COVID-19 and NC’s Homeless Population

Blog | June 9, 2020


Written by James Coleman


As our country and the global community as a whole work to mitigate the effects of COVID-19, we must not lose sight of how this virus affects the most vulnerable in our society. One group that faces unique challenges and risks during this public health crisis is our homeless population. As our understanding of the true impact and spread of COVID-19 among all populations is still in the early stages, we do not yet have concrete data on COVID-19 and the homeless. But we can look at early estimates and examples of outbreaks among the homeless across the United States to paint a picture of the potential impact that COVID-19 will have on homeless populations. For example, in large cities across the country, we are seeing outbreaks of COVID-19 in homeless shelters. An analysis conducted by researchers at the University of Pennsylvania, University of California Los Angeles, and Boston University projects that people experiencing homelessness will be twice as likely to be hospitalized, two to four times as likely to require critical care, and two to three times as likely to die as the general population if appropriate mitigation actions are not taken.


Multiple factors come into play that put the homeless at increased risk. Underlying health conditions are prevalent in the homeless population, and on average the homeless are aged 60 and above, both of which are risk factors for severe illness from COVID-19. Also, lack of housing contributes to poor physical and mental health outcomes, which further compromise the health of the homeless. Even when the homeless have access to service sites such as overnight and day shelters, they  still face challenges, since COVID-19 can spread rapidly within and between congregate housing facilities such as homeless shelters. Common mitigation methods that are used to decrease the spread of infectious diseases like COVID-19, such as testing, contact tracing, physical distancing, and restricting movement, are difficult to implement among the homeless, and stay-at-home orders are impractical for this population.


Few state and local measures have been implemented to address this issue. One exception is the Strategic Plan to House Wake, a six-to-eight-month plan coordinating federal, state, and local COVID-19 funding to address housing instability that has been exacerbated by the pandemic in Wake County.


Considering the disparate impact that COVID-19 can potentially have on homeless populations, the Centers for Disease Control and Prevention (CDC) and advocacy organizations have developed guidelines, plans, and other resources that can help public health officials, local leaders, and homeless service providers prevent and prepare for COVID-19 outbreaks among the homeless. Some of these resources can be found below: