COVID-19 in the Homeless: How To Reduce Infections, Hospitalizations and Health Care Costs

MedicalResearch.com Interview with:

Kenneth Freedberg, MD
Director, Medical Practice Evaluation Center
Massachusetts General Hospital
Professor of Medicine at Harvard Medical School
Study senior author

Jessie Gaeta, MD
Chief Medical Officer
Boston Health Care for the Homeless Program
Assistant Professor of Medicine
Boston University School of Medicine

Travis P. Baggett, MD, MPH
Faculty clinician-investigator
MGH Division of General Internal Medicine
Assistant Professor of Medicine
Harvard Medical School

MedicalResearch.com: What are the main findings? 

Dr. Baggett: We found that two strategies are crucial for addressing COVID-19 among people staying in homeless shelters:

1) Proactively identifying and testing people with symptoms, and

2) Providing a dedicated, medically supervised, non-hospital space for isolation and management of people with mild to moderate COVID.

Together these two strategies would reduce infections, hospitalizations, and health care costs compared to not doing them. During a pandemic surge, like we are seeing now, it makes sense to add periodic universal testing of all shelter residents, even those without symptoms.

homelessMedicalResearch.com: What should readers take away from your report?

Dr. Freedberg: This is an unusual instance where investing up-front in the approaches described above will improve clinical outcomes and actually save health care dollars.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Dr. Freedberg: Our study findings come from a computer simulation model incorporating the best data we have. The next step is to continue collecting better data for the model, and even more importantly studying the outcomes of these recommended approaches. As the COVID-19 vaccine is rolled out, this should provide substantial benefit in sheltered homeless populations, which can also be assessed. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The main reason we have to contrive and test these complicated strategies is because we haven’t yet found the collective will to end homelessness in the US.


Baggett TP, Scott JA, Le MH, et al. Clinical Outcomes, Costs, and Cost-effectiveness of Strategies for Adults Experiencing Sheltered Homelessness During the COVID-19 Pandemic. JAMA Netw Open. 2020;3(12):e2028195. doi:10.1001/jamanetworkopen.2020.28195


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Last Updated on December 23, 2020 by Marie Benz MD FAAD