Background The COVID-19 pandemic has disproportionately impacted homeless populations and service workers, especially within homeless shelter/hostel settings. To date, there have been few evidence syntheses examining outbreaks of COVID-19 among both homeless shelter residents and service workers and no critical review of infection control and prevention (IPAC) measures. This scoping review offers a much-needed synthesis of COVID-19 prevalence within homeless shelters and a review of pertinent IPAC measures.  Methods We conducted a scoping review that aimed to synthesize academic and gray literature published from March 2020 to July 2021 pertaining to (1) the prevalence of COVID-19 among both residents and staff in homeless shelters and hostels in high-income countries and (2) COVID-19 IPAC strategies applied in these settings. Two reviewers independently screened the literature from several databases that included MEDLINE, PsycInfo, and the WHO’s COVID-19 Global Health Portal. The extracted data was mapped, categorized, and thematically discussed. Results Thematic analysis of 77 academic and gray literature documents revealed four key themes: (1) the demographics of COVID-19 in homeless shelters, (2) asymptomatic spread, (3) pre-existing vulnerability of people experiencing homelessness and shelters, and (4) the inconsistency and ineffectiveness of IPAC implementation. Conclusion This review offers a useful glimpse into the landscape of COVID-19 outbreaks in homeless shelters/hostels and the major contributing factors to these events. This review revealed that there is no clear indication of generally accepted IPAC standards for shelter residents and workers. This review also illustrated a great need for future research to establish IPAC best practices specifically for homeless shelter/hostel contexts. Finally, the findings from this review reaffirm that homelessness prevention is key to limiting disease outbreaks and the associated negative health outcomes in shelter populations. Limitations of this review included the temporal and database constraints of the search strategy, the exclusion of quality assessments of the literature, and the absence of investigation on the influence of emerging variants on public health policy. Systematic review registration This scoping review has not been registered on any database; the protocol is available on York University’s Institutional Repository https://dx.doi.org/10.25071/10315/38513.

The COVID-19 pandemic has disproportionately impacted people experiencing homelessness. Homeless shelters and hostels, as congregate living spaces for residents with many health vulnerabilities, are highly susceptible to outbreaks of COVID-19. A synthesis of the research-to-date can inform evidence-based practices for infection, prevention, and control strategies at these sites to reduce the prevalence of COVID-19 among both shelter/hostel residents and staff. Methods: A scoping review in accordance with Arksey and O’Malley’s framework will be conducted to identify literature reporting COVID-19 positivity rates among homeless shelter and hostel residents and staff, as well as infection control strategies to prevent outbreaks in these facilities. The focus will be on literature produced in high-income countries. Nine academic literature databases and 11 grey literature databases will be searched for literature from March 2020 to July 2021. Literature screening will be completed by two reviewers and facilitated by Covidence, a systematic review management platform. A third reviewer will be engaged to resolve disagreements and facilitate consensus. A narrative summary of the major themes identified in the literature, numerical counts of relevant data including the COVID-19 positivity rates, and recommendations for different infection control approaches will be produced. Discussion: The synthesis of the research generated on COVID-19 prevalence and prevention in homeless shelters and hostels will assist in establishing best practices to prevent the spread of COVID-19 and other airborne diseases at these facilities in high-income countries while identifying next steps to expand the existing evidence base.

Background: The COVID-19 pandemic has disproportionately impacted homeless populations and service workers, especially within homeless shelter/hostel settings. To date, there have been few evidence syntheses examining outbreaks of COVID-19 among both homeless shelters residents and service workers, nor has there been a critically engaged summary of relevant infection control and prevention (IPAC) measures. This scoping review offers a timely and much-needed synthesis of COVID-19 prevalence within homeless shelters and a review of current and pertinent IPAC measures. Methods: We conducted a scoping review in June 2021 that synthesized academic and grey literature published from March 2020 to July 2021 pertaining to 1) the prevalence of COVID-19 among both residents and staff in homeless shelters and hostels in high-income countries, and 2) COVID-19 IPAC strategies applied in these settings. Two reviewers independently screened the results of the literature search of several databases that included MEDLINE, PsycInfo, and the WHO’s COVID-19 Global Health Portal. All the extracted data was mapped, categorized, and thematically discussed. Results: Thematic analysis of included literature revealed five key themes: 1) the demographics of COVID-19 in homeless shelters, 2) asymptomatic spread, 3) pre-existing vulnerability of the homeless and shelters, 4) the limited application of IPAC, and 5) IPAC effectiveness. Conclusion: This review offers a useful glimpse into the landscape of COVID-19 outbreaks in homeless shelters/hostels and the major contributing factors to these events. The scoping review revealed that there is no clear indication of generally accepted IPAC standards for homeless populations and shelter care workers. This review also illustrated a great need for future research to establish IPAC best practices as well as additional resources for shelter systems to protect residents and staff at homeless shelters/hostels in high-income countries. Finally, the findings from this review reaffirm that homelessness prevention is a key to limiting disease outbreaks, and the associated negative health outcomes in shelter populations.