In March 2020, the people of the UK were confined to their homes as the Covid19 pandemic swept Europe and the question of, ‘what do we do with the homeless?’ loomed large in the policy corridors of the devolved governments of the UK. As Covid19 complicates existing health inequalities and exclusions from care, there was increasing concern that people with lived experience of homelessness already had high rates of infection and death. Reports from London were also indicating that people experiencing homelessness were thought to be 25 times more likely to die of Covid-19 than the general population. In addition, people experiencing homelessness were increasingly vulnerable to Covid-19 due to lack of ability to follow recommended public health measures of hand hygiene and social distancing, coupled with high rates of existing health problems.
In England, the ‘Everyone In’ strategy was introduced, directing all local authorities in England to provide self-contained accommodation to all street homeless people, and those living in accommodation that prevented social distancing and isolation (i.e. shared temporary assessment centres and shelters). The Scottish government built on existing work with the Homeless And Rough Sleeping Action Group (HARSAG) requiring local authorities to rapidly house those who were rough sleeping, accommodating them in city centre hotels.
Public Health departments were replete with panic at the high risk of potential spread among the homeless population, particularly those who were sleeping on the streets and in hostels. Alarm bells were ringing about transmission pathways for people who could not isolate, and about death rates for those who already experience very poor health. Emergency meetings were held. Extra money was found. People with lived experience of homelessness and frontline homelessness workers found themselves in high-level zoom government meetings. Bureaucratic barriers were broken down. A solution was found. And so it came to be, that a plan was devised for people experiencing homelessness to be rapidly rehoused in tourist hotels in the city centre. By the end of March 2020, many cities in Scotland had repurposed their centrally located hotel rooms into individual accommodation to house people who had previously been sleeping on the streets or in homeless hostels.
Workers across the UK were challenged with the huge task of getting ‘Everyone In’ and providing support to vulnerable people who were likely to struggle with social distancing. This was an unprecedented move, ending rough sleeping in many parts of the Uk almost overnight, placing homeless people in spaces (for example luxury hotels) where they would not normally be welcomed and changing the relations between government and the homeless sector as this highly marginalised sector became the focus of huge community effort. In Edinburgh, rapid work led by Edinburgh City Council and the NHS Lothian led to the creation of a Covid-19 hostel hub and new prescribing practices.
During this unique space in time, the Cyrenians Scotland began a project called ‘Living With Covid’, where frontline workers, people with lived experience of homelessness and managers documented their experiences. This was funded by a grant from the Lankelly Chase Foundation. They did this creatively through poems, songs, video interviews, Tweets and photos. This data was collected for 3 months from the end of March – June 2020 and then subsequently analysed by two researchers, Dr Rosie Stenhouse and Dr Fiona Cuthill, through the Centre for Homelessness and Inclusion Health at the University of Edinburgh. In total, 17 participants submitted their data to the Living With Covid project. This data has now been analysed and a report ready for publication in the next two weeks. This is a participatory project and the research team met last week with 12 of the participants in the ‘Living With Covid’ project to discuss the findings, agree the recommendations and to select the songs, photos, Tweets, quotes and poems that will be used to curate a community showcase exhibition later this summer. The findings from all of this work uncovered a city turned upside down: people who had previously been sleeping on the streets were now in luxury city centre hotels; people who normally stay in luxury city centre hotels were confined to their homes; and, frontline workers who normally work in homelessness services were either working from home or had the run of the empty city streets. It was a triumph of ‘solving rough sleeping’ and the homelessness sector were understandably proud of what had been achieved.
Because the city has opened up these hotels and other residential properties to those who experience homelessness we have, as a city, almost completely solved rough sleeping for the time being. [‘Frontline’ Worker C4].
And so began a period of paradoxical freedom and containment in the city.
A City Turned Upside Down
Poem by Dr Rosie Stenhouse created from the findings of the Living With Covid study, March 2020
City streets lie empty
No longer bustling with tourists and office workers
Buildings, like sentries, line the streets keeping watch over this new order of things
The ever-present hum of traffic replaced by birdsong
broken only by the passing of a bus carrying key workers
Familiar, weathered faces, sitting at the top of the steps into Waverley Station
Or outside the stores on Princes Street
Hoping for the few coins that passers-by might give
No furlough to support them
As the pandemic removes their income
A tree stands forlorn, its narrow trunk and sparse branches
No longer needed for protection
A rectangular patch of bare earth, grass long dead
the only clue to the previous occupier of this spot
persuaded to take shelter in a city hotel
Hotels whose foyers and bars would
Echo with the voices of those from far off places
Whose rooms are a luxury that comes at a price
Find themselves occupied by a population
Unwelcome in such spaces in normal times
Bureaucracy and competition removed
Facilitates partnership working and a sense of purpose
Repurposing services to keep people safe
Within 48 hours
Policy makers and CEOs sit alongside those with experience of homelessness
Occupying equal size squares on the screen
Zoom the leveller, enabling access
For new voices to be heard
In the spaces where decisions are made
Norms and rules disrupted
This city is upside down
The ‘Living With Covid’ project is an excellent example of the ways that the University of Edinburgh and the local community are working together to shine a light into the amazing work of the homelessness sector in our city during the Covid19 pandemic. We look forward to the full publication of our findings at the end of May 2020. For a copy of the report, please contact: firstname.lastname@example.org
Dr Fiona Cuthill is a Senior Lecturer in Nursing in the School of Health in Social Science, University of Edinburgh. She has a particular research interest in homelessness and refugee health. Fiona is the Academic Director for the Centre for Homelessness and Inclusion Health, which is a collaboration between the University of Edinburgh and local partners in Scotland to improve the health and wellbeing of people who experience homelessness.
Dr Rosie Stenhouse is a Senior Lecturer in Nursing in the School of Health in Social Science, University of Edinburgh. She has expertise in qualitative methodologies, specifically narrative methods, and conducting research with vulnerable populations. She is Associate Director of the Centre for Creative-Relational Inquiry.
- Photo credit: Photo taken by a frontline worker in the homelessness sector for the Living With Covid project.