Almost two years into the Covid-19 pandemic, a wealth of scientific information has been amassed. We understand the range of symptoms, how the virus spreads, how to mitigate the risk of infection and what is necessary to build and maintain adequate isolation and quarantine facilities. Much of this fundamental data that has benefited Americans and the world comes from people affected by homelessness and those who work with them. Yet despite the knowledge gleaned from this populace, the response has been continued demonization and criminalization.
In early February 2020, organizations across the United States that serve people living with homelessness, including emergency shelters and government-qualified health centers, recognized the potential of the novel coronavirus to harm their populations. Given the historical treatment of people affected by homelessness, many people knew they would be among the last on the list of priorities for state and federal assistance. As a result, organizations – often in coordination with local health departments – took action to develop as early as possible Symptom Screening Tools and Referral systems for testing and isolation. From these efforts resulted the knowledge of the whole frequency of SARS-CoV-2 across the country, transmission dynamics and risk factors for the disease that causes it. These efforts also resulted in designs for isolation and quarantine facilities that protected the general population and prevented the collapse of the healthcare system.
one early report from Boston described the Herculean efforts of an organization that tested 408 guests at an animal shelter over a two-day period and found that nearly 90 percent of those who tested positive were asymptomatic. Works like this helped the world understand that SARS-CoV-2 was silently spreading among us. In another example, SARS-CoV-2 samples collected from guests and staff at Boston homeless shelters were analyzed and some of the first provided proof on the importance of super-spreading events in shaping the course of the Covid-19 pandemic. On that basis, contact-tracing protocols were enacted across the country, modeled on what had been done by a small group of health workers in Boston.
Our knowledge of how severe a Covid-19 disease can be unfortunately also of people with homelessness who were infected early in the first wave, were unable to isolate and who had multiple comorbidities that put them at risk. Because homelessness is associated with an increased risk of hospitalization, these individuals could be “screened” to learn this comorbidities such as heart disease, lung disease and diabetes were specific risk factors for serious illness and death. Therefore, these and other health issues were subsequently prioritized for early vaccination and Covid-19 treatment – saving thousands, if not millions, of lives.