A population level study of SARS-CoV-2 prevalence amongst people experiencing homelessness in Wales, UK.
A population level study of SARS-CoV-2 prevalence amongst people experiencing homelessness in Wales, UK.
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DOI：
10.23889/ijpds.v5i4.1695
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发表时间：
2020
影响因子：
--
通讯作者：
Mackie P
中科院分区：
文献类型：
--
作者：
Thomas I;Mackie P
先前对无家可归者（PEH）中SARS-CoV-2感染流行率的研究主要涉及社区形式的临时住宿的人，在COVID-19大流行期间，这种类型的住宿仍然是应对无家可归的主要部分。关于SARS-CoV-2在更广泛的PEH中的流行情况，以及在支持独立住宿的政策和实践背景下（如英国威尔士），人们知之甚少。描述SARS-CoV-2在英国威尔士PEH中的流行情况，使用安全匿名信息链接数据库中常规收集的管理数据。使用常规收集的数据来识别2020年3月1日至2021年3月1日期间威尔士的PEH。使用SARS-CoV-2病理学检测数据，生成了PEH和三个对照组的患病率：（1）非无家可归人群;（2）年龄、性别、地方当局和区域贫困的“精确匹配”队列;（3）使用这些相同变量和倾向评分匹配（PSM）创建的匹配对照组。对包含每个对照组的样本进行了三次逻辑回归，以探索经历无家可归对SARS-CoV-2检测阳性的影响。PEH中SARS-CoV-2感染的患病率为5.0%，而非无家可归人群为5.6%。对于完全匹配和PSM匹配对照组，患病率分别为6.9%和6.7%。Logistic回归发现，与普通人群中没有无家可归的人相比，PEH中SARS-CoV-2感染的可能性低0.9倍。SARS-CoV-2感染PEH的几率分别为0.75和0.73，其中“非无家可归者”对照品分别来自完全匹配和PSM样本。我们的分析显示，在COVID-19大流行一年后，威尔士PEH中SARS-CoV-2的患病率低于一般人群。对离开社区住所的无家可归者的政策反应可能是PEH中SAR-CoV-2感染减少的部分原因。
Prior research into the prevalence of SARS-CoV-2 infection amongst people experiencing homelessness (PEH) largely relates to people in communal forms of temporary accommodation in contexts where this type of accommodation remained a major part of the response to homelessness during the COVID-19 pandemic. Little is known about the prevalence of SARS-CoV-2 amongst PEH more broadly, and in a policy and practice context that favoured self-contained accommodation, such as Wales, UK. Describe the prevalence of SARS-CoV-2 amongst PEH in Wales, UK, using routinely collected administrative data from the Secure Anonymised Information Linkage Databank. Routinely collected data were used to identify PEH in Wales between 1st March 2020 and 1st March 2021. Using SARS-CoV-2 pathology testing data, prevalence rates were generated for PEH and three comparator groups: (1) the not-homeless population; (2) a cohort ‘exact matched’ for age, sex, local authority and area deprivation; and (3) a matched comparison group created using these same variables and Propensity Score Matching (PSM). Three logistic regressions were run on samples containing each of the comparator groups to explore the effect of experiencing homelessness on testing positive for SARS-CoV-2. The prevalence of SARS-CoV-2 infection amongst PEH was 5.0%, compared to the not-homeless population at 5.6%. For the exact matched and PSM match comparator groups, prevalence was 6.9% and 6.7%, respectively. Logistic regression found that SARS-CoV-2 infection was 0.9 times less likely amongst PEH compared to people not experiencing homelessness from the general population. The odds of SARS-CoV-2 infection for PEH was 0.75 and 0.73 where the ‘not-homeless’ comparators were from the exact match and PSM samples, respectively. Our analysis revealed that a year into the COVID-19 pandemic, the prevalence of SARS-CoV-2 amongst PEH in Wales was lower than the general population. A policy response to homelessness that moved away from communal accommodation may be partly responsible for the reduced SAR-CoV-2 infection amongst PEH.