Med Journal Jan 2021 Final - Page 9

investigation , contact tracing , and mitigation strategies for homeless shelters . The Operation Compassion team reached out to homeless shelter directors and partners across the state , especially the Arkansas Homeless Coalition , to schedule testing dates and identify the needs of the shelter and its clients in advance of the visit . A two-pronged approach for testing was developed and implemented as the pandemic began to unfold . The approach consists of proactive , scheduled COVID-19 testing of the homeless shelters and a reactive approach of testing shelter residents and its staff if there was a suspected cluster or an outbreak . Given the evidence for presymptomatic and asymptomatic transmission of SARS-CoV-2 , testing of all residents and staff members , regardless of symptoms , was performed . 6 The testing was started in homeless shelters in Central Arkansas Counties ( Pulaski , Faulkner , and Saline ) and was then expanded to other regions of the state . The Operation Compassion team worked with ADH ’ s case investigation team to follow up on those who tested positive and offer them mitigation strategies . The team also assisted with contact tracing , which was a challenge given the unique challenges faced by this population . Because of this , we forged alliances with shelter directors who assisted in some of the contact tracing processes . We used a snowball method of tracing individuals , as many of these individuals do not have a phone and tend to move to various places on different days of the week – or even within a day – to seek food and shelter . Also , we had a weekly call with homeless shelters across the state that was facilitated by the Arkansas Department of Human Services and the U . S . Housing and Urban Development offices in Little Rock , Arkansas . This helped address several of the questions and concerns from the shelter directors .
Dr . Bala , medical director and team leader for Operation Compassion .
The team worked with different types of shelters ( Family , Women and Children , LGBTQ , substance use recovery centers , street ministry , shower ministry , Catholic health initiatives , etc .). The team also partnered with UAMS College of Public Health faculty and graduate students to assess needs of these homeless shelters through a survey of the shelter directors and assisted them with personal protective equipment ( PPE ) and non-PPE needs . The team also worked with local non-profit organizations ( Arkansas Chapter of American Association of Physicians of Indian Origin , Friends of India ) to offer food and masks to the shelters in need . Plans are in place to offer the seasonal flu vaccine and potentially the COVID-19 vaccine to homeless populations in Arkansas through Operation Compassion . Operation Compassion continues to be a key public health outreach strategy in COVID-19 mitigation by ADH that strives towards its mission to protect and improve the health of all Arkansans .
Results
Since the beginning of the pandemic , a third of the 96 Arkansas homeless shelters closed due to lack of volunteers , supplies , funding , or staff ( who were out due to high-risk conditions themselves ). Operation Compassion staff reached out to those shelters that were open and operational to provide them with guidance on COVID-19 precautions and worked with shelter directors to schedule COVID-19
Operation Compassion team member before COVID-19 testing .
test dates . As of October 29 , 2020 , a total of 1,053 homeless individuals have been tested through the Operation Compassion program , with a 3.5 % positivity rate . Among those who tested positive , 46 % were females and 54 % were males . Sixty-eight percent were White , 24 % African American , and 8 % were from other racial and ethnic groups . Among those who tested positive , 11 % were under 18 years of age ; 76 % were between 18 and 64 ; and 13 % were 65 years of age or older . Those who tested positive were offered placement and transportation to a Quarantine and Isolation Facility ( QF1 ) operated by the ADH to meet their isolation and quarantine requirements . QF1 is a 29-bed facility that offers eligible individuals and families a place to isolate or quarantine if they test positive for COVID-19 or are in close contact with someone who tests positive . The facility offers individual rooms , along with meals and snacks during their stay , at no cost to them .
Discussion
The relatively low positivity rate among Arkansas homeless shelters ( 3.5 %) compared to other congregate settings such as nursing homes could be attributed to Operation Compassion ; this proactive outreach provided guidance , testing , case investigation , contact tracing , and early isolation and quarantine measures among the homeless in Arkansas . 7
As the pandemic looms , the plight of Arkansas homeless residents continues , and
Volume 117 • Number 7 JANUARY 2021 • 153