The COVID-19 (Coronavirus) outbreak presents specific risks to people experiencing homelessness. People rough sleeping or living in temporary accommodation are in a high risk group, many with long term conditions, that mean becoming infected with the virus could have severe consequences.
The Government has issued advice regarding this virus. And on 16.03.20 the Government published guidance for hostels and day centres. Hostels and day centres are currently advised to stay open and take precautions broadly in line with those for the general public
Pathway is deeply worried that this guidance fails to address many of the practical concerns being raised by specialist homeless clinicians and the homeless charity sector across the country. This is our response.
We, and many in the homeless charity sector, advocate the advice given by Dr Al Story at our Homelessness and Inclusion Health conference on 12th March – with COVID-19 clearly explained by Prof Andrew Hayward – links to both presentations here.
Pathway on 19.02.20 published an OPEN LETTER from London Clinicians COVID-19. London specialist homelessness clinicians and partners are calling on NHS England, Public Health England and the Mayor of London, to help support a rapid COVID-19 response for vulnerable homeless patients. The letter was published alongside a COVID-19 Homeless Sector Plan produced by Dr Al Story, Clinical Lead Find & Treat and Prof Andrew Hayward UCL Professor of Epidemiology and Inclusion Health.
This action plan is an evolving, practical plan and there are active discussions with colleagues across the NHS, local government and the charity sector about how to mobilise resources to deliver this plan. It is based on the established principles in managing any epidemic. Separate infectious people from non infectious people, keep them apart. Care for and support both groups.
Health Education England e-Learning for Healthcare (HEE e-LfH) has launched a free, open access to COVID-19 e-learning programme. It includes key materials to help the health and care workforce respond to Coronavirus.
NHS London Clinical Networks have produced this Primary Care and Community Respiratory Resource Pack during COVID-19 guide.
Protocols and plans are being continuously made as this crisis evolves:
Great Chapel St Medical Centre COVID19 protocol.
The Journals Critical Care Medicine (CCM) and Intensive Care Medicine (ICM) have drafted an International review of critical care guidelines.
NHS guidance on NHS Hospital steps on COVID-19
South London and Maudsley NHS Foundation Trust (SLAM) has produced harm reduction strategies for alcohol dependence – many people moving into social isolation will be addicted, and may not be able to access detox.
BMJ paper summarises how to remotely consult for COVID-19, with useful tips such as how to assess breathlessness in the absence of a validated tool.
The RCGP with the BMA have produced this RCGP workload prioritisation during COVID-19 chart.
Barnet CCG, have shared this Barnet Primary Care Covid19 flowchart assessment for assessing COVID-19 patients remotely.
Other organisations also calling for action and offering practical support:
The World Health Organization
The World Health Organization has rolling updates on COVID-19.
Crisis is calling for emergency measures to accommodate and protect the homeless population, regardless of legal barriers.
Full text of Crisis’ open letter to The Prime Minister, seeking facilities and support for people facing homelessness to be able to self-isolate and protect themselves from COVID-19.
Doctors of the World
Doctors of the World, in partnership with the British Red Cross, Migrant Help and Clear Voice, has developed COVID-19 advice in over 20 languages, free to download here.
Homeless Link has also responded to the government guidance on COVID-19 for hostel and day centre services for people experiencing rough sleeping.
Homeless Link also has a useful COVID-19 resources page that is regularly updated.
The Museum of homelessness and Streets Kitchen have implemented emergency measures to respond to the rapidly escalating situation with COVID-19.
They have developed a 3-pronged strategy:
– Mobilise: Outreach in a safe way to make up for a reduction in services
– Communicate: Facilitate meetings with relevant parties to plan together
– Advocate: Make asks of authorities and share knowledge on safe responses
This work has involved outreach work on the ground, screenings and the publication of a plan for the homelessness sector. Currently all the MoH efforts are focused on preventing unnecessary deaths during this pandemic. Look out for their continuous updates.
FEANTSA, the European Federation of National Organisations Working with the homeless, an umbrella group working with NGOs committed to combatting homelessness in Europe, has organised self isolation spaces for people experiencing homelessness diagnosed with COVID-19 in 15 locations.
Shelter has a resources page full of information and advice on housing and COVID-19.
Maternity Action have highlighted the particular impact of COVID-19 on pregnant women in a letter to the Chancellor. Their website hosts a range of useful information, including the telephone number of their advice line which offers help to women at risk of exclusion.
Groundswellhave developed resources to support people experiencing homelessness during the current coronavirus (COVID-19) pandemic.
The Camden Health Improvement Practice have shared their CHIP COVID19 response.
Friends Families and Travellers have produced guidance for Local Authorities specific to the needs of Travellers, Gypsies and Boaters.
Medact has drawn up a petition calling on all party leaders and all MPs to radically rethink public health and work together to ensure legislation is passed that protects everyone’s wellbeing now and through the duration of the COVID-19 crisis. Medact is calling for secure housing, secure incomes, access to care and international solidarity. You can sign the petition here.
The BMJ has a practical guide for GPs on when to suspect COVID-19 and how to respond.
The No Recourse to Public Funds Network (NRPF) has this guide to assisting people who are receiving social services’ support and COVID-19.
The Lancet has published a paper on parenting through COVID-19, with useful links to parenting resources.