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COVID-19 Testing and Containment Strategies for Children in Congregate Housing Facilities in Texas, 2021-2023

Andrew Godoshian1, Zachary R Smith1, Peter Boersma1

  • 1Andrew Godoshian is with the Office of Readiness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. At the time of this study, Zachary R. Smith, Ellen N. Kersh and Joseph D. Miller were with the Office of Readiness and Response, CDC, Atlanta, GA. Peter Boersma is with the National Center for Health Statistics, CDC, Hyattsville, MD. Julia Charles is with the National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Rebecca J. McNall and Christy Myrick are with the Office of Laboratory Systems and Response, CDC, Atlanta, GA. Virginia Bowen was with the Office of Refugee Resettlement, Administration for Children and Families, Washington, DC, at the time of this study. Dean L. Winslow is with the Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA. Michael F. Iademarco is with the US Public Health Service (retired), Rockville, MD. Marcus Siddall was with the Office of Readiness and Response, CDC, Atlanta, GA, and Chickasaw Nation Industries, Norman, OK, at the time of this study.

American Journal of Public Health
|July 2, 2026
PubMed

Insights

Implementing site-specific testing and isolation protocols significantly reduced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in unaccompanied migrant children. These measures prevented substantial on-site transmission in federal congregate care settings.

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Health Policy

Background:

  • Congregate care settings for unaccompanied migrant children pose risks for infectious disease transmission.
  • Effective strategies are needed to prevent on-site severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections.

Purpose of the Study:

  • To evaluate the effectiveness of site-specific testing and isolation protocols in preventing SARS-CoV-2.
  • To assess the impact of the Increasing Community Access to Testing, Treatment, and Response (ICATT) program on infection rates.

Main Methods:

  • Utilized logistic regression, chi-squared tests, and Kaplan-Meier survival analysis.
  • Analyzed data from 385,234 tests administered to 68,674 children at two emergency intake sites in Texas.
  • Estimated on-site infections and cases prevented by ICATT protocols.

Main Results:

  • ICATT protocols identified 83% of SARS-CoV-2 cases at intake.
  • Projected 92% of cases were isolated before on-site transmission.
  • Prevented an estimated 1335-2377 on-site infections, reducing transmission by 68-79%.

Conclusions:

  • Site-specific testing and isolation protocols significantly reduced SARS-CoV-2 transmission in federal congregate care settings.
  • Enhanced testing and isolation strategies are crucial for mitigating within-facility transmission among temporary residents.

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