Coronavirus and homelessness: A ticking time bomb


April 7, 2020

Editor’s note: CHN Intern Olivia Maurer is a junior at Cornell University, where she is majoring in Human Biology, Health, and Society, with a minor in Global Health. Voices for Human Needs is examining the effects of coronavirus on low-income and other vulnerable populations. This post is one in a continuing series. 

Robbie is a homeless man living in Polk County, Florida. He has faced serious physical and mental health challenges and now, in the wake of coronavirus, he feels misunderstood and underrepresented. He notes, “[the government has] already failed us, I believe they should look out for us while this pandemic is going on. It’s a nightmare on top of a nightmare and we feel left out.” How do you self-isolate if you don’t have a home?

As social distancing policies shut down local businesses, people living on the streets lose access to public bathrooms, major news updates, and indoor places to stay safe during the day. When public spaces such as libraries close, the homeless population has no way to access the internet, which prevents them from staying updated on how they can protect themselves from the virus and from staying in contact with others. If a homeless person is especially vulnerable to the virus, there is no place where they can isolate themselves, particularly if shelters don’t have the adequate resources to put safety measures in place.

It has been a whirlwind of a few weeks for all of us. As the coronavirus pandemic sweeps the nation, the busiest of American cities are drawn to a halt and the human condition has been truly shaken. As we adjust to these strange times and shift our work desks to our living rooms, our classrooms to our kitchen tables, and our weekly grocery trip to Instacart, we must also shift our focus as a nation. It’s easy to worry about the lack of toilet paper at the grocery store, but an estimated 553,000 people experiencing homelessness throughout the United States are worried about much more.

Dr. Stuart Malcolm (Haight Ashbury Free Clinic) speaks with a person living on the street about the coronavirus in San Francisco, California, on March 17, 2020. Photo Credit: Josh Edelson/AFP

Many of these individuals have the underlying health conditions that often result from living in poverty: diabetes, asthma, heart disease, and other chronic health conditions. On average, an unsheltered person in the United States is between 50 and 55 years old, yet they display health issues more commonly seen among adults aged 70 or 75.

An anonymous resident at a Salvation Army shelter in Anaheim, CA has been staying at the shelter for over two years, waiting for housing. Having gone through cycles of hope and disappointment thinking by now he’d have a safe place to call home, he has just about given up hope. Now that coronavirus threatens thousands of shelters throughout the nation, he said “If I get [it], I could die.”

Eve Garrow, the homelessness policy analyst with the ACLU of Southern California calls the situation a “recipe for disaster.” Many shelters lack the resources to respond to the tsunami of need they’ve encountered due to the outbreak. California officials have urged residents to stay inside and practice social distancing, but people living in several Orange County homeless shelters report dangerous overcrowding and a lack of basic hygiene supplies and amenities. Residents are trying to survive a public health crisis with empty soap dispensers, a lack of toilet paper, no hot water, broken sinks, no working thermometers, blood-stained walls, and infrequent cleaning.

At least 20 shelters across the country have needed to close their doors as they lose staff to illness and volunteers because of social distancing. Even more facilities lack hand sanitizer, masks, gloves, and other protective equipment necessary to keep their doors open safely.  Diane Yentel, President and CEO of the National Low Income Housing Coalition reports that shelters are “really struggling to implement social distancing.” Without the funds necessary to build new wings or obtain more hotel rooms, they are taking out half of the beds in their shelters so they can spread the ones that remain further apart. As the need for their services skyrockets, shelters face an impossible dilemma: serve half as many people and maintain some defense against the spread of the virus or serve everyone in close, potentially unsafe quarters?

And sickness isn’t the only thing shelter residents are risking. Some shelter residents have been waiting years for more permanent housing because of a national shortage of seven million homes available to low-income renters. NLIHC reports that only 36 affordable and available rental units exist for every 100 extremely low-income renter households. If shelter residents leave, even if other options are epidemiologically safer, they risk losing their spot in line for affordable housing.

As the coronavirus outbreak continues, Los Angeles has been providing unhoused people with motorhomes and RVs, which allow them to maintain social distance. Photo Credit: Apu Gomes/ Getty Images

Many people, myself included, are left wondering, what can we do? A recent story surfaced detailing Las Vegas’s makeshift “camp” for its homeless population: a parking lot painted with “social distancing” rectangles. In a city known for its hospitality and giant hotels, officials chose to offer its homeless population an outdoor parking lot. Officials have stated that the lot was chosen due to time constraints as well as their anticipated need to provide extra indoor space to hospitals. Still, more must be done to protect those who are suffering from homelessness.

We do not have much time to prevent widespread transmission of COVID-19 among those who are living on the streets or in crowded shelters. The kind of rapid, devastating impact the virus would have on the homeless community is unimaginable. Dr. Miriam Komaromy of Boston Medical Center, and Michael Botticelli, former Director of National Drug Control Policy at the White House, suggest that we have the space to provide every homeless person with a private room between university closures, office closures, and hotel closures. Doing so is a humane solution that just might work.

HUD’s 2013 Annual Homelessness Assessment Report states approximately 257,000 people experiencing homelessness have a severe mental illness or a chronic substance use disorder. Komaromy and Botticelli, both specialists in addiction treatment and drug policy, note that another challenge that must be tackled with this plan is effective treatment of addiction. They urge the federal government to authorize all licensed medical providers to prescribe buprenorphine, a prescription drug used to treat opioid use disorder, and to make such medications accessible to the homeless population.

If we take the necessary steps, as a nation, to provide people needing housing with the health resources they need, we may be able to prevent the spread of COVID-19 and ensure a safe and stable period of quarantine for all.