Homelessness and COVID-19:

Converging Crises and the

Emerging Response Framework
April 2020

Dennis Culhane, Dan Treglia, Ken Steif

University of Pennsylvania
Randall Kuhn
UCLA
Thomas Byrne
Boston University
Recent Homelessness Crises
Preceding COVID-19
• Rapid growth in unsheltered homelessness,
especially in West Coast cities since 2014

• Aging population with accelerated rate of

morbidities and disability (15-20 years)
Adult 90,000

81,468
83,394
84,482 83,502

Homelessne
81,182
79,488 80,066 79,688 79,771
80,000 78,050 77,701
75,823
74,191 74,145

ss: Note
70,000
63,772
61,406
59,373 59,581

71%
60,000

51,907
50,037 49,099
50,000 48,675 48,378

Increase in
45,585 46,577
43,260
39,536 38,658
40,000

Unsheltered
35,402
32,068 32,405
29,162 30,102 29,343
30,000 28,598 28,100
27,439
25,748

Nonchronic,
23,791
19,634 20,184 20,097
17,769 18,841
20,000 17,346
15,951
13,475 13,747 12,992 13,585

2014-2019
11,784 11,934
10,000

(in yellow) 0
2007 2008 2009 2010 2011 2012

Chronically Homeless Individuals, Sheltered

2013 2014 2015 2016 2017 2018

Chronically Homeless Individuals, Unsheltered

2019

Non-chronically Homeless Individuals, Sheltered Non-chronically Homeless Individuals, Unsheltered

Homelessness, A Birth Cohort Phenomenon
Single Adult Male Shelter Users, United
States
Sheltered
%
Homeless Single

% of Single Adult Male Homeless Population

Adult Males Aged
12
46-54
10 1990 1 in 8 in 1990

8 2000 1 in 5 in 2000

6
2010 1 in 3 in 2010

0
 Forecasting Change in 65+ Homeless Population

3.0

Population Growth Relative to 2017 2.5

2.0

1.5

1.0
2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Los Angeles New York City
Boston
 Age-specific risk for COVID-related scenarios, homeless population in
comparison to general population
40%
Panel A: Hospitalization

35%
Figure 1: Age-specific risk for homelessness-adjusted scenarios
in comparison to general population

30%

25%

20%

15%

10%

5%

0%
25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89

General Homeless
 Age-specific risk for COVID-related scenarios, homeless
population in comparison to general population

Panel B: Critical Care

30%

25%

20%

15%

10%

5%

0%
25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89

General Homeless
 Age-specific risk for COVID-related scenarios, homeless population
in comparison to general population

Panel C: Fatality
16%

14%

12%

10%

8%

6%

4%

2%

0%
25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89

General Homeless
Emergency Accommodation Need
for Adult Homeless Population
• Density Reduction in Existing Shelter Inventory to Accommodate Recommended
Social Distancing (100 sq feet per person, FEMA, 110 sq feet per person, CDC)

• Current supply of 200,000 beds with est. 50% density reduction = +100,000 beds

• Unsheltered Population of 211,000, possibly 300,000 (assuming 40% undercount)

• + 300,000 beds to shelter everyone

• “High risk” only, +180,000 beds (assuming 60% high risk)

• Net New Accommodation Need: 280,000 – 400,000, $8.5 - $11.5 B (annual)

Three Primary Bed Planning
Targets
• COVID Negative – High Risk: avoid infection

• COVID Positive - High and Low Risk: avoid

hospitalization

• Exposed -- symptomatic and asymptomatic: testing,

observation and quarantine