pandemic on rough sleepers

How do you stay at home if you are homeless?: the impact of the COVID-19 pandemic on rough sleepers

An old man huddled in an alcove besides a supermarket, his hands outstretched for a warm drink or food. A woman asking passers-by for spare change so she can find shelter, braving the cold and chancing the generosity of strangers. A young man queuing for shelter, barely eighteen, wishing for warmth and a roof over his head.

The faces of homelessness, much like its causes, are myriad in number and variety. It is easy to forget that throughout the COVID-19 pandemic of 2020, the instruction to ‘Stay at Home’ may have wildly different meanings for different groups of people. How do you stay at home if you are homeless?

For the rough sleeping community, the government’s much welcomed ‘Everyone In’ scheme provided emergency accommodation for 15,000 homeless people in unused hotels and hostels. According to a study published in the Lancet, 266 deaths were avoided during the first wave among England’s homeless population, as well as 21,092 infections, 1,164 hospital admissions and 338 ICU admissions. There have largely been no sustained outbreaks of the coronavirus amongst the UK’s homeless community, in contrast to the devastating impact the pandemic has had on the USA’s rough sleeping population which is now regarded as a ‘pandemic within a pandemic.’

While this may indicate that the ‘Everyone In’ scheme was resoundingly successful, the government itself has acknowledged that up to 90 percent of rough sleepers were not accommodated during the first lockdown. Now that we are in the depths of winter, emerging from a second, shorter lockdown in November, it is clear that the pressure faced by homeless shelter and support services is immense and only increasing.

There are many elements contributing to the intense strain on these crucial services. Statutory homelessness figures in London are at 15-year high, due to a number of factors that ultimately stem from the pandemic response: increased incidences of domestic abuse, rising youth homelessness, job losses and the economic recession. Furthermore, support services are also reporting significant levels of staff absence due to illness and self-isolation. This incurs additional administrative costs to replace them with agency staff or redeploy existing staff. Recent funding from the government has not been ringfenced and given the vast range of challenges local authorities are facing during this pandemic, not all are providing more funding for support. Yet without additional financial support, many services may be forced to shut-leaving thousands of rough sleepers back on the streets.

There are no easy fixes in a crisis like the one we have faced with COVID-19 in 2020. The impacts of the pandemic

and the ensuing lockdown are multifaceted and in a normal year would be considered serious and widespread issues in their own right.

However, as students living in Bristol, the difficulties faced by the homeless community and these services may offer unique opportunities for us to help and to learn from. Help Bristol’s Homeless is a well-profiled and invaluable source of support and accommodation for our city’s rough sleeping population, with a direct partnership with our medics hockey team. Their recent Christmas shoebox and rucksack appeal highlights the generosity of our community as well as the importance of such services and fundraising drives. They are always in need of fundraising efforts and activities, making them an excellent organisation to be involved with. These fundraising drives and events make a vast difference to the quality and quantity of services and spaces they are able to create and maintain for the homeless population in Bristol.

As many of us returned home for Easter and Christmas for a much-needed respite from unprecedentedly strange versions of terms at university, I would encourage everyone to reflect and research small things that can be done to help support homeless people in your local area. From shoebox appeals to working as a call companion, there are a number of opportunities that can make a huge difference to a population that continues to face immense struggles this winter as the pandemic continues.

By Zin Htut

Why our work is important by the BAME Medical Student Group

The BAME Medical Student Group (BAME-MSG) is a group of University of Bristol medical students that was formed in 2019 to improve racial representation within the MBChB curriculum. We sit as an advocacy group between medical students and the medical school and work to ensure teaching surrounding diversity will be integrated into content taught throughout the course, providing an understanding of the ways ethnicity and race affects the clinical presentation and prevalence of disease. We also aim to increase awareness of social issues affecting practice such as cultural bias and sensitivity, which is recognised in the GMC’s Outcomes for Tomorrow’s Doctors. Importantly, by providing an avenue for BAME students to work directly with the medical school, we hope that this work could help address the BAME attainment gap and our school being actively anti-racist.

As tomorrow’s doctors, it is important we are all adequately trained to treat a diverse range of patients which reflects the diverse world we live in. We know that BAME patients disproportionately have worse health outcomes, and this has been further exacerbated and brought to the forefront by the current COVID-19 situation. An example is black women being 5 times more likely to die from childbirth than their white counterparts. The racial disparity even extends to the medical devices we rely on so much with black patients being three times more likely to have oxygen levels missed by pulse oximetry. These examples highlight a structural bias within healthcare that continues to endanger the lives of BAME patients.

Some of our members gave their thoughts on why the work we do is important:

Ifrah Omar: “The BAME-MSG is a great way to get involved in many opportunities around the BAME medical student experience. It’s an active and lively group of like-minded students who are working to improve BAME representation in the medical school curriculum, in research and anything healthcare related. I joined after discussions with a friend regarding our frustrations about the lack of diversity in dermatology teaching and these ideas are now being implemented directly by the medical school. If you are someone who enjoys collaboration and has ideas about projects or changed you would like to see, I would highly recommend you join BAME-MSG”

Ayesha Abbas: “At present, a structural bias still exists within the healthcare setting at the expense of BAME patients. BAME-MSG is a fantastic collaboration between passionate students with the common goal of decolonising the medical curriculum and implementing tangible changes from the very start to reduce this gap. My decision to join BAME-MSG was based on the fact that I desperately felt like I needed to get more involved to make important changes, particularly because of the lack of practical clinical skills teaching specifically on BAME patients, including recognising life-saving clinical signs (such as cyanosis, jaundiced