The novel coronavirus has spread to every US state except Virginia, and the elderly with underlying health conditions have been identified by health officials as the most vulnerable.

But another segment of the US population may be even more susceptible to contracting the disease-the 550,000 homeless people.

Their living conditions and poor health may place them at higher risk for contracting the disease and dying from it, although there have been no reported cases among homeless people.

Among the cities with the largest homeless populations are: New York; Los Angeles; San Francisco; Phoenix, Arizona; Portland, Oregon; Washington; and Austin, Texas.

New York has the largest of 78,000 homeless, about 95 percent of whom have temporary shelter while others live on the streets, the US Department of Housing and Urban Development said.

New York recently issued 11 pages of instructions to those who run shelters - which at times can house about 60,000 homeless people every night. They include specific steps on how to maintain clean spaces, communicate with their residents, protect their staff and screen visitors for respiratory symptoms.

Mayor Bill de Blasio recently said that 550 outreach workers have been trained on educating homeless individuals on the symptoms of COVID-19, according to The New York Times.

In Los Angeles with 36,300 homeless, city officials said that more than 100 hand-washing stations were being distributed where homeless have encampment sites throughout the city.

In San Francisco, there are more than 8,000 homeless, according to a homeless count last year. And there are consistently more than 1,000 people on the city's adult shelter waiting list. The city has set aside a $5 million emergency fund to reduce risk of exposure to the virus for homeless living in shelters and homeless supportive housing.

Inadequate response

The latest effort is to use recreational vehicles around the city to house homeless people who are infected with the coronavirus for self-quarantine. But advocates say the city's response is inadequate.

"Homeless people have no way to do so (wash their hands) because of inadequate housing options available and the lack of public restrooms and hand washing stations," said Quiver Watts of the Coalition for the Homeless.

"Folks living on the streets and in shelters often have weakened immune systems due to exposure, sleep deprivation and stress, so an outbreak in a shelter or encampment could be devastating."