CDC: Screening clients for respiratory infection symptoms at entry to homeless shelters

The following is a simple screening tool that can be used to identify people with symptoms that indicate they might have a respiratory infection. Although not every person who has respiratory infection symptoms will have coronavirus disease 2019 (COVID-19), using this tool during community spread of COVID-19 may help separate those who are more likely to have COVID-19 from the general population at entry to a homeless shelter or other homeless service program.
If someone screens positive for symptoms, they should be directed to where they can stay, either within the shelter or at another location, according to a predesignated plan developed with the local Continuum of Care (CoC), public health department, and community leadership.
  1. Determine if the client has a fever, by:
    • Taking their temperature using a temporal thermometer (see box), or
    • Asking “Have you felt like you had a fever in the past day?”
  1. Ask the client “Do you have a new or worsening cough today?”
If the client has a fever OR a new/worsening cough:
  1. Provide a facemask for the client to wear over their nose and mouth, if facemasks are available and if the client can tolerate it.
    a. If facemasks are not available, advise the client on cough etiquette and provide tissues.
  2. Notify management and appropriate healthcare providers, as available
  3. Direct them to an isolation room if available, or an available space in the area designated for symptomatic persons
    a. If your shelter does not have an area for symptomatic people, redirect the person to the location prespecified by your CoC, public health department, and community leadership
  4. Let the client know:
    a. If their symptoms worsen, they should notify someone immediately
    b. Not to leave their room/the symptomatic area except to use the restroom
    c. If they leave their room/the symptomatic area, they must wear a mask
Use standard shelter protocols for medical emergencies.

Taking a client’s temperature using a temporal thermometer.

Temporal thermometers use an infrared scanner to measure the temperature of the temporal artery in the forehead. Temperature takers should keep as much distance from clients as they can, wash their hands with soap and water or use alcohol-based hand sanitizer (at least 60% alcohol) regularly, and use gloves if available.
To use thermometer:
  1. Turn on the thermometer.
  2. Gently sweep the thermometer across the client’s forehead.
  3. Remove the thermometer and read the number:
    • Fever: Any temperature 100.4 F or greater is considered a fever.
    • No fever: People with temperatures at or below 100.3 F may continue into the shelter using normal procedures.
  4. Clean the thermometer with an alcohol wipe (or isopropyl alcohol on a cotton swab) between each client. You can reuse the same wipe as long as it remains wet.