Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

Rao, Carol Y.; Robinson, Tashina; Huster, Karin; Laws, Rebecca L.; Keating, Ryan; Tobolowsky, Farrell; McMichael, Temet M.; Gonzales, Elysia; Mosites, Emily

doi:10.1371/journal.pone.0253108

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…As a result, numerous healthcare providers either left their jobs or were fired for going against hospital policy. 26 , 27…”

Section: Discussionmentioning

confidence: 99%

“…As a result, numerous healthcare providers either left their jobs or were fired for going against hospital policy. 26,27 These challenges in obtaining and receiving authorization to access PPE during the early days of the pandemic affected providers in GPD and HPACT programs. One GPD leader took it upon himself to purchase a sewing machine to produce masks for staff and Veteran clients.…”

Section: Maintaining Clinician Confidence Through Preparedness Planningmentioning

confidence: 99%

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Responding to COVID-19 While Serving Veterans Experiencing Homelessness: The Pandemic Experiences of Healthcare and Housing Providers

Gin

Balut

Alenkin

et al. 2022

J Prim Care Community Health

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The U.S. Department of Veterans Affairs (VA) provides essential care through transitional housing and healthcare for Veterans experiencing homelessness through the Grant and Per Diem (GPD) program and the Homeless Patient Aligned Care Team (HPACT), respectively. At the onset of the SARS-CoV-2 pandemic, GPD organizations and HPACT clinics faced the challenge of being essential providers tasked with ensuring the well-being of Veterans under their care. Through semi-structured interviews with 13 providers (6 HPACT health care providers representing 2 HPACT programs, and 7 GPD staff members) across the U.S., this study explored their experiences navigating the tasks of keeping Veterans safe and providing ongoing care from the start of the pandemic up to the 2021 interview dates. Both GPD and HPACT providers reported amplified safety concerns about COVID-19 infection among staff at the start of the pandemic, which diminished to a lower, stable level after a few months as adaptations made for safety became embedded in their routines. However, ongoing challenges included isolation and mental health challenges among Veterans, inherent limitations of telehealth as a care delivery avenue, provider frustration and burnout due to increased workload and frequent change, and the logistics of administering testing for Veterans to enter GPD housing. Enhanced pandemic preparedness planning for GPD organizations, funding for personal protective equipment (PPE) and providing technology to facilitate Veterans’ telehealth access, and strategies for preventing provider burnout are critical to both sustaining homeless providers’ capabilities during this pandemic and enhancing readiness to respond to the next public health emergency.

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“…As a result, numerous healthcare providers either left their jobs or were fired for going against hospital policy. 26 , 27…”

Section: Discussionmentioning

confidence: 99%

Section: Maintaining Clinician Confidence Through Preparedness Planningmentioning

confidence: 99%

Responding to COVID-19 While Serving Veterans Experiencing Homelessness: The Pandemic Experiences of Healthcare and Housing Providers

Gin

Balut

Alenkin

et al. 2022

J Prim Care Community Health

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“…Previous literature has found that lack of guidance, insu cient training, and di culty obtaining infection control supplies were barriers to implementing infection control measures in homeless shelters and other community settings [4,5,9]. Homeless shelter staff and health care providers have also described sta ng constraints as barriers to infection prevention and control [10,11]. However, little is known about WASH practices in shelters serving PEH in general and during infectious disease outbreaks.…”

Section: Introductionmentioning

confidence: 99%

A qualitative assessment of cleaning and hand hygiene practices at shelters serving people experiencing homelessness during the COVID-19 pandemic, Atlanta, GA – May-June, 2020.

Besrat¹,

Mosites²,

Montgomery³

et al. 2023

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Background: Cleaning practices and hand hygiene are important behaviors to prevent and control the spread of infectious disease, especially in congregate settings. This project explored hygiene- and cleaning-related experiences in shelters serving people experiencing homelessness (PEH) during May–June 2020 of the COVID-19 pandemic. Methods: We conducted qualitative, in-depth interviews by phone with 22 staff from six shelters in Atlanta, Georgia. The interview guide included questions about cleaning routines, cleaning barriers and facilitators, cleaning promotion, hand hygiene promotion, and hand hygiene barriers and facilitators. We analyzed interview transcripts using thematic analysis. Results: Multiple individuals, such as shelter individuals (clients), volunteers, and staff, played a role in shelter cleaning. Staff reported engaging in frequent hand hygiene and cleaning practices. Barriers to cleaning included staffing shortages and access to cleaning supplies. Staff reported barriers (e.g., differing perceptions of cleanliness) for clients who were often involved in cleaning activities. Barriers to hand hygiene included limited time to wash hands, forgetting, and inconvenient handwashing facilities. Specific guidance about when and how to clean, and what supplies to use, were requested. Conclusion: During the early months of the COVID-19 pandemic, shelters serving PEH in the Atlanta-metro area needed resources and support to ensure sufficient staffing and supplies for cleaning activities. As part of future pandemic planning and outbreak prevention efforts, shelters serving PEH could benefit from specific guidance and training materials on cleaning and hand hygiene practices.

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“…Throughout the pandemic, data from public health surveillance and field investigations, as well as anecdotal evidence from media reports, have suggested that certain worker groups experience increased risk of contracting COVID‐19 due to their work. Epidemiologic evidence points to occupational acquisition of COVID‐19 among healthcare personnel 2–5 and case clusters have been associated with various workplaces including hospitals, 6 long‐term care facilities, 7,8 correctional facilities, 9,10 homeless shelters, 11,12 and meat and seafood processing plants 13–17 . This evidence implies that transmission of SARS‐CoV‐2 occurs in the workplace and that workers in certain occupations or industries could be at increased risk for infection.…”

Section: Introductionmentioning

confidence: 99%

“…This evidence implies that transmission of SARS‐CoV‐2 occurs in the workplace and that workers in certain occupations or industries could be at increased risk for infection. Factors suspected to be associated with increased risk of occupational acquisition of COVID‐19 include close contact with COVID‐19 patients in healthcare settings; working in close proximity with coworkers, customers, or the public, especially for prolonged periods; working in densely populated, enclosed, or poorly ventilated workplaces; and the requirement for in‐person work 2–17 …”

Section: Introductionmentioning

confidence: 99%

Excess risk of SARS‐CoV‐2 infection among in‐person nonhealthcare workers in six states, September 2020–June 2021

Groenewold

Billock

Free

et al. 2023

American J Industrial Med

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Background: While the occupational risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for healthcare personnel in the United States has been relatively well characterized, less information is available on the occupational risk for workers employed in other settings. Even fewer studies have attempted to compare risks across occupations and industries. Using differential proportionate distribution as an approximation, we evaluated excess risk of SARS-CoV-2 infection by occupation and industry among non-healthcare workers in six states.Methods: We analyzed data on occupation and industry of employment from a sixstate callback survey of adult non-healthcare workers with confirmed SARS-CoV-2 infection and population-based reference data on employment patterns, adjusted for the effect of telework, from the U.S. Bureau of Labor Statistics. We estimated the differential proportionate distribution of SARS-CoV-2 infection by occupation and industry using the proportionate morbidity ratio (PMR).Results: Among a sample of 1111 workers with confirmed SARS-CoV-2 infection, significantly higher-than-expected proportions of workers were employed in service occupations (PMR 1.3, 99% confidence interval [CI] 1.1-1.5) and in the transportation and utilities (PMR 1.4, 99% CI 1.1-1.8) and leisure and hospitality industries (PMR 1.5, 99% CI 1.2-1.9). Conclusions:We found evidence of significant differences in the proportionate distribution of SARS-CoV-2 infection by occupation and industry among respondents in a multistate, population-based survey, highlighting the excess risk of

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Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

Cited by 13 publications

References 26 publications

Responding to COVID-19 While Serving Veterans Experiencing Homelessness: The Pandemic Experiences of Healthcare and Housing Providers

Responding to COVID-19 While Serving Veterans Experiencing Homelessness: The Pandemic Experiences of Healthcare and Housing Providers

A qualitative assessment of cleaning and hand hygiene practices at shelters serving people experiencing homelessness during the COVID-19 pandemic, Atlanta, GA – May-June, 2020.

Excess risk of SARS‐CoV‐2 infection among in‐person nonhealthcare workers in six states, September 2020–June 2021

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