Earlier this year, James Whitford, executive director of Watered Gardens homeless shelter, called the New York City Rescue Mission to learn how its leaders mitigated COVID-19’s spread. “I was very surprised ... to find they had only one positive case,” he said. “This was when New York City was exploding with cases.”
Whitford was having a similar experience in Joplin, Mo. The shelter did not have a single positive case of COVID-19 despite continuing all services and accepting new residents. “The infection rate in homeless communities seems to be very low,” he said.
John Anderson, president of the Bay Area Rescue Mission near San Francisco, agreed. His facility tested more than 100 people with no positive results. But while fewer homeless people have contracted the coronavirus than health officials predicted, the pandemic has brought other dangers to those living on the streets.
In the spring, disease experts and government officials rushed to identify groups particularly vulnerable to COVID-19. Many agreed that the homeless qualified because they regularly deal with outdoor exposure, nutrient deficiency, stress, and mental illness. Often they cannot maintain good hygiene or social distancing. Life on the streets exacerbates treatable conditions such as diabetes, asthma, and addiction.
The Centers for Disease Control and Prevention issued guidance for shelters to space out residents and cities to leave homeless camps undisturbed. Shelters moved beds apart and checked temperatures as people arrived. San Francisco relaxed enforcement of its tent camping ban and created some sanctioned encampments. Las Vegas also provided a parking lot for tents, with marked spaces 6 feet apart from one another.
In April, a San Francisco homeless shelter reported five COVID-19 cases had spiked to 70 in just three days. Barbara DiPietro, senior policy director for the National Health Care for the Homeless Council, said that more than 200 testing events in five cities showed infection rates among the homeless ranging from zero to 66 percent: “So this is a wildly variant moving target, depending on who and how and when you test.”
But those clusters were the exception.
“It has … been miraculous,” said Andy Bales, president of Union Rescue Mission in Los Angeles. “We’ve only lost 32 lives of people devastated by homelessness in Los Angeles to COVID-19, and just over 170 lives [of homeless people] in the United States.”
Deborah Borne of San Francisco's public health department agreed: “I am shocked ... because it’s a very vulnerable population.”
No one can say for certain why the pandemic hasn’t devastated homeless communities as some predicted. Some experts speculate homeless people might have tougher immune systems or benefit from extra vitamin D from the sun. Others suggested the homeless can more easily stay apart.
But homeless communities still face pandemic problems. In some areas, demand has taxed food banks and local food pantries cannot reach people who need help. Shelters and rehab centers admit fewer or no new clients even though overdoses are rising. Some homeless people have contracted COVID-19 in city-subsidized hotel rooms or died there from other health causes.
Still, Bales is encouraged: “Working together, along with what I describe as a supernatural protection, we were able to surprise even ourselves in mitigating the loss of precious lives.”