Homelessness During the COVID-19 Pandemic: What to Know

Before the COVID-19 pandemic, there was another epidemic in the United States: In January 2019, an estimated 567,715 people experienced homelessness.

Experts believe that number has risen during the pandemic, in part because 22.2 million people were laid off or furloughed in March and April 2020, though there isn't yet any official data on the pandemic's impact on homelessness or the people experiencing it.

"The pandemic really just shows the importance of housing for health and that you really can't have a healthy society when you have half a million people or more who are homeless," says Kelly Doran, MD, an emergency physician and assistant professor at the NYU School of Medicine.

The Pandemic's Impact on Shelters

In big cities, COVID-19 spread rapidly through homeless shelters. In New York City, upwards of 57,000 people experienced homelessness in August 2020. Doran, who works at an ER in New York, says that she struggled to find safe places for her patients experiencing homelessness to go once they were discharged.

"You didn't want to send them back to the shelter," she says. "Then the subway shut down, which added just another layer of challenge because a lot of people who are homeless, they sleep in the subway because they feel that that's the safest option for them."

As of May 31, 2020, the Department of Homeless Services (DHS) in New York City reported 926 confirmed positive COVID-19 cases in about 179 shelter locations, according to analysis from the Coalition for the Homeless. "As of that date, DHS had reported 86 deaths of homeless people due to COVID-19," the Coalition wrote. "In the month of April alone, 58 homeless people died of COVID-19, the vast majority (54) among homeless people living in shelters."

One anonymous person experiencing homelessness who tweets about how he lives from his Twitter account Homeless New Yorker says that when the city shut down in March 2020, homeless people had to leave their shelters every day.

It caused "tremendous stress and anxiety," he says in a message via Twitter. "After public outcry, DHS allowed residents of their shelters to stay in dorms, except for three hours a day for cleaning; soon it gave up those three hours too," he says. For two weeks in March, he says there were also shortages of food at soup kitchens and shelters.

In response to a question about how he has been coping with the situation in New York City, he says, "How I feel is determined by my situation. What I do about it is try to improve it. I don't have much success, but I live indoors, unlike others."

The Role of Systemic Racism

African Americans, Native Americans and American Indians, and Hispanic and Latino people are more likely to die of COVID-19 than white people, according to data from the Centers for Disease Control and Prevention. They also disproportionately experience homelessness for a variety of reasons.

"The whole history of housing segregation and discrimination of African Americans in this country are really what has led to African Americans being 13% of the general population, and over 40% of those experiencing homelessness at any given time," says Bobby Watts, MPH, the CEO of the National Health Care for the Homeless Council.

Discriminatory lending practices by banks have prevented Black people from owning homes at the same rates as white people, Watts says, and those disparities in homeownership have contributed to a racial wealth gap and have impacted education.

People of color are much more likely to work in fields that are considered high risk during the pandemic, like the hospitality and service industries and public education. "They're more likely to be exposed, more likely to live in denser housing and denser neighborhoods, more likely to take public transportation and not go to work in a private car," Watts says.

All of those factors and more—housing segregation, having less access to quality education, working in a lower-wage job, being more likely to have interactions with law enforcement due to racism—increase the risk of homelessness. "

"All of that leads to poor health, an over-representation of African Americans and Native Americans among those experiencing homelessness, and health outcomes, especially as it relates to COVID," Watts says.

What's the Deal With Housing Moratoriums?

Centers for Disease Control and Prevention Director Robert Redfield signed a declaration ordering the suspension of evictions if the tenant can't afford to pay rent due to financial hardship caused by the pandemic. The declaration is in effect until Dec. 31, 2020.

But that date is rapidly approaching, experts note, and Congress has yet to sign an additional relief package, with millions of Americans still out of work. The moratorium doesn't really have "teeth," says Nicholas Barr, PhD, assistant professor of social work at the University of Nevada, Las Vegas.

"In order to be protected by that federal eviction moratorium, you have to show that you're being evicted because of your inability to pay rent due to COVID, and that's burdensome," he says.

The people who are most at risk of facing eviction are people of color working low-wage jobs, LGBTQ+ people—particularly transgender people who are more likely to live in poverty—people with poor mental health, and those with substance misuse problems. Those people likely don't have access to a lot of support, Barr says.

"It's not clear to me how they're going to push back against the determined landlord who wants to get them out," he says. In some states, legal aid organizations and nonprofits have set up help lines to assist people who are facing eviction.

The Need for Long-Term Solutions

The Aspen Institute estimated that at least 30 million people were at risk of eviction at the end of September 2020. Barr says the federal government needs to help relieve the rental debt people are accumulating while they're out of work while also taking care of landlords.

"What you don't want to do is have a huge new influx of people into already stressed service systems where it's now more difficult to meet face to face because of the burden of the pandemic," Barr says.

In New York City, Doran says the city has come up with a temporary solution: It is housing people experiencing homelessness in hotels. There are isolation hotels for those who have tested positive for COVID or are experiencing symptoms, and then de-densifying hotels to try to prevent other folks who are negative from getting and spreading the virus, she says.

Cities in California, Connecticut, North Carolina, and Minnesota have also placed people in hotels temporarily. Doran says she would like to see those efforts turn into a push for permanent housing, and in some areas, they have.

In the Bay Area, California Governor Gavin Newsom distributed grants to help cities buy hotels and apartment buildings and convert them into long-term housing for people experiencing homelessness. "I'm hoping that that there are priorities moving forward to recognize housing as a necessity, both for public health, and obviously also as a human right," Doran says.

Regarding long term solutions to homelessness, Watts says that universal health care would help address the effects of racism. Expanding affordable housing options and access to affordable housing would also help, and Barr says the federal minimum wage should be raised to $15 from its current $7.25.

Though the pandemic highlighted the public health dangers people experiencing homelessness face, Watts says there was one bright spot: "For the first time, many cities were concerned about the health of their neighbors without homes," he said.

"We've made the strong link in practical terms between housing and health care in ways that we haven't done before," says Watts. Now, we need to build upon those connections, he says, to help prevent the next pandemic.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.