Editor's note: This reporting is the result of a partnership between KNKX's Will James, host of the Outsiders podcast, and the team of Transmission — a new podcast about life at the center of an epidemic. Listen to Episode 3: Houseless and subscribe.
The first publicly disclosed cases of novel coronavirus in the U.S. homeless population emerged this week, as local governments and nonprofits rushed to prevent the virus from spreading to tens of thousands of people living outside or in shelters on the West Coast.
California Gov. Gavin Newsom said Monday that a person who was homeless died of the virus in the Santa Clara area, the first publicly disclosed case in the homeless population.
One model of the outbreak showed more than 60,000 homeless people in California could be infected over the next eight weeks, Newsom said.
“That creates a deep point of anxiety for the existing population but moreover for our health care delivery system, our capacity to move people in and out of the shelters safely without contacting other people and putting them at risk as well,” the governor said in a Facebook address.
In Tacoma this week, two shelters reported what may be the first publicly disclosed cases among homeless people in Washington state.
One man in the Nativity House shelter run by Catholic Community Services tested positive, a leader of the nonprofit said.
The man, who is in his 30s, appeared “healthy enough to leave the hospital” Tuesday, said Denny Hunthausen, who oversees Catholic Community Services operations in the South Sound.
Nine shelter guests who were “most exposed” to the man were moved to the basement of the Tahoma Family Center, next door to Nativity House, Hunthausen said.
A man staying at the Tacoma Rescue Mission tested positive Wednesday, shelter staff said. He was moved to a “secure location” where he’s being monitored by the Tacoma-Pierce County Health Department, nonprofit officials said.
The Tacoma cases were first reported by the News-Tribune.
The Tacoma Rescue Mission has coordinated with the health department to expedite testing among shelter residents, said Amelia Kaiser, the nonprofit’s executive assistant.
“They consider our population one of the most at-risk and certainly vulnerable to fast spread,” Kaiser said. “I believe... we are able to access some fast-tracking that the public doesn’t currently have. That’s my very rough understanding.”
Staff and residents who interacted with the man are awaiting test results, Kaiser said.
'PRETTY IMPOSSIBLE SITUATION'
Strategies meant to prevent infection, such as “social distancing” and frequent handwashing, aren’t realistic for people who sleep in packed shelters or live outside in camps, nonprofit and government leaders say.
The Tacoma Rescue Mission building was designed to house 80 people, but regularly has 190 guests on a cold night, Kaiser said — with some sleeping on mats on the floor.
Shelter managers and outreach workers said they were nonetheless trying to safeguard the homeless population from infection.
At many shelters, staff began screening guests for symptoms at their doors this week, asking about coughs and using forehead thermometers to check for fevers. Some used wristbands purchased at party supply stores to signify a guest was cleared for entry.
But it can be a lot to ask someone to self-report symptoms when a “vital resource” like a shelter bed is at stake, said Meg Martin, who oversees the 42-bed Interfaith Works shelter in Olympia.
“We’re not wanting people to downplay their symptoms, but we would understand why they might,” she said. “Our staff are also monitoring everybody’s symptoms and if people are showing signs, even if they reported that they feel fine, then we may require them to take their temperature.”
If a resident’s temperature is above 100.4 degrees and they have respiratory symptoms, staff wouldn’t let them stay at the shelter, but would help them get tested at a local clinic, Martin said.
Interfaith Works also extended its hours this week to allow guests to stay around the clock, and arranged for meals to be served on site — actions meant to make it easier for residents to stay inside and out of public spaces like food banks.
“Just essentially trying to minimize interaction as much as possible, in a pretty impossible situation to do that in,” Martin said.
The Centers for Disease Control and Prevention has said that the coronavirus can spread to someone who comes into contact with droplets from a sneeze or cough up to 6 feet away.
But if Interfaith Works moved its beds 6 feet away from each other as a precaution, the shelter would lose 17 of its 42 beds.
“Those are the kinds of decisions that providers are having to face right now,” Martin said. “Follow the CDC recommendations that aren’t really based in reality… or do the best with what we’ve got.”
Elizabeth King, who is homeless in Olympia, said she was “extremely nervous” about staying at the Union Gospel Mission shelter, despite the screenings at the door.
“What worries me the most is people not reporting their symptoms,” King said. “Like, they’re checking them at the door. ‘Do you have a fever? Do you have a cough?’ And they’re standing there coughing in line saying, ‘No.’ ...So that’s the thing is that, yes, I’m afraid of staying at the shelters. However, I just can’t abandon mankind, you know?”
'NERVOUS IN THE PIT OF MY STOMACH'
King sat on the sidewalk across the street from Olympia’s Providence Community Care Center, a building where homeless people can use a bathroom, take a shower, do laundry, receive mail, meet with a caseworker, or just get out of the elements.
The center typically buzzes with activity, serving an average of 200 people a day. On Tuesday, it sat empty, closed that morning as a “social distancing” measure meant to slow the spread of the coronavirus.
Several people gathered outside its locked gates chatting about the situation. Some were coughing. One man laid down in a sleeping bag in the parking lot.
Also closed: Starbucks, the Olympia Timberland Library, and virtually every other place where homeless people take refuge during the day.
“Starbucks gives away a lot of food,” King said. “So with no bathrooms, no place to wash hands, and no places for people to be generous… I’m nervous in the pit of my stomach. Like, what’s going to happen if people get drunk and angry? Are they going to start breaking windows?”
It was a Catch-22 repeated in cities across the region. Widespread closures, while doing away with crowds, also cut homeless people off from bathrooms and other resources they use to stay clean.
In Seattle, officials planned to deploy portable handwashing stations and toilets, along with four “hygiene trailers,” across the city.
King said she hoped for the same in Olympia. In the meantime, she was relying on her personal stash of alcohol wipes.
A block away, William Crow, known as Wild Bill in downtown Olympia, busked for change on an empty street of shuttered stores. He strummed “Knocking on Heaven’s Door” on his guitar. The wide-brimmed hat where he collects tips was empty.
SCRAMBLE FOR ISOLATION SITES
Allen Jenkins, 72, is one of the oldest residents of Olympia’s “mitigation site,” where people live in tents on a repurposed city parking lot.
His heart problems grew so concerning years ago that surgeons implanted a pacemaker and defibrillator in his chest. He sleeps with an electronic heart monitor in his tent.
Asked earlier this month if he was aware of the coronavirus outbreak, he replied: “I don’t think I gotta worry about it. If I do, oh well. Everybody’s gotta die sometime.”
At the mitigation site, he’s surrounded by 105 other residents living in 10-foot by 10-foot campsites, with about a foot separating each tent. Despite his cavalier attitude about the virus, he said he tries to limit his interactions at the site to a handful of people.
This week, city officials said they planned to move 10 or so mitigation site residents to motel rooms because their age or health makes them especially vulnerable to complications from the virus.
“We do have some individuals that are very vulnerable due to asthma or age or, say, cancer even,” said Brandon Ault, a city employee who helps manage the site.
Another challenge facing cities and nonprofits: finding ways to quarantine people who test positive for the virus, but don’t have a home.
King County’s efforts included the purchase of a Kent motel as an isolation and quarantine site. The county also plans to set up several “field hospitals” for the same purpose. One 200-bed field hospital is planned for a soccer field in Shoreline, according to a message on the city’s website.
Nonprofits in the Olympia area hope to use hotels and motels to quarantine any homeless people who contract the virus.
Martin said nonprofit and government officials were exploring ways to bring meals and supplies to people in quarantine or isolation, so they wouldn’t have a reason to leave their rooms.
“We’re even looking right now at bringing on temp workers who were just laid off from the restaurant industry and the service industry,” Martin said. “Just really, really looking at how we can float the whole boat because everybody is really worried right now.”