Massachusetts and the United States overall are ill-equipped to deal with a pandemic, and homeless people stand to bear the brunt of this lack of preparedness. Many homeless people have pre-existing health conditions, and public health officials in Massachusetts have not set up places for homeless people to wash their hands, or to isolate themselves should they become sick.
The Department of Housing and Urban Development has released an “Infectious Disease Toolkit” for managing the spread of infectious diseases in shelters, encampments, and for people experiencing homelessness in general.
According to the document, people experiencing homelessness are at a greater risk of a number of diseases such as flu, Hepatitis A, and tuberculosis, even when the world is not going through an outbreak of a new disease for which there is no vaccine and little treatment, such as the recent spread of Covid-19, also known as Coronavirus. Citing the outcome of a recent outbreak of Hepatitis A among homeless people, the report notes that they often have worse outcomes than the general population when they’re diagnosed with infectious diseases.
According to the document, there are three primary stages of outbreak management: preparation, mitigation, and response. The management strategy includes providing necessary supplies to service providers, training and educating service providers and facilitating communication between continuums of care and service providers. The mitigation stage might include increasing sanitation, developing screening procedures, and developing isolation procedures.
Any effort to limit the spread of coronavirus will need to start with leadership from public health officials, as well as a significant influx of money to pay for screening, treatment, and preventative measures. On Friday, March 6, Congress approved $8.3 billion in spending to fight the spread of coronavirus. This is more than three times the $2.25 billion requested by the Trump Administration.
The Office of the Secretary of Health and Human Services will receive the largest portion of money, with $3.1 billion going towards their office. It’s not yet clear how all of that money will be spent, but $100 million will be given to community health centers that provide care to underserved populations. State and local health departments will receive $950 million.
Chunhuei Chi, the Director of the Center for Global Health at Oregon State University, recently told ABC News that homeless people are twice as likely to get coronavirus as the general populace. One of the main preventative measures that’s been espoused by public health officials is frequent hand washing, something that’s difficult to do when one is living in an encampment, or in their car.
King County in Washington State, which has seen the greatest number of coronavirus cases thus far, set up more than a dozen trailers near areas frequented by homeless people so that they have a place to wash their hands. The County has also bought a hotel where patients, including homeless people, can recover from the disease in isolation.
Spare Change News has reached out to the Massachusetts Department of Public Health for information on how the agency plans to mitigate the spread of coronavirus among homeless people in Boston and throughout Massachusetts, but we have yet to receive a response, and no plans have been announced about implementing measures similar to those in Washington State.
A spokesperson for the Boston Public Health Commission (BPHC), Caitlin McLaughlin, says that the BPHC has distributed materials to its shelters and engagement center outlining best practices for preventing the spread of coronavirus among Boston’s homeless population. The shelters will be deep cleaned weekly, and there are sinks and soap available for hand washing. In addition, tissues and hand sanitizer are being provided to clients of the shelters. McLaughlin added that the BPHC is communicating with other Boston shelters, as well as outreach staff, to share status updates, and identify gaps in services, and share resources.
McLaughlin did not answer directly when asked whether or not BPHC planned to provide more services, such as handwashing stations, to Boston’s homeless population, providing instead a general statement about BPHC’s mission: “Protecting the health and well-being of all Boston residents, particularly the most vulnerable, is our mission. We continue to prepare for all scenarios to do that.
As of Saturday, March 14, there are 123 confirmed or presumptive cases of coronavirus in Massachusetts, and Governor Charlie Baker has declared a state of emergency. Many cases are connected to a conference of Biogen employees. However, as the situation in other places, such as Italy, has demonstrated, this could change rapidly. Worldwide, there are currently almost 150,000 cases of coronavirus, and more than 5,500 people have died. Many of those who died of the illness had preexisting health conditions that made them more vulnerable to the disease, an issue that many homeless people also deal with as the disease spreads.