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Answer questions Homeless people particularly affected by the Corona crisis

Why are previous illnesses so dangerous for the homeless?

Covid-19 is an infectious disease that affects the airways. People with previous illnesses, especially those of the respiratory tract, are therefore particularly at risk. According to the lung information service, most Covid 19 patients - including those with an existing respiratory disease - only showed mild symptoms in the course of their infection with the coronavirus and have fully recovered from the infection. Nevertheless, people with a respiratory disease are particularly at risk, as they have a higher risk of a serious infection and the disease is more often fatal.

In particular, the homeless, who - compared to the rest of the population - have a disproportionately high number of previous illnesses, belong to the high-risk group in this regard. All the more so because the proportion of nicotine, alcohol and drug addicts in this group is significantly higher than in the rest of the population, which - in addition to the social problems mentioned - exacerbates the existing clinical pictures even further. US data shows that homeless people often get serious and chronic illnesses 10-15 years earlier than non-homeless people.

Which pre-existing conditions are particularly common among the homeless?

Numerous studies have shown that lung diseases in particular are widespread among the homeless. Data from Hamburg from 2007 to 2015 showed that of the 263 homeless people examined, almost 38 percent suffered from a lung disease. A 2019 US study found chronic lung disease in nearly a third of homeless people, and a 2019 UK study found similar results. Of the 1,336 homeless people examined, around 14 percent suffered from chronic obstructive pulmonary disease (COPD).

US data also shows that the homeless are two to three times more likely to develop COPD than the rest of the population. Data that were collected in Canada between 2002 and 2006 assume an even higher risk. They show that pneumococci, the most common cause of pneumonia in adults, are up to 27 times more common in homeless people than in non-homeless people. For tuberculosis, the data are similar, which is why the homeless are one of the most vulnerable groups in the richest countries, according to Mario Raviglione, who headed the WHO's tuberculosis program from 2003 to 2017.

Many homeless people do not have insurance coverage. The majority of the around 80,000 people in Germany who live without health insurance are homeless. In the United States, single adults living below the poverty line are insured through the Medicaid program. However, 14 states have not adopted Obamacare's amendment. As a result, two thirds of the homeless there do not have health insurance. But there are also large gaps in supply in the participating states, as almost a quarter of the homeless in them also have no insurance coverage whatsoever.

What role do emergency and collective shelters play?

The risk of contracting the coronavirus in an emergency or collective shelter is high. On the one hand, this is due to the limited space and, on the other hand, the fact that objects used jointly in the facilities contribute to the spread of the pathogens. There is still no valid data for the coronavirus itself. But a study carried out in 2019 in homeless shelters in Seattle, one of the current strongholds of corona disease in the United States, was able to reconstruct the transmission routes. The biggest problem was the mattresses that various homeless people had used for sleeping and resting over the years. The researchers came to the conclusion that influenza was mainly transmitted, whereby people with previous illnesses of the respiratory tract were particularly badly affected.