Daily COVID-19 Briefing April 1, 2020

United Church of Christ – Wider Church Ministries
Humanitarian Development Team
Coronavirus (COVID-19) Daily Briefing
Barbara T. Baylor, MPH – Temporary Health Liaison

April 1, 2020

Support for homeless and other vulnerable populations during COVID-19

Currently, the United States has confirmed more COVID-19 cases than has any other country – more than 186,000, according to a CNN count. More than 3,800 people have died in the United States to date.

A recent article in The New Yorker Dispatch titled “How do you shelter in place when you don’t have a home?” caught my attention. The protocol is that if you feel sick go home and self-isolate. But where would the homeless go?

The novel coronavirus could hit people experiencing homelessness hard.

In 2018, there were more than 552,800 homeless people in the United States — 33 percent of whom were families with children, according to the National Alliance to End Homelessness. The rate of respiratory disease, which is a major risk factor for COVID-19 patients, is particularly high among this population. And, while The Centers for Disease Control and Prevention have recommended staying away from others who are sick, avoiding crowds and proper hand-washing, these practices are nearly impossible for those living on the streets who have no way to bathe or wash hands. There are no portable toilets or sinks. People eat, sleep and congregate close to each other.

The conditions of homelessness may increase the risk of transmitting the coronavirus to homeless people and ultimately its spread to others in the community. These include:

1. Many people living on the street already have diminished health, have higher rates of chronic illnesses or have compromised immune systems, all of which are risk factors for developing a more serious manifestation of the coronavirus infection.
2. Many homeless persons live in shelters that may not provide access to bathrooms and hot water or hand sanitizer.
3. Homeless people may sleep in large spaces with cots placed in close proximity to one another. They may eat and participate in activities in groups at a shelter, which increases the risk of an exposed person transmitting the virus to those nearby.
4. Homeless people who do not stay in shelters may may sleep in train or bus stations, ride subways or buses or go the waiting room of a hospital emergency department for the evening, increasing the likelihood they may contaminate doors, bathroom fixtures, chairs or other objects, providing opportunities for spreading the infection to others.
5. Homeless people have less access to health care providers who could order diagnostic testing and, if confirmed, isolate them from others in coordination with local health departments.

What has been/is being done to support the homeless during COVID-19?

1. On Friday, March 27, 2020, the CARES ACT (Coronavirus Aid, Relief, and Economic Security Act) was signed into law. It includes a $5 billion Department of Housing and Urban Development (HUD) Community Development Block Grant (CDBG).According to the Disaster Housing Recovery Coalition, the CDBG is a flexible program that will provide communities and states with funding to provide a wide range of resources to address COVID-19, such as services for senior citizens, the homeless and public health services.

   Also included are $4 billion for Homeless Assistance Grants. These funds will enable state and local governments to address coronavirus among the homeless population and will provide effective, targeted assistance to contain the spread of coronavirus among homeless individuals. These grants will also provide state and local governments with homelessness prevention funding for individuals and families who would otherwise become homeless due to coronavirus.

2. The CDC has provided interim guidance, which is intended to support response planning by homeless service providers, including overnight emergency shelters, day shelters and meal service providers. Click here to read the guidance.

Possible Unmet Needs

1. According to a journal article in The Lancet, testing kits and training on how to recognize COVID-19 should be widely disseminated to homeless service providers and deployed in shelters, encampments and street outreach. Alternative spaces might be needed to quarantine and treat people experiencing homelessness. Unfortunately, there continues to be a shortage of testing supplies and equipment in many cities.
2. As the nation increases shelter-in-place and extends social distancing policies to prevent COVID-19 transmission, there are few emergency preparedness plans to transport and provide shelter for the large number of people experiencing homelessness.  It is unclear how and where unsheltered people experiencing homelessness will be moved to as these regulations are implemented.Source: Schutt RK, Goldfinger SM – Homelessness, housing, and mental illness. Harvard University Press, Cambridge, MA 2011
3. What impact will the possible closing of shelters and transitional housing during this outbreak of COVID-19 have on the homeless?  How will they access needed services such as health care, medication and food?
4. According to the director of the D.C.-based nonprofit Capital Area Asset Builders, many homeless and other vulnerable populations will not collect the proposed stimulus money because they did not file a 2018 or 2019 tax return.  Because of their transient status, they probably did not receive a Social Security Benefits Statement this year, a tax form that notes how much income someone received from the previous year through benefits such as disability or retirement. Those who are homeless, undocumented, or underemployed are virtually non-existent in the system.

What might churches do to meet unmet needs and mitigate exposure of COVID-19 in homeless population?

1. Work in partnership with other churches and faith-based organizations, local public health/health and human services agencies, to share ideas, information and solutions on ways to continue services for homeless and other vulnerable populations and possibly provide new, clean shelters.
2. Increase food services to homeless by providing “walk-up” meal bags in your church parking lot and/or pass out hygiene kits.
3. Update church policies on how to relate to homeless people during the COVID outbreak.

References

During the COVID-19 pandemic, nowhere is safe for homeless people

2019 Annual Homeless Assessment Report to Congress

The State of Homelessness in America 2019

Poor and homeless people are Poor and Homeless People are included in the CARES Act stimulus, but they’ll probably have to “raise their hand” to get it