COVID-19 and pandemic planning in the context of rural and remote homelessness

Abstract

Addressing the vulnerability and unique needs of homeless populations during pandemics has been a major component of the Canadian federal response to the COVID-19 crisis. Rural and remote communities, however, have received little to no funding to aid in their care of homeless people during the pandemic. Similarly, there has been little to no research on rural communities’ pandemic preparedness in the context of homelessness. There are large numbers of homeless individuals in rural and remote Canada, including Indigenous peoples who are over-represented in homeless populations. Rural communities, including rural and remote Indigenous communities, are often isolated and more limited than urban areas in their capacity to respond to pandemics. They are particularly vulnerable due to fewer healthcare and social service resources—the lack of which has been particularly evident during the COVID-19 pandemic. In this commentary, we suggest that policy-makers need to take seriously the situation of rural homelessness in Canada, its implications for individual and community health, and consequences in the context of pandemics. Policy- and decision-makers can address these concerns through increased homelessness funding and support for rural and remote communities, policy change to recognize the unique challenges associated with rural pandemic planning and homelessness, and more research that can be translated into policy, programs, and supports for rural homelessness and pandemic planning response.

Assessment of Sars-Cov-2 Infection through Rapid Serology Testing in the Homeless Population in the City of Rome, Italy. Preliminary Results

“…Fragile populations have specific peculiarities in regard to virus transmission and disease status compared to the general population. 8 These populations usually live in settings that favor infection spread, such as shelters, encampments or abandoned buildings, 4 and may not have regular access to basic hygiene supplies or showering facilities, [1][2][3]5,6,11,[13][14][15][16] thus leading to potential outbreaks as those reported in the past months by several authors. 12,[17][18][19] In addition, these persons might be more geographically mobile than the general population, 1,4 making it difficult to track and prevent infection transmission.…”

“…8 These populations usually live in settings that favor infection spread, such as shelters, encampments or abandoned buildings, 4 and may not have regular access to basic hygiene supplies or showering facilities, [1][2][3]5,6,11,[13][14][15][16] thus leading to potential outbreaks as those reported in the past months by several authors. 12,[17][18][19] In addition, these persons might be more geographically mobile than the general population, 1,4 making it difficult to track and prevent infection transmission. 1,16 Furthermore, many homeless persons have chronic or acute comorbidities such as mental and physical conditions, 20 may engage in substance abuse, 21 and have limited access to health care structures; 9,22 this may worsen the impact of COVID-19 symptoms in these patients leading to a higher rate of SARS-CoV-2 morbidity and mortality.…”

“…The development of the recent Coronavirus Disease 19 (COVID-19) pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has affected all segments of the population transversely; however, the infection had a significantly worse impact on vulnerable subjects, such as homeless persons. [1][2][3][4] In these specific populations the presence of the SARS-CoV-2 virus is rarely known, and it is possible to imagine them as hidden sources of contagion that may be difficult to trace through epidemiological link studies. [5][6][7][8][9][10][11][12] Furthermore, people experiencing homelessness live in congregate settings that may favor contagion and infection spread, as they share common spaces often without adequate social distancing, individual protections such as face masks may be unavailable or incorrectly worn, and in some cases, they may not fully understand rules and means of contagion as they are not correctly and routinely informed.…”

COVID-19 blind spots: A consensus statement on the importance of competent political leadership and the need for public health cognizance

“…At the same time, rural regions have also seen significant cuts in both funding and the availability of important public health services. [ 305 306 ] Because of these rural-urban disparities, it is crucial that appropriate support programs are created and funded to serve the homeless in rural regions. At present, food and housing security for the rural population is under a much higher threat than that of the urban homeless.…”

Pandemic preparedness and response in service hub cities: lessons from Northwestern Ontario

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Purpose Responding to the needs of homeless and marginally housed persons has been a major component of the Canadian federal and provincial responses to the COVID-19 pandemic. However, smaller, less-resourced cities and rural regions have been left competing for limited resources (Schiff et al, 2020). The purpose of this paper is to use a case study to examine and highlight information about the capacities and needs of service hub cities during pandemics.

Design/methodology/approach The authors draw on the experience of Thunder Bay – a small city in Northern Ontario, Canada which experienced a serious outbreak of COVID-19 amongst homeless persons and shelter staff in the community.

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