What is the role of primary care in COVID-19 programs focused on people experiencing homelessness?

Background: The pandemic has had a disproportionate impact on people who are living in socially disadvantaged situations. People experiencing homelessness are less able to isolate and follow public health messaging to reduce the risk of infection. In addition, due to the higher prevalence of chronic disease, they have a poorer prognosis with infection with higher rates of mortality and hospitalisation. In the early pandemic, many countries implemented programs that were exclusively focused on the care of people experiencing homelessness. Aim/Objectives: Our aim was to describe programs that have been implemented to reduce COVID-19 transmission and severity of illness in homeless populations and to understand the involvement of primary care. Method(s): We performed a rapid review of the international literature documenting COVID-19 related programs for people experiencing homelessness. We searched PubMed, Embase, and CINAHL plus Google using search term combinations of homeless persons and COVID-19. All articles were screened by two independent reviewers and one person extracted the items of interest. Finding(s): After screening 615 studies we included 42 studies and most were from the USA (n = 26). Programs commonly focused on isolation centres for people experiencing homelessness who tested positive for COVID-19 (n = 15). Sixteen studies included an evaluation of program effectiveness and two investigated the perspective of program participants. Universal screening was more effective than symptomatic screening in reducing COVID-19 transmission in homeless shelter settings. Comprehensive healthcare, including mental health and addiction support, was essential for people to be able to tolerate isolation, but care continuity post-isolation was problematic with limited primary care involvement. Implications: Few COVID-19 programs for people experiencing homelessness involve the primary care sector. As continuity of care post-program was a common problem, primary care may have a role in cross-sector collaboration.

HERDSA TATAL tales: Reflecting on academic growth as a Community for Practice

This chapter tells the story of 13 higher education (HE) practitioners (academics and academic developers) from 10 universities across Australia and New Zealand leveraging the COVID-19 disruption as a ‘disorienting dilemma’ that precipitated transformation from a Community of Practice (CoP) to a Community for Practice (CfP). The aim is to show how the group commenced as a CoP to ‘Talk About Teaching and Learning’ (TATAL) and support one another towards HE fellowships, and grew into a CfP that supports holistic growth that benefits each member based on their specific contexts, needs, and goals. With reflections woven throughout as evidence of transformation, the purpose of this chapter is to demonstrate how an interdisciplinary, multiuniversity group has created and nurtured a sustainable CfP. Experiential learning and reflective practice models, which are underpinned by considerations of action research and collaborative autoethnography, support and account for insights into the transformative changes. © 2022 Elsevier Ltd. All rights reserved.