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Andrew Hayward, Professor of Infectious Disease Epidemiology and Inclusion Health Research at University College London, reminds us that despite an ease in national restrictions, the level of risk has not substantially diminished. This is particularly pertinent when working with people experiencing homelessness. Vaccine uptake amongst this population is low, with one in three receiving both doses of a Covid vaccination, compared to 75% of the general population. It is uncertain what Covid levels we can expect to see in the winter months but it’s likely the virus will seek out unvaccinated groups, increasing the risk of covid outbreaks in communal settings. 

People who are clinically vulnerable are still at risk, even if double vaccinated. Although official statistics say this applies to one in 10 people experiencing homelessness, the likelihood is that a higher proportion of those within homelessness services would fall into this group. People within our cohort who are unvaccinated with health conditions are arguably at higher risk than those who are extremely clinically vulnerable but double jabbed. 

Leaders and service providers across the homelessness sector face the difficult decision of whether to return to pre-covid ways of working, which is likely to put pressure on available resources; or retain some of the measures that have been put in place to minimise the risk of covid outbreaks. To help with this, our Digital Inclusion Lead Julie Cook has written a very helpful blog summarising advice on running night shelters this coming winter. 

SAGE recommends that appropriate controls need to be maintained and/or enhanced in hostel/shelter settings.  

Some of these control measure include; 

  • A continuous offer of vaccinations for both staff and those using services. There is a powerful correlation between staff hesitancy and subsequent uptake from service users. Peer to peer conversations are working in supporting vaccine uptake and these should be ramped up where possible. 
  • A preference for single room accommodation, whilst recognising that this might not always be possible or financially viable, especially as we approach the winter months. Concerns are already being raised about capacity to self-isolate in terms of pathways, space and funding following ‘Everyone In’. 
  • Maintain social distancing where possible, yet understanding the challenges of this in some settings. 
  • Good ventilation to reduce the risk, even in short bursts during the winter months. 
  • The wearing of masks for both staff and those using services. 
  • Protecting the clinically vulnerable, which may apply to a higher proportion of the homelessness population than we are aware of. 

One thing that is clear, is the need to hold on to the successful partnership working that has taken place throughout the pandemic. Services will face many challenges in the coming months as they decide their future operating models, it remains more important than ever that we continue to support one another, share best practice and work together to provide appropriate and safe accommodation for those that need it. 

If you want to know more about the health needs of people experiencing homelessness in your area, Homeless Link’s Homeless Health Needs Audit can help you gather this information. For more info, please get in touch.