Resources to support people experiencing homelessness

People who are homeless are at risk of COVID-19. Homeless services are often provided in congregate settings, which could facilitate the spread of infection. Because many people who are homeless are older adults or have underlying medical conditions, they may also be at higher risk for severe disease than the general population. Health departments and healthcare facilities should be aware that people who are homeless are a particularly vulnerable group. If possible, identifying non-congregate settings where those at highest risk can stay may help protect them from COVID-19.

Many of the recommendations to prevent COVID-19 may be difficult for a person experiencing homelessness to do. Although it may not be possible to avoid certain crowded locations (such as shelters), people who are homeless should try to avoid other crowded public settings and public transportation. If possible, they should use take-away options for food. As is true for everyone, they should maintain a distance of about 6 feet (two arms’ length) from other people. They also should wash their hands with soap and water for at least 20 seconds as often as possible, and cover their coughs and sneezes.

Any person experiencing homelessness with symptoms consistent with COVID-19 (fever, cough, or shortness of breath) should alert their service providers (such as case managers, shelter staff, and other care providers). These staff will help the individual understand how to isolate themselves and identify options for medical care as needed.

If they meet criteria for testing, people experiencing homelessness will access COVID-19 testing through a healthcare provider. Local public health and healthcare facilities need to determine the best location for this testing in coordination with homeless healthcare clinics and street medicine clinics.

Those with suspected or confirmed COVID-19 should stay in a place where they can best be isolated from other people to prevent spreading the infection. Local health departments, housing authorities, homeless service systems and healthcare facilities should plan to identify locations to isolate those with known or suspected COVID-19 until they meet the criteria to end isolation. Isolation housing could be units designated by local authorities or shelters determined to have capacity to sufficiently isolate these people. If no other options are available, homeless service providers  should plan for how they can help people isolate themselves while efforts are underway to provide additional support.  Please see the Interim Guidance for Homeless Service Providers and Interim Guidance for People Experiencing Unsheltered Homelessness for more information.

Homeless service providers can accept donations during community spread of COVID-19, but general infection control precautions should be taken. Request that donors not donate if they are sick. Set up donation drop-off points to encourage social distancing between shelter workers and those donating. According to usual procedures, launder donated clothing, sheets, towels, or other fabrics on high heat settings, and disinfect items that are nonporous, such as items made of plastic. Food donations should be shelf-stable, and shelter staff should take usual food-related infection prevention precautions. For more information about COVID-19 and food, see the Food and Drug Administration’s website on Food Safety and COVID-19external icon. For further information on cleaning and disinfection, see here.

Homeless shelters can screen incoming guests for symptoms of respiratory infections. Any person with symptoms of COVID-19 should be provided with a facemask, if available. In accordance with the Interim Guidance for Homeless Service Providers, they should then be directed to a predetermined area. This may be an alternate location or an area within the shelter. Ideally, these guests would stay in individual rooms. If individual rooms are not available, consider using a large, well-ventilated room where beds at least 6 feet apart with temporary barriers between them. Request that all guests sleep head-to-toe. At this time, it is not recommended to screen incoming guests for COVID-19 using laboratory tests unless directed to do so by local health authorities. For information about staff/volunteer illness, please refer to the Interim Guidance for Homeless Service Providers.

Homeless shelters serve a critical function in our communities. Shelters should stay open unless homeless service providers, health departments, and housing authorities have determined together that a shelter needs to close.

Connecting people to stable housing should continue to be a priority. However, if individual housing options are not available, allow people who are living in encampments to remain where they are.  Encourage people living in encampments to increase space between people and provide hygiene resources in accordance with the Interim Guidance for People Experiencing Unsheltered Homelessness.