Guidance and resources for correctional and detention facilities and sites serving people experiencing homelessness

Last updated on December 28, 2022.

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Correctional and detention facilities and sites serving people experiencing homelessness should follow CDC Guidance on the Management of COVID-19 in Homeless Service Sites and in Correctional and Detention Facilities for recommended COVID-19 infection prevention and control strategies. In addition, facilities providing health care services should consult CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the COVID-19 Pandemic for recommended infection prevention and control strategies for patient care. Facilities should also review the resources below. 

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Testing

Strategies for everyday operations

  • Test people with signs and symptoms of COVID-19.

  • Test people  who have recent or known exposure to people with COVID-19.

  • Test all residents at intake (correctional and detention facilities only). 

Enhanced prevention strategies

  • Test during transfer or release (correctional and detention facilities only).

  • Conduct routine screening testing (test asymptomatic persons without recent known or suspected exposure to COVID-19 for early identification, isolation, and disease prevention).

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Testing considerations
Testing people with signs and symptoms of COVID-19 Test immediately using a viral test (nucleic acid amplification test (NAAT), antigen, or other tests). If the test result is negative using an antigen test, repeat antigen testing per FDA guidance or confirm with a NAAT.
Testing people who are asymptomatic and have a recent known or suspected exposure to SARS-CoV-2 Test at least five days after the exposure. If the test result is negative using an antigen test, repeat antigen testing as recommended by FDA guidance or, during instances of higher pretest probability (such as high incidence of infection within the community or a person with household or continuous contact with a person with COVID-19), consider confirming with a NAAT. 
Testing people who recently tested positive and recovered from COVID-19 Exposed AND had COVID-19 within the past 30 days*

If newly symptomatic: Antigen tests should be used to identify a new infection. If the test result is negative, antigen tests should be repeated per FDA guidance

If asymptomatic: Testing to identify a new infection is not recommended.

Exposed AND had COVID-19 within the past 30-90 days*

Consider using antigen tests rather than a NAAT to identify a new infection. 

If symptomatic: Follow “Testing people with signs or symptoms of COVID-19” guidance above. 

If asymptomatic: Follow “Testing asymptomatic people who have recent known or suspected exposure to SARS-CoV-2” guidance above.

Serial testing during cohorted quarantine (for facilities that choose to implement quarantine) Serial testing every 3-7 days can help identify new cases early. If new cases are identified in a cohort, restart quarantine. This strategy can be used for all residents in a cohort or prioritized for people who are more likely to get sick from COVID-19 to identify infections early and assess for treatment promptly.

*The clock starts from the day of your first positive test result or your original onset of symptoms, whichever came first.

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Vaccinations

Getting all recommended doses of the COVID-19 vaccine is critical to protect both staff and residents from COVID-19. Current vaccine recommendations are available in CDC’s Use of COVID-19 Vaccines in the United States. Continue to offer vaccines at your facility and encourage staff and residents to keep up to date on their vaccinations. Provide education about COVID-19 vaccines to staff and residents. Information on possible vaccine side effects and how to relieve side effects can be found on CDC’s website. Facilities can request vaccination events using our online form.

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Treatments and pre-exposure prophylaxis

CDPHE's COVID-19 Treatments webpage has the latest information regarding COVID-19 treatments in Colorado. Early testing and evaluation by a health care provider for COVID-19 treatments is critical . COVID-19 treatments must be given within a short timeframe of when symptoms begin. Therefore, staff and residents should be referred for evaluation by a health care provider as soon as possible to determine if treatment is right for them.

Pre-exposure prophylaxis can prevent COVID-19 in people who have moderate to severe immune compromise. It can also be used by those for whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe adverse reaction to a COVID-19 vaccine(s) or its component. Encourage staff and residents to talk with their health care provider to determine if they are eligible for pre-exposure prophylaxis. Providers can learn more about how to order therapeutics on CDPHE’s website.

Facilities that provide medical care to staff and/or residents should have a plan in place to identify people who meet criteria for COVID-19 treatments and/or pre-exposure prophylaxis and connect them to appropriate therapies through direct administration or referral. To prevent delayed treatment, discuss therapeutics with your residents and staff now. For example, some people may need a plan for stopping or modifying their current medications if they are recommended to take Paxlovid. Working with their health care providers ahead of time to determine the best course of action is helpful, especially if someone gets sick on a weekend or over the holidays.