Homeless shelters, programs ill-equipped for coronavirus, U.S. cities warned

WASHINGTON, March 10 (Thomson Reuters Foundation) - Homeless people in the United States are at particular risk of contracting coronavirus, and the systems that care for them are poorly equipped to handle a major outbreak, according to public health experts.

The United States had more than 750 confirmed cases of the respiratory virus - which emerged in China's Hubei province late last year - as of Tuesday morning and 26 related deaths, as estimated by a national tally kept by Johns Hopkins University.

The count could rise sharply as testing increases this week. More than 110,000 people have been infected globally and about 4,000 people have died, according to a Reuters tally of government announcements.

Fears have been raised that the U.S. homeless population - nearly 600,000 people in 2019 - could be particularly vulnerable to the disease, which spreads primarily through tiny droplets coughed or sneezed from an infected person and inhaled by another.

"For the general public that contracts this virus, they're told to quarantine, rest and recuperate at home," said Barbara DiPietro, senior director of policy at the National Health Care for the Homeless Council (NHCHC), a nonprofit.

"What does that mean if you don't have a home or a service provider who can accommodate them 24/7?," she said.

Vigilant hygiene can prevent transmission, health experts say, in what could be a challenge for people living without homes.

Los Angeles lawmakers are considering setting up washing facilities in encampments, while county officials in Seattle have purchased a motel and set up modular housing, in part to quarantine homeless individuals who contract the disease.

There have been no reports of coronavirus among U.S. homeless populations.

The U.S. shelter system is ill-equipped to deal with a major outbreak, with most housing open only at night for sleeping and little room for quarantines, DiPietro said.

"We don't have a homeless services infrastructure that is equipped, funded or staffed to be able to respond to a pandemic public health emergency," she added.

Concerns about the potential for homeless populations to spread coronavirus have cropped up on social media and among conservative commentators who see homeless encampments ripe for spreading the disease.

But G. Robert Watts, an epidemiologist and head of the NHCHC, downplayed the concerns as "fearmongering."

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Coronavirus outbreak in the U.S.
Vice President Mike Pence points to a question as he speaks during a briefing about the coronavirus in the James Brady Press Briefing Room of the White House, Sunday, March 15, 2020, in Washington. (AP Photo/Alex Brandon)
Tyler Baldwin mops the floor after closing for the night at the Taproom at Pike Place, Sunday, March 15, 2020 where he works as a bartender in Seattle. Washington Gov. Jay Inslee said Sunday night that he would order all bars, restaurants, entertainment and recreation facilities in the state to temporarily close to fight the spread of coronavirus, as Washington state has by far the most deaths in the U.S. from the disease. Baldwin said he closed more than an hour early Sunday after he heard the announcement. (AP Photo/Ted S. Warren)
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Shelves are emptied of paper toilet and product supplies at a Safeway store in Phoenix on Sunday, March 15, 2020. Arizona's governor and school superintendent on Sunday ordered a statewide closure of schools through at least March 27 as authorities rush to contain the outbreak of the new coronavirus. (AP Photo/Brian Skoloff)
A store vendor wears a face mask as she waits for customers in Chinatown in New York, on Sunday, March 15, 2020. President Donald Trump on Sunday called on Americans to cease hoarding groceries and other supplies, while one of the nation's most senior public health officials called on the nation to act with more urgency to safeguard their health as the coronavirus outbreak continued to spread across the United States.(AP Photo/Wong Maye-E)
Workers from a Servpro disaster recovery team wearing protective suits and respirators are given supplies as they line up before entering the Life Care Center in Kirkland, Wash., to begin cleaning and disinfecting the facility, Wednesday, March 11, 2020. The nursing home is at the center of the coronavirus outbreak in Washington state. For most people, the virus causes only mild or moderate symptoms. For some it can cause more severe illness, especially in older adults and people with existing health problems. (AP Photo/Ted S. Warren)
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NBA referee Marc Davis, left, takes a phone call as fellow referee Justin Van Duyne stands next to Davis before the basketball game between the New Orleans Pelicans and Sacramento Kings was postponed at the last minute in Sacramento, Calif., Wednesday, March 11, 2020. The league said the decision was made out of an "abundance of caution," because official Courtney Kirkland, who was scheduled to work the game, had worked the Utah Jazz game earlier in the week. A player for the Jazz tested positive for the coronavirus. (AP Photo/Rich Pedroncelli)
NBA referee Marc Davis leaves the court after the the NBA basketball game between the Sacramento Kings and the New Orleans Pelicans was postponed at the last minute in Sacramento, Calif., Wednesday, March 11, 2020. The postponement was due to what the league said was an "abundance of caution," because official Courtney Kirkland, who was scheduled to work the game, had worked the Utah Jazz game earlier in the week. A player for the Jazz tested positive for the coronavirus. (AP Photo/Rich Pedroncelli)
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President Donald Trump speaks in an address to the nation from the Oval Office at the White House about the coronavirus Wednesday, March, 11, 2020, in Washington. (Doug Mills/The New York Times via AP, Pool)
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Judie Shape, center, who has tested positive for the coronavirus, blows a kiss to her son-in-law, Michael Spencer, left, as Shape's daughter, Lori Spencer, right, looks on, Wednesday, March 11, 2020, as they visit on the phone and look at each other through a window at the Life Care Center in Kirkland, Wash., near Seattle. In-person visits are not allowed at the nursing home. The vast majority of people recover from the new coronavirus. According to the World Health Organization, most people recover in about two to six weeks, depending on the severity of the illness. (AP Photo/Ted S. Warren)
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Tim Killian, center, a spokesman for Life Care Center in Kirkland, Wash., talks to reporters, Monday, March 9, 2020, at the facility near Seattle. The nursing home is at the center of the outbreak of COVID-19 in Washington state. (AP Photo/Ted S. Warren)
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Carrying multiple people who have tested positive for COVID-19, the Grand Princess maintains a holding pattern about 30 miles off the coast of San Francisco, Sunday, March 8, 2020. The cruise ship is scheduled to dock at the Port of Oakland on Monday. (AP Photo/Noah Berger)
A man wears a mask aboard the Grand Princess as it maintains a holding pattern about 25 miles off the coast of San Francisco on Sunday, March 8, 2020. The cruise ship is scheduled to dock at the Port of Oakland on Monday for COVID-19 quarantine after 21 people tested positive for the virus. (AP Photo/Noah Berger)
SPRINGFIELD, VA - MARCH 7: Local Target store in the D.C area depleted of cleaning and sanitizing supplies and left with empty shelves as fear grow of COVID-19 (the coronavirus) reports increasing on March 7, 2020 in Springfield, Virginia. Credit: mpi34/MediaPunch /IPX
SPRINGFIELD, VA - MARCH 7: Local Target store in the D.C area depleted of cleaning and sanitizing supplies and left with empty shelves as fear grow of COVID-19 (the coronavirus) reports increasing on March 7, 2020 in Springfield, Virginia. Credit: mpi34/MediaPunch /IPX
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Ambulance workers move a man on a stretcher from the Life Care Center in Kirkland, Wash. into an ambulance, Friday, March 6, 2020. The facility is the epicenter of the outbreak of the the COVID-19 coronavirus in Washington state. (AP Photo/Ted S. Warren)
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Vice President Mike Pence greets Washington Gov. Jay Inslee, left, as Pence arrives, Thursday, March 5, 2020 at Joint Base Lewis-McChord in Washington state. Officials are avoiding handshakes due to the COVID-19 coronavirus. (AP Photo/Ted S. Warren)
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Because they often have weakened immune systems, "people experiencing homelessness are at greater risk of contracting this disease than of passing it on," he told the Thomson Reuters Foundation.

Several of the U.S. coronavirus cases have been in the states of Washington and California, which have among the highest homeless populations in the country.

Last week the U.S. Department of Housing and Urban Development released extensive new guidance on dealing with infectious disease outbreaks in shelters, encampments and among homeless populations in general.

Also, President Donald Trump on Friday signed an $8.3 billion emergency bill to fight the virus, with $100 million for community health centers that NHCHC said could include homeless services.

Looking ahead to potential dangers, cities and homeless services providers are adopting a spectrum of new strategies for dealing with the outbreak.

"We are developing special protocols such as phone screening for patients calling into our primary care sites, education to prevent the spread of illness and support for our staff," said Rachel Solotaroff, head of Central City Concern, a nonprofit in Portland, Oregon.

Some shelters are starting to assign people to sleep in the same beds every night to limit the potential for exposure, said Watts.

But homeless people get help from a host of service providers from shelters to food pantries, day centers and outreach teams, all of which are often pressed for resources and left out of response plans, DiPietro said.

A lack of resources could lead any of those to turn away anyone with potential symptoms that are not necessarily coronavirus, triggering a "vast increase" in homeless people with nowhere to go, she said.

(Reporting by Carey L. Biron @clbtea, Editing by Ellen Wulfhorst and Zoe Tabary. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)

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