Persons experiencing homelessness who were at high risk of severe COVID-19 were 2.5 times less likely to contract SARS-CoV-2 if they were provided with individual hotel rooms and medical and social support compared to citywide rates in homeless shelters, according to new research from the University of Chicago Medicine, Lawndale Christian Health Center and the Chicago Department of Public Health (CDPH).
Additionally, persons experiencing homelessness (PEH) who participated in this housing intervention also saw improvements in certain health measures such as blood pressure, and more than half of them moved on to longer-term housing after the intervention. The results were published on December 13 in JAMA Network Open. [AC1]
The findings provide hard data demonstrating these types of interventions can be highly effective for improving stability for PEH and that increasing healthcare and social support access can drive better health outcomes and improve health equity.
Initially, the team did not set out to conduct a research study; instead, their focus was simply to minimize the impact of COVID-19 on an extremely vulnerable population.
“As we started learning about the coronavirus wreaking havoc in nursing homes, we thought about folks living in congregate shelter settings in Chicago, where in some settings, 300 to 400 people are living together in open rooms, and we realized this virus could be a real threat to this population,” said Wayne Detmer, MD, Chief Clinical Officer of Operations at the Lawndale center.
Thomas Huggett, MD, a family medicine physician at Lawndale, said positivity rates were spiking at the shelters within weeks of Illinois Governor JB Pritzker’s lockdown announcement in March 2020.
“On March 20, 2020, Governor Pritzker said, ‘Stay at home.’ But where are people who are experiencing homelessness going to stay?” said Huggett. “By the beginning of April, up to 60% of the tests we were conducting in the shelters were positive, and we realized we couldn’t test and isolate our way out of this. But we had some very vulnerable folks over the age of 60 with chronic conditions, and Dr. Detmer had the idea — rather than isolating folks who were positive for the virus, why not protect people before they got it?”
The City of Chicago offered a hotel — with almost 200 rooms — for the intervention, and the first guests arrived on April 2, 2020. The healthcare team conducted screenings in shelters to identify high-risk individuals meeting at least one of the following criteria: at least 60 years old, at least 55 years old with any underlying health condition, or under 55 years old with any health condition known to substantially increase COVID-19 risk (e.g., HIV/AIDS). Those who met the criteria were offered the option to move from the shelter to an individual hotel room with extensive supportive services, where they were able to stay as long as needed, up to the full five-month length of the intervention.
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This story was first published by University of Chicago Medicine.
