Low Prevalence of SARS-CoV-2 Infections and Antibodies Among Clients and Staff Members of Homeless Services in Amsterdam Following The Second Wave of Infections in The Netherlands: Did The Dutch Policy Work?

Author: Ellen Generaal

Theme: Epidemiology & Public Health Research Year: 2022

Background: People experiencing homelessness (PEH) seem more susceptible to SARS-CoV-2 infection
and a severe course of COVID-19. In the Netherlands, there were no major outbreaks of SARS-CoV-2
among PEH. The Dutch government setup emergency shelters and preventive measures were
introduced in the homeless services. This study aimed to evaluate the impact of this shelter policy by
conducting an on-site COVID-19 screening project among PEH and staff at homelessness services in
Methods: We assessed the proportion of clients and staff members of two homelessness services with
positive SARS-CoV-2 PCR and antibody results (IgG/IgM Rapid Test) in May 2021, shortly after the
second wave of infections. We also assessed their socio-demographic, clinical and lifestyle
characteristics, compliance with basic prevention measures and intention to vaccinate against COVID19.
Results: A total of 138 clients and 53 staff members, unsuspected of COVID-19, were tested and filled
out a questionnaire. Among PEH, the prevalence of SARS-CoV-2 infection was 0% (0/133;95%CI=0-1.9)
and of SARS-CoV-2 antibody positivity 1.6% (2/131;95%CI=0.8-7.5). Among staff, these figures were
3% (1/32;95%CI=0.1-16.2) and 11% (5/53;95%CI=3.6-23.6). The majority of participants wasfrequently
compliant with the basic preventive measures ‘not shaking hands’, ‘wearing a face mask’ and ‘washing
hands’, but not with ‘physical distancing’. Overall, intention to vaccinate for COVID-19 was low (30%
for clients, 10% for staff) or medium (28% for clients, 35% for staff). The majority of participants
reported their confidence in the COVID-19 policy to be low (27% for clients, 17% for staff) or neutral
(32% for clients, 53% for staff).
Conclusion: Potential explanations for the low prevalence of SARS-CoV-2 infections and antibodies
among PEH may be the shelter policy and their compliance with prevention measures. The vaccine
hesitancy and low governmental trust is alarming for vaccination uptake, suggesting to improve public
heath communication towards clients and staff of homeless services.
Disclosure of Interest: None to declare. This project was funded by the Public Health Service of Amsterdam.

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