Diagnosis and risk prevention of Covid 19 in homeless people in Lisbon

Background The study is part of a broader research project – Public Bathouse Nursing - dedicated to the study of vulnerable populations that use the Public Bathouse in the city of Lisbon [1]. When SARS-CoV-2 pandemic situation started, structures for homeless people, at that time counted as 3029, were reinforced in Lisbon city. These people do not manage health autonomously, thus requiring defnition of strategies for testing and early diagnosis, to promote isolation and quick endorsementto Portuguese National Health Service. The project was approved by the Health Ethics Committee of the Regional Health Administration of Lisbon and Tagus Valley (Opinion 2776/CES/2021). Materials and methods Tracking SARS-CoV-2 lab tests were performed to the people from Temporary Housing Centers, Social Emergency Housing Centers and to those who, being homeless, were identifed by street technical teams. Our objectives were the detection of SARS-CoV-2 in the homeless people using the Public Bathhouse of Alcântara and of 10 structures of Planning and Intervention Centers in homelessness, such as street teams, temporary emergency shelters and cafeterias, promoting early detection and adequate endorsement of positive cases. The process of collection of spittle was performed between November 29th,2021and February 7th, 2022. From the initial 455 samples collected, 59 were annulled, due to poor quality and quantity. An error of 3,6% was considered, with a confdence level of 95,0%, thus making viable samples n= 396. Results Those 396 tracked people revealed an incidence rate of the disease of 2%, while, during the same period, the whole country rounded 18%. A study carried out in the United States of America did not fnd statistically signifcant relevance between the values of the incidence of the disease COVID-19 among homeless and non-homeless [2]. On the other hand, a Danish study revealed that the homeless population seems not to have been afected by COVID-19 in the frst wave [3]. The positive cases of COVID-19 who were lodged temporarily in Social Emergency Housing Centers, were isolated there, upon indication of Regional and Local Authorities, that were properly informed. Positive cases of homelessness people identifed and tracked on the streets, were endorsed to the Rear Support Structure, to guarantee appropriate isolation and dignifed convalescence. Conclusions The conclusion was that the incidence rate of COVID-19 in homeless people is below general population in Portugal.