{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:29:41Z","timestamp":1753892981757,"version":"3.41.2"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>People experiencing homelessness (PEH) are disproportionately affected by the COVID-19 pandemic. For many PEH it is impossible to isolate due to the lack of permanent housing. Therefore, an isolation facility for SARS-CoV-2 positive PEH was opened in Berlin, Germany, in May 2020, offering medical care, opioid and alcohol substitution therapy and social services. This study aimed to assess the needs of the admitted patients and requirements of the facility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This was a retrospective patient record study carried out in the isolation facility for PEH in Berlin, from December 2020 to June 2021. We extracted demographic and clinical data including observed psychological distress from records of all PEH tested positive for SARS-CoV-2 by RT-PCR. Data on duration and completion of isolation and the use of the facilities\u2019 services were analyzed. The association of patients\u2019 characteristics with the completion of isolation was assessed by Student\u2019s <jats:italic>t<\/jats:italic>-test or Fisher\u2019s exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 139 patients were included in the study (89% male, mean age 45\u2009years, 41% with comorbidities, 41% non-German speakers). 81% of patients were symptomatic (median duration 5\u2009days, range 1\u201326). The median length of stay at the facility was 14\u2009days (range 2\u201341). Among the patients, 80% had non-COVID-19 related medical conditions, 46% required alcohol substitution and 17% opioid substitution therapy. Three patients were hospitalized due to low oxygen saturation. No deaths occurred. Psychological distress was observed in 20%, and social support services were used by 65% of PEH. The majority (82%) completed the required isolation period according to the health authority\u2019s order. We did not observe a statistically significant association between completion of the isolation period and sociodemographic characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The specialized facility allowed PEH a high compliance with completion of the isolation period. Medical care, opioid and alcohol substitution, psychological care, language mediation and social support are essential components to address the specific needs of PEH. Besides contributing to infection prevention and control, isolation facilities may allow better access to medical care for SARS-CoV-2 infected PEH with possibly positive effects on the disease course.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1147558","type":"journal-article","created":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T20:56:36Z","timestamp":1686084996000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A COVID-19 isolation facility for people experiencing homelessness in Berlin, Germany: a retrospective patient record study"],"prefix":"10.3389","volume":"11","author":[{"given":"Merle","family":"H\u00f6rig","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah M.","family":"Klaes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Krasovski-Nikiforovs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Welmoed","family":"van Loon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Murajda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa C. O.","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Schade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anabell","family":"Specht","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Equihua Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank P.","family":"Mockenhaupt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Seybold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas K.","family":"Lindner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navina","family":"Sarma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"331","DOI":"10.2217\/fvl-2020-0156","article-title":"COVID-19 in homeless populations: unique challenges and opportunities","volume":"15","author":"Conway","year":"2020","journal-title":"Futur Virol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e186","DOI":"10.1016\/S2468-2667(20)30053-0","article-title":"COVID-19: a potential public health problem for homeless populations","volume":"5","author":"JackTsai","year":"2020","journal-title":"Lancet Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"E716","DOI":"10.1503\/cmaj.200834","article-title":"COVID-19 and people experiencing homelessness: challenges and mitigation strategies","volume":"192","author":"Perri","year":"2020","journal-title":"CMAJ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e202","DOI":"10.1016\/S2468-2667(21)00001-3","article-title":"Seroprevalence and risk factors of exposure to COVID-19 in homeless people in Paris, France: a cross-sectional study","volume":"6","author":"Roederer","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"101032","DOI":"10.1016\/j.eclinm.2021.101032","article-title":"SARS-CoV-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis","volume":"38","author":"Mohsenpour","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"ofaa477","DOI":"10.1093\/ofid\/ofaa477","article-title":"Risk factors for severe acute respiratory syndrome coronavirus 2 infection in homeless shelters in Chicago, Illinois\u2014March\u2013May, 2020","volume":"7","author":"Ghinai","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E302","DOI":"10.9778\/cmajo.20200253","article-title":"Factors associated with SARS-CoV-2 positivity in 20 homeless shelters in Toronto, Canada, from April to July 2020: a repeated cross-sectional study","volume":"9","author":"Kiran","year":"2021","journal-title":"CMAJ Open"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2020.6887","article-title":"Prevalence of SARS-CoV-2 infection in residents of a large homeless shelter in Boston","volume":"323","author":"Baggett","year":"2020","journal-title":"JAMA"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"6425","DOI":"10.26355\/eurrev_202110_27016","article-title":"SARS-CoV-2 infection prevalence in people experiencing homelessness","volume":"25","author":"Ralli","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.9778\/cmajo.20200287","article-title":"Testing, infection and complication rates of COVID-19 among people with a recent history of homelessness in Ontario, Canada: a retrospective cohort study","volume":"9","author":"Richard","year":"2021","journal-title":"CMAJ Open"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"25","DOI":"10.25646\/9856.2","article-title":"Pr\u00e4valenz von sexuell und durch Blut \u00fcbertragenen Infektionen und Tuberkulose bei Menschen in Wohnungslosigkeit in Berlin \u2013 Erste Ergebnisse der Pilotstudie POINT","volume":"13","author":"Steffen","year":"2022","journal-title":"Epidemiol Bull"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e85","DOI":"10.1017\/S0950268820000722","article-title":"Communicable disease among people experiencing homelessness in California","volume":"148","author":"Liu","year":"2020","journal-title":"Epidemiol Infect"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e025192","DOI":"10.1136\/bmjopen-2018-025192","article-title":"Health-related quality of life and prevalence of six chronic diseases in homeless and housed people: a cross-sectional study in London and Birmingham, England","volume":"9","author":"Lewer","year":"2019","journal-title":"BMJ Open"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/S0140-6736(14)61132-6","article-title":"The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations","volume":"384","author":"Fazel","year":"2014","journal-title":"Lancet"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1370\/afm.1882","article-title":"Rates and predictors of uncontrolled hypertension among hypertensive homeless adults using new York City shelter-based clinics","volume":"14","author":"Asgary","year":"2016","journal-title":"Ann Fam Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s40292-020-00424-8","article-title":"Prevalence of hypertension in homeless adults: an interprofessional education community-based health fairs cross-sectional study in urban Long Beach, California","volume":"28","author":"Ngo","year":"2021","journal-title":"High Blood Pressure Cardiovascular Prevention"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"665","DOI":"10.3238\/arztebl.2017.0665","article-title":"The prevalence of mental illness in homeless people in Germany","volume":"114","author":"Schreiter","year":"2017","journal-title":"Dtsch Arztebl Int"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e1003750","DOI":"10.1371\/journal.pmed.1003750","article-title":"The prevalence of mental disorders among homeless people in high-income countries: an updated systematic review and meta-regression analysis","volume":"18","author":"Gutwinski","year":"2021","journal-title":"PLoS Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"85","DOI":"10.47626\/2237-6089-2020-0085","article-title":"COVID-19 pandemic and social distancing: economic, psychological, family, and technological effects","volume":"43","author":"Both","year":"2021","journal-title":"Trends Psychiatry Psychother"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.2105\/AJPH.2009.182022","article-title":"Universal health insurance and health care access for homeless persons","volume":"100","author":"Hwang","year":"2010","journal-title":"Am J Public Health"},{"key":"ref21","unstructured":"2023"},{"key":"ref22","unstructured":"Erste Ergebnisse der Obdachlosenz\u00e4hlung: Senatorin Breitenbach will Hilfsangebote vor Ort f\u00fcr obdachlose Menschen verbessern \u2013 Berlin.de2020"},{"key":"ref23","unstructured":"2022"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1007\/s00103-022-03536-9","article-title":"Zusammenh\u00e4nge zwischen psychischen Erkrankungen und Wohnungslosigkeit: Ergebnisse einer Sekund\u00e4rdatenanalyse in einem Berliner Gesundheitszentrum f\u00fcr Obdachlose","volume":"65","author":"Kn\u00f6rle","year":"2022","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1111\/phn.13027","article-title":"Services for homeless people in Germany during the COVID-19-pandemic: a descriptive study","volume":"39","author":"Gr\u00e4ske","year":"2022","journal-title":"Public Health Nurs"},{"key":"ref26","unstructured":"BAG-W \u2013 Werena Rosenke. Corona-Krise \u2013 BAG W fordert 10-Punkte-Sofortprogramm"},{"key":"ref27","unstructured":"RKI \u2013 Robert Koch Institut. RKI \u2013 Coronavirus SARS-CoV-2 \u2013 Coronavirus-Erkrankung 2019 (COVID-19) im Kontext Wohnungslosigkeit \u2013 Empfehlungen f\u00fcr Gesundheits\u00e4mter und Anbieter der Wohnungslosen- und Obdachlosenhilfe2022"},{"key":"ref28","unstructured":"BreuerBarbara\n          2022"},{"key":"ref29","unstructured":"RKI \u2013 Coronavirus SARS-CoV-2 \u2013 Epidemiologischer Steckbrief zu SARS-CoV-2 und COVID-192022"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur Heart J"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1007\/s00103-020-03213-9","article-title":"Somatische Erkrankungen Wohnungsloser in Deutschland. Ein narratives Literaturreview der Jahre 2009\u20132019","volume":"63","author":"Schindel","year":"2020","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1007\/s00103-013-1698-1","article-title":"Verbreitung des Rauchens in der Erwachsenenbev\u00f6lkerung in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)","volume":"56","author":"Lampert","year":"2013","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"109440","DOI":"10.1016\/j.drugalcdep.2022.109440","article-title":"Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness","volume":"235","author":"Brothers","year":"2022","journal-title":"Drug Alcohol Depend"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e210490","DOI":"10.1001\/jamanetworkopen.2021.0490","article-title":"Assessment of a hotel-based COVID-19 isolation and quarantine strategy for persons experiencing homelessness","volume":"4","author":"Fuchs","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/PHH.0000000000001349","article-title":"Establishment of isolation and noncongregate hotels during COVID-19 and symptom evolution among people experiencing homelessness-Atlanta, Georgia, 2020","volume":"27","author":"Montgomery","year":"2021","journal-title":"J Public Health Manag Pract"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1146\/annurev-publhealth-040617-013553","article-title":"Solving homelessness from a complex systems perspective: insights for prevention responses","volume":"40","author":"Fowler","year":"2019","journal-title":"Annu Rev Public Health"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1056\/NEJMc2022860","article-title":"An isolation hotel for people experiencing homelessness","volume":"383","author":"MacKenzie","year":"2020","journal-title":"N Engl J Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s12954-020-00404-0","article-title":"Harm reduction in an emergency response to homelessness during South Africa\u2019s COVID-19 lockdown","volume":"17","author":"Marcus","year":"2020","journal-title":"Harm Reduct J"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2233","DOI":"10.1353\/hpu.2021.0195","article-title":"Implementation of an isolation shelter for individuals with COVID 19 experiencing homelessness","volume":"32","author":"Moss","year":"2021","journal-title":"J Health Care Poor Underserved"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e2138464","DOI":"10.1001\/jamanetworkopen.2021.38464","article-title":"Assessment of a hotel-based protective housing program for incidence of SARS-CoV-2 infection and Management of Chronic Illness among Persons Experiencing Homelessness","volume":"4","author":"Huggett","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/dar.13335","article-title":"Finding stability amidst the COVID-19 pandemic: the impact of emergency temporary housing for people who use drugs","volume":"41","author":"Scallan","year":"2022","journal-title":"Drug Alcohol Rev"},{"key":"ref42","unstructured":"BrehmerM\n          2022"},{"key":"ref43","unstructured":"B\u00f6ldtD\n          2022"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1147558\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T20:56:43Z","timestamp":1686085003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1147558\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,6]]},"references-count":43,"alternative-id":["10.3389\/fpubh.2023.1147558"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1147558","relation":{},"ISSN":["2296-2565"],"issn-type":[{"type":"electronic","value":"2296-2565"}],"subject":[],"published":{"date-parts":[[2023,6,6]]},"article-number":"1147558"}}