On the backstreets and in sheltered doorways of cities around the country, thousands of rough sleepers — unable to comply with the directive to "stay home" — are emerging as a source of growing concern in the battle against COVID-19.

Key points: People who are homeless are more susceptible to getting the infection

People who are homeless are more susceptible to getting the infection They are also more likely to have bad outcomes or even die

They are also more likely to have bad outcomes or even die A pilot program is housing people in hotels, but some don't want to comply

There are estimated to be about 100,000 people who are homeless in Australia, and 15 to 20 per cent of them are sleeping rough.

Andrew Davies, of Perth-based charity Homeless Healthcare, is among those calling for urgent action to move as many rough sleepers as possible into accommodation to protect both themselves and the wider society.

"We've been in close contact with our colleagues from the US and UK and basically it's a ticking time bomb," Dr Davies said.

"We'll have a quite extensive outbreak of COVID among homeless people if we don't act."

There are estimated to be about 1,000 rough sleepers across Perth and Fremantle. ( ABC News: Claire Moodie )

Homeless at particular risk of infection and death

Dr Davies is providing the medical and nursing support to a new push in Western Australia to get the homeless off the streets.

More than 20 rough sleepers have been placed in the Pan Pacific Hotel in Perth's CBD and confined to their rooms under the pilot program.

"There's a lot of co-existing health problems that put rough sleepers at very high risk of firstly getting COVID infection," Dr Davies said.

"But also at very high risk of having bad outcomes, of being hospitalised or even passing away from the infection.

"The last thing we want is any group in society that's out there, that is particularly susceptible to this infection, being able to spread it to other people."

A huge sign on a Fremantle warehouse tells people to isolate at home. Not very helpful advice if you're homeless. ( ABC News; Claire Moodie )

Not everyone's keen on being confined to a hotel room

Coronavirus and the hotel initiative is drawing mixed reactions from the homeless in the WA port city of Fremantle.

Former chef Gary has been sleeping rough since January and has watched the normally bustling streets empty out.

But the 47-year-old said he did not know anyone sleeping on the streets who was worried about the virus, and that many did not even think it was real.

"No-one's scared by it," he said.

"They're more worried that services are being shut down."

Gary, who is homeless, says he would not be keen to move into a hotel during the pandemic. ( ABC News: Claire Moodie )

Gary has been out of work since being injured in a serious car accident.

He was seriously assaulted by another rough sleeper in January, but has since forgiven his attacker.

Despite the dangers, he loves the freedom of living on the street.

WA COVID-19 snapshot Confirmed cases so far: 661

Confirmed cases so far: 661 Recovered: 648

Recovered: 648 Deaths: 9

Deaths: 9 Total tests: 392,908 Latest information from the WA Health Department





Asked if he would move into a hotel room to self-isolate, he said he could not think of anything worse.

Gary said many people living on the street were complying with social-distancing measures and he was encouraging other rough sleepers to follow the rules.

"Because it's going to get worse," he said.

Perth man James Harwood is relieved to be off the streets during the coronavirus pandemic. ( ABC News: Claire Moodie )

James Harwood, on the other hand, is relieved to be off the streets during the pandemic, after several weeks of living in his car.

He was recently helped into some accommodation by Fremantle's St Patrick's Community Support Centre.

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The 24-year-old has been battling mentally since losing his best friend to suicide.

"It [COVID-19] just made me more stressed," he said.

"It just adds to your problems."

Brothers Anthony and Shane found accommodation after years of being on and off the streets.

COVID-19 social distancing restricts services

The plea to get more rough sleepers off the streets around Australia comes as groups with the difficult task of caring for the homeless find themselves with an even harder job.

While the virus has closed down some church-run soup kitchens, drop-in centres like St Patrick's are trying to maintain what services they can.

But, it is a tough balance.

With social-distancing measures, it is no longer the buzzing social hub that homeless people or those at risk of homelessness have come to depend on.

It has plenty of donated food to distribute to the needy and still offers counselling and health services, but people are no longer encouraged to congregate at the centre and food is supplied on a takeaway basis only.

St Pat's has had to bring in new rules, but is still managing to provide emergency provisions to the vulnerable. ( ABC News: Claire Moodie )

For chief executive Michael Piu it has been heartbreaking.

"They really depend on that human connection," Mr Piu said.

"The new challenge is actually trying to reach people.

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"We know that there's more need than ever, but it's a question of how we adapt to keep the services going."

New wave needing support

St Patrick's, or as it is commonly known, St Pat's, is located just across the road from Fremantle's Centrelink office where long queues have been forming since last month.

Mr Piu said there was a new wave of need that St Pat's hoped to help, regardless of the restrictions.

Volunteer Laurelle McDonald makes takeaway lunches for the homeless at St Pat's in Fremantle. ( ABC News: Claire Moodie )

As the concerns about rough sleepers increase, Homeless Healthcare has joined forces with the University of Western Australia to push for a dedicated COVID-19 facility for people who are homeless and test positive for the disease or who have symptoms and are waiting for results.

A location has already been identified within the Perth CBD.

Shelter WA's Michelle Mackenzie supports the idea, as well as the need to get many more rough sleepers into accommodation around the country.

"We know in South Australia, 223 people have been put into emergency accommodation in motels in Adelaide," she said.

"We know that Victoria is looking at how they can get people off the streets into hotel rooms.

"In terms of those that are rough sleeping, they are at acute risk. Nobody should be on the streets now.

"If you look overseas you can see the tsunami that could happen here in WA and Australia if we don't take urgent action.

"What we need to do is make sure that this isn't a short-term fix and that there's a lot of work done on a permanent housing solution so that at the end of this people have the housing supports they need moving forward."

St Pat's is still managing to provide food to those who need it, despite the physical distancing measures. ( ABC News: Claire Moodie )

WA's Community Services Minister Simone McGurk said once the current "Hotels with Heart" pilot program at the Pan Pacific was complete, a decision would be made about the next step.

"For example the Pan Pacific could scale up to 120 hotel rooms," she said in a statement.

The Minister also confirmed other hotels had put up their hands to help and that the program was voluntary.

"It will continue to be voluntary, unless the health advice changes and requires a different approach," Ms McGurk said.