Knowledge, attitudes, practices and impact of COVID-19 among persons living in homeless shelters in France: first results of the echo study

Introduction - People experiencing socioeconomic disadvantage appear to have been especially impacted by the COVID-19 epidemic Multiple factors could constitute obstacles to the implementation of preventive measures of SARS-CoV-2 infection and to access to health care Persons experiencing socioeconomic disadvantage could also be more impacted by the social and economic consequences of the sanitary crisis We aimed to study the knowledge, attitudes and practices related to the COVID-19 epidemic and its impact among persons living in homeless shelters in France Methods - ECHO is a cross-sectional study conducted in 18 homeless shelters mostly in the Paris and Lyon regions from the 2d of May to the 7th of June 2020, during and just after the first COVID-19-related lockdown The questionnaire was delivered by trained interviewers, with the help of an interpreter whenever needed Results - Among the 535 participants who were included, we observed a good level of knowledge of COVID-19 symptoms and satisfactory acceptance of preventive and curative measures (ex tests, isolation) Associated factors include age, schooling level, health literacy, duration of residence in the shelter and region of origin An important proportion of participants reported not being able to access healthcare for non-related COVID-19 reasons during lockdown, and seeing their mental health and socioeconomic situation deteriorate