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Implementation of a Recuperation Unit and Hospitalization Rates Among People Experiencing Homelessness With COVID-19

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Coronavirus disease 2019 (COVID-19) may spread rapidly through homeless shelters because they are congregate settings1,2 where factors associated with the spread of the virus are common, including lack of personal protective equipment, overcrowding, and lack of recuperation spaces. As Boston experienced a COVID-19 surge that disproportionately affected persons experiencing homelessness (PEH) and threatened to overwhelm hospital capacity, a large safety-net hospital implemented a novel COVID-19 Recuperation Unit (CRU) for this population. The CRU, located adjacent to Boston Medical Center (BMC), provided isolation and quarantine for PEH and treatment for substance use.3 We aimed to determine the association of the care provided by the CRU with COVID-19 hospitalizations among PEH.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: February 1, 2021.

Published: March 10, 2021. doi:10.1001/jamanetworkopen.2021.2826

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Barocas JA et al. JAMA Network Open.

Corresponding Author: Joshua A. Barocas, MD, Boston University Medical Campus, 801 Massachusetts Ave, 2nd Flr, Boston, MA 02131 (joshua.barocas@BMC.org).

Author Contributions: Dr Barocas 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: Barocas, White, Komaromy.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: White, Komaromy.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Barocas, Gai, White.

Obtained funding: Barocas.

Administrative, technical, or material support: Barocas, Faretra, Sachs.

Supervision: Barocas, White, Komaromy.

Conflict of Interest Disclosures: Dr Komaromy reported receiving grants from American Society of Addiction Medicine and the National Institute of Mental Health outside the submitted work. No other disclosures were reported.

Funding/Support: This study was supported with National Institutes of Health grant R01 GM122876 04S1.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Mosites  E , Parker  EM , Clarke  KE ,  et al.  Assessment of SARS-CoV-2 infection prevalence in homeless shelters—four US cities, March 27–April 15, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(17):521-522. Published online April 22, 2020. doi:10.15585/mmwr.mm6917e1Google ScholarCrossref
2.
Baggett  TP , Keyes  H , Sporn  N , Gaeta  JM .  Prevalence of SARS-CoV-2 infection in residents of a large homeless shelter in Boston.   JAMA. 2020;323(21):2191-2192. doi:10.1001/jama.2020.6887PubMedGoogle ScholarCrossref
3.
Komaromy  M , Harris  M , Koenig  RM , Tomanovich  M , Ruiz-Mercado  G , Barocas  JA .  Caring for COVID’s most vulnerable victims: a safety-net hospital responds.   J Gen Intern Med. 2021. doi:10.1007/s11606-020-06499-2PubMedGoogle Scholar
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