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Near-Term Outcomes Associated with COVID-19 in the United States Among Persons Experiencing Homelessness: A Modelling Study

18 Pages Posted: 7 Jul 2020

See all articles by Joshua Barocas

Joshua Barocas

Boston University - Section of Infectious Diseases; Boston University - School of Medicine

Alexandra Savinkina

Boston University - Section of Infectious Diseases

Benjamin P. Linas

Boston University - Section of Infectious Diseases

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Abstract

Background: The coronavirus disease 2019 (Covid-19) epidemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will likely disproportionately impact persons experiencing homelessness in the U.S. We aimed to estimate the near-term risk of Covid-19-related hospitalization and death in the U.S. general population and compare it to that of population of persons experiencing homelessness. 

Methods: We developed and calibrated a microsimulation model of Covid-19 to project associated hospitalizations and mortality. We populated the model with primary and published data from the U.S. We then projected Covid-19-related outcomes for two populations: the general U.S. population and the population of persons experiencing homelessness. We modeled representative cohorts of each population from March 1, 2020 through August 1, 2020. 

Findings: We estimated from March 1, 2020 through August 1, 2020, the general U.S. population will experience approximately 11·0 hospitalizations per 10,000 persons and 5·4 deaths per 10,000 persons. Comparatively, the U.S. population experiencing homelessness will experience an estimated 1,600 hospitalizations and 800 deaths per 10,000 persons. Findings were robust in deterministic sensitivity analyses of prevalence, primary infection rate, and reinfection rate.

Interpretation: Persons experiencing homelessness in the U.S. are disproportionately impacted by Covid-19 and are likely to experience substantial mortality in the near-term. Immediate efforts to decrease transmissibility of the virus are needed.

Funding Statement: This work was supported by the National Institute on Drug Abuse at the National Institutes of Health [R01DA046527 to B.P.L and A.S; R01DA046527-02S1 to J.A.B, and P30DA040500 to B.P.L], and the Charles A. King Trust to J.A.B.

Declaration of Interests: The authors declare no conflicts of interest.

Keywords: simulation modeling; SARS-CoV-2; COVID-19; homelessness; disparities

Suggested Citation

Barocas, Joshua and Savinkina, Alexandra and Linas, Benjamin P., Near-Term Outcomes Associated with COVID-19 in the United States Among Persons Experiencing Homelessness: A Modelling Study (5/12/2020). Available at SSRN: https://ssrn.com/abstract=3605334 or http://dx.doi.org/10.2139/ssrn.3605334

Joshua Barocas (Contact Author)

Boston University - Section of Infectious Diseases ( email )

801 Massachusetts Ave, 2nd Floor
Boston, MA 02118
United States

Boston University - School of Medicine ( email )

771 Albany St
Boston, MA 02118
United States

Alexandra Savinkina

Boston University - Section of Infectious Diseases

801 Massachusetts Ave, 2nd Floor
Boston, MA 02118
United States

Benjamin P. Linas

Boston University - Section of Infectious Diseases

801 Massachusetts Ave, 2nd Floor
Boston, MA 02118
United States

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