Homeless shelters are especially vulnerable to COVID-19 spread, deaths

It is difficult for those staying in homeless shelters to follow the CDC’s guidelines on social distancing.

Tauna Raiche spends a lot of time these days dousing her two-year-old son with soap and hand sanitizer. She warily eyes each person at the South Park Inn who coughs and doesn’t wash their hands. She tries her best not to let them pinch her toddler’s face or give him a high-five.

Raiche and her son have been staying at the Hartford homeless shelter for the past eight weeks. In the last few days, she’s grown more concerned about a potential outbreak of COVID-19 in the temporary housing facility.

“If someone has it in here, then we’re all going down,” she said.

As the state steels itself for a long fight against the spread of a global pandemic, those staying in homeless shelters are particularly vulnerable to contracting and experiencing complications from COVID-19. Space is often tight in these facilities, making it difficult for people to follow federal guidelines on social distancing. And many who use such services are elderly or have underlying health conditions.

“If someone has it in here, then we’re all going down.”

Tauna Raiche
Resident of South Park Inn shelter

“We are working with a population who are living in poverty, who are homeless, who have limited access to health care, and who also are frail and fragile in their own ways, not just with mental health or behavioral issues, but [Chronic Obstructive Pulmonary Disease] and other health issues that impact their lives,” said Jane Banks, the executive director of South Park Inn. She estimated that about 20% of the roughly 120 people her shelter serves each day is either elderly or has a pre-existing medical issue, characteristics that could make the virus more deadly.

“We obviously don’t have people who traveled to China and Italy, but the fear is once the virus gets into our area, our population is medically vulnerable,” said the Rev. Cathy Zall, executive director of New London Homeless Hospitality Center.  “What we’re trying to do is provide people with the absolutely safest space that we possibly can.”

Last week the Connecticut Coalition to End Homelessness hosted a webinar on preparing providers and shelters for COVID-19. A poll was conducted to gauge whether shelters have adequate supplies to mitigate the spread of the virus. Of the 95 people who responded, almost a quarter said they did not have an appropriate amount of cleaning supplies to keep their shelter clean. Nearly three-quarters said they had enough for their services but not enough to share. Just 2% said they had ample cleaning materials and could give some of their supplies to others.

Richard Cho, the coalition’s CEO, said his organization’s role in combating COVID-19 is to help shelters minimize the virus’ spread, and offer suggestions on how to alter services as the need arises.

“Our message is ‘Don’t close down, don’t shut down services, just modify them to the extent that you can,'” said Cho.

Some of the sleeping arrangements at South Park Inn.

Regional homelessness service networks typically follow three models to help people acquire a place to live. Supportive housing is long-term rental assistance model that provides people with wraparound services like addiction and mental health treatment. Rapid rehousing, meanwhile, is short-term rental assistance coupled with housing navigation services and some case management. And rapid exit, short term, one-time financial systems help people acquire an apartment as soon as possible.

Each month, Cho said, there are about 1,200 people on a wait-list for housing.

“There’s only one opening in supportive housing, rapid rehousing and rapid exit for every seven households on that list,” Cho said. “That’s the bottleneck. That’s why we have shelters that are filled with people.”

Zall said the state funding that would pay for rapid rehousing programs in her region has been exhausted. She’s hoping the state comes through with resources to divert people from having to use services. As hourly workers lose their paychecks, and potentially their homes, she said, “That’s all, like a beeline, going to come into the homeless system.”

Cho said advocates are working with the state to free up emergency funding that will give individuals housing and create space for shelters to better manage those still utilizing their services.

He’s working with officials to relax regulations so people can move into secure housing as quickly as possible. Often those experiencing homelessness must provide extensive documentation verifying their identity and housing instability. Moving people who qualify for support services into apartments would free up beds in the state’s 91 shelters, Cho said.

“Now we’re not a prison, so if people who have fevers choose to say, ‘No I’m not going to stay in that room,’ they’ll be free to leave and we’ll notify the appropriate city resources. That could be somebody who’s contagious who just left our site.”

Rev. Cathy Zall
Executive Director, New London Homeless Hospitality Center

“Let’s cut through the red tape as much as possible, and worry about documentation later,” he said.

In the meantime, shelter officials are brainstorming about where they can isolate people showing symptoms. Zall’s New London Homeless Hospitality Center has seven private rooms that can be used for quarantine. They are already isolating one person showing COVID-19 symptoms, meaning they have space for at least six more people who contract the virus, potentially more, if multiple people test positive.

“Now we’re not a prison, so if people who have fevers choose to say, ‘No I’m not going to stay in that room,’ they’ll be free to leave and we’ll notify the appropriate city resources,” Zall said. “That could be somebody who’s contagious who just left our site.”

Banks said South Park Inn will soon be taking the temperature of each person who walks through the door. The plan is to quarantine those showing symptoms in the suite where Banks’ office is, There’s a bathroom and separate entrance to those offices, so those inside can be essentially isolated from the rest of the shelter. Banks estimated they could quarantine eight people there .

“It’s what we have to start with, she said. “And if it’s not enough, then we will continue to try and locate space within our program.”

Banks suggested South Park Inn’s more isolated parts of its shelter could be used to house those more at risk of complications due to COVID-19 because of their age or underlying health conditions.

A revolving door 

Housing advocates are also concerned that shelters and correctional institutions could both be vulnerable to a COVID-19 outbreak because of the high degree of overlap between the two institutions.

The overlap between homelessness and incarceration exists in Connecticut and across the country. A joint report conducted by the state and the Connecticut Coalition to End Homelessness found that 48% of people who had stayed in a homeless shelter over the past three years had at some point been admitted to a prison or jail.

The relationship between incarceration and homelessness could prove disastrous in light of COVID-19. Prisons are tightly contained spaces that, in Connecticut, house a large number of elderly inmates. If an outbreak makes its way into one of the state’s 14 penitentiaries, many fear the pandemic could spread to shelters.

“You’re pushing the public health crisis from one highly congregated setting to another,” Cho said. “There’s not really any mechanism you can put in place to stop that revolving door.”

Cho said he’s talking with officials about acquiring emergency funding so the Department of Correction can help people acquire temporary housing once they leave the penitentiary.

“If they don’t have a stable home, you may just be taking them right out of the frying pan and [putting them] into the fire,” Cho warned. “They need to have a plan in place.”