A COVID-19 isolation facility for people experiencing homelessness in Berlin, Germany: a retrospective patient record study
Creators: name: Hörig, Merle
name: Klaes, Sarah M.
name: Krasovski-Nikiforovs, Svetlana
name: Van Loon, Welmoed
name: Murajda, Lukas
name: Rodriguez, Rosa C. O.
name: Schade, Christine
name: Specht, Anabell
name: Equihua Martinez, Gabriela
name: Zimmermann, Ruth
name: Mockenhaupt, Frank P.
name: Seybold, Joachim
name: Lindner, Andreas K.
name: Sarma, Navina
Publisher: name: Charité - Universitätsmedizin Berlin
Year: 2023
Subjects: subject: homelessness
subject: homeless shelter
subject: isolation and infection control
subject: COVID-19
subject: SARS-CoV-2
subject: people experiencing homelessness
subject: isolation facility
subject: 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit

description: Introduction: People experiencing homelessness (PEH) are disproportionately affected by the COVID-19 pandemic. For many PEH it is impossible to isolate due to the lack of permanent housing. Therefore, an isolation facility for SARS-CoV-2 positive PEH was opened in Berlin, Germany, in May 2020, offering medical care, opioid and alcohol substitution therapy and social services. This study aimed to assess the needs of the admitted patients and requirements of the facility. Materials and methods: This was a retrospective patient record study carried out in the isolation facility for PEH in Berlin, from December 2020 to June 2021. We extracted demographic and clinical data including observed psychological distress from records of all PEH tested positive for SARS-CoV-2 by RT-PCR. Data on duration and completion of isolation and the use of the facilities' services were analyzed. The association of patients' characteristics with the completion of isolation was assessed by Student's t-test or Fisher's exact test. Results: A total of 139 patients were included in the study (89% male, mean age 45 years, 41% with comorbidities, 41% non-German speakers). 81% of patients were symptomatic (median duration 5 days, range 1-26). The median length of stay at the facility was 14 days (range 2-41). Among the patients, 80% had non-COVID-19 related medical conditions, 46% required alcohol substitution and 17% opioid substitution therapy. Three patients were hospitalized due to low oxygen saturation. No deaths occurred. Psychological distress was observed in 20%, and social support services were used by 65% of PEH. The majority (82%) completed the required isolation period according to the health authority's order. We did not observe a statistically significant association between completion of the isolation period and sociodemographic characteristics. Conclusion: The specialized facility allowed PEH a high compliance with completion of the isolation period. Medical care, opioid and alcohol substitution, psychological care, language mediation and social support are essential components to address the specific needs of PEH. Besides contributing to infection prevention and control, isolation facilities may allow better access to medical care for SARS-CoV-2 infected PEH with possibly positive effects on the disease course.