Health professionals and health care workers from clinics and hospitals throughout the Twin Cities have observed the disproportionate toll that COVID-19 is having on our neighbors experiencing homelessness. In recent days more than 300 health care workers including physicians, nurse practitioners, social workers, psychiatrists, case managers, midwives and others have signed a petition urging state and local public health officials to meet the immediate survival and health care needs of those experiencing homelessness.
Taking care of people experiencing homelessness is the right and dignified thing to do. In addition, it will decrease further community spread of this insidious virus and minimize the utilization of our limited clinical, emergency and hospital resources.
The Centers for Disease Control and Prevention and Gov. Tim Walz’s administration recognize sheltering in place, physical distancing and handwashing as vital measures to mitigate the dangers of COVID-19. But these are unavailable to people experiencing homelessness.
Existing shelters are understaffed, overcrowded and facing the threat of closure due to chronic underfunding and the inability to protect staff from the highly contagious and life-threatening illness. People living outside of the shelter system — at least 700 in Hennepin County alone — rely on public spaces that are now overwhelmingly closed for basic needs. For them, sheltering in place and even handwashing or bathroom facilities are now more inaccessible than ever.
The first documented cases of COVID-19 in the local homeless population were confirmed just before the start of this petition drive. We now have information from the Boston Health Care for the Homeless Program that suggests rates of asymptomatic positivity are very high among the homeless populations — 37% in the Boston cohort. These individuals, while asymptomatic, have the potential to pass the virus to others in the wider community.
We appreciate the resources already allocated by the Minnesota Legislature and the work that has been done. However, more action is needed to deliver a resource commitment that matches the scale of the crisis at hand.
Without further hesitation, we urge city, county, state and public health officials to:
1) Immediately locate and create restroom and handwashing facilities for unsheltered people near their encampments. Provide outreach teams with the resources needed to engage those who are sheltering in place outside.
2) Immediately and fully fund the move of existing emergency shelters into local hotels with safe staffing at all sites — including safe conditions, appropriate personal protective equipment, healthy wages and paid leave.
3) Use available public and private properties to offer safe, dignified and accessible emergency housing on demand to people without shelter. Waive requirements for unsheltered individuals to stay in overcrowded shelters before accessing emergency housing.
With 80,000 largely vacant hotel rooms in the state, we have the resources to prevent catastrophic spread of COVID-19. Each day that passes without action increases the harm the virus will inflict on our neighbors and patients without housing, those of us who directly care for them, and everyone in our communities. Every delay lengthens the duration needed to shelter in place and the impact this has on our health systems, economy and communities.
Rebecca Skoler is a family nurse practitioner at the Community-University Health Care Center. Cara Carlson is a social worker and clinical director at Anam Cara Therapies. Timothy Ramer is a family physician at Smiley’s Clinic, University of Minnesota Physicians. Jack Martin is executive director at Southside Harm Reduction. This article is submitted on behalf of more than 300 petition signatories. The opinions expressed are solely those of the authors and signatories.