Residential Mobility of a Cohort of Homeless People in Times of Crisis: COVID-19 Pandemic in a European Metropolis

Abstract

Most vulnerable individuals are particularly affected by the COVID-19 pandemic. This study takes place in a large city in France. The aim of this study is to describe the mobility of the homeless population at the beginning of the health crisis and to analyze its impact in terms of COVID-19 prevalence. From June to August 2020 and September to December 2020, 1272 homeless people were invited to be tested for SARS-CoV-2 antibodies and virus and complete questionnaires. Our data show that homeless populations are sociologically different depending on where they live. We show that people that were living on the street were most likely to be relocated to emergency shelters than other inhabitants. Some neighborhoods are points of attraction for homeless people in the city while others emptied during the health crisis, which had consequences for virus circulation. People with a greater number of different dwellings reported became more infected. This first study of the mobility and epidemiology of homeless people in the time of the pandemic provides unique information about mobility mapping, sociological factors of this mobility, mobility at different scales, and epidemiological consequences. We suggest that homeless policies need to be radically transformed since the actual model exposes people to infection in emergency.

SARS-CoV-2 incidence, seroprevalence, and COVID-19 vaccination coverage in the homeless population: a systematic review and meta-analysis

“…Out of the 49 included studies ( Supplementary Table S1 ), 20 eligible studies ( N = 29,513) were conducted in the United States ( 43–45 , 47–50 , 52 , 53 , 56 , 57 , 60 , 63 , 73 , 74 , 82 , 83 , 86 , 88 , 89 ), 7 ( N = 25,074) in Canada ( 46 , 54 , 59 , 62 , 64 , 69 , 84 ), 7 ( N = 3,957) in France ( 65–68 , 70 , 72 , 85 ), 2 ( N = 4,870) in the United Kingdom ( 78 , 81 ), 2 ( N = 757) in Denmark ( 58 , 91 ), 2 ( N = 181) in Germany ( 76 , 79 ), 2 ( N = 6,641) in Italy ( 55 , 90 ), and one each from Belgium ( N = 1,985) ( 71 ), Brazil ( N = 203) ( 75 ), Iran ( N = 234) ( 80 ), Mexico ( N = 481) ( 87 ), Slovakia ( N = 331) ( 51 ), Switzerland ( N = 215) ( 61 ) and Vatican ( N = 960) ( 77 ), respectively. The estimated pooled median age of 45.0 (95% CI, 42.9, 47.1) years was reported in 33 articles, and 37 publications reported gender of homeless people whose majority was male.…”

“…Thirty-two studies reported the SARS-CoV-2 incidence or seroprevalence in sheltered homeless and their median sample size was 331 (QTR 51-11,463) ( 43 , 44 , 46–51 , 53 , 54 , 56–60 , 63 , 66–69 , 71 , 73 , 75 , 79 , 82 , 83 , 86–89 , 91 ) while 15 studies also simultaneously investigated SARS-CoV-2 incidence or seroprevalence among the shelter staff ( N = 5,000) ( 43 , 46 , 47 , 49 , 53 , 56 , 63 , 66 , 67 , 75 , 77 , 83 , 88 , 89 , 91 ) ( Supplementary Tables S1, S2 ). Four studies ( N = 1,351) ( 53 , 65 , 80 , 86 ) were conducted in the unsheltered homeless people while 15 ( N = 31,232) ( 44 , 52 , 55 , 61 , 62 , 70 , 72 , 74 , 76–78 , 81 , 84 , 85 , 90 ) in the mixed population comprising sheltered and unsheltered homeless subjects whose SARS-CoV-2 incidence or seroprevalence was not separately reported. For the diagnosis of active SARS-CoV-2 infection in homeless people, 40 studies were based on NAATs alone, 1 study was based on antigen tests alone, and 1 investigation was based on the combination of NAAT and antigen tests.…”

“…For the diagnosis of active SARS-CoV-2 infection in homeless people, 40 studies were based on NAATs alone, 1 study was based on antigen tests alone, and 1 investigation was based on the combination of NAAT and antigen tests. Moreover, the seroprevalence of SARS-CoV-2 was evaluated in the homeless population in 11 surveys ( 51 , 55 , 58 , 66 , 70 , 72 , 75 , 85–87 , 91 ) ( Supplementary Table S1 ).…”

Deprivation effect on COVID-19 cases incidence and severity: a geo-epidemiological study in PACA region, France

“…The spread of the COVID-19 pandemic in France was heterogenous across administrative departments 1 , or neighborhoods 2,3 . This has been described for the severity too, estimated by the in-hospital COVID-19 incidence and mortality 1,4 .…”