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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.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted about upcoming changes to hotel programs for unhoused people. With California’s Project Roomkey winding down, hotels for Bay Area residents experiencing homelessness are slated to close. Despite uncertain prospects for keeping people housed in the future, “Project Roomkey has played a huge role in decreasing the disasters in the Bay Area,” said Dr. Kushel, including slowing the spread of COVID-19.

Maria Raven, MD, Chief of Emergency Medicine at UCSF and a faculty advisor at BHHI, was quoted in this piece about a UCSF study about Project Welcome Home showing that permanent supportive housing can help keep chronically homeless people with severe health and substance-abuse issues housed. Margot Kushel, MD, coauthored the study.

This UCSF study examined whether permanent supportive housing reduces the use of acute health care and other services among people experiencing chronic homelessness. The Permanent Supportive Housing program intervention was able to house 86% of chronically homeless adults randomized to the treatment group based on their high use of multiple systems. Even the most frequent clients of medical, psychiatric, and emergency services were housed successfully, as demonstrated in this study of Project Welcome Home in Santa Clara County.

An increase in San Francisco homelessness funding could sharpen focus on permanent supportive housing. The UCSF Benioff Homelessness and Housing Initiative's Cynthia Nagendra emphasized the importance of permanent supportive housing as the centerpiece of any plan for using new funds to address homelessness.

Older homeless-experienced adults have low rates of advance care planning (ACP) engagement. In this cross-sectional qualitative study, researchers examined potential barriers and solutions to ACP engagement. Researchers found that participants believed that ACP is important, but acknowledge the multiple barriers to engagement. Potential solutions include capitalizing on opportunities outside health care setting and focusing on the period after housing and tailoring content.

KQED’s Sold Out housing podcast examined the interplay of Margot Kushel’s work within and beyond medicine as traditionally understood. “There is no medicine as powerful as housing,” Dr. Kushel said.