[The following is an editorial opinion piece written by Rachel Lockard and Kelsey C. Priest, medical students at Oregon Health & Science University (OHSU). Here they present an argument in favor of opening hotels to the homeless during the COVID-19 crisis to prevent further outbreaks in the houseless community. —eds.]

Portland has a housing crisis.

We need Housing First—a program that provides a place to live as well as support services to the homeless—and we needed it yesterday. But if we can’t have that, we need hotels today.

There are anywhere from 5,200 to 38,000 individuals experiencing homelessness or housing insecurity in Clackamas, Multnomah, and Washington counties. The number of shelter beds currently available, at baseline, is nowhere near the population needs.

Our homeless neighbors are undoubtedly at increased health risk from COVID-19. National estimates predict that approximately 21,000 people experiencing homelessness could be hospitalized due to COVID-19. In Seattle, 27 people living in homeless shelters tested positive for COVID-19, and one in three Boston adults experiencing homelessness have, to date, tested positive. Two out of 519 confirmed COVID-19 cases in Multnomah County were unhoused individuals.

The effects of overcrowded shelters can be devastating: 23 residents of a single New York City homeless shelter have died due to COVID-19. If our local leaders do not take immediate, aggressive action, we could face a similar surge in our community.

Efforts so far, for asymptomatic persons, include opening 400 beds in community centers and the Convention Center. Unfortunately, these programs do not increase bed capacity, but are an important public health measure for physical distancing. Concerningly, studies demonstrate that six feet isn’t nearly enough distance for safety. Additionally, there will be three temporary emergency outdoor shelters that will “house” up to 135 individuals.

Las Vegas has been publicly scorned for packing unsheltered homeless individuals in 6-foot grids in an outdoor parking lot, despite having thousands of empty hotel rooms. Congregate settings remain an enormous risk for viral spread and are not safe spaces for preventing COVID-19 transmission. In contrast, San Francisco, LA, and NYC are all taking steps to move their unhoused communities into hotels.

Estimates suggest that nationwide, nearly 80 percent of hotels are vacant. This means there could be upward of 6,000 available hotel rooms in Portland. The Jupiter Hotel and another local motel opened its doors to symptomatic houseless individuals awaiting COVID-19 screening—an important step that doesn’t go far enough.

County, city, and state agencies need to work with local and national hotel chains to facilitate immediate transitions from shelters to hotel rooms, and then to long-term housing. The Hilton and Marriott are donating free hotel rooms for medical workers responding to COVID-19. Could this generosity be extended towards our unhoused community members?

Our decisions during this crisis will exacerbate the structural harms and violence that vulnerable communities already face. Homelessness, like COVID-19, exceedingly and disproportionately impacts Black Americans and other historically marginalized populations. We need creative solutions that do not include the further congregation of vulnerable Oregonians in parking lots or the proposed Wapato Jail.

It's clear that hotels are not a long-term solution, but the public health impacts of ignoring physical distancing in our homeless population could be catastrophic. Housing First interventions are not only humane, but proven to be cost-effective, and in the middle of a global pandemic, this couldn’t be more true.

Rachel Lockard, MPH, is a first year medical student at Oregon Health and Science University, and student leader with the Bridges Collaborative Care Clinic. @rachelanjenee

Kelsey C. Priest, PhD, MPH, is a 6th year M.D./Ph.D. student and substance use disorder researcher at Oregon Health and Science University in Portland, Oregon. @kelseycpriest