RT Journal Article
SR Electronic
T1 Outbreak of SARS-CoV-2 infection at a large refugee shelter in Toronto, April 2020: a clinical and epidemiologic descriptive analysis
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E819
OP E824
DO 10.9778/cmajo.20200165
VO 8
IS 4
A1 Vanessa Redditt
A1 Vanessa Wright
A1 Meb Rashid
A1 Roy Male
A1 Isaac Bogoch
YR 2020
UL http://www.cmajopen.ca/content/8/4/E819.abstract
AB 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.