Homelessness in Brazil during the covid-19 pandemics

Brazil has suffered the fifth highest morbidity and second mortality of global COVID-19 cases. Although persons experiencing homelessness (PEH) have been hitearly on by the SARS-CoV-2 spreading, estimative of cases and deaths in such vulnerable population during pandemics remains unknown in Brazil. Nonetheless, São Paulo presented the highest worldwide COVID-19 IgG sero prevalence to date, detected in PEH most likely due to vulnerability and outdoors exposure. As other Brazilian vulnerable populations such as incarcerated and indigenous populations have specific healthcare services and statistics, COVID-19 pandemics may have hit the hardest in PEH populations nationwide. As already established for other vulnerable populations, PEH healthcare assistance should be registered and monitored throughout Brazil. Moreover, monthly records of PEH cases and deaths should be retrospectively recovered for health, epidemiological and humanitarian purposes. Delay on mass vaccination of vulnerable populations may have impacted on an increase of cases and deaths, despite concomitant nationwide decrease in general population. Brazilian COVID-19 pandemics has taught that vulnerable populations, particularly PEH, should be always included as priority in early testing, surveillance, monitoring and mass vaccination plans.