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Challenges faced by people experiencing homelessness and their providers during the COVID-19 pandemic: a qualitative study.
Hodwitz, Kathryn; Parsons, Janet; Juando-Pratts, Clara; Rosenthal, Esther; Craig-Neil, Amy; Hwang, Stephen W; Lockwood, Joel; Das, Paul; Kiran, Tara.
  • Hodwitz K; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Parsons J; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Juando-Pratts C; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Rosenthal E; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Craig-Neil A; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Hwang SW; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Lockwood J; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Das P; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
  • Kiran T; Applied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences I
CMAJ Open ; 10(3): E685-E691, 2022.
Article in English | MEDLINE | ID: covidwho-1954934
ABSTRACT

BACKGROUND:

People experiencing homelessness are vulnerable to SARS-CoV-2 infection and its consequences. We aimed to understand the perspectives of people experiencing homelessness, and of the health care and shelter workers who cared for them, during the COVID-19 pandemic.

METHODS:

We conducted an interpretivist qualitative study in Toronto, Canada, from December 2020 to June 2021. Participants were people experiencing homelessness who received SARS-CoV-2 testing, health care workers and homeless shelter staff. We recruited participants via email, telephone or recruitment flyers. Using individual interviews conducted via telephone or video call, we explored the experiences of people who were homeless during the pandemic, their interaction with shelter and health care settings, and related system challenges. We analyzed the data using reflexive thematic analysis.

RESULTS:

Among 26 participants were 11 men experiencing homelessness (aged 28-68 yr), 9 health care workers (aged 33-59 yr), 4 health care leaders (aged 37-60 yr) and 2 shelter managers (aged 47-57 yr). We generated 3 main themes navigating the unknown, wherein participants grappled with evolving public health guidelines that did not adequately account for homeless individuals; confronting placelessness, as people experiencing homelessness often had nowhere to go owing to public closures and lack of isolation options; and struggling with powerlessness, since people experiencing homelessness lacked agency in their placelessness, and health care and shelter workers lacked control in the care they could provide.

INTERPRETATION:

Reduced shelter capacity, public closures and lack of isolation options during the COVID-19 pandemic exacerbated the displacement of people experiencing homelessness and led to moral distress among providers. Planning for future pandemics must account for the unique needs of those experiencing homelessness.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ill-Housed Persons / COVID-19 Type of study: Diagnostic study / Observational study / Qualitative research Limits: Humans / Male Language: English Journal: CMAJ Open Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ill-Housed Persons / COVID-19 Type of study: Diagnostic study / Observational study / Qualitative research Limits: Humans / Male Language: English Journal: CMAJ Open Year: 2022 Document Type: Article