Considering the recent COVID-19 pandemic, we recognised a lack of synthesis amongst the available literature pertaining to the intersections of homelessness and pandemic response and planning. Therefore, the purpose of this review was to identify relevant peer-reviewed literature in this area to thematically produce evidence-based recommendations that would inform community planning and response amongst homeless populations. Although this review is inspired by the COVID-19 pandemic, our intention was to produce relevant recommendations to for all current and future outbreaks and pandemics more generally. Our search criteria focused on pandemics and rapid-spread illnesses such as contagious respiratory diseases with contact spread and with an emphasis on individuals experiencing homelessness. Content analysis methods were followed to extract and thematically synthesise key information amongst the 223 articles that matched our search criteria between the years of 1984 and 2020. Two reviewers were assigned to the screening process and used Covidence and undertook two rounds of discussion to identify and finalise themes for extraction. This review illustrates that the current breadth of academic literature on homeless populations has thus far focused on tuberculosis (TB) rather than diseases that are more recent and closely related to COVID-19—such as Severe Acute Respiratory Syndrome (SARS) or H1N1. Our thematic content analysis revealed six themes that offer tangible and scalable recommendations which include (1) education and outreach, (2) adapting structure of services, (3) screening and contract tracing, (4) transmission and prevention strategies, (5) shelter protocols and (6) treatment, adherence and vaccination. The breadth and depth of reviews such as these are dependent on the quantity and quality of the available literature. Therefore, the limited existing literature outside of tuberculosis specific to homelessness in this review illustrates a need for more academic research into the intersections of pandemics and homelessness—particularly for evaluations of response and planning. Nonetheless, this review offers timely considerations for pandemic response and planning amongst homeless populations during the current COVID-19 pandemic and can facilitate future research in this area.

中文翻译：

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应对无家可归人群的流行病和其他疾病暴发：文献回顾和内容分析

考虑到最近的 COVID-19 大流行，我们认识到有关无家可归和大流行应对和规划交叉点的可用文献之间缺乏综合。因此，本次审查的目的是确定该领域的相关同行评审文献，以主题方式提出循证建议，为无家可归人群的社区规划和应对提供信息。尽管本次审查受到 COVID-19 大流行的启发，但我们的目的是为更普遍的所有当前和未来的爆发和大流行提供相关建议。我们的搜索标准侧重于流行病和快速传播的疾病，例如具有接触传播的传染性呼吸道疾病，并强调无家可归的个人。遵循内容分析方法，从 1984 年至 2020 年间符合我们搜索条件的 223 篇文章中提取关键信息并按主题进行综合。 两名审稿人被分配到筛选过程中，并使用 Covidence 进行了两轮讨论以确定并最终确定提取的主题。这篇综述表明，目前关于无家可归人群的学术文献的广度都集中在结核病 (TB) 上，而不是最近出现的与 COVID-19 密切相关的疾病，例如严重急性呼吸系统综合症 (SARS) 或 H1N1。我们的主题内容分析揭示了六个提供切实和可扩展建议的主题，其中包括 (1) 教育和外展，(2) 调整服务结构，(3) 筛选和合同追踪，(4) 传播和预防策略，(5) 庇护所协议和 (6) 治疗、依从性和疫苗接种。此类评论的广度和深度取决于现有文献的数量和质量。因此，本综述中针对无家可归的结核病以外的有限现有文献表明，需要对流行病和无家可归的交叉点进行更多的学术研究，尤其是对应对和规划的评估。尽管如此，本综述为当前 COVID-19 大流行期间无家可归人群的大流行应对和规划提供了及时的考虑，并可以促进该领域的未来研究。此类评论的广度和深度取决于现有文献的数量和质量。因此，本综述中针对无家可归的结核病以外的有限现有文献表明，需要对流行病和无家可归的交叉点进行更多的学术研究，尤其是对应对和规划的评估。尽管如此，本综述为当前 COVID-19 大流行期间无家可归人群的大流行应对和规划提供了及时的考虑，并可以促进该领域的未来研究。此类评论的广度和深度取决于现有文献的数量和质量。因此，本综述中针对无家可归的结核病以外的有限现有文献表明，需要对流行病和无家可归的交叉点进行更多的学术研究，尤其是对应对和规划的评估。尽管如此，本综述为当前 COVID-19 大流行期间无家可归人群的大流行应对和规划提供了及时的考虑，并可以促进该领域的未来研究。本综述中针对无家可归者的结核病以外的有限现有文献表明，需要对流行病和无家可归者的交叉点进行更多的学术研究，尤其是对应对和规划的评估。尽管如此，本综述为当前 COVID-19 大流行期间无家可归人群的大流行应对和规划提供了及时的考虑，并可以促进该领域的未来研究。本综述中针对无家可归者的结核病以外的有限现有文献表明，需要对流行病和无家可归者的交叉点进行更多的学术研究，尤其是对应对和规划的评估。尽管如此，本综述为当前 COVID-19 大流行期间无家可归人群的大流行应对和规划提供了及时的考虑，并可以促进该领域的未来研究。