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Jan Teeuwisse works as a Homeless Health Care Navigator for Groundswell, a homelessness charity that works to tackle homelessness and health inequalities. Groundswell is a partner within the city of Westminster, which is part of the European End Street Homelessness Campaign

People who are suffering the effects of homelessness are all too aware of threats and risks, and I’m not just talking about COVID-19. In a ‘risk’ environment, trust is an extremely rare commodity with those who are often sceptical about everything – often due to being let down by the system – having difficulty to muster will, for whom everything moves ever so slowly, who have been around the circuit so many times and nothing seems to get done.

It’s as if nobody cares.

But people do care. The fact that people feel abandoned by society does not mean that they in turn abandon society. People who feel hurt by their fellow humans do not automatically go about wanting to hurt others in return. Social distancing is observed, and face masks are worn. ‘These people’ are still part of a society and do still play their role within it – even if they can’t ‘stay home’ which has remained the key instruction for the best part of a year.

Nevertheless, despite this will to be a part of society, society doesn’t always allow it. Barriers exist in the system which make it difficult for people who are homeless to ‘comply’. For example, communal hostels with shared bathrooms and cooking facilities; the ‘test and trace’ system relying on access to a mobile phone and the internet; and the COVID-19 vaccine roll out relying on GP registration and a fixed address.

What a roller-coaster this last year has been. And it’s not even as if this has been a first. We have been dealing with this type of virus transmission for decades now; Groundswell has always worked alongside health inclusion teams during the annual winter flu vaccination campaigns because of the risk flu brings to people with underlying health conditions, which are very common among people affected by homelessness. At the start of the COVID-19 pandemic, the research clearly showed that the vast majority of the population was taking the outbreak very seriously indeed.

This was very much the attitude of the support staff as well, including Groundswell’s peer volunteers and staff. We calculated the risks for ourselves and, where possible, we kept things going to ensure people without a home were supported with their physical and mental health.

Then comes the surprise. Not just the COVID-19 vaccine itself – the result of a massive international effort – but first of all the testing, which was essential to stopping the virus spreading. I can speak for health inclusion teams in Westminster. There they were, at the testing centres, staffed with professionals and volunteers. Fill in details, do the test, be out in less than ten minutes and have your result within the hour. And on top of that the test teams came to the hostels to get the tests done – as a result there were no mass outbreaks of the virus in these settings.

The roll-out of the vaccination programme has been even more impressive. Those of us working on the frontline received our first dose in early January and the second dose 12 weeks later. Our clients, people experiencing homelessness who are in the high-risk group, also received their first jab very early. By 23 March 2021, Westminster had offered four in every five (80%) of people experiencing homelessness their first vaccine and over 800 people (nearly half) had received it. The whole operation ran smoothly and without much incident.

Was there no push-back? Of course there was, but for the most part it did not hold after a quick chat. A microchip being implanted? Pointing out the size of the syringe and the battery pack that would be required proved convincing. The vaccine being rushed? This is not the first Coronavirus that they have been working on; the vaccine is a further development. A worldwide conspiracy to enslave us all? Pointing out the absurdity of all those bickering politicians suddenly working together usually did the trick. It’s great to have accessible, trustworthy resources made by Groundswell to be able to share with people in a range of languages (English, Polish, Romanian, Turkish, Amharic, Arabic and Tigrinya) – answering key questions about the vaccine, explaining how it was made and how it works. This simple, clear information cuts through the noise and provides a helpful talking point.

Within the homelessness and inclusion health sector there are lots of discussions around challenges of rolling out the vaccine and comparing ‘success rates’. But ultimately people want to protect themselves and the people they care about. When rolling out the vaccine to people experiencing homelessness, communication, planning and teamwork are key. As long as people have the information they need, the opportunities to ask questions, and a group of frontline workers prepared to work together and be flexible, then we can easily rollout the COVID-19 vaccination for people experiencing homelessness. Last month Groundswell released a short film and accompanying resource for frontline workers rolling out the vaccine in their area, based on our success here in Westminster.

The rollout of the vaccine to people in Westminster has been a success, achieved before people experiencing homelessness were added to priority group six in the UK’s Joint Committee on Vaccination and Immunisation recommendations in mid-March. And that in a group of people who have multiple health and social conditions to deal with. This world does not cease to surprise me!

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