Preventing within household transmission of COVID-19: Is self-isolation outside the home feasible and acceptable?

Denford, Sarah; Morton, Kate S; Horwood, Jeremy; Garang, Rachel de; Yardley, Lucy

Background Within-household transmission of COVID-19 is responsible for a significant number of infections. The risk of within-household infection is greatly increased among those from Black Asian and minority ethnic (BAME) and low income communities. Efforts to protect these communities are urgently needed. The aim of this study is to explore the acceptability of the availability of accommodation to support isolation among at risk populations. Methods Our study used a mixed methods design structured in two phases. In phase 1, we conducted a survey study of a sample of volunteers from our existing database of 300 individuals who had provided consent to be contacted about ongoing research projects into infection control. In phase 2, we conducted semi-structured interviews with 19 participants from BAME communities and low income communities recruited through social media. Results Participants from the survey and interview phase of the study viewed the provision of accommodation as important and necessary. Factors influencing likely uptake of accommodation included perceived 1) vulnerability of household 2) exposure to the virus and 3) options for isolation at home. Barriers to accepting the offer of accommodation included 1) being able to isolate at home 2) wanting to be with family 3) caring responsibilities 4) concerns about mental wellbeing 5) upheaval of moving when ill and 6) concerns about infection control. Participants raised a series of issues that should be addressed before accommodation is offered. These included questions regarding who should use temporary accommodation and at what stage to effectively reduce transmission in the home, and how infection control in temporary accommodation would be managed. Conclusion This research provides evidence that the provision of accommodation to prevent within household transmission of the virus is viewed as acceptable, feasible and necessary by many people who are concerned about infection transmission in the home. We explore ways in which accommodation might be offered. In particular, vulnerable members of the household could be protected if accommodation is offered to individuals who are informed through test trace and isolate that they have been in contact with the virus.