Concerns over lack of strategy to protect rough sleepers from coronavirus | World news

Concerns have been raised that the government has no clear strategy in place to protect homeless people from catching the coronavirus.

The homeless charity Crisis, together with the Liberal Democrats, are asking for immediate guidance on how to help rough sleepers who are likely to have pre-existing health conditions that make them vulnerable to the illness.

Advice is also needed on how the self-isolation protocol could work for people who live on the streets and how they can regularly wash their hands, they suggest.

Matthew Downie, director of policy and external affairs for Crisis, said: “People sleeping rough are particularly vulnerable because they are more likely to have a range of existing health conditions and face specific challenges in that they may be unable to regularly wash their hands, nor can they self-isolate if they feel unwell.

“This guidance must set out what measures government is taking to ensure rough sleepers get appropriate health checks, what accommodation will be provided so that people can self-isolate and advice for the public on how best they can support people who are homeless during the coronavirus outbreak.”

The Liberal Democrat MP Layla Moran has written jointly to the secretary of state for housing, Robert Jenrick, and the secretary of state for health, Matt Hancock, to seek clarity and urge the government to act.

What is Covid-19 – the illness that started in Wuhan?

It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.

Have there been other coronaviruses?

Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.

What are the symptoms caused by the new coronavirus?

The virus can cause pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.

Should I go to the doctor if I have a cough?

UK Chief Medical Officers are advising anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last 14 days and who is experiencing a cough or fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.

Is the virus being transmitted from one person to another?

China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere.

How many people have been affected?

As of 4 March, the global death toll was 3,190, while more than 93,000 people have been infected in more than 80 countries.

The death toll has passed 3,000 in China, where there have been over 80,000 cases. South Korea, the nation worst hit by the outbreak outside China, has had 5,328 cases. More than 44,000 people in China have recovered from Covid-19.

There have been 87 recorded cases and no fatalities to date in the UK. There are 53 confirmed cases in Australia, with two deaths.

Why is this worse than normal influenza, and how worried are the experts?

We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2% at the centre of the outbreak, Hubei province, and less than that elsewhere. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.

Another key unknown is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.

Is the outbreak a pandemic?

A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed outside China, but by no means in all 195 countries on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority of cases are travellers who picked up the virus in China.

Should we panic?

No. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern. The key issues are how transmissible this new coronavirus is between people, and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.

Sarah BoseleyHannah Devlin and Martin Belam

Moran suggests that emergency accommodation should be provided so that people can self-isolate. She said: “This government does not appear to have thought about the homeless at all in its management of this emergency. Stakeholders and charities are still waiting for information on what the government is going to do.

“Meanwhile, members of the public do not know what to do if they find a homeless person who they suspect has Covid-19 – they want to help, but don’t know how.”

A government spokesperson said: “We’re well prepared to deal with the impacts for Covid-19. We are already working closely with local authorities to support vulnerable groups including homeless people.

“We’re working closely with the sector and will publish further guidance shortly.”

Just weeks ago the government was accused of dramatically under-reporting the scale of rough sleeping following council data showing numbers almost five times higher than Whitehall estimates.

The Ministry of Housing, Communities and Local Government reported that last year 4,677 people slept outside across the country but council data from freedom of information requests showed almost 25,000 people slept rough in 2019.

In the US, health care officials and charity workers who support homeless people on the west coast are already raising similar concerns that coronavirus could seriously affect communities of rough sleepers.


They have highlighted that they typically have poor access to doctors and a high prevalence of underlying respiratory problems.

Previously there has been a rapid spread of diseases such as typhus and tuberculosis among the homeless in LA because of the likelihood of large numbers of people sleeping close together.

So far there have been no outbreaks of the virus in homeless shelters or encampments in the US.

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