Guidance for providers of services for people experiencing homelessness (in the context of COVID-19)
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- Homelessness in the context of COVID-19
- Planning for a COVID-19 outbreak in your community
- Responding to a COVID-19 outbreak in your community
- Recovery from a COVID-19 outbreak that has ended in your community
- Public Health Authorities
Homelessness in the context of COVID-19
Many people experiencing, or at risk of experiencing homelessness rely on community-based organizations, non-profit and voluntary organizations for a range of essential services. The following recommendations are for the homelessness-serving sector (including overnight emergency shelters, day shelters, and meal service providers).
Those who experience homelessness may be at higher risk of contracting COVID-19 or developing complications due to COVID-19, as they may not be able to access and use traditional services and standard resources. Footnote 1 These circumstances may affect their ability to follow public health advice, such as being able to effectively isolate/self-isolate from others and perform proper hand hygiene.
Organizations, community health workers and volunteers play an important role in helping prevent the spread of COVID-19 among those who experience homelessness. It is important that these service providers plan ahead and take precautions in their environments/workplaces, based on public health advice to reduce disruptions to their services. Consider reaching out to the population you serve, management and local governments to understand the essential requirements of your organization during the COVID-19 outbreak.
Planning for a COVID-19 outbreak in your community
Homeless service providers should collaborate, share information, and review emergency plans with community leaders and local Public Health Authorities (PHAs) to ensure measures in place to help protect their staff, clients, and guests.
- Collaborate with your local government on emergency planning. Your input helps ensure that your local government's emergency operations plan can provide your organization with the support and resources needed to respond effectively.
- Consider specialist services that may be required e.g. mental health services, drug and addictions support/programming, social workers.
- Work with community networks (such as community leaders, PHA, and faith-based organizations) in advance to secure additional shelter spaces in order to accommodate the requirements of social distancing (e.g. recreation facilities, community centres, hotels or modular units).
- Coordinate with affiliated shelters or congregate living facilities in the community to plan to cohort those who have mild cases of COVID-19 together, recognizing that those with severe symptoms (see below) should be transported via emergency medical services (EMS) to a health care facility.
- Anticipate an increase in emergency shelter usage. Consult with community leaders, local public health departments, and faith-based organizations about places to refer clients if your shelter space is full. Identify short-term volunteers to staff a shelter with more usage or alternate sites. Consider the need for extra supplies (e.g., food, toiletries) and surge staff.
- Plan to have appropriate supplies on hand, such as personal protective equipment for those who are providing care to ill clients (e.g. gloves and gowns).
- Transportation of clients (e.g. for non-urgent medical appointments) should be temporarily suspended in the context of the outbreak.
- Ensure you have a plan in place to access and maintain supplies specific to the environment, including those to support environmental cleaning.
Set a time to discuss what homeless service providers should do if cases of COVID-19 are suspected or confirmed in their facility. Identify if alternate care sites are available for clients with suspected or confirmed COVID-19 or if service providers should plan to isolate cases within their facility.
Anticipate an increase in absenteeism among homeless service provider staff. Develop flexible attendance and sick-leave policies. Staff (and volunteers) may need to stay home when they are sick, caring for a sick household member, or caring for their children in the event of school dismissals. Identify critical job functions and positions, and plan for alternative coverage by cross-training staff members.
Note: Use a process similar to the one you use when you cover for staff workers during the holidays.
Ensure that staff and/or clients are aware of financial and other support programs available through federal, provincial/territorial and local governments to those with financial instability related to COVID-19 (e.g. for those who are not able to work due to illness/exposure, isolation/self-isolation, or loss of job/income). Information on Government of Canada assistance is available at
Help counter stigma and discrimination in your community. Speak out against negative behaviors toward those who may experience stigma.
Responding to a COVID-19 outbreak in your community
Work with your local PHA to establish plans to reduce the risk of transmission in your environment, and to ensure alignment with local or jurisdictional protocols for diagnostic testing, self-isolation/isolation and clinical management if your clients or staff have exposures or develop symptoms. If there is person-to-person spread in your local community, consider that clients with respiratory symptoms (new or worsening cough, fever or difficulty breathing) may have COVID-19.
- Decisions about whether clients with mild illness due to suspected or confirmed COVID-19 should remain in the shelter or be directed to alternative housing sites should be made in coordination with the PHA.
- Identifying respite care locations for patients with confirmed COVID-19 who have been discharged from the hospital should be made in coordination with local healthcare facilities and your PHA.
Put your emergency operations and communication plans into action
- Stay informed about the local COVID-19 situation. Get up-to-date information from your PHA. Regularly provide accessible and actionable information to people who are currently living outdoors and in shelters in accessible ways relevant to the population.
- Educate staff, VOLUNTEERS AND CLIENTS about ways to prevent the spread of COVID-19:
- Washing hands often with soap and hot water or use of alcohol based sanitizer.
- Increasing access to hand hygiene and cough etiquette supplies (e.g., alcohol-based hand rub, soap, paper towels, tissues, waste containers).
- Cleaning frequently used spaces, surfaces and objects (kitchens, common areas, dining areas, desks, shared sleeping spaces, doorknobs, and faucets).
- Staying home when sick.
- Avoiding the use of shared personal items.
- Sharing information about what to do if staff or a client shows symptoms of becoming sick.
- Sharing steps about how to care for and isolate people living in a crowded facility (including the use of separate washrooms, if available).
- Monitor or connect with clients who could be at higher risk for complications from COVID-19 (those who are older or have underlying health conditions) and reach out to them regularly. Ensure they are informed about the symptoms of COVID-19 and how they may protect themselves through social distancing.
- Download fact sheets and keep your clients and guests informed about public health recommendations to prevent disease spread and about changes to services that might be related to the outbreak. Messaging strategies to clients and guests may include:
- Posting signs at entrances and in strategic places providing instruction on hand hygiene, respiratory hygiene, and cough etiquette.
- Signs should be written in languages representative of the community, have a simple message, use a large font, include one or two graphics and focus on actions that should be taken rather than actions to avoid.
- Implement everyday preventive actions and provide instructions to your clients, workers and volunteers about actions to prevent disease spread.
- Stock bathrooms with soap and drying materials for handwashing.
- Provide alcohol-based hand sanitizers that contain at least 60% alcohol (if that is an option at your shelter) at key points within the facility, including registration desks, entrances/exits, and eating areas.
- Provide clients with access to fluids, tissues and plastic bags for the proper disposal of used tissues.
- Follow environmental cleaning recommendations for how to prevent further spread within the facility.
- Encourage social distancing:
- Staff should role model social distancing and remind clients and guests of these precautions as appropriate (e.g. maintaining 2 metre distance, not shaking hands).
- When working with symptomatic clients or guests:
- staff and volunteers at high risk of severe COVID-19 should not be designated as caregivers for sick clients who are staying in the shelter.
- If staff and volunteers are not able to maintain a 2 meter distance between themselves and those who are symptomatic, contact the PHA for advice in implementing measures within the shelter to minimize the opportunity for close unprotected contact.
- Assign clients with mild respiratory symptoms consistent with COVID-19 infection to individual rooms.
- Additional advice on caring for a person with COVID-19 at home is available.
- If individual rooms for sick clients are not available, consider using a large, well-ventilated room to cohort symptomatic patients together.
- In areas where clients with respiratory illness are staying, keep beds at least 6 feet apart and use temporary barriers between beds, such as curtains, and request that all clients sleep head-to-toe.
- If possible, designate a separate bathroom for sick clients with COVID-19 symptoms.
- Ensure frequent environmental cleaning.
- Place possibly contaminated laundry into a container with a plastic liner and do not shake.
- Wash with regular laundry soap and hot water (60-90°C) and dry well
- Clothing and linens belonging to the ill person can be washed with other laundry.
- In general, sleeping areas (for those who are not experiencing respiratory symptoms) should have beds/mats placed at least 6 feet apart, and request that all clients sleep head-to-toe.
- Limit visitors to the facility.
- If possible, provide storage for those who require relocation due to illness or self-isolation, to alleviate concerns about clients having to lose their belongings.
- If you identify any client with severe respiratory symptoms, arrange for medical care immediately, and notify the PHA. If this is a client with suspected COVID-19, notify the transfer team and medical facility before transfer. Severe symptoms include:
- Extremely difficult breathing (not being able to speak without gasping for air)
- Bluish lips or face
- Persistent pain or pressure in the chest
- Severe persistent dizziness or light-headedness
- New confusion, or inability to arouse
- New seizure or seizures that won't stop
Recovery from a COVID-19 outbreak that has ended in your community
A COVID-19 outbreak could last a long time, and the impact on your facility may be considerable. When the PHA determines the outbreak has ended in your community, take time to talk over your experiences with your clients, staff and volunteers. As PHAs continue to plan for COVID-19 and other disease outbreaks, your organization has an important role to play in ongoing planning efforts.
Evaluate the effectiveness of your organization's plan of action
- Discuss and note lessons learned. How effective were your organization's COVID-19 preparedness actions?
- Talk about problems found in your plan and effective solutions. Identify additional resources needed for you and your organization.
- Participate in community discussions about emergency planning. Let others know about what readiness actions worked. Maintain communication lines with your community (e.g., social media, email lists and methods specific and unique to the population served).
Continue to practice everyday preventive actions. Stay home when you are sick; cover your coughs and sneezes with a tissue; wash your hands often with soap and water; and clean frequently touched surfaces and objects daily.
Maintain and expand your emergency planning. Look for ways to expand community partnerships. Identify agencies or partners needed to help you prepare for an infectious disease outbreak in the future.
For more information: 1-833-784-4397
|Provinces and Territories||Telephone number||Website|
|Prince Edward Island||811||www.princeedwardisland.ca/covid19|
|Newfoundland and Labrador||811
- Footnote 1
PHAC. January 13 2020. Tracey O'Sullivan. DRAFT. Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector: Psychosocial Considerations for Resilience Annex.
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