Global Coronavirus Resources and Guidance For Homeless Services

UPDATED: March 30, 2020

OVERVIEW

To support your efforts in protecting people experiencing homelessness from the coronavirus and in response preparations, we have collected some guidance and resources from around the world. The coronavirus guidance points to the establishment of links to local health departments, increased communication, and a focus on preparedness. 

We recognize that these resources are heavily sourced from the United States, so if you have any resources or plans from your country, please send them to us here. We will be updating this page as new guidance becomes available. 

SUMMARY

  1. Develop community-wide coronavirus protocols and plans for homeless services in conjunction with local public health partners and be clear in your communication about the needs and vulnerability of the homeless population in your community
    • For communications, be prepared to describe: homeless numbers, subpopulation information, housing inventory, unsheltered locations and encampments
    • Example plans/guidance: Los Angeles, New York City
  2. For homeless direct service organizations, review layout of communal spaces, supply needs and distribution, access to sanitation and handwashing
    • Provide regular communication and information about hand washing/covering your mouth when you cough or sneeze, remind clients/staff what symptoms are, and what to do if clients/staff have any symptoms
    • Undertake deep cleanings weekly and regularly disinfecting for frequent ‘high-touch’ areas like doorknobs, handrails (examples of sanitation guidelines can be found here)
    • Prepare for staff absences at the same time as increased client volume
  3. Guidance to Homeless Service Providers on Coronavirus.
    This guidance comes from the United States Department of Housing and Urban Development.
    • In general sleeping areas (for those who are not experiencing respiratory symptoms), ensure that beds/mats are at least 1 meter (3 feet) apart, and request that all clients sleep head to-toe
    • Provide access to fluids, tissues, plastic bags for the proper disposal of used tissues
    • Ensure bathrooms and other sinks are consistently stocked with soap and drying materials for handwashing
    • Provide alcohol-based hand sanitizers that contain at least 60% alcohol (if that is an option at your shelter) at key points within the facility, including registration desks, entrances/exits, and eating areas 
    • At check-in, provide any client with respiratory symptoms (cough, fever) with a surgical mask. If there is person to person spread in your local community, clients may have COVID-19
    • Monitor clients who could be at high risk for complications from COVID-19 (those who are older or have underlying health conditions) and reach out to them regularly
    • Confine clients with mild respiratory symptoms consistent with COVID-19 infection to individual rooms, if possible, and have them avoid common areas

GUIDANCE FOR STREET OUTREACH AND TRIAGE

This guidance comes from Homeless Link in the U.K. Click through to read Frequently Asked Questions and further information.
 
Where an individual who is currently sleeping rough is found to have (or is suspected of having) the virus, a multi-agency approach should be taken to identifying and commissioning suitable self-contained accommodation as a matter of urgency. This may include hostel accommodation where a ‘safe zone’ has been established (see above); self-contained private rented accommodation; housing association stock; or a self-contained room in a hospital ward. This accommodation should be sourced in the locality where the person presents as sleeping rough, so as to avoid unnecessary travel. 

  • Local areas ought to establish a homelessness and COVID-19 task force, including the police, housing, health, homelessness, people with lived experience, the wider voluntary sector, and other relevant stakeholders. 
  • A local needs analysis should be undertaken, which includes the nature and location of homeless/rough sleeping cohorts; current intelligence on the demographic and the needs of current rough sleepers; the perceived risk in each of the main homelessness services (day centres, hostels and night shelters) including risk from staff and volunteers. This should include the numbers of people with no recourse to public funds in their area, as this is one of the groups that may be disproportionately affected.
  • Services should be mindful that COVID-19 is more likely to enter the sector through staff than through clients, so it will be important that all local messaging by stakeholders avoids a focus on people using services as the source of any outbreak. Members can influence this locally.
  • Services ought to establish a screening protocol for all staff, volunteers and others in regular contact with the service. At a minimum, outreach teams will need guidance on what to look for and training in what to do should they suspect the presence of COVID-19.
  • A self-isolation protocol, and contingency plan should be developed, as well as a plan for priority treatment for rough sleepers found to have the virus who cannot self-isolate.

CHECKLIST FOR SERVICES

Taken from the National Public Health Lead in National Social Inclusion.

  1. Each agency / service should designate person at an appropriately senior level / and or GP/clinician / nurse who is responsible for leading their response to Covid-19.
  2. All staff should be familiarized with, and have contact details for, your organisation/service area’s lead.
  3.  Appropriate guidance should be made available for service users, families and staff which is in line with the most Health Protection Surveillance Centre (HPSC) guidance in regard to:
    • Good hand hygiene practice
    • Good respiratory practice
    • What to do in the event of a suspected case of Covid 19
    • What to do in the event of a confirmed case of Covid 19
  4. Remember Patient confidentiality and data protection regulations.
  5. Site-specific signage and posters should be posted prominently to raise awareness of basic critical infection control measures and to phone before attending a healthcare facility if the person is worried they may have symptoms of COVID-19
  6. Ensure workforce adequately trained in relation to:
    • Good hand and respiratory hygiene
    • the use of personal protective equipment if appropriate
    • How to spot symptoms of a potential COVID-19 infection
    • What to do in the event of a potential COVID-19 infection
    • What to do in the event of a confirmed case of COVID-19 infection
  7. Do you have a plan in place that includes:
    • containment measures;
    • delay measures;
    • mitigation measures;
    • infection control;
    • personal protective equipment (PPE)
    • environmental cleaning;
    • restrictions on visitor access
  8. Have you developed protocols to:
    • prevent the spread of COVID-19
    • manage placement of suspected cases
    • manage the environment in the event of a suspected case
  9. Develop a plan in place for isolation if required, and identify an appropriate facility where individuals can self-isolate.
  10. Take appropriate measures to secure supply chains of all routine supplies (including PPE).
  11. Have a Capacity Contingency Plan in place in the event that you need to curtail your services.
  12. Have a Business Continuity Plan in place in the event that a case of Covid-19 is confirmed among members of staff in your organisation/facility.

GUIDANCE BY COUNTRY - UPDATED MARCH 25, 2020

For specific guidance, follow local health guidelines including how to refer clients with symptoms, a list of available guidance (by country) is below. To see guidance translated into other languages, click here.

Publication Date: 
2020
Publisher(s): 
Institute of Global Homelessness