The COVID-19 pandemic is creating a severe and emergent health crisis for the homeless population across the United States, a crisis that our shelter and health systems are simply not adequately prepared to meet. The current virus, when scaffolded on top of the already present crisis of aged homelessness, as well as a myriad of other factors impacting this population, is likely to wreak havoc on this already highly vulnerable group.
For the 500,000 single adults who experience homelessness on a given night, the current crisis is likely to cause upwards of 21,000 hospitalizations and 3,400 deaths. Given an annual shelter turnover rate of at least 3 – meaning that over the course of a year at least three times the PIT-estimate will experience homelessness and the confined and harsh conditions that come with it, the infection, critical care, and fatality rates presented here are almost certainly lower bound estimates. Compounding this, we model these rates and solutions for current (2019) levels of homelessness. While economists are only beginning to quantify the short-and long-term economic impacts of this pandemic, we are almost certain to see a recession resulting from the infection itself, resultant social distancing, and general market uncertainty. Predictions vary widely, but the current record unemployment claims will be followed by additional housing instability and homelessness that will further stretch an already taxed homelessness assistance system.
There are obvious and immediate steps that we can take to mitigate this situation. By creating adequate and humane accommodations for people living unsheltered, leveraging existing private units like hotels while creating new ones as feasible, and reconfiguring existing facilities to accommodate social distancing and isolate symptomatic individuals, lives can be saved. Federal, state and local governments will need to collaborate around the funding, staffing and siting of facilities. But the urgency is clear, as is the moral imperative to act.
Our estimates suggest the need for an additional 400,000 units to manage the COVID-19 pandemic for the current, estimated homeless population. This includes:
- 300,000 units to accommodate homeless persons living unsheltered (including unsheltered families)
- 100,000 units to make up for reduced capacity in existing shelter facilities, to enable social distancing.
At a cost of approximately $25,000 per unit per year, we estimate the annual cost of meeting this need at $10 billion. In addition, we assume a peak 40% infection rate among the homeless population at any given time. Given that we are calculating need based on a static estimate of the homeless population with a high-estimate of the infection rate, this is presumed to represent a worst-case scenario. Assuming a premium of $7,500 per unit per year for more private accommodations for persons who are infected or under observation, including placement in hotels and motels, this would require an additional $1.5 billion for 200,000 of the estimated total need. The total estimated cost to meet the additional need is approximately $11.5 billion for the current year.
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