Across the United States, there has been a lack of testing of COVID-19 in homeless communities, even though homeless people are particularly susceptible to the virus. Sleeping on the streets and in homeless shelters, side-by-side, members of this vulnerable group can easily contract COVID-19.
The result has been coronavirus outbreaks in major cities around the country, including in Los Angeles, San Francisco and Boston. Famously, a homeless shelter in Boston had an outbreak where 146 homeless people tested positive for coronavirus but didn’t display any symptoms.
If testing had occurred earlier, then perhaps such an outbreak could have been prevented.
So why hasn’t there been more COVID-19 testing of homeless people? And just how dangerous is the lack of testing? Let’s find out more.
The Risks of Not Testing Homeless People
Not testing homeless people not only impacts homeless people themselves but also the wider community.
First, homeless people do not have a home to go to. They cannot easily practice social distancing, and oftentimes congregate in the same public places as the general public. This alone makes a strong argument for testing homeless people.
Once someone tests positive for COVID-19, they are told to stay at home and isolate. Again, homeless people have no shelter to isolate in. Likewise, group-living facilities like homeless shelters do not offer the required level of separation.
In Los Angeles, where outbreaks in homeless shelters have occurred, there is a comprehensive program bringing homeless people into hotels. While this is progressive, without a robust COVID-19 testing program running alongside, the risk of an outbreak increases. There is the danger of infected people being placed in hotels with people who aren’t.
Even in hotels where people can self-isolate, there is still a risk of infection with shared facilities. Plus, those who are infected and display symptoms will require a high level of medical support.
Another reason to test homeless people is they are more vulnerable; many have underlying health conditions. Physical health issues, mental health problems, and substance abuse issues common in homeless people can make it more challenging for the body to protect itself from coronavirus. Likewise, many homeless people live in close quarters where they are unable to practice proper hygiene standards. These factors increase the risk of contracting the virus.
We know people who are older than 65 are more likely to develop severe symptoms of coronavirus. But did you know people who experience homelessness for an extended period usually age faster? This means they have the same health conditions of people much older than their actual age. One more strike against them.
All of these factors put homeless people at increased risk of severe complications due to the virus, including death. So, why haven’t more homeless people been tested for COVID-19? In the United States, the reason isn’t clear.
Rosa Lucas, the homeless outreach coordinator for Coachella Valley Volunteers in Medicine said, “We asked the county for testing for the unsheltered homeless and have gotten no response for the last eight weeks, so we got private donors to help us. How do we know what resources to provide if we don’t know who is positive?”
Homeless shelters that conduct testing have results that show testing is worth it. The U.S. Centers for Disease Control and Prevention shows that out of 1,192 residents of shelters in Boston, Seattle, San Francisco, and Atlanta, 25% tested positive.
Out of 313 shelter staff members tested, 11% were positive.
With early testing, we can prevent an outbreak in homeless shelters and on city streets. Why aren’t we?
Cities Where COVID-19 Testing Is Successful
Fortunately, there are some cities around the country where COVID-19 testing methods for homeless people are effective. Take, for example, Jacksonville’s homeless community, which has shown a clean bill of health.
In Jacksonville, Florida, authorities have developed a process that enables COVID-19 testing of homeless communities. If homeless people test positive, they are given a private room to isolate in.
In May, the Sulzbacher Center, a homeless facility in the city, teamed up with UF Health Jacksonville. COVID-19 tests were administered at every local homeless service provider. This included Sulzbacher Village and Sulzbacher downtown, Trinity Rescue Mission, Clara White Mission, The Salvation Army, Hubbard House, City Rescue Mission, and the two Urban Rest Stop locations.
The plan was the result of a partnership with the national non-profit Community Solutions. Jacksonville, Florida, and Phoenix, Arizona, were the only two cities across the United States selected by Quest Diagnostics, where all homeless people would be tested for COVID-19.
In Jacksonville, 679 homeless people were tested, and every person received a negative result.
Led by Changing Homeless, in Jacksonville, homeless people service providers could use their existing relationships with local hotels to offer private rooms for isolation to those who tested positive. Likewise, hospitals could also discharge homeless people who needed to quarantine to these hotels.
The program included having staff available at the hotels, with three meals delivered to guests daily.
In addition, a “pop-up” urban rest stop was set up at The Salvation Army building. This allowed more homeless people to have a safe spot to stay during the day, which offered enough space to social distance.
Funding for the hotels was provided by the City of Jacksonville Urban Rest Stop grant. Private donors also gave financing, including the United Way’s First Coast Relief Fund.
The result was a collective and successful effort to keep the entire homeless population of Jacksonville safe from coronavirus.
With an all-clear of COVID-19 in Jacksonville’s homeless communities, a strong strategy of testing the virus proves that quick planning and thorough testing can go a long way.
When can we see other cities in the United States follow suit so we can keep some of the country’s most vulnerable safe from COVID-19, along with the rest of the general public?