Rough sleepers will die this winter without urgent government action as coronavirus and cold weather create a terrifying double threat, doctors and campaigners have warned. Homeless people face a dilemma between staying outside or squeezing into crowded shelters where Covid hygiene will be limited, the Royal College of Physicians and Royal College of General Practitioners have told ministers. Alongside charities including Crisis, Shelter and St Mungo’s they want a repeat of the “everyone in” policy adopted in March and April, when 15,000 homeless people were given emergency accommodation, including in hotels, saving an estimated 266 people from death, according to one study. Prof Andrew Hayward, a member of the government’s Sage advisory group and director of UCL’s Institute of Epidemiology and Health Care, is among the signatories of a letter that says self-contained accommodation must be a priority. It cited a study from New York showing the risk of dying from Covid-19 for people staying in communal shelters was 61% higher than for the general population. Prof Andrew Goddard, president of the Royal College of Physicians, said: “Without urgent action from the government to keep homeless people off the streets this winter, lives will most certainly be lost.” Jon Sparkes, the chief executive of Crisis, said: “Predictions of deaths among people who have nowhere else to go, other than our streets, or sleeping in communal night shelters that are not Covid-secure, must act as a wake-up call to the government. We cannot have hundreds or even thousands of people forced to live in crowded places, where proper social distancing is impossible and the risk of coronavirus transmission is incredibly high.” The letter warns that funding packages for local councils to get people into safe accommodation are drying up. One study of people facing homelessness in London showed that levels of frailty were comparable to 89-year-olds in the general population, it said. It follows a similar call by the London mayor, Sadiq Khan, who this week told the housing secretary, Robert Jenrick, that the government was displaying “complacency and inaction”. “With only weeks to go before shelters would normally begin to open, and with one having opened already in London, the government has neither published any guidance to the sector on communal sleeping nor made provision to fund Covid-safe alternatives,” Khan said in a letter. A spokesperson for the Ministry of Housing, Communities and Local Government said it is working on operating principles so night shelters, which are currently closed, can be reopened as safely as possible when self-contained accommodation can’t be made available. The spokesperson said: “Working with councils, charities and other partners we will protect vulnerable rough sleepers this winter and fund longer-term accommodation and tailored support to end rough sleeping for good.”