Challenges faced by people experiencing homelessness and their providers during the COVID-19 pandemic: a qualitative study

Hodwitz, Kathryn; Parsons, Janet; Juando-Pratts, Clara; Rosenthal, Esther; Craig-Neil, Amy; Hwang, Stephen W.; Lockwood, Joel; Das, Paul; Kiran, Tara

doi:10.9778/cmajo.20210334

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…Supplementary Table S1 details the included studies, which were descriptive or observational in design. The most common country of origin was the United States [ 29 – 31 , 35 – 37 , 39 , 40 , 43 , 46 , 47 , 50 , 59 , 62 , 67 ], then France [ 27 , 32 , 33 , 38 , 41 , 42 , 44 , 45 , 52 , 56 , 60 ], with further contributions from Wales [ 63 , 65 , 66 ] and Denmark [ 34 , 48 , 49 , 64 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies adopted a qualitative methodology and examined the personal impact of the pandemic on people experiencing homelessness [ 32 , 35 , 36 ] as well as those working in homeless shelters [ 37 , 50 ]. Several studies described deleterious impacts of the pandemic on mental health [ 36 , 50 ], citing worries about COVID-19 and limited accessibility to substance-misuse support because of the pandemic.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies described deleterious impacts of the pandemic on mental health [ 36 , 50 ], citing worries about COVID-19 and limited accessibility to substance-misuse support because of the pandemic. In other studies, participants described feeling restricted in their ability to manage their personal health due to a reduced capacity to isolate effectively [ 32 ], challenges in dealing with uncertainty, and a perception of restrictions on normal activities [ 32 , 37 ]. Two studies mentioned increased drug use, alcohol use, and smoking as coping mechanisms [ 36 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

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The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review

Ogbonna,

Bull,

Spinks

et al. 2023

Int J Public Health

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Objective: The homeless population experiences inequality in health compared with the general population, which may have widened during the COVID-19 pandemic. However, the impact of being homeless on the outcomes of COVID-19 is uncertain. This systematic review aimed to analyse the impact of experiencing homelessness on the clinical outcomes of COVID-19, including the effects on health inequalities.Methods: A review protocol was developed and registered in PROSPERO (PROSPERO registration 2022 CRD42022304941). Nine databases were searched in November 2022 to identify studies on homeless populations which contained primary research on the following outcomes of COVID-19: incidence, hospitalisation, mortality, long COVID, mental wellbeing, and evidence of inequalities. Included studies were summarised with narrative synthesis.Results: The searches yielded 8,233 initial hits; after screening, 41 studies were included. Overall, evidence showed that those in crowded living settings had a higher risk of COVID-19 infection compared to rough sleepers and the general population. The homeless population had higher rates of hospitalisation and mortality than the general population, lower vaccination rates, and suffered negative mental health impacts.Conclusion: This systematic review shows the homeless population is more susceptible to COVID-19 outcomes. Further research is needed to determine the actual impact of the pandemic on this population, and of interventions to mitigate overall risk, given the low certainty of findings from some of the low-quality evidence available. In addition, further research is required to ascertain the impact of long COVID on those experiencing homelessness, since the present review yielded no studies on this topic.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review

Ogbonna,

Bull,

Spinks

et al. 2023

Int J Public Health

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“…Shelters for PEH feature high population density and rapid turnover, client marginalization and poverty, poor ventilation, lack of access to optimal hygiene, insufficient infection control and other regulatory protections, and limited staff training and resources, all of which increase the risk of transmission of COVID-19 and other respiratory diseases (( 9 )). Although guidelines for the control of COVID-19 in shelters have been developed and recommended by public health organizations during earlier phases of the pandemic (( 10 )), shelter service providers described feelings of uncertainty and powerlessness given limited resources in the support of PEH during the pandemic (( 11 )). These factors together contribute to the increased prevalence of COVID-19 in shelters relative to other settings (( 12 )).…”

Section: Introductionmentioning

confidence: 99%

Wastewater surveillance for COVID-19 in shelters: A creative strategy for a complex setting

Ranasinghe,

Baral,

Stuart

et al. 2024

CCDR

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People experiencing homelessness experience disproportionate rates of morbidity and mortality from coronavirus disease 2019 (COVID-19) compared to the general population and shelters for people experiencing homelessness are a major contributing factor to these negative outcomes. As a result of their unique structure, population and physical space, these settings pose several challenges to the prevention of COVID-19 infection that are not adequately addressed by conventional non-pharmaceutical public health interventions. Wastewater surveillance for COVID-19 is a viable strategy for health protection in shelters due to its ability to meet these unique challenges. Its passive nature does not depend on individual health-seeking behaviours, and it can provide useful epidemiological information early on in an outbreak setting. In this commentary, the authors examine a recent application of wastewater surveillance of COVID-19 in a men’s shelter in Toronto. Further applications of wastewater surveillance for other infectious diseases of concern in shelters are proposed, and the need for the development of ethical frameworks governing the use of this technology is discussed.

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“…There is a small body of international literature reporting accounts from people who are homeless, and at risk of homelessness, about COVID‐19 impacts (Crouzet et al, 2022; Finnigan, 2020; Henwood et al, 2020; Hodwitz et al, 2022; Padgett et al, 2021; Tucker et al, 2020). The impacts reported are diverse, but commonly relate to service closures, transitions (voluntary and forced) into temporary accommodation, lockdowns, changes to income, and social distancing, hygiene, and infection risk.…”

Section: Introductionmentioning

confidence: 99%

Impacts of the COVID ‐19 pandemic, and of government responses to the pandemic, on people who are homeless in Australia: Mapping perceptions of a national sample of homelessness service workers

McCosker

Ware

Maujean

et al. 2022

Health Social Care Comm

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People who are homeless are disproportionately impacted by the COVID‐19 pandemic, and by government responses to the pandemic. This study maps the perceptions of homelessness service workers in Australia, about the impacts of the COVID‐19 pandemic and government responses to it on people who are homeless. An electronic survey was distributed to homelessness service across Australia in June/July 2020, following Australia's ‘first wave’ of COVID‐19. Fifty‐nine homelessness services from all eight states/territories responded. Perceptions of impacts on people who are homeless were mapped in six themes: (1) changes in the types of people presenting, (2) overall impacts on peoples' lives, (3) impacts on mental health, (4) impacts of changes in service delivery, (5) impacts of government support and (6) ongoing impacts. The COVID‐19 pandemic, and government responses to the pandemic, have affected every aspect of the lives of people who are homeless in Australia. There is a continuing need to support people who are homeless as the world transitions to the ‘new normal’ of COVID‐19, particularly as rates of homelessness increase. Understanding impacts is vital to informing relevant and effective health, social and other supports for this group.

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Challenges faced by people experiencing homelessness and their providers during the COVID-19 pandemic: a qualitative study

Cited by 8 publications

References 31 publications

The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review

The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review

Wastewater surveillance for COVID-19 in shelters: A creative strategy for a complex setting

Impacts of the COVID ‐19 pandemic, and of government responses to the pandemic, on people who are homeless in Australia: Mapping perceptions of a national sample of homelessness service workers

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