In room 116, former coarse sleeper Paresh Shah completes the last hours of his self-isolation. He was admitted to the East London facility 15 days ago after being tested positive for the virus. “I was glad I was brought in,” said the 55-year-old. “I must have picked it up when we were transferred from our overnight shelter. There was a drunk guy splitting all over the sidewalk and it could easily have been him. “
Public health consultant, Al Story, who runs a London-wide NHS outreach service for people with tuberculosis, set up the facility three weeks ago because of fears of a potentially explosive coronavirus outbreak. “The reality is that the average age of death on the street is 45 for men and 43 for women,” he said. “If they get a whiff of Covid, they are on a fast track to a very poor clinical outcome. “
Story, who is based at University College London Hospital, chose the hotel because its basic facilities made it easy to clean. “It is perfect for infection control,” he says. “It is well ventilated. There are no carpets. There is no furniture other than the mattress. “
So far, nearly 40 homeless people have been treated, and more expected in the coming weeks as the facility begins to receive homeless patients with Covid-19 directly from London A&E services. “Many of the people we support would be hospitalized if we didn’t exist, because they have nowhere to go. We also observe them regularly day and night and meet all of their health needs, ”he says. Those in need of ventilation are sent to hospital, including two in the past three weeks.
The facility, known as Covid Care, is jointly managed by MSF as part of its very first deployment in the UK. The international humanitarian organization works primarily in war zones and natural disasters in the developing world, but has realized that it has the capacity to help protect one of the most marginalized groups in the United Kingdom. “It is in our DNA to provide emergency medical support,” said Rosamund Southgate, British medical coordinator for MSF. “Our overseas field projects remain our priority, but we have seen vulnerable people affected by the coronavirus epidemic in the UK.”
The rent is covered by the Greater London authorities, the NHS and MSF paying their own staff costs. MSF provided 10 nurses and logistical support to transform the hotel into a treatment center in just 24 hours. “What we bring from our experience with outbreaks and emergencies is that we can respond quickly,” she said. The charity, which also hopes to help nursing homes in the north of England, has also deployed doctors for the first time to coronavirus hotspots in other developed countries, including France and the Spain. “We are deploying to these countries for the first time because of the unprecedented crisis we are facing,” she adds.
Exclusive figures from the UCL Collaborative Center for Inclusion Health, seen by The Guardian, show that people living in homeless homes in London are 15 times more likely to die from Covid-19 than the rest of the population of age. to work. The center, which studies health inequalities, has identified at least three suspected deaths from coronavirus in hostels since March, with a third of hostels reporting suspected cases of coronavirus.
The number of gross sleepers in England is estimated at 11,000. More than 5,400 raw sleepers known to boards have been offered accommodation since March, but there are still more than 35,000 homeless people living in hostels across the UK. Upcoming UCL modeling indicates that more than a third of the homeless and street population could get Covid-19 without intensive infection control. This could result in 4,000 hospital admissions and 364 deaths in August.
“Youth hostels are as risky as nursing homes and prisons,” says the epidemiologist. Andrew Hayward, Director of the UCL Collaborative Center for Inclusion Health. “Many people with chronic illnesses share toilets, showers and common areas. They provide the perfect conditions for coronavirus outbreaks. “
Another hotel patient fell ill while living in a crowded hostel in Shepherd’s Bush, west of London. “I tried to isolate myself in my bedroom because I had pneumonia,” said Luke Donnelly, 39. “But I had to run the gauntlet to get my dinner everyday by queuing on a hot plate with 30 or 40 people. There were also probably six or seven residents on my landing using the same toilet. It was a recipe for disaster. “
Yet London has managed to avoid the much larger and deadly epidemics seen in American cities like New York and San Francisco. Tests carried out by the UCL awareness team suggest that only 3-5% of people sleeping in London are now infected with the virus. “There is a very low asymptomatic carry rate in our homeless population, especially when you compare it to the American numbers,” says Story. So far, the three UCLH outreach teams have tested nearly 500 rude sleepers, 29 of whom have the virus. Starting this week, they will increase their testing capacity to over 100 people a day. One of the teams is led by John Gibbons, a former heroin user and a resident of the inn. Gibbons has references that keep coming up. “We will immediately test any suspected cases. If they are positive, we take them to the care hotel, “he said. “We also contact the people who have been in contact and test them. “
Shah and Donnelly were tested and removed from situations where they could have put other people at risk. Donnelly is grateful for the care he has received because he was afraid of losing his life. “I was very scared,” he says. “I thought I was going to die. I was out of breath all the time. But when I got to the hotel, the nurses were like friends, family and caregivers. They were brilliant. “
However, the supply outside the capital seems uneven. Other cities in the UK with large numbers of rough sleepers such as Liverpool, Manchester and Newcastle do not have medically equivalent isolation facilities for the homeless and few appear to perform targeted testing. Instead, coarse sleepers with symptoms of Covid-19 need to self-isolate as best they can in homeless homes or hotels.
The absence of a nationwide Covid network makes Hayward nervous about future waves of the virus. UCL modeling estimates that a second wave could lead to 22,000 homeless people catching the virus. “I am really worried that we could see new outbreaks in hostels in the UK when the lockout is relaxed and the transmission begins to spread again in the wider community. “
A spokesperson for the Ministry of Housing said: “More than 90% of people sleeping on the streets known to councils at the start of this crisis have been offered safe housing – ensuring that some of the most vulnerable in society are protected from the pandemic. “
Back at the hotel, Story watches six convicts from Covid-19 read books donated across the hotel parking lot. He wants every part of the country to fully prepare for a potential reemergence of the virus in the homeless population – and to think about how to permanently house people currently staying in empty hotels. “We have successfully prevented massive epidemics among coarsely sleeping people by quickly isolating and treating people with Covid-19.” But if we send everyone back to a totally dangerous environment, we are asking for trouble, ”he says. “They’re the dry tinder waiting for a spark. “