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COVID-19 homelessness is a public health problem — it's about to get worse

COVID-19 homelessness is a public health problem — it's about to get worse
© FREDERIC J. BROWN/AFP via Getty Images

As we mark the one year anniversary of the World Health Organization’s (WHO) declaration of the pandemic, we can see signs of long awaited progress. 

President BidenJoe BidenBiden announces picks to lead oceans, lands agencies Overnight Defense: Top general concerned about Afghan forces after US troops leave | Pentagon chief: Climate crisis 'existential' threat to US national security | Army conducts review after 4 Black soldiers harassed at Virginia IHOP Feds expect to charge scores more in connection to Capitol riot MORE has accelerated the vaccine delivery timetable, now promising every adult who wants one will be eligible by May 1. Nearly 25 percent of the nation’s adult population has already received at least one dose. Many states are seeing decreasing numbers of new cases and deaths. There’s still work to do, but there’s undeniable excitement that we’re headed in the right direction.

For America’s homeless, however, there will be little celebration when we reach herd immunity.

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Before the pandemic struck, the number of unsheltered people in the U.S. was on the rise for three straight years. California alone recorded a 16 percent increase in 2019. At the time, then-Secretary of the U.S. Department of Housing and Urban Development (HUD) Ben CarsonBen CarsonWatchdog blames Puerto Rico hurricane relief delays on Trump-era bureaucracy Ben Carson defends op-ed arguing racial equity is 'another kind of racism' COVID-19 homelessness is a public health problem — it's about to get worse MORE said the problem in California demanded “crisis-like urgency” from state and local leaders. Federal leadership was sadly lacking and we have yet to start a national conversation about how to make housing affordable for all.

It’s no surprise COVID-19 has had a disproportionate impact on America’s homeless. Nearly twice the number of homeless suffer from underlying health conditions in the areas of hypertension and diabetes, among others, heightening exposure risk to the virus’s most serious effects. Washington alone reported a 54 percent increase in the number of homeless who died in 2020 compared to the previous year. As of last October, the death rate for the sheltered homeless in New York was 75 percent higher than that of New York City. 

COVID-19 precautions — hand washing, social distancing and wearing clean masks — pose significant challenges for the unsheltered, especially for those who suffer from untreated mental illness. Safety isn’t always the priority when daily survival is the primary objective. Being homeless also complicates nutritional health, regular access to bathrooms and medical care and the ability to store, cook and consume food in a safe manner. 

Fortunately some nonprofits and locales are helping. Project Roomkey provides motel and hotel rooms for those without shelter in L.A. County. Austin Street Center has been coordinating donations to help the homeless following the recent Texas winter storms. Another group, The City Mission, is “compassionately restoring individuals in crisis” who have been displaced in Cleveland. Public Interest Registry recognized The City Mission with an award in 2019 and honored their work as part of an ongoing series celebrating mission-driven groups making a difference. 

Organizations like these are doing what they can. But the rise of homelessness is about to explode to a level it’s never been before. The Economic Roundtable predicts that chronic homelessness will increase by an astonishing 49 percent over the next four years, where an estimated 603,000 more Americans will be unsheltered by 2023. 

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The 2020 Coronavirus Aid, Relief and Economic Security (CARES) Act provided $4 billion in homeless aid funding for emergency shelter and relief services. But it reportedly took over four months for those resources to reach areas where they were needed most. The men, women and children who live on America’s streets don’t have the luxury of time to wait for help to arrive.

President Biden showed great leadership in ordering the Federal Emergency Management Agency (FEMA) to reimburse states and cities that paid hotels to house the homeless during the pandemic, such as those in L.A. County. It was an important stopgap measure but it didn’t go far enough to address the underlying problem. Now, a federal order by the Centers for Disease Control and Prevention (CDC) prohibiting landlords from evicting tenants with delinquent payments to prevent further spread of COVID-19 is set to expire at the end of this month. With nearly one in five adult renters behind in their payments, millions of Americans could soon be displaced with nowhere to go. 

Extending the CDC moratorium is needed to prevent this problem from becoming far worse. But it will take bold action by Congress, Biden and a national plan to reverse the rising trend of homelessness in America. Children and families deserve stable and safe housing, and it is past time we as a nation examine the root causes of homelessness to reduce the number of Americans who live in extreme poverty.

We can’t ignore it any more.      

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.