What is at stake for people experiencing homelessness during the coronavirus pandemic?

Examining the particular challenges and policy responses for the homeless.

Last updated 8 April 2020

For people with a safe and secure home to self-isolate in, reducing the impact from the coronavirus is stressful enough, but for Australian residents and visitors, such as stranded backpackers,  who are experiencing homelessness, the situation is very acute. In particular, people who are sleeping rough, that is living a place not designed for habitation such as a park, derelict building or car, are vulnerable to respiratory infections during normal times.

In our latest AHURI Brief, we examine some of the issues faced by homeless Australians during the COVID-19 pandemic.

Inability to self-isolate

Rough sleepers often congregate in common areas for safety while other popular locations may provide shelter and a degree of warmth, such as public transport stations or hospital waiting rooms. Crisis accommodation may not be appropriate either as they can become crowded and do not have the space to allow physical distancing.

People experiencing homelessness while living in severely overcrowded or transient housing may also find it very difficult to maintain the appropriate physical distancing necessary to prevent spreading COVID-19. In addition, with large numbers of people sharing the living space the chance of someone bringing the infection into the dwelling is greater than for people sharing dwelling space with a small number of people.

Lack of access to proper sanitation

Rough sleepers have less access to places where they can wash or disinfect hands or clothing that may potentially have been contaminated by the virus. In addition, with the virus having the ability to survive on some surfaces for several days,  readily available sanitation places such as public toilets and their wash basin taps may not be cleaned often enough to destroy the virus.

Food and medical supplies compromised

Charity and not-for-profit organisations who rely on older volunteers to staff operations that prepare or deliver meal services, food supplies and other services to people experiencing homelessness (particularly rough sleepers) are finding they may need to reduce their activities due to the need for older volunteers to self-isolate so as to avoid the virus.

In areas affected by panic buying or hoarding of supplies, people experiencing homelessness, whether on the streets or in crowded housing, may have nowhere to safely and securely store food and essential medication. If panic buying leads to increased prices for such products, people experiencing homelessness may not be able to afford them and may be forced to go without.

Greater reliance on hospitals

If a person experiencing homelessness does get sick with the COVID-19 virus they won’t be able to stay home to recuperate for the obvious reason that they don’t have a home. This means that a person experiencing homelessness and who has a mild case of the virus would be expected to remain in hospital until they have recovered so as not to spread the virus further, whereas someone with proper housing may be released into self-isolation at home until they have recovered.

Impact on couch surfers

Across Australia social distancing laws may inadvertently push people experiencing homelessness who are living temporarily with family or friends (e.g. 17,725 individuals in 2016 Census) into becoming rough sleepers.

Many of these individuals, often termed ‘couch surfers’ usually find they need to move to another person’s place after a period of time (ranging from a few days to a couple of months) so as to not outstay their welcome. New coronavirus social distancing requirements essentially prohibit a couch surfer from easily moving locations, potentially restricting them to their current location for much longer than both householders and couch surfers feel comfortable, thereby leading to the risk of causing severe tensions. As a consequence, individuals may feel they have no options but to leave and to sleep rough.

The laws also mean individuals who lose their employment, and subsequently their accommodation during the coronavirus emergency (which could easily last until July 2020, if not even longer) would not be able to take up the offer of sleep at a friend’s place, even for a short period of time. Instead they may have no other option but ‘rough sleeping’.

Policy responses

Guidelines for homelessness services

The Victorian Government has introduced Homelessness Covid 19 support guidelines to assist homelessness services in the State in responding to the coronavirus crisis.

The guidelines offer directions on prioritising service delivery during the pandemic, suggest modifications to a range of services and outlines a series of additional considerations. The guidelines recognise that some people who are receiving support through a homelessness support service may have ‘often experienced trauma in their lives’ and that feelings of anxiety, stress and a loss of control can trigger responses such as challenging behaviours.

The Guide suggests practitioners ‘frequently check in with clients in relation to their mental health and explain the purpose behind impactful policy or practice decisions. Understanding the reason behind decisions can give people a sense of control and clarify that what they are feeling is normal in the current environment.’

Hotels With Heart

The Western Australian Government is trialling a month-long program where 20 people experiencing homelessness are being accommodated in hotel rooms in the Pan Pacific Hotel in Perth.

The program, ‘Hotels With Heart’, was announced by the Government on 31 March and, if successful, will expand to include 120 rooms. The Government suggest the larger program would include people experiencing mental health issues, people fleeing domestic violence, as well as people experiencing homelessness.

The program screens people to identify those rough sleepers who are most at risk and might benefit most. Once in their hotel room participants are encouraged not to leave, though they can access an outdoor area for exercise and smoking, and are given meals and access to support workers for issues such as drug and alcohol dependency and mental health issues.

A quick assessment of the trial after nearly a week (3 April 2020) showed ‘no unexpected issues and most have been related to alcohol and drug withdrawals – and acclimatising to being in a room, sleeping in a bed and living within the property’.

Some international responses

The UK government has instigated the ‘COVID-19 Homeless Sector Plan for rough sleepers’, or those at risk of rough sleeping, supported by £3·2 million of emergency funding.

‘The funding will be available to all local authorities in England and will reimburse them for the cost of providing accommodation and services to those sleeping on the streets to help them successfully self-isolate.’

‘There will be a central command team consisting of doctors and public health experts to coordinate resources, and facilities will be divided into two categories—COVID-CARE, for people who are symptomatic or have tested positive, and COVID-PROTECT, for people who have other medical vulnerabilities who are asymptomatic or screen negative, but who also need to self-isolate.’

In both CARE or PROTECT hotels, rough sleepers will be housed in separate rooms with their own bathroom in unused hotels sourced commercial operators.

In NZ, the Ministry of Housing and Urban Development (HUD) is increasing the supply of emergency and transitional housing for the homeless and rough sleepers, working with CHPs and commercial hotels to secure more places.

In the USA, the Centers for Disease Control and Prevention (CDC) has issued an ‘interim guidance’ ‘to provide key actions that local and state health departments, homelessness service systems, housing authorities, emergency planners, healthcare facilities, and homeless outreach services can take to protect people experiencing homelessness from the spread of COVID-19.’