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In the United States, 567 715 people were homeless on a single night in January 2019.1 The congregate nature and hygienic challenges of shelter life create the potential for rapid transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in this vulnerable population.
On March 13, 2020, the Boston Health Care for the Homeless Program (BHCHP), in partnership with city and state public health agencies and community partners, rolled out a coronavirus disease 2019 (COVID-19) response strategy that included respiratory symptom screening at shelter front doors, expedited referrals for SARS-CoV-2 testing and isolation for those with respiratory symptoms, dedicated treatment settings for individuals with positive test results, and contact tracing of confirmed COVID-19 cases.
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Corresponding Author: Travis P. Baggett, MD, MPH, Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge St, 16th Floor, Boston, MA 02114 (email@example.com).
Accepted for Publication: April 16, 2020.
Published Online: April 27, 2020. doi:10.1001/jama.2020.6887
Author Contributions: Dr Baggett had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Baggett, Gaeta.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Baggett.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Baggett.
Administrative, technical, or material support: All authors.
Conflict of Interest Disclosures: Dr Baggett reported receiving royalties from UpToDate for authorship of a topic review on homeless health care. Mr Keyes reported receiving nonfinancial support from the Massachusetts Department of Public Health and the shelter where the testing was conducted during the conduct of the study. No other disclosures were reported.
Previous Posting: This manuscript was posted as a preprint on medRxiv.org on April 15, 2020. doi:10.1101/2020.04.12.20059618
Additional Contributions: We thank Alfred DeMaria, MD, and colleagues at the Massachusetts Department of Public Health Bureau of Infectious Disease for facilitating the testing described in this article. We thank Joana Barbosa Teixeira, MA, Andrea Joyce, MA, Elijah Rodriguez, BA, and Erin Ford, BA (Massachusetts General Hospital), and Alexei Alvarado, BA (Boston Health Care for the Homeless Program), for their assistance with data entry. None of these individuals were compensated for their contributions.
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