Access more information on Pandemic Planning for the Homelessness sector at the Homelessness Learning Hub. 

Dominating the news cycle in recent weeks, the 2019 Novel Coronavirus (COVID-19) outbreak was declared a pandemic by the WHO yesterday. A quick Google search reveals over 3 billion alerts, top stories, and websites that provide safety tips and information. While these resources are meant to educate, the sheer volume may at times be overwhelming.

If your work involves supporting clients experiencing homelessness or housing vulnerability, you may be worried about how an outbreak could effect their welfare as well as your own. Rightly so; research has shown that individuals experiencing homelessness may be at greater disadvantage during pandemic outbreaks, are often nutritionally vulnerable, and may have health conditions that put them in medically high risk populations.

Managing pandemic outbreaks within the context of homelessness requires measures that go beyond mainstream approaches. The messages we commonly hear – to “stay home if you are sick” and “keep your distance from others” – are good advice, but not feasible for those without a home who reside in congregate shelter settings.

How, then, do you prepare for COVID-19 when your clients face additional risks and the information that is available is not entirely applicable? Fortunately we have learned a lot from previous outbreaks, such as the H1N1 pandemic in 2009. Researchers in sites across Canada documented the impact of the H1N1 outbreak from the perspectives of individuals experiencing homelessness, service providers in the sector, and key stakeholders.

Overall homelessness agencies and sectors were well prepared during H1N1 and the outbreak was well-contained among client populations. This success was largely attributed to communication between agencies and the public health sector, infection control measures such as increased cleaning, and open-door policies with clients and staff.

The successful management of H1N1 was not without its challenges, however. Social service workers were often expected to take on health-care related roles despite not being formally trained or equipped to do so. Access to supplies was a commonly cited concern, related to confusion over what supplies were needed, the cost of purchasing them outside a regular budget, and not having enough storage to stockpile and meet demand.

The message that came out most clearly during the H1N1 outbreak was that it is vital to have an advanced plan, that is considerate of the needs of persons experiencing homelessness, yet flexible enough to adapt to changing conditions.

What you need to know to make a COVID-19 plan

Based on what we know about pandemic outbreaks and homelessness, here are some important points to consider in preparing for COVID-19:

  1. Review your city’s pandemic plan, particularly if there is one for vulnerable populations. During H1N1 most service providers were aware a plan existed, but had not read it. You can find these plans online through your local Public Health Agency’s website.
  2. Check to see whether your organization has its own pandemic plan in place.
    • If an organizational plan exists, distribute it to staff and/or hold a meeting to review the key points.
  3. If no plan exists, or an update is needed to the existing plan, consider the following:
    • Designate one person within the agency to be the pandemic lead, so that there is a clear point-person for communication internally and externally.
    • Create a list of all staff members, including their contact information. Within that list include any skills that person may have that could be useful in the event of a severe outbreak, such as First Aid training, cooking skills, or knowledge of multiple languages.
    • Identify a communication strategy within the plan – including how information about COVID-19 will be acquired, such as through the local Public Health Agency, and how that information will be communicated to staff and clients.
    • Implement infection control protocols that include hand-washing and disinfecting surfaces with anti-bacterial cleansers. It may be advisable to distribute hand wipes or to post liquid dispensers in clear view of staff to avoid client consumption of the liquid sanitizers, as occasionally occurred during the H1N1 outbreak.
    • Consider what capacity exists, or could be created, for outreach services. Client use of drop-in centres declined during H1N1, and nutritional and hygiene supports would be primary supplies needed if the same service-avoidance occurred.
  4. Create a sector-wide plan that coordinates efforts and resources across agencies. During H1N1 service providers relied on informal partnerships and noted they would have felt more secure with a formal plan in place. In preparation for a potential COVID-19 outbreak, agencies should collectively:
    • Create a master list of staff who could work across agencies in the event of staffing shortages.
    • Shift and coordinate hours of operation between agencies, such that services remain open to clients at all times.
    • Create a shared stockpile of resources, including sanitization supplies, masks, and First Aid supplies.
    • Designate one agency that has the capacity to serve as a central infirmary for clients who become infected.
    • In the event a vaccine becomes available, host clinics directly in shelters and drop-in centres, to be more accessible for clients.

Pandemic outbreaks can be anxiety-provoking for service providers and for clients. The best way to deal with the fear and uncertainty is to have a plan. To learn more about pandemic planning for populations experiencing homelessness, check out this report and video workshop. We have also compiled a collection of resourced focused on Pandemic Planning, you can access them here.