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Hard to reach: COVID-19 responses and the complexities of homelessness

he severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused more than 954 000 deaths worldwide to date, but the burden of morbidity and mortality has fallen unevenly on particular countries and population groups. Worldwide, COVID-19 has been recognised as a potential public health problem among people experiencing homelessness and other vulnerable cohorts such as prisoners.

Broadly, reduced access to health care and basic sanitation, the potential for mobility between services and crowding within facilities, the greater sharing of resources between individuals, substance-seeking behaviours, economic need resulting in employment such as survival sex work, and underlying health conditions put such individuals theoretically more at risk of morbidity and mortality from COVID-19. There is growing evidence, however, of regional differences in the impact of COVID-19 on the socially vulnerable.


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