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Noël Del Toro is a senior majoring in neuroscience, minoring in biology and a 2020-21 health care ethics intern at the Markkula Center for Applied Ethics. Views are her own.
We have all found ourselves thinking about health within the past year—for some, it might even feel as if you’ve been thinking about health an overwhelming amount. But what about homelessness? Have you thought very often about that? Like many others, your answer to my posed question is likely “No,” “Not really,” or “Hmm...I’m not quite sure.” As the COVID-19 pandemic has progressed forward, important topics for discussion and recognition have emerged: social justice, racial justice, gender equality, medical ethics, and more. However, we have not seen many headlines, listened to many podcasts, read many articles, or seen much protest advocating for the homeless community.
Ways in which life has changed due to the pandemic are drastic. Last March, immediate closure of grocery stores, restaurants, and public places ensued in large cities and smaller towns, many urgent care centers closed their doors, masks were sold out everywhere, sanitization means were absurdly expensive, and everyone was terrified of anyone who wasn’t in their immediate “pod.” A year later, the pandemic still exists, but things have become better. We have a vaccine. The businesses that made it through the last year are operating in some form. With the right precautions, many public places are now open. Hand sanitizer is no longer $15 for a 3oz bottle, and the shelves are restocked with toilet paper. Life is looking up for everyone … huh? Well, in reality, homeless individuals are still struggling with the pandemic. In many conversations of COVID-19 regulations, the homeless were forgotten as if they were invisible; as if they were an “other.”
Before the existence of the COVID-19 pandemic, an estimated 553,742 people experienced homelessness on a given night within the United States. Approximately 100,000 children are homeless each day, and 50% of these children are younger than five years of age. Children of the LGBTQIA+ community make up a significant number of the homeless youth. It exists in all races and ethnic groups, but affects Black and Latino populations inordinately. Some individuals are chronically homeless while some are acutely homeless. Since the onset of the pandemic, these numbers have only continued to rise as businesses have closed, jobs have been lost, the number of job openings have become incredibly scarce, and medical bills relating to COVID-19 inpatient care have drained people’s bank accounts.
Federal and state mandates are visible on the signs scattered around town: wear your mask, wash and sanitize your hands frequently, socially distance with a minimum of six feet between yourself and others, stay home when you are feeling ill, and use telemedicine to meet with a medical professional who will take care of your health and medical needs. For the homeless, one or more of these mandates are likely difficult to follow. For those without a home, it’s impossible to stay at home when you are feeling ill. For those who do not have a cell phone or computer, telemedicine is not a viable option, especially with the closure of public libraries. Without the option of telemedicine and with the closure of urgent care centers and accessible medical clinics, options to have their medical needs met are scarce. For those who reside within a homeless encampment, it is incredibly difficult to socially distance yourself from others. For those who relied on shelters, churches, and community centers for food, water, hygienic needs, and shelter at night, these amenities disappeared. For a family or families that live in a one bedroom, one bathroom house, if one person acquires COVID-19, it’s likely the rest will too. Being homeless is difficult, and COVID-19 has only made it more so.
There is a linkage between housing and health. Those who have a house have an 80-year life expectancy, while those who are chronically homeless have a 60-year life expectancy. Those who are sick are commonly the most vulnerable to becoming homeless, and once homeless, they become more sick and more vulnerable. Due to this, I would argue that the homeless population is the most vulnerable group to be faced with the COVID-19 pandemic, but in many cities they have been forgotten. In the past year, cities within the U.S. with large chronic and acute homeless populations have attempted to help. Cities including Colorado Springs, Los Angeles, Phoenix, San Francisco, and Washington D.C.; have initiated discussions about possible temporary housing options for the homeless to reduce the spread of COVID-19, the implementation of free and easy testing sites near homeless encampments, the distribution of food and water to homeless communities, and even the provision of means of sanitization. While a few have been successful in helping their homeless communities, most cities have watched as the ideas faded away—they lost sight of the project before it even began.
In April of 2020, local officials in Phoenix, AZ, responded quickly to provide a temporary encampment for the city’s unsheltered homeless in hopes of decreasing the spread of the virus. The officials promised that this encampment would have around-the-clock security for protective purposes, mandatory social distancing, water, toilets, and hygiene and sanitizing supplies. No COVID testing was provided because tests were not allocated for homeless communities by the federal government. As a large number of the estimated 7,500 homeless individuals residing in the Phoenix area arrived, the toilets quickly became overused, hygienic and sanitizing supplies became scarce, social distancing was not followed, and the around-the-clock security the city had promised was by no means around-the-clock. Phoenix officials took a step forward and provided an area for homeless individuals to, supposedly, remain safe throughout the pandemic, but it seems that the city quickly forgot to continue to care for these citizens and provide and enforce the conditions that had been promised.
How do we know that this vulnerable population has been forgotten in this pandemic? Everyday, you can go on the internet and search how many active cases of COVID exist and, unfortunately, how many deaths have occurred in any city, state, or country. However, homeless individuals will not be included in these numbers. No one seems to have any idea as to how many homeless individuals have died within this country due to the pandemic. In these big cities with large homeless populations in which COVID-19 cases were, and still are, skyrocketing, the number of homeless people who have contracted and sadly passed from COVID-19 have not been counted. Homeless populations have not been part of the large conversation surrounding COVID-19 because they were never even included before the pandemic began. It was forgotten that they are members of the community who have and will continue to be affected by the virus. This inequity needs to be a part of the larger discussion.
To truly put an end to this pandemic, the homeless population must be included in the conversation. It is our obligation to care for this community amidst this pandemic as we would anyone else. Why? Well, realistically, by protecting the homeless community from the virus, we are protecting society from it as well. However, morally, it is our obligation to protect the homeless from COVID-19 because they are human beings. To protect, to love, and to respect all, we must actually protect, love, and respect ALL. No one should be forgotten, but this is exactly what we have done to the homeless community, not only during the pandemic, but for years prior as well.
Thankfully, as of April 8th, 38 states have approved those who are 16 years and older to receive a COVID vaccination, allowing homeless individuals above the age of 16 to qualify. This eligibility will, hopefully, reduce the spread of the virus within homeless communities.
In conclusion, I urge you to safely spread love and awareness to homeless people within your community. We can all think of someone within our community who is or has been homeless—whether it is you, a family member, a friend, a classmate, a colleague, or the stranger you pass everyday on your walk home from work. Unfortunately, a smile cannot end the COVID-19 pandemic, but it can change someone’s day, and sometimes that means more than we ever know.