(Bloomberg Opinion) -- As coronavirus spreads across the U.S., epidemiologists and public health experts keep hitting one message: Stay home. Without social distancing, Covid-19 could kill nearly 2 million Americans — perhaps 17 times as many as there would be if everyone hunkers down. This is why, as of early April, the vast majority of Americans are living under shelter-at-home orders. But what about those who have no homes? On any given day, more than 550,000 people live in the country’s shelters and on its streets. It’s a human tragedy — and a huge hole in the country’s public-health fabric.
Sickness is both a cause and effect of homelessness: It’s hard to stay healthy without reliable access to showers, laundry and toilets, for example, or to manage diabetes if you don’t have a fridge to store insulin. So while people without homes often go to great lengths to stay clean — long before there were bidding wars over hand sanitizer, researchers found its use was nearly universal among the homeless — they nevertheless remain at elevated risk of Covid-19, as well as almost all other health problems. This is true even of those with health insurance.
And crucially, most homeless people in America aren’t sleeping rough: They’re living out of view in shelters. While these facilities do an admirable job of preventing, say, frostbite, they aren’t designed for social distancing. Indeed, they’re frequently overcrowded: In some New York City shelters, it’s not uncommon for people to sleep 12 to a room. In Washington, D.C., one room can accommodate as many as 60. In Las Vegas, when a shelter with more than 500 beds was forced to temporarily close due to the coronavirus, its residents were relocated to a parking lot.
Ultimately, homeless shelters are prone to outbreaks for the same reason cruise ships are: When lots of people live close together, it’s like a petri dish.
This is terrible news for shelter residents — many of whom are elderly, more than 100,000 of whom are children, and none of whom deserves to be sick. And it’s a risk to everyone else, too. A substantial number of people in the shelter system hold full-time jobs — frequently in the crucial but low-paying sectors now deemed “essential.” Over the 10 years I’ve spent volunteering in New York City shelters, I’ve met grocery-store clerks, home health aides, food-prep workers and delivery people. These low-wage workers will spend the pandemic shuttling from crowded shelters to fast-food joints and groceries and back again — potentially taking germs with them.
The pandemic has also shown that no man is an island in the health-care system. Homeless people are already disproportionately likely to use hospital services, and according to one conservative estimate, some 22,000 will need to be hospitalized due to Covid-19. (A grimmer estimate has the number at roughly 50,000.) At a time when ventilators, beds, masks and medical professionals are in short supply, why not take basic preventive action to keep the most vulnerable people from falling ill in the first place?
In the short term, cities and counties should “de-densify” homeless shelters — in other words, give residents private spaces, ideally with their own bathrooms, where they can self-isolate if necessary. New Orleans is one of many cities housing homeless residents in newly vacant hotels. (Las Vegas, with its thousands of empty rooms, should take note.) California is taking similar action, with one state official suggesting those rooms could later become permanent housing. Other places are getting creative: Los Angeles County has set aside RVs for the homeless, while Seattle has fast-tracked a new village of tiny houses.
Meanwhile, cities with large unsheltered populations should follow the CDC’s advice to leave outdoor encampments standing — dispersing them could spread the virus — and provide washing facilities nearby. Many places have wisely halted evictions during the crisis, which will prevent more people from joining the ranks of the homeless.
In the longer term, all levels of government should prioritize creating affordable housing. Nationally, there are more than 10 million extremely low-income households in the U.S., and just 3.2 million affordable housing units. True, many homeless adults require psychiatric or social services. But many others — the thousands working and raising families — are just poor. They only need homes they can afford. This is especially the case in New York, California and Washington state — all coronavirus hotspots — which until recently had superheated job markets but little affordable housing for workers.
But it’s not just true of blue states or urban areas. No matter where you live in America, homeless people are part of your community. And when they’re at risk, your entire community is. If we can bail out the airline-food industry, surely we can make sure America’s working poor — and every American child — has a home to shelter in. The health of our country depends on it.
This column does not necessarily reflect the opinion of Bloomberg LP and its owners.
Tracy Walsh is an editor for Bloomberg Opinion. She was an editor at the Dish and Euromoney Institutional Investor.
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