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CMAJ Open . Outbreak of SARS-CoV-2 infection at a large refugee shelter in Toronto, April 2020: a clinical and epidemiologic descriptive analysis

tetano

Editor, Senior Moderator
CMAJ Open


. 2020 Dec 8;8(4):E819-E824.
doi: 10.9778/cmajo.20200165. Print Oct-Dec 2020.
Outbreak of SARS-CoV-2 infection at a large refugee shelter in Toronto, April 2020: a clinical and epidemiologic descriptive analysis


Vanessa Redditt[SUP] 1 [/SUP], Vanessa Wright[SUP] 2 [/SUP], Meb Rashid[SUP] 1 [/SUP], Roy Male[SUP] 1 [/SUP], Isaac Bogoch[SUP] 1 [/SUP]



Affiliations

Abstract

Background: There is high risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in congregate settings, including shelters. This study describes a coronavirus disease 2019 (COVID-19) outbreak and corresponding reported symptomatology at a shelter in Toronto.
Methods: This clinical and epidemiologic analysis focuses on a COVID-19 outbreak at a dedicated refugee shelter in downtown Toronto. All adult residents on site at the shelter were offered SARS-CoV-2 testing on Apr. 20, 2020. At the time of testing, residents were screened for 3 typical COVID-19 symptoms (fever, cough and shortness of breath). Among those who tested positive, a more comprehensive clinical assessment was conducted 1 day after testing and a standardized 15-item symptom screen was administered by telephone 14 days after testing. We report rates of positive test results and clinical symptoms with each assessment interval.
Results: Of the 63 adult residents on site at the shelter, 60 agreed to be tested. Among those tested, 41.7% (n = 25) were positive for SARS-CoV-2 infection. Of those who tested positive (n = 25), 20.0% (n = 5) reported fever, cough or shortness of breath at the time of testing. On more detailed assessment 1 day later, 70.8% (17/24) reported a broader range of symptoms. During the 14 days after testing, 87.5% (21/24) reported symptoms of infection.
Interpretation: We found a high rate of SARS-CoV-2 infection in this shelter population. Our study underscores the high risk of SARS-CoV-2 transmission in congregate living settings and the importance of mobilizing timely testing and management of symptomatic, paucisymptomatic and asymptomatic residents in shelters.
 
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