Assessment of Contact Tracing for COVID-19 among People Experiencing Homelessness, Salt Lake County Health Department, March–May 2020

Fields, Victoria L.; Kiphibane, Tair; Eason, Jeffrey T.; Hafoka, Siosaia F.; Lopez, Adriana S.; Schwartz, Amy; Henry, Ankita; Tran, Cuc H.; Tate, Jacqueline E.; Kirking, Hannah L.; Laws, Rebecca L.; Venkatappa, Thara; Mosites, Emily; Montgomery, Martha P.

PURPOSE: : Contact tracing is intended to reduce the spread of coronavirus disease 2019 (COVID-19), but it is difficult to conduct among people who live in congregate settings, including people experiencing homelessness (PEH). This analysis compares person-based contact tracing among two populations in Salt Lake County, Utah, from March–May 2020. METHODS: : All laboratory-confirmed positive cases among PEH (n=169) and documented in Utah's surveillance system were included in this analysis. The general population comparison group (n=163) were systematically selected from all laboratory-confirmed cases identified during the same period. RESULTS: : Ninety-three PEH cases (55%) were interviewed compared to 163 (100%) cases among the general population (p<0.0001). PEH were more likely to be lost to follow-up at end of isolation (14.2%) versus the general population (0%; p-value<0.0001) and provided fewer contacts per case (0.31) than the general population (4.7) (p-value<0.0001). Contacts of PEH were more often unreachable (13.0% vs. 7.1%; p-value<0.0001). CONCLUSIONS: : These findings suggest that contact tracing among PEH should include a location-based approach, along with a person-based approach when resources allow, due to challenges in identifying, locating, and reaching cases among PEH and their contacts through person-based contact tracing efforts alone.