. Logan
A1 Riazi, Sheila
A1 Lena, Suvendrini
A1 Kazemi, Mina
A1 Bawden, Jessica
A1 Wright, Vanessa
A1 Richardson, Lisa
A1 Mills, Selena
A1 Belsito, Laura
A1 Mukerji, Geetha
A1 Bhatia, Sacha
A1 Gupta, Meenakshi
A1 Barrett, Cristina
A1 Martin, Danielle
YR 2022
UL http://www.cmajopen.ca/content/10/2/E483.abstract
AB Background Outbreaks of SARS-CoV-2 in shelters and congregate living settings are a major concern because of overcrowding and because resident populations are often at high risk for infection. The objective of this study was to describe the development, implementation and assessment of the COVID-19 Community Response Team, a program that enabled Women’s College Hospital in Toronto, Ontario, to work in partnership with shelters and congregate living settings to prevent outbreaks.Methods The Community Response Team, associated with Women’s College Hospital, an academic ambulatory hospital, carried out mobile testing for SARS-CoV-2, supported outbreak management and prevention through ongoing onsite partnership with medical staff, and conducted infection prevention and control (IPC) training to shelter staff. We conducted a descriptive analysis of the sites supported by the program between Apr. 20, 2020, and Aug. 15, 2020. We also assessed the program’s feasibility (number of completed needs assessments, mobile testing events and IPC training events, and median time from referral to service delivery), adoption (number of nasopharyngeal swabs, number of pre- and post-program outbreaks and IPC uptake) and acceptability or satisfaction.Results The Community Response Team supported 32 sites. Of those, 30 completed an intake needs assessment, 24 completed mobile testing for SARS-CoV-2 and 15 received IPC support. Mobile testing resulted in the collection of 1566 nasopharyngeal swabs, of which 64 were positive for SARS-CoV-2 infection. Three sites had confirmed outbreaks. The median time from referral to needs assessment was 4 days (interquartile range [IQR] 1–13 days), and the median time to the testing day was 9 days (IQR 1–49 days). The median time from referral to IPC staff training was 14 days (IQR 4–79 days), and 100% of respondents reported being pleased or very pleased with the training. During the follow-up period, the 3 facilities with outbreaks overcame those outbreaks. Three sites supported by the Community Response Team had further single cases, but no site reported subsequent or secondary outbreaks.Interpretation The Community Response Team program led to the transfer of IPC knowledge, allowed for the management and prevention of SARS-CoV-2 outbreaks, and demonstrated feasibility. Collaborative supports between hospitals and the community housing sector may serve as models for ongoing system integration beyond the COVID-19 pandemic.