CURRENT/EMERGING ISSUES & STRATEGIES FOR SUCCESS

1. Enforcing masking within shelters and congregate settings is becoming more difficult as communities remove mask mandates for the general public.
2. Increasing movement toward “returning to normal” often includes returning clients to congregate shelter, requires a lot of coordination, comes with much confusion, and reminds us that “normal” is completely unacceptable.
3. Needing to identify isolation and quarantine beds at shelters and reserve medical respite beds for other referrals.
4. Ongoing challenges of clients not being eligible for Paxlovid due to the narrow window for prescribing and the numerous health care conditions and medications that are listed as contraindications.
5. Continuing vaccine hesitation in many communities that has been difficult to move.
6. Increasing incidences of mental health episodes as stress and tension build and limited staffing resources are struggling to meet the need.
7. Growing desire to reopen clinics shut by COVID while also being concerned about needing to re-deploy staff for any future COVID response.
8. Unintentionally decreasing access for the most vulnerable people when low-barrier resources (i.e., warming stations) are closed in favor of full-service shelters.
9. Ongoing encampment sweeps, which include severed relationships, dispersed communities, and lost belongings.
10. Rapidly waning appetite for transforming congregate shelter spaces into non-congregate shelter for all individuals.
    
    

1. Maintain mask mandates in congregate settings regardless of community/jurisdiction changes for the general public.
2. Continue to advocate changing congregate shelters into non-congregate shelter.
3. Purchase hotels once used as isolation and quarantine facilities to provide permanent housing, medical respite, and/or resources for the next wave of COVID (or other public health emergencies).
4. Establish persistent outreach with the same team of individuals to increase vaccine acceptance. Be slow, steady, and consistent.
5. Prepare for next wave of COVID to avoid the rush that occurred during Omicron by having conversations with community partners about Isolation & Quarantine resources now. With FEMA resources scheduled to go offline soon, communities will need strategies for any future COVID surges.
6. Prioritize testing resources for staff to maintain workforce until community supplies become more readily available and then pivot to prioritizing for clients.
7. Offer incentives, even in nominal amounts, to restaurants (e.g., McDonald’s) that often require purchases to stay inside or require vaccinations to enter.
8. Consider allowing staff to reduce their FTE to less than 1.0 as a retention strategy to keep high quality staff who are burned out and may otherwise leave altogether.
   

POLICY DEVELOPMENTS

• Lifting Mask Mandates: States have begun lifting mask mandates in public spaces and in school – leaving decisions up to local businesses and school districts on how they want to proceed. The CDC is expected to make changes to their recommendations this week.
• Biden Administration Distributes Next Round of Vaccine Ambassador Funds: The Biden Administration is distributing $66.5 million to community groups in 38 states and Washington, D.C., to support efforts to build vaccine confidence.
• HRSA Expanding Testing Supply Program: HRSA will be making supplies for on-site testing (point-of-care testing analyzers and test strips) available to health centers in addition to the at-home self-testing supplies currently available through the program.
• FDA Authorizes Another Monoclonal Antibody Treatment: A new antibody treatment by Eli Lilly, bebtelovimab, has been authorized by the FDA for treatment of COVID-19. Unlike the other antibody treatment by Eli Lilly that was halted for being ineffective against the Omicron variant, this medication has proven to work against Omicron and its sister viruses.
  

NEW RESOURCES

• BHCHP: COVID on the Streets of Boston
• CDC (updated): Interim Guidance on People Experiencing Unsheltered Homelessness
• CDC (updated): Investigating and Responding to COVID-19 Cases at Homeless Service Provider Sites
• CDC (updated): Interim Guidance for SARS-CoV-2 Testing in Homeless Shelters and Encampments
• CDC (updated): Interim Guidance for Homeless Service Providers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)
• CDC MMWR: Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19 – Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance – VISION Network, 10 States, August 2021-January 2022
• HUD: Homeless System Response: Shelter Renovations to Address Infection Control and Improve Shelter Quality
• HUD: Strategies to Address Staffing and Service Shortages
• HUD: Addressing Your Concerns About the COVID-19 Booster Shot
  

RESEARCH

• National Library of Medicine: Drug Overdoses During the COVID-19 Pandemic Among Recently Homeless Individuals
• CIDRAP: Babies Born to COVID-Vaccinated Moms Have Antibodies at 6 Months
  

WHAT WE'RE READING

• The Guardian: ‘Homelessness is Lethal’: US Deaths Among Those Without Housing are Surging
  

• NBC News: Low-Income, Uninsured Face Hurdles to Obtain COVID Antivirals
• PEW: Lifesaving COVID Medications Can Be Hard to Come By
• The Guardian: Vastly Unequal US Has World’s Highest COVID Death Toll – It’s No Coincidence
• KHN: Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead
• KHN: COVID Precautions Are Part of Hispanic Community’s Efforts to Tend to Community Good
• Peterson-KFF: COVID-19 Leading Cause of Death Ranking 
• Peterson-KFF: Outpatient Telehealth Use Soared Early in the Pandemic But Has Since Receded
• NPR: If You Tested Positive and the Contact Tracer Never Called, Here’s Why
• Reuters: U.S. CDC stands by K-12 School Masking Guidance as States Relax Rules - Walensky
• Housing Matters: Noncongregate Housing Plus Services Can Better Protect People Experiencing Homelessness During and Beyond the Pandemic