Guidance on Management of COVID-19 in Homeless Service Sites and in Correctional and Detention Facilities

ABSTRACT

Combines and replaces previous CDC guidance documents for COVID-19 in homeless service sites and correctional and detention facilities. ;Describes tailored everyday and enhanced COVID-19 prevention strategies. ;Recommends adding enhanced COVID-19 prevention strategies when the COVID-19 Community Levels are high (previously medium) or when there are facility-specific risks. ;No longer routinely recommends quarantine after someone is exposed to a person with COVID-19. Continues to provide considerations for facilities that prefer to continue implementing quarantine protocols. ;Includes an option to end isolation for people with COVID-19 after 7 days with a negative viral test. ;Emphasizes the importance of maximizing access to in-person visitation to promote correctional and detention facility residents’ mental health and well-being. ;Because of the congregate living arrangements in homeless shelters and correctional and detention facilities, the risk of COVID-19 transmission is higher in these settings compared with the general population. In addition, there is a high prevalence of certain medical conditions associated with severe COVID-19 among people experiencing homelessness and among people who are incarcerated, increasing the risk for severe outcomes from COVID-19 in these populations. ;;This guidance can be used to inform COVID-19 prevention actions in homeless service sites and correctional and detention facilities and replaces previous CDC guidance documents for these settings. ;; For Healthcare Professionals This guidance does not apply to dedicated patient care areas within these settings. Any healthcare workers who provide care in these settings should follow Infection Control Recommendations for Healthcare Personnel. ;;On This Page ;Assessing a Facility's Risk ;COVID-19 Prevention Strategies ;Quarantine ;Personal Protective Equipment and Source Control ;Identifying Exposures ;Additional Considerations ;Assessing a Facility’s Risk ;CDC recommends that homeless service sites and correctional and detention facilities use a combination of COVID-19 Community Levels and facility-specific risks to guide decisions about when to apply specific COVID-19 prevention actions. Assessing the following factors can help decide if additional layers of protection are needed because of facility-specific risks ;;Facility structural and operational characteristics Assess whether facility characteristics or operations contribute to COVID-19 spread. For example, facilities may have a higher risk of transmission if they have frequent resident or staff turnover, a high volume of outside visitors, poor ventilation, or areas where many people sleep close together. ;Risk of severe health outcomes: Assess what portion of people in the facility are more likely to get very sick from COVID-19, for example, due to underlying health conditions, older age, pregnancy, or poor access to medical care. ;COVID-19 transmission in the facility Assess the extent to which transmission is occurring within the facility. Transmission can be assessed through diagnostic testing of people with COVID-19 symptoms and their close contacts, through routine screening testing (not routinely recommended, but some facilities might use it in consultation with their health department to facilitate early identification of infections in populations with especially high risk for severe illness from COVID-19), or other surveillance testing that the facility uses (such as wastewater testing). Results of testing at intake are not recommended as an indicator of transmission inside the facility, since infections identified at intake most likely occurred elsewhere.