A fifth wave. At the gates of establishments like the Old Brewery Mission, a variant that is up to four times more contagious. He hasn’t crossed our threshold yet, but he almost certainly will. Homeless people are more than 20 times more likely than the general population to be hospitalized with COVID-19, and 10 times more likely to be admitted to intensive care. Even more terrifying: their death rate is 5 times higher within 21 days of diagnosis.
The Omicron variant will reach homeless people. First, the majority live in shelters, eat in cafeterias and share common rooms: this community life facilitates the spread of an aggressive virus. Second, food and shelter are the top priorities for most homeless people, not masks, distancing and hand washing. Third, a majority of these people have complex conditions that hamper their ability to follow public health protocols.
Homeless people are therefore more likely to be infected and much more likely to be hospitalized and die after contracting the disease. This reality affects society as a whole, as hospital beds are very valuable.
Knowing the vulnerability of the homeless population and its disproportionate impact on the health system, seeing makeshift settlements reforming in major cities, what have governments done to prepare for Omicron’s impact on the population homeless and minimize it? The answer is simple: “not enough”.
The example of last winter
Last winter, hundreds of homeless people contracted COVID-19 during the holiday season. The infection quickly spread, leading to the closure or reduction of services: shelters, day centers and night-time shelters. Homeless people infected and those awaiting test results have been moved to the quarantine facility operated by the Old Brewery Mission and its partners.
People who are homeless, by definition, cannot self-isolate at home. The facility allowing them to isolate themselves exceeded its capacity when the first large outbreaks broke out in shelters.
A second isolation center had to be opened. Fortunately, under pressure from the community sector, homeless people have been given priority vaccination and the number of infected people has finally started to decline.
But what will happen this winter? First the good news. The staff are more experienced and show resilience and dedication. Teams are adept at finding ways to keep people who are sometimes very difficult to serve – including those with serious mental illnesses and addictions – inside and in isolation. Homeless people (regardless of their age) and the workers who serve them are entitled to a third dose of the vaccine. Rapid screening tests could also be very helpful.
However, faced with a more contagious variant, we have fewer isolation beds in our red and orange zones than last year with little room to increase capacity. As the saying goes: “Hope for the best, prepare for the worst. Currently, the health care system is not prepared for a worst-case scenario.
The lesson: For homeless people, the best vaccine against COVID-19 is affordable housing, all their own.