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Researchers from UCSF Benioff Homelessness and Housing Initiative and the San Francisco Department of Public Health found that housing homeless residents with mild to moderate COVID-19 in hotel rooms lowered the burden on hospitals overwhelmed with more seriously ill patients. The findings, published in JAMA Network Open, underscore the public health benefits of providing stable housing and services to those who need them most.

A new study from authors at the San Francisco Department of Public Health the UCSF Benioff Homelessness and Housing Initiative showed that San Francisco’s early use of isolation and quarantine hotels for unhoused residents who showed symptoms of or had been exposed to Covid-19 may have significantly freed up hospital capacity and prevented transmission.

COVID-19 impacted access to medical care and social services, potentially worsening HIV outcomes among people experiencing homelessness. In San Francisco, Ward 86, initiated POP-UP, a low-barrier, multicomponent model of care to address barriers to care for people living with HIV experiencing homelessness. Researchers found that care engagement and viral suppression did not worsen among the 85 patients enrolled, despite concerns that the COVID-19 pandemic might worsen outcomes. The study suggests that multicomponent interventions may help maintain viral suppression despite unanticipated structural barriers.

A new study from UCSF Benioff Homelessness and Housing Initiative and the San Francisco Department of Public Health describes how San Francisco rapidly scaled a hotel-based isolation and quarantine (I/Q) system of care for people experiencing homelessness during the COVID-19 pandemic. Researchers found the program safely delivered integrated medical and behavioral health support to more than 1000 individuals outside the hospital setting, while helping to preserve hospital capacity.

Graham Pruss, PhD, a post-doctoral scholar at the UCSF Benioff Homelessness and Housing Initiative, spoke about the rapid growth of vehicle residency over the last decade, especially during the pandemic. Many people without permanent homes are turning to cars, vans, RVs, and campers as a form of affordable housing instead of shelters or encampments, but parking restrictions and lack of infrastructure remain challenges.

During the COVID-19 pandemic youth experiencing homelessness (YEH) were disproportionately impacted; there were common upstream factors, including racism, homophobia, poverty, and structural violence that place youth at risk for homelessness and exposure to SARS-CoV-2. Public health guidelines overlooked YEH. In this commentary, researchers discuss practical strategies to address the unique health and social needs of YEH.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted in the San Francisco Chronicle saying she hopes the city continues to focus on more permanent solutions to homelessness, such as housing vouchers and rent subsidies, over group shelters.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was interviewed for a New York Times article about how rates of COVID-19 among unhoused people remained lower than feared in 2020, as mitigation measures such as providing hotel rooms for the most vulnerable people and closing crowded shelters helped suppress infection rates.

Graham Pruss, PhD, a post-doctoral scholar at the UCSF Benioff Homelessness and Housing Initiative, was interviewed about a Portland, OR, vehicular campsite in a year that saw a self-made community confront its disaffiliation from the rest of society. “Vehicle residency is the biggest problem in America that no one’s talking about,” said Pruss.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted in the San Jose Mercury News discussing rollout of COVID vaccines for people experiencing homelessness. The Benioff Homelessness and Housing Initiative team recently surveyed unhoused people in Oakland and San Francisco and found they were more likely than the general population to want the vaccine.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted regarding an outbreak of COVID-19 in San Diego’s large congregate shelter, which has prompted medical professionals and advocates to renew calls to expand usage of hotel placements for unhoused people. Dr. Kushel noted that even shelters with intensive strategies to control the spread of coronavirus were unlikely to prevent outbreaks.

California launched Project Roomkey during the pandemic to house thousands of homeless seniors and people with medical conditions in hotels. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, spoke on NPR about how critical it is that people in these hotels stay housed.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted about California’s Project Roomkey and Project Homekey, including their prospects to make a lasting impact on homelessness across the state. “(Roomkey) really grabbed those who were at the highest risk of doing poorly and got them to safety,” said Dr. Kushel.

UCSF study demonstrates need for alternatives to congregate shelter arrangements. Even if shelters take extensive precautions to prevent COVID-19 outbreaks, cities may need to reduce their reliance on congregate shelters.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was interviewed on KQED's Forum along with other guests providing an update on programs to help the homeless during the pandemic and what’s being done to ensure permanent solutions to the housing crisis.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was interviewed about BHHI’s work with Community Health Outreach Workers and community organizations to deliver COVID-19 testing to unhoused people. “A lot of the lessons we learned will resonate very clearly, not just for COVID, but for any public health outreach, whether it’s vaccination campaigns, bringing health care services to people, or doing work on sexually transmitted infections and overdose prevention,” Dr. Kushel said.

The coronavirus pandemic is upending the Bay Area’s fight against homelessness. Many of the changes—good and bad—will outlast the pandemic, says Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, who studies the intersection of homelessness and health.