CURRENT/EMERGING ISSUES & STRATEGIES FOR SUCCESS

1. Increasing prevalence of COVID-19 variants may take hold in homeless service settings because communities have removed many restrictions.
2. Ensuring health care systems have surge capacity as hospitals decrease staff in response to low utilization.
3. Responding to possible need for booster shots without streamlining the administrative burden will be difficult.
4. Emerging COVID+ cases in shelters raise concerns about the low vaccination rate among PEH and breakthrough illness, as well as scrambling for resources to provide isolation and quarantine.
5. Offering options of vaccines has been limited for several weeks because federal suppliers are not sending any J&J vaccine.
6. Responding to behavioral health and chronic disease issues that went untreated due to the pandemic has been overwhelming.
7. Ongoing challenges to hire staff, particularly bi- or multilingual staff, delays access to care for consumers who have great needs.
8. Increasing vicarious trauma in frontline staff who witness numerous overdoses and unmet needs.
9. Surging shelter utilization as alternate care sites close has decreased overall vaccination rate in shelters.
10. Growing difficulty to build vaccine confidence has led to increase in un-used doses and delay in being able to order more vaccines.

1. Prepare for a fall surge by stocking PPE and testing supplies to prevent the shortage experienced in 2020.
2. Mobile teams of providers, medical assistants, peers, and outreach case managers are a great way to get health care into shelters and encampments, which can increase COVID-19 vaccine uptake as well as other health services.
3. Employing peer outreach staff remains essential for building relationships and increasing vaccine acceptance, as well as engagement in care.
4. Focus on using doses before they expire rather than worry about wasting doses in a vial that is opened for one person.
5. Evaluate data by language, ethnicity, and gender identity – not just race – to look at equity from a variety of different perspectives.
6. Conduct a staff and consumer art contest for designing vaccine promotion material. Solicit donations or small grants to provide prizes for winners.
7. Implement rapid testing at shelters to allow for quick diversion of asymptomatic cases to alternate care sites.
8. As shelter volumes increase, collaborate with shelter staff to orient residents to the “menu of services” available onsite (or nearby) to increase access to vaccines specifically, and health care more broadly.
9. Incorporate screening for behavioral health for all clients at all access points to identify risks as soon as possible and connect them to a provider directly.
10. As more community partners return to full service, build partnerships to offer outreach, testing, and vaccination onsite.
    

POLICY DEVELOPMENTS

• The CDC issued a final extension of the eviction moratorium to July 31. The Supreme Court rejected a request to lift the ban on eviction which will allow the extension until July 31 to remain.
• Pfizer will request Emergency Use Authorization in August for a third, booster dose of COVID-19 vaccine. The dose should be administered within 12 months of the second dose.
• Moderna has requested approval from the FDA to use its vaccine in youth age 12-17. Approval from the FDA is anticipated soon. This will be especially helpful for the HCH Community, which is generally using Moderna more than Pfizer.
• The FDA and CDC announced that individuals who are fully vaccinated do not require a booster shot at this time.
• The FDA announced a new warning of a possible side effect with the Johnson & Johnson COVID-19 vaccine. The report states that there is “a small possible risk” of Guillain-Barre syndrome, which is an immune system disorder that can cause muscle weakness and occasional paralysis.
  

NEW RESOURCES

• The Framework for an Equitable COVID-19 Homelessness Response has issued a new summary of how to maximize the use of American Rescue Plan funds for people experiencing homelessness and housing insecurity, and tips on prioritizing people for emergency housing vouchers.
• The Commonwealth Fund: Inequities in Health and Health Care in Black and Latinx/Hispanic Communities: 23 Charts
• The Commonwealth Fund: Deaths and Hospitalizations Averted by Rapid U.S. Vaccination Rollout
• CDC MMWR: COVID-19 Vaccination Coverage Among Adults – United States, December 14, 2020-May 22, 2021
• CDC MMWR: COVID-19 Vaccination Coverage and Intent Among Adults Aged 18-39 Years – United States, March-May 2021
• University of Minnesota: Get Vaccinated Campaign
• CDC: Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance
• Furman Center: Challenges and Opportunities for Hotel-to-Housing Conversions in NYC (Working Paper)
  
• OSHA: COVID-19 Healthcare Emergency Temporary Standard
  

RESEARCH

• Journal of Urban Health: Eviction, Health Inequity, and the Spread of COVID-19: Housing Policy as a Primary Pandemic Mitigation Strategy
  

WHAT WE'RE READING

• Health Affairs: Empowering Patients Through Shared Visit Notes
• BillyPenn: Opinion: COVID Showed ‘Housing is Healthcare.’ Let’s Build on the Lesson.
• KMVT: Homeless Residents Particularly Vulnerable During Excessive Heat
• KQED: Homeless Should Be Forced Into Treatment, Says California GOP Gubernatorial Candidate John Cox
  

• NPR: The U.S. Has Hit 600,000 COVID Deaths, More Than Any Other Country
• NPR: Delta Is Now The Dominant Coronavirus Variant in The U.S.
• NPR: Fauci Warns Dangerous Delta Variant Is The Greatest Threat to U.S. COVID Efforts
• NPR: The Supreme Court Leaves The CDC’s Moratorium On Evictions In Place
• Politico: Million-Dollar Lotteries Fail to Cut Through Vaccine Apathy
• Axios: The Psychology Behind COVID-19 Vaccine Lotteries
• KHN: Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs
• KHN: Without Enough Boots on the Ground, California’s Vaccination Efforts Falter
• The Commonwealth Fund: Why Have Some States Pulled Ahead in the Race to Vaccinate Against COVID-19?
• City Limits: As They Return to Group Shelters, Homeless New Yorkers Make Vaccine Choices
• CIDRAP: White House: 70% of Adults 30 and Up Have One Dose of COVID Vaccine
• AP: Tuskegee Relatives Promote COVID-19 Vaccines in Ad Campaign
• AP: Global COVID-19 Deaths Hit 4 Million Amid Rush to Vaccinate
• STAT: 12 Lessons COVID-19 Taught Us About Developing Vaccines During a Pandemic
• NBC News: No Evidence Yet to Suggest COVID Vaccine Booster is Needed, CDC Group Says