The homeless often have underlying medical problems

The argument

The argument identifies a population whose baseline health made them unusually vulnerable to the disease, and holds that vulnerability is what should direct help. Two mechanisms are at work, and they compound. The first concerns the conditions of rough sleeping themselves. Sleep deprivation, poor hygiene and continual exposure to the elements each independently degrade the body's capacity to resist infection, and homeless communities live with all three at once. The result is that a great many homeless people are effectively immuno-compromised — not because of a diagnosed condition but because of sustained physical stress — which places them at a higher risk of death should they contract COVID-19. The second mechanism concerns what has already gone untreated. Many within these communities have long been unable to access essential health services or preventative care. The consequence is that common health conditions, the kind routinely identified and managed in a population with a regular doctor, go undiagnosed and untreated for years. Comorbidities that would elsewhere be controlled are instead present, unmanaged and often unknown even to the person carrying them. Severe outcomes from the disease track precisely such underlying conditions. Put together, homeless people face a compounded risk: a weakened immune response produced by their living conditions, sitting on top of untreated illness produced by their exclusion from care. Neither factor is self-inflicted in any straightforward sense, and neither can be remedied by the individual concerned. That is what makes this a claim about where help should go. The case for directing assistance towards the homeless during the pandemic is not simply that they are poor or visible, but that they occupy the intersection of highest exposure and lowest physiological reserve. Help delivered to a population already reached by health services averts less harm per unit of effort than help delivered to one that has been reached by none.

Context

We know that those with pre-existing conditions and underlying medical issues are more likely to suffer negative health outcomes as a result of COVID-19. The homeless community has an increased rate of disease, leaving many with compromised immune systems.

Premises

Counter-arguments

The COVID-19 pandemic has proven to affect the entire human population. While the elderly and those with underlying conditions are of particular risk to complications and death as a result of the disease, young and healthy individuals have proven to be vulnerable to particularly bad bouts with the contagion. While death is less likely to befall them, many young survivors of the disease have reported complications well after the disease has passed. While death may be the worst outcome, we cannot relegate lower-risk populations to face the potential of complications and hospitalization in an effort to prioritize smaller vulnerable populations.

Rejecting the premises

[Rejecting P1] COVID-19 can cause lasting damage to even those who survive, so we cannot only focus on those at risk of death. [Rejecting P2] Completely healthy adults have been hospitalized and/or died as a result of contracting the disease. [Rejecting P3] Many individuals, across different communities and socioeconomic circumstances are immuno-compromised and suffer from underlying health conditions.