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When staying at home isn’t an option: Homelessness and the COVID-19 crisis

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On Tuesday, March 17, the Bay Area entered a near-lockdown, as seven counties instated “shelter-in-place” policies. Three days later, Gov. Gavin Newsom extended shelter-in-place to the entirety of California, and dozens of other states and municipalities have since followed suit: As of today, more than 167 million people in 17 states, 18 counties and 10 cities are being told to stay at home. These drastic social distancing measures, while destabilizing, are a crucial public health imperative. However, for some of the most vulnerable Americans, shelter-in-place is an impossible directive. Roughly 568,000 people are experiencing homelessness on any given night, including more than 150,000 Californians. While most Americans stay at home and communal spaces shut down, people experiencing homelessness are left without safe places to go.

Many shelters only operate during nighttime hours, and the places where unhoused people may spend their time during the day — like public libraries and coffee shops — are closed due to shelter-in-place restrictions. Without these spaces, some unhoused people do not have a safe place to stay during daytime hours and lack access to the Internet. They are cut off from breaking news, virtual support systems and online social networks — sources of critical information, practical guidance and emotional comfort on which we so heavily depend during this uncertain and lonely time. Without in-person volunteer support, shelters and social service agencies have less capacity to support people experiencing homelessness during their time of greatest need. 

Meanwhile, homelessness and illness are closely intertwined. Becoming homeless can intensify preexisting health problems and put people at greater risk of contracting chronic illnesses. Contagious diseases can easily spread in crowded shelter spaces, while living on the streets means exposure to inclement weather, weakened immune systems and limited access to hygiene facilities. Poor health among the unsheltered homeless population is an especially grave problem in California, where less than one-third of unhoused people stay in shelters — as compared to 74% in Chicago, 85% in Washington, D.C. and 95% in New York City. Most people experiencing homelessness lack health insurance and a primary care doctor, leading them to turn to emergency healthcare services on a regular basis.

Such vulnerabilities make it even likelier for unhoused people to develop complications from COVID-19. Studies suggest that the average life expectancy among unhoused people is 20 to 30 years shorter than that of housed people. Unhoused people are at increased risk of respiratory disease, which is associated with more severe and potentially fatal COVID-19 cases. Last week, Newsom reported the first known death of an unhoused American from COVID-19. In New York City, 30 unhoused people have tested positive for COVID-19 in 22 different shelters. Many unhoused people fear that the pandemic will be exceptionally devastating to their communities — a sense of anxiety compounded by lack of clear information and limited options in the case of outbreak at shelters or homeless encampments. Shelter-in-place will save lives and reduce pressure on America’s healthcare infrastructure, but it leaves unhoused people in a state of uncertainty and does not sufficiently address their particular vulnerabilities.

Fortunately, state and local governments are taking some of these issues into account. In the Bay Area, people experiencing homelessness are exempt from shelter-in-place requirements and will not be charged with a misdemeanor for being in public spaces. Some cities and nonprofit organizations are creating public hygiene stations for homeless encampments. Newsom’s office allocated $150 million to protect Californians experiencing homelessness, which will enable counties to purchase emergency trailers and lease hotel and motel rooms for unhoused people who need to self-isolate. Newsom also issued an executive order that allows local governments to halt evictions, though it does not impose a statewide moratorium. California cities including San Jose, San Francisco and Los Angeles have enacted temporary eviction bans, and other major cities across the country — as well as the entirety of New York State — have followed suit. At the federal level, the Department of Housing and Urban Development suspended evictions and foreclosures for homeowners with federal-backed mortgages for at least 60 days. As COVID-19 upends livelihoods and imposes financial hardship, these measures will provide a degree of housing security for some families and shield them from the heightened health risks that homelessness entails. 

Of course, government at every level could take even more substantial action to protect people experiencing homelessness. The first congressional coronavirus response package does not explicitly mention support for unhoused people and does not provide resources specifically targeted to their needs. California’s $150 million allocated to the unhoused population will not erase underlying health disparities, and by the time individuals with COVID-19 symptoms are moved to hotel rooms, it may be too late to prevent outbreaks at homeless shelters or encampments. Widespread eviction suspensions may keep some families from experiencing homelessness, but they provide little comfort to people already living on the streets.

Over the next few days and weeks, it is imperative that we address these shortcomings and mitigate the threat that COVID-19 poses to unhoused people. You can reach out to your congressional representatives and urge them to prioritize people experiencing homelessness in COVID-19 legislation, encourage your state and local leaders to enact a moratorium on evictions if they have not yet done so and support shelters in your community. In the Bay Area, nonprofits like WeHOPE and Destination: Home are working to meet the health needs of unhoused people and supporting residents at risk of displacement. In addition, many members of the Stanford community will grapple with housing insecurity over the coming weeks and months. You can assist them by donating to the Stanford Student Support Fund or offering other forms of long-term aid.  

Nationwide, hundreds of thousands of unhoused people are especially susceptible to contracting COVID-19 and have fewer resources to combat it, which diminishes our collective capacity to minimize its spread. As we work to strengthen COVID-19 protections for unhoused people, it is important to recognize that homelessness not only exacerbates the threat of the virus — it is a crisis in and of itself. Many of us eagerly anticipate an eventual return to normalcy, but when it comes to homelessness, we cannot go back to the status quo. As we all struggle to adjust to daily life in an emergency situation, we should recognize that homelessness is a perpetual state of emergency that ought to be treated as such. Even in ordinary times, our political leaders should recognize that housing is a human right. The resources supplied to unhoused people as part of California’s COVID-19 response — like public hygiene facilities and leased hotel rooms — should always be readily available, which could mitigate the health issues that unhoused people disproportionately face. 

Just a few weeks ago, even these basic measures would have been considered radical, but COVID-19 demonstrates that they are reasonable, necessary and achievable. Our country’s shared experience of crisis will create opportunities to push the boundaries of the possible. As Dr. Martin Luther King famously stated, we are all “caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.” Nothing makes this poetic proclamation more concrete than the threat of contagious disease. We are only as safe as those most vulnerable; only as prepared as those with the least access to soap and hot water; only as protected as those with no private place to take refuge. We cannot forget this interdependence, even when we eventually return to business as usual. COVID-19 highlights the dangerous impact of homelessness on housed and unhoused people alike, and underscores our imperative to fight homelessness with all the resources and political energy that any emergency demands.

Contact Courtney Cooperman at ccoop20 ‘at’ stanford.edu.