Covid-19’s “safe space” for the homeless

An interview with author Steph Grohmann about homelessness in the time of Coronavirus

Author Steph Grohman’s recently released book about squatting and homelessness, The Ethics of Space, explores the space we occupy and how it impacts our very survival.  Writing from personal experience about being ‘roofless’, Steph’s analysis throws up parallels with contemporary global issues, and forces deep emotional and moral reflection. Wind forward a few months, and we all find ourselves facing insecurity and uncertainty in a way previously unimagined. Paradoxically, the global pandemic has created a ‘safe space’ for the homeless in Scotland’s capital, Edinburgh, where Steph lives and where she volunteers as a co-ordinator for some third sector organisations. The following is an interview with the author about doing ethnography in Lockdown and how the collapse of normalcy has made the world more ‘normal’ for those previously excluded from it.

SG: We’re in the middle of a global pandemic, so doing ethnography under these circumstances is somewhat difficult. Not only do we, as ethnographers, have to think of our own safety, we also have to think about ways in which our mere physical presence in the field now poses whole new risks to our respondents. Of course, under Lockdown conditions, much of what anthropologists do – first and foremost participant observation – is almost impossible. I am actually currently prohibited from working both by the UK government and my employer. So, I’m currently working mainly online, interviewing volunteers and third sector workers involved in pandemic relief, to learn more about mutual aid and solidarity in these extraordinary times.

I do have a small window on “the field” as I double as volunteer co-ordinator for some of the third sector organisations we (the Centre for Homelessness and Inclusion Health at Edinburgh) collaborate with. This gives me some insight into the response of Edinburgh’s homeless services to the pandemic, and it is quite remarkable what’s going on here.

My colleague, Dr John Budd, a GP at the Edinburgh Access Practice which caters to homeless people, says there are currently neither any rough sleepers in Edinburgh, nor are there any homeless persons with Covid-19. John stresses that this will not be the case for long (“we know it’s coming, we just don’t know when”), but until that happens, it seems that the pandemic has opened up something of a window of opportunity when it comes to creating what John calls a “health beneficial environment” for Edinburgh’s homeless population.

The local response to the pandemic has been quick and efficient – within just days after the alarm was raised, every single rough sleeper in Edinburgh was housed, and a brand-new Covid Response System, consisting of four spaces, was created. There are two “Covid Hubs” established in hotels in the city (who, for understandable reasons, do not want their names widely known). The council has rented them as temporary accommodation so rough sleepers and people staying in temporary accommodation who test positive for Covid-19 can self-isolate. The hotels are run by Streetwork Edinburgh, and the Cyrenians, two charities from the homelessness sector. Every day a team of medical staff from the Access Practice comes in to provide medical care. A few small rooms are set aside as offices and one serves as a medical examination room, when it does not temporarily double as a storage space. The majority of the hotel rooms are set aside as isolation rooms.

A third space has been created for all regular residents of the large Edinburgh night shelter, who have collectively moved into another hotel. Like many homeless shelters, this one too was so cramped it made social distancing near impossible, and an outbreak there would be extremely hard to control. The Hotel, on the other hand, provides excellent spatial conditions, and can also double as an isolation unit should infection spread.

The fourth space is an intermediary space that serves as a “Covid-free Zone” for homeless persons who leave hospital. It provides a temporary space for convalescence, and also for a structured assessment of the person’s housing- and health needs. Ideally, according to staff, no homeless person should be ‘released’ back into homelessness, although whether that will be possible remains to be seen.

While so far, this response seems almost a little over the top, seeing as miraculously, there aren’t any actual patients yet, it has had a range of surprising synergistic effects. Once people enter these temporary settings, John tells me, even if they don’t have Covid, they suddenly have time and space to address other health issues, such as substance dependence or mental health difficulties. Health care staff at the Covid Hubs, aim to get as many drug users as possible on substituting medication, because, among other things, the pandemic affects the availability and quality of street drugs, needles and syringes. This leads to more needle sharing and cutting of substances, which leads to more blood-borne infections such as HIV and Hepatitis C. One central focus of health assessment across the board is therefore harm reduction and substitution. This includes a volunteer-supported programme of methadone delivery, where medical student volunteers deliver prescription medication to the doorstep of self-isolating patients. “Strangely, we’re seeing fewer overdoses,” says John, “almost as if people are taking better care of their health overall.”

For others, especially those struggling with mental health as a result of adverse life experiences, the Covid Hubs offer a safe and consistent setting where trust in health care staff can slowly be built, for some for the very first time. “People with difficult early life experiences often distrust any form of care,” explains John, “it takes time to win their trust, and time we have here.”

Meanwhile, others consider new solutions to old problems – even dyed-in-the-wool smokers suddenly become amenable to the idea of vaping, seeing as standing around in groups sharing cigarettes can now kill you much quicker than before. Some, finally – isolating but not sick – find the Hubs offer a new relationship to inhabited space: being housed, even temporarily, comes as a relief from the stresses of everyday life on the street, and activities like cleaning and tidying the shared spaces, while necessary to prevent infection, also seem to have a relaxing effect on those used to chaotic lifestyles. One resident, I hear, has already made enough of an impression to be offered a post-pandemic job at the Hotel he’s staying at.

In the microcosm of Edinburgh’s homelessness services, the pandemic has thus, paradoxically, created a safe space – as if the collapse of normality has made the world more ‘normal’ for those who were previously excluded from it. “Exciting times,” says John, “and the fact that there’s no Covid makes it even better.”

Yet, all is not rosy – while Edinburgh’s homeless experience a degree of relief, anxieties among staff, especially non-healthcare staff, run high. This leads to some undesirable dynamics, especially that health care staff, who are assumed to have a higher risk of infection, are anxiously avoided even by their own colleagues. The same effect can be observed for some patients – just like regular hospitals, the Access Practice has seen less footfall recently, leading medical staff to suspect that patients are foregoing healthcare for fear of Covid infection. Most importantly, even the most optimistic staff at the Hubs do not believe the calm will last – the storm is definitely coming, and even the relaxed and friendly atmosphere at the Hubs is laced with a sense of trepidation as people wearing face masks awkwardly squeeze past each other in narrow hotel corridors. Everyone knows the spread of infection among homeless people, who most often suffer from a multitude of underlying conditions, could be catastrophic – even more so if the small teams looking after them are reduced by people falling ill.

John says they are therefore working closely with Public Health Scotland (part of the Scottish National Health Service) to test and monitor patients and immediately isolate anyone testing positive so the curve remains flat. This public health approach, he stresses, is key to preventing the catastrophic scenes we see in other countries, where homeless people are simply piled into parking lots and left to their fate.

If nothing else, the pandemic has demonstrated what decades of homelessness campaigning have not been able to fully establish: that homelessness is not, in fact, an individual problem to be solved with individual means, but a societal issue and therefore a problem for everyone. Where social isolation is not just a matter of self-preservation but also a societal duty, homeless people are in the difficult position that they cannot do the right thing by themselves or others – more importantly though, for others, their condition suddenly appears not just as an abstract-ethical problem, but a concrete, physical one. People who cannot self-isolate increase the overall infection risk for everyone, and so anyone left behind jeopardises the safety of all. John therefore stresses the importance of a public health approach to homelessness, since “we are all connected on a physical level,” keeping the population safe means keeping every single individual safe, and vice versa.

Some observers have remarked that the speed at which many cities were all of a sudden able to resolve 100% of their rough sleeping problem when the pandemic hit, raises serious questions about why this is only happening now, and more importantly, what will happen after. “Surely they cannot just throw people out on the streets again,” muses one volunteer at the Covid Hub, to which John replies, “Well we’re certainly not going backwards.”

His optimism is not without cause – rumour has it there is talk of resolving Edinburgh’s AirBnB problem alongside its homelessness problem, which indicates a large-scale repurposing of inhabitable space across the city. It certainly has never been easier to make the case for ending homelessness once and for all, if not for the sake of the homeless, then for that of everyone else. Whether the coming recession will foil these plans (and lead to new waves of homelessness) is as of yet difficult to tell. In any case, the swift action to get people off the streets we are seeing in Edinburgh and elsewhere, may not be the sudden outgrowth of social consciousness one might have been hoping for, but rather a population health measure to prevent overall mortality in this pandemic and beyond. For those who benefit from it, however, that may just be good enough.

You can download an open-access copy of Steph Grohmann’s recent book The Ethics of Space, Homelessness and Squatting in Urban England or buy a print version from the University of Chicago Press.

Steph Grohmann currently works at the Centre for Homeless and Inclusion Health at the University of Edinburgh. She is currently conducting ethnographic research on homelessness in the UK supported by The Leverhulme Trust.