• The CDC issued a MMWR report, Notes from the Field: COVID-19 Vaccination Coverage Among Persons Experiencing Homelessness – Six U.S. Jurisdictions, December 2020-August 2021, which highlights efforts in six jurisdictions to analyze vaccination rates among people experiencing homelessness. This study shows that PEH have a lower vaccination rate than the broader community they are in. Stay tuned in early 2022 for an issue brief providing additional resources for communities to engage in this data analysis.
  
  
• Vaccine Focus Group (“Brain-Trust”) member Dr. Tom Huggett co-authored the article Assessment of a Hotel-Based Protective Housing Program for Incidence of SARS-CoV-2 Infection and Management of Chronic Illness Among Persons Experiencing Homelessness, published on the JAMA Network. Their retrospective research showed that access to protective housing significantly reduced the incidences of COVID-19 compared with shelter residents in Chicago, as well as improvements in hypertension and glycemic control. Impressively, 51% of residents of the protective housing were successfully housed at departure. 
  

CURRENT/EMERGING ISSUES & STRATEGIES FOR SUCCESS

1. Ongoing outbreaks among primarily unvaccinated individuals continues to put major strains on all levels of health care.
2. Prioritizing which patients to quarantine based on risk factors due to lack of resources to quarantine everyone with a potential exposure.
3. Growing need -- but not always capacity -- for surveillance testing as more cases, many breakthroughs, are being identified in both symptomatic and asymptomatic people.
4. Shortening isolation and quarantine stays to seven days (from 10 days) when capacity is reached but new referrals continue to come in.
5. Increasing demand for booster doses -- and even first doses -- as cases rise is renewed opportunity that requires ongoing outreach.
6. Growing tension as encampment sweeps increase across the country has staff scrambling to reconnect with clients.
7. Increasing presence of suburban encampments challenges outreach to span greater area and respond to differing needs.
8. Continuing challenges connecting unsheltered clients with housing options, or even shelters, as many programs do not practice harm reduction.
9. Reconnecting clients with health care once they move into housing units or programs that do not offer on-site services.
10. Emphasizing an ongoing focus on permanent housing when communities consider safer/sanctioned outdoor spaces instead.

1. Develop mobile testing and vaccination teams that can go into shelters or encampments and respond to outbreaks.
2. Use rapid tests at entry to residential programs in addition to symptom screening to identify any positive cases that are asymptomatic.
3. Test (rapid or PCR) fully vaccinated people with a COVID+ exposure 5-7 days after exposure if the first test was negative.
4. Use any available data to estimate vaccination rates among PEH, even if the data is not able to capture the full picture.
5. Offer incentives for booster shots to encourage greater uptake.

POLICY DEVELOPMENTS

• Mandates on hold: The four components of the federal vaccine mandate (federal employees, federal contractors, health care workers at Medicare/Medicaid funded facilities, and private employers with 100+ employees) are all being challenged in the courts. This means the pending deadline for compliance of January 4, 2022, is no longer in place.
• Running out of rental assistance: More than 100 states and local entities have exhausted their federal rental assistance funds, causing some states to stop accepting new applications. The Treasury Department will begin reallocating funds from states that are not using their funds; however, the delay in using funds is likely a bureaucratic one and not indicative of a lower need in those communities.
• Not distributing emergency housing vouchers: Less than 8% of EHV units have been leased, which delays exits from homelessness. (Use this dashboard to find your community’s rate of EHV distribution.)
• Expanded access to boosters: The FDA authorized and the CDC endorsed their recommendations for booster shots stating that everyone 16 and older should receive a booster shot.
• Recommendations to USICH for Federal Strategic Plan to Prevent and End Homelessness: The Council has submitted written recommendations to the U.S. Interagency Council on Homelessness (USICH) for consideration as they develop their Federal Strategic Plan to Prevent and End Homelessness.
  

NEW RESOURCES

• CDC MMWR: Notes from the Field: COVID-19 Vaccination Coverage Among Persons Experiencing Homelessness – Six U.S. Jurisdictions, December 2020-August 2021
• CDC: Antigen Testing Algorithm in Congregate Settings
• NASHP: Strategies to Increase COVID-19 Vaccination Rates in Medicaid Enrollees: Considerations for State Leaders
• HHS: Family Vaccination Site Playbook
• NAEH: What Happened After Congress Invested in Emergency Housing Vouchers: A Survey of Homeless Service Providers
• National Homelessness Law Center: Housing Not Handcuffs 2021: State Law Supplement (November 2021)
  

RESEARCH

• NHCHC: Medication-Assisted Treatment (MAT) for Opioid Use Disorder for People Experiencing Homelessness
• UCLA: We Do Not Forget: Stolen Lives of LA’s Unhoused During the COVID-19 Pandemic
  

WHAT WE'RE READING

• YRT News: Hennepin County Says Hepatitis A Outbreak Has Been Contained
  
  (Have something you've published related to COVID-19? Let us know!)

• KHN: Data Science Proved What Pittsburgh’s Black Leaders Knew: Racial Disparities Compound COVID Risk
• KFF: An Update on Vaccine Roll-Out for 5-11 Year-Olds in the U.S.
• The Hill: New Report Says Staggering 1,500 People Died on Streets of LA During Pandemic
• Brookings: To Address Homelessness, Place Governance Must Evolve
• AP: NYC to Impose Vaccine Mandate on Private Sector Employers
• Bloomberg: Omicron Threat May Be Countered With Extra Dose of Vaccine