Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA Inner City Health Associates, Toronto, ON M5C 1K6, Canada
Andrew Bond
Inner City Health Associates, Toronto, ON M5C 1K6, Canada Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
Andrew Boozary
Population Health and Social Medicine, University Health Network, Toronto, ON M5G 2C4, Canada University of Toronto, Toronto, ON M5S 1A8, Canada Columbia University, New York, NY 10032, USA
Eva Bruketa
Queen’s University, Kingston, ON K7L 3N6, Canada
Nika Elmi
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Deirdre Freiheit
Shepherds of Good Hope, Ottawa, ON K1N 5M9, Canada
S. Monty Ghosh
Department of General Internal Medicine & Neurology, University of Alberta, Edmonton, AB T6G 2G3, Canada Department of Medicine & Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada
Marie Eve Goyer
Family Medicine and Emergency Department, University of Montréal, Montréal, QC H3T 1J4, Canada
Aaron M. Orkin
Inner City Health Associates, Toronto, ON M5C 1K6, Canada Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada Department of Emergency Medicine, St. Joseph’s Health Centre, Toronto, ON M6R 1B5, Canada Department of Emergency Medicine, Humber River Hospital, Toronto, ON M3M 0B2, Canada
Jamie Patel
Faculty of Community Services, Ryerson University, Toronto, ON M5B 2K3, Canada
Tim Richter
Canadian Alliance to End Homelessness, Calgary, AB T3H 0N8, Canada
Angela Robertson
Parkdale Queen West Community Health Centre, Toronto, ON M6K 1L2, Canada
Christy Sutherland
PHS Community Services Society, Vancouver, BC V6A 1M9, Canada Department of Family Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Tomislav Svoboda
Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
Jeffrey Turnbull
University of Ottawa, Ottawa, ON K1N 6N5, Canada Ottawa Inner City Health, Ottawa, ON K1N 5N7, Canada
Alexander Wong
Department of Medicine, University of Saskatchewan, Regina, SK S4T 0H8, Canada
Alice Zhu
University of Toronto, Toronto, ON M5S 1A8, Canada
Those experiencing homelessness in Canada are impacted inequitably by COVID-19 due to their increased exposure, vulnerability of environment and medical comorbidities, and their lack of access to preventive care and treatment in the context of the pandemic. In shelter environments one is unable to effectively physically distance, maintain hygiene, obtain a test, or isolate. As a result, unique strategies are required for this population to protect them and those who serve them. Recommendations are provided to reduce or prevent further negative consequences from the COVID-19 pandemic for people experiencing homelessness. These recommendations were informed by a systematic review of the literature, as well as a jurisdictional scan. Where evidence did not exist, expert consensus from key providers and those experiencing homelessness throughout Canada was included. These recommendations recognize the need for short-term interventions to mitigate the immediate risk to this community, including coordination of response, appropriate precautions and protective equipment, reducing congestion, cohorting, testing, case and contact management strategies, dealing with outbreaks, isolation centres, and immunization. Longer-term recommendations are also provided with a view to ending homelessness by addressing the root causes of homelessness and by the provision of adequate subsidized and supportive housing through a Housing First strategy. It is imperative that meaningful changes take place now in how we serve those experiencing homelessness and how we mitigate specific vulnerabilities. These recommendations call for intersectoral, collaborative engagement to work for solutions targeted towards protecting the most vulnerable within our community through both immediate actions and long-term planning to eliminate homelessness.
