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Table 1 People without accommodation and people living in temporary or crisis accommodation

From: “Staying at home” to tackle COVID-19 pandemic: rhetoric or reality? Cross-cutting analysis of nine population groups vulnerable to homelessness in Japan

  People without accommodation People living in temporary or crisis accommodation
Free- or low-cost accommodation and public assistance facilities Self-reliance support centers Internet café or comic book café
Characteristics and vulnerabilities • A total of 4253 in Japan, and 1037 people in Tokyo alone, the majority of whom are males aged over 60 [10, 23].
• Night-time count of homeless people by NGO indicated an actual number that is 2.8 times higher than that produced by a public survey in Tokyo [24].
• High prevalence of mental illness, intellectual disability, and chronic diseases, such as hypertension, diabetes, and alcoholism [19, 23, 25].
• Threatened by natural disasters, eviction requests, and raids [26, 27].
• Free- or low-cost accommodations shelter 15,600 people in Japan [28] and 4069 people in Tokyo alone, out of which 3779 are recipients of public assistance [26].
• Public assistance facilities accommodate 35,918 people [29].
• Congregated dwelling environment [28].
• TB infection clusters reported [30].
• Utilized by a total of 16,641 people in Japan in 2019 [21].
• Capacity for accommodation is 350 people in Tokyo [31].
• Tenancy terminates in 6 months [31].
• Inmates are required to follow rules, such as alcohol ban and curfews, which drives them to escape [32].
• The number of people that utilize such cafes is 5000 for Japan (2007) and 5055 for Tokyo (2016). The majority are males aged between 30 and 59 years [33].
• Frequent visitors are mainly non-regular workers without employment or health insurance. Oftentimes, many sleep on the streets [34].
• Despite its availability, the existing social welfare is not utilized [34].
• TB infection clusters reported [34].
Socio-economic consequences of COVID-19 • Loss of income [35].
• Soup kitchen services are on hold [36].
• Increase in number of people on the streets [37].
• Those who are not welfare recipients lose job income [38]. • Difficulty of finding a job during the 6-month tenancy period [32]. • Loss of income [39].
• Suspension of internet cafés, which deprives accommodation [40].
Risks of COVID-19 infections and progression • Aging and chronic diseases [23].
• Difficulty performing hand hygiene practices [37].
• Delay in access to medical services [23].
• Sharing a small room with several people [28]. • Sharing a room and amenities, no rooms are individually available, particularly in Tokyo [31]. • Sharing a big space and amenities [36].
• 61.2% of them are without health insurance [33].
• Delay in access to medical services [23].
Existing measures most relevant to vulnerabilities • Public Assistance System for Guaranteeing Minimum Standard of Living [41].
• Self-reliance Support for Needy Persons [42].
• Public Assistance System for Guaranteeing Minimum Standard of Living [41]. • Self-reliance Support for Needy Persons [42]. • Self-reliance Support for Needy Persons [42].
• Tokyo Challenge Net [43].
Urgent measures for COVID-19 consequences and risks • MHLW circular on streamlining approval procedures of public assistance [44].
• MHLW circular on single rooms for the newly needy [45].
• Infection control manuals [46]. • Infection control manuals [47]. • MHLW circular on streamlining approval procedures of public assistance [44].
• MHLW circular on single rooms for the newly needy [45].
Remaining challenges for COVID-19 consequences and risks • Low utilization (20%) of the Public Assistance System due to tedious local government procedures and stigma against the system [48].
• Implement single room arrangement.
• Access to medical services.
• Despite infection control practices, multiple inmates continue to share rooms [46]. • Despite infection control practices, multiple inmates continue to share rooms [47]. • Low utilization (20%) of the Public Assistance System due to tedious local government procedures and stigma against the system [48].
• Implement single room arrangement.
• Access to medical services.