Monkeypox and People Experiencing Homelessness: A Public Health Advisory

Monkeypox and People Experiencing Homelessness: A Public Health Advisory

August 10, 2022

On August 4, federal officials declared monkeypox a public health emergency and there are currently 9,492 cases in the U.S. At this time, the National HCH Council is aware of outbreaks in four cities that include people experiencing homelessness—a number likely to grow as the infection spreads.

Monkeypox is a communicable disease and people experiencing homelessness may be at increased risk of infection. Congregate settings and a high burden of chronic health conditions like HIV makePeople experiencing homelessness are more vulnerable to severe illness from monkeypox. The CDC has created a webpage with information related to the signs, symptoms, treatment, and other information about monkeypox, and has issued guidance to help reduce transmission in congregate living settings (such as homeless shelters).

As hospitals and public health authorities identify cases of monkeypox among people who are homeless and seek appropriate venues for care, we strongly urge the use of non-congregate hotel/motel rooms for isolation purposes.

Local communities should plan to accommodate patients for up to 4 weeks in isolation. This is the timeframe needed to ensure individuals are no longer contagious. Accommodations should meet the following criteria:

  • Have private rooms with access to a private restroom
  • Handle laundry (such as clothing and bed linens)
  • Provide appropriate clinical and social supports
  • Provide staff appropriate PPE when working with patients and handling bed linens
  • Require patients to wear masks, cover lesions, and limit contact with others in congregate spaces

Normally, medical respite care programs would offer a safe hospital discharge venue for people experiencing homelessness in order to receive post-acute care; however, there are very few of these programs currently in the U.S that meet the above criteria.

Discharging patients with monkeypox to inappropriate congregate settings (or to the street) can pose a significant public health threat to the community.

The lessons learned from the COVID-19 response should inform best practices, which includes access to non-congregate spaces for appropriate health care isolation interventions.

Our fact sheet on monkeypox provides more information about this disease, challenges in providing care, the unique risks for people who are homeless, and recommendations for appropriately providing support to those in isolation.

For more information, contact Courtney Pladsen, Director of Clinical & Quality Improvement, at

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