Background People experiencing homelessness who live in congregate shelters are at high risk of SARS-CoV2 transmission and severe COVID-19. Current screening and response protocols using rRT-PCR in homeless shelters are expensive, require specialized staff and have delays in returning results and implementing responses. Methods We piloted a program to offer frequent, rapid antigen-based tests (BinaxNOW) to residents and staff of congregate-living shelters in San Francisco, California, from January 15 th to February 19 th , 2021. We used the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework to evaluate the implementation. Results Reach: We offered testing at ten of twelve eligible shelters. Shelter residents and staff had variable participation across shelters; approximately half of eligible individuals tested at least once; few tested consistently during the study. Effectiveness: 2.2% of participants tested positive. We identified three outbreaks, but none exceeded 5 cases. All BinaxNOW-positive participants were isolated or left the shelters. Adoption: We offered testing to all eligible participants within weeks of the project’s initiation. Implementation: Adaptations made to increase reach and improve consistency were promptly implemented. Maintenance: San Francisco Department of Public Health expanded and maintained testing with minimal support after the end of the pilot. Conclusion Rapid and frequent antigen testing for SARS-CoV2 in homeless shelters is a viable alternative to rRT-PCR testing that can lead to immediate isolation of infectious individuals. Using the RE-AIM framework, we evaluated and adapted interventions to enable the expansion and maintenance of protocols.
【초록키워드】 public health, SARS-CoV2, protocol, severe COVID-19, Intervention, Transmission, homelessness, Antigen, rRT-PCR, Outbreaks, implementation, Program, Isolation, Rapid, expansion, adaptation, adoption, protocols, high risk, maintenance, San Francisco, Support, Consistency, individual, participant, Department, positive, rRT-PCR testing, offer, Public, responses, current, IMPROVE, Result, tested, evaluate, evaluated, individuals, exceeded, eligible, eligible participant, offered, 【제목키워드】 SARS-CoV2, Antigen,