A new risk for the homeless

Monroe County’s homeless could be easy pickings for COVID-19.

“The population itself is particularly vulnerable to infection,” says Anna Valeria-Iseman, executive director of the Open Door Mission, which has a homeless shelter and a transitional housing facility for women and children in Rochester.

With Monroe County’s aid, local shelter providers are taking steps to keep the virus at bay, including screening residents and moving the most vulnerable to other locations. Nearly 900 adults and children in the county are homeless.

Since COVID-19 first appeared in the U.S. in January, the virus has rampaged across the country. As of April 15, more than 605,000 people in the U.S., its territories and its protectorates had been diagnosed with the highly contagious disease, and more than 24,000 had died. Monroe County had 883 confirmed cases of the virus. Fifty-seven people had died.

In San Francisco, at least 70 people at the city’s largest homeless shelter have tested positive for the coronavirus. In New York City, 23 homeless people succumbed to the virus, as of April 12.

Though the virus had not appeared in the county’s homeless shelters as of last week, those who stay in such facilities are particularly prone to contracting communicable diseases, including influenza and tuberculosis. Lack of adequate food and shelter, limited access to social services and other conditions all leave them vulnerable. Moreover, when they become ill, the homeless might not take the action they need. 

“They may not be medically treated, whether it’s lack of access or lack of follow-through,” Iseman explains.

That can further compromise the immune system, leaving the individual less able to ward off the virus. 

COVID-19 is easily transmitted through respiratory droplets produced when an infected person coughs, sneezes or even talks, or contact with infected surfaces or objects. The Centers for Disease Control and Prevention guidelines for limiting the spread of COVID-19 include frequent handwashing, covering the nose and mouth when sneezing or coughing, and regularly cleaning all the surfaces of indoor areas. People are also advised to stay at least six feet from each other whenever possible.

Tough on resources

Measures of this kind can prove challenging for homeless shelters to implement. A recent National Alliance to End Homelessness survey of more than 700 organizations and facilities found that many lacked the supplies they needed to cope with the coronavirus. 

The report suggests that the total estimated cost to meet the nation’s emergency and observational/quarantine shelter bed need is roughly $11.5 billion for 2020. Homeless individuals would be twice as likely to be hospitalized, two times as likely to require critical care, and two to three times as likely to die compared with the general population, the study states.

“The big need is for personal protective equipment, masks and gloves and so forth, (and) the cleaning supplies,” says Nan Roman, the Washington, D.C.-based nonprofit’s president and CEO.

Atop that, the threat of contracting the coronavirus has left many of the organizations short of employees.

“Shelters are losing staff, sometimes of their own illnesses, but also because of family reasons,” Roman says. “Their kids are home from school and they have to stay home, or they’ve got a family member who’s ill.”

In addition, the shelters reported that they did not have the space they needed to keep their residents far enough apart, and to respond to occurrences of the virus.

“They need spaces to quarantine people if they’re symptomatic, or if they’ve tested positive, even if they’re not symptomatic,” Roman says.

Implementing measures

Local homeless shelters are responding to COVID-19 in various ways. Anyone wanting to enter Open Door’s Samaritan House, a shelter for homeless adults, or its transitional housing facility have their temperatures taken and must answer a series of question before being allowed in. That includes staff.

“We have a screen tool that we developed several weeks ago,” Iseman notes. “It’s two or three questions about symptoms.”

Pre-COVID-19, the Salvation Army of Greater Rochester normally cleaned its four local shelters once or twice a day.

“Now, everything is wiped down several times a day,” says Christina Barnwell, the agency’s director of social services. “We’re also giving Clorox wipes and cleaning supplies directly to the clients to use in their rooms.” 

Open Door also has taken steps to limit the spread of the coronavirus within its facilities. 

“We have handwashing stations and hand-sanitizing stations,” Iseman says. “Our food service workers are always following the proper procedures.” 

Measures of this kind have forced the nonprofits to use more of their supplies for cleaning and sanitizing their premises.

“We’re using more than we would normally, because we’re wiping down doorknobs, refrigerator handles, faucets, everything, on a regular basis,” Barnwell says. “We’re purchasing them out of our budget.”

Monroe County has created a web portal that local shelters can use to obtain some of the supplies they need. The Salvation Army has already made use of it.

“We have for cleaning supplies, hand sanitizer, gloves, and masks,” Barnwell says. “These items are out of stock with our regular distributors and area stores.”

Fear of spreading the coronavirus has left some shelters with fewer staff and volunteers to care for their residents. 

“All of our program and operations staff are onsite, and administrative staff is offsite,” Open Door Mission’s Iseman says.

Both that nonprofit and the Salvation Army are also operating without their normal complements of volunteers. 

“Zero percent of volunteers are showing up, which is expected and preferred at this time,” Barnwell says.

The shelters also have striven to give their residents enough space to engage in social distancing. 

“We are instructing residents not to congregate in common areas,” Barnwell says. “There is enough space in the bedrooms to keep individuals three to six feet apart, which is the recommendation in sleeping areas.”

In addition, both nonprofits have had to designate isolation areas for residents who show symptoms associated with COVID-19.

“What we have implemented is to identify two rooms at each location,” Iseman explains. “Those rooms need to be six feet away from other common areas.”

Open Door residents who manifest symptoms of COVID-19 would be placed in isolation rooms. The nonprofit then would contact the person’s primary care physician (if he or she has one), Rochester Regional Health and/or the Monroe County Department of Public Health for further instructions. 

Access to care

Shelter residents who need to be isolated or quarantined might find themselves at a local hotel. Monroe County announced on March 28 that it had acquired exclusive use of the 43-room Clarion Pointe Rochester for housing county residents who cannot be quarantined or isolated where they normally live. 

“As we find ways to help people during this difficult and uncertain time, it is reassuring to know that so many businesses in our community are eager to step up and do the right thing,” Deputy Monroe County Executive Jeffrey McCann said in a statement.

The county Health Department would monitor the health of those staying at the Clarion Pointe, make sure they have the medicine, food and other items they need, and to ensure that they remain in safe quarantine or isolation in their rooms. The county would provide security at the hotel.

In addition to Clarion Pointe, Monroe County has allowed shelters to move some of their residents into local hotels with which it has relationships. By reducing crowding, those facilities can decrease the risk that COVID-19 will spread among their residents. Open Door has shifted 35 people to new, temporary homes.

“We’re prioritizing and selecting those who get placed in hotels by the CDC recommendations for who’s most at risk,” Iseman explains.

Open Door continues to provide its usual services to residents after they move to the hotels. 

The Salvation Army and Open Door also could turn to RRH’s Health Reach Healthcare for the Homeless Program for help dealing with COVID-19. HCHP’s medical professionals visit both nonprofits at least weekly.

“We provide full primary care services with these visits,” says Carlos Swanger, M.D., Health Reach’s medical director. “The only difference is that we go directly to where the patient is currently living.”

The Health Reach team would screen the shelter resident, then if warranted refer that person to an appropriate COVID-19 testing site or, if the symptoms of the illness were severe, to an emergency department. HCHP personnel can also conduct the COVID-19 screens by telephone. 

Financial assistance soon might be on the way to local shelters, with the passage of the CARES Act, which President Donald Trump signed into law on March 27. The $2.2 trillion economic relief package, which is intended to help American workers and businesses cope with the effects of the COVID-19 pandemic, contains $4 billion in Emergency Solution Grants.

“It’s really emergency money to help people who are experiencing homelessness,” Roman says.

Other financial aid has become available as well. On March 17, the United Way of Greater Rochester and the Rochester Area Community Foundation created the Community Crisis Fund to help local nonprofits—including homeless shelters—deal with the COVID-19 pandemic.

“We are funding, at a high level of priority, basic needs—food, shelter, clothing, products, supplies—that people need in our community to stay safe,” says Jennifer Cathy, chief impact officer of United Way.

As of April 10, the Community Crisis Fund had raised more than $3 million. Of that total, $874,543 had been distributed to local nonprofits, including the Salvation Army.

Despite the risks posed by COVID-19, those who serve the Rochester area’s homeless and needy appear ready to soldier on.

“All of our programs remain at full capacity,” Iseman says.

Mike Costanza is a Rochester Beacon contributing writer.