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A group of people bundle against the cold during a winter night in Portland. This year, like the past, the conditions of homelessness aggravate efforts to stem the flu. (Photo by Robert Britt)

Flu season hits hardest where care is hardest to find

Street Roots
by Street Roots Staff | 25 Feb 2013

By Alex Zielinski, Staff Writer

Chills. Hot flashes. Achy muscles. Migraines. A rattling cough on top of a dry, sore throat. This time of year under the gray cloud of the Pacific Northwest, these symptoms are tossed between coworkers, family members and friends daily. Sick days are devoured, appointments are forgotten, and most confine themselves to a warm bed and a tower of Kleenex boxes until the fog of the flu has passed.

But what about the folks without the luxury of a roof over their head?

“It’s cold. Real cold,” said Jen Atkins, who just got over a weeklong battle with the flu on the streets. “You got to find yourself a good spot for the day to rest, maybe get some sleep if you’re lucky, and hope the police don’t find you.”

According to the Multnomah County Health Department, the county’s been hit harder this year by influenza than in the last couple. Doctors can’t say if we’ve reached the peak month yet, but the week’s averages of positive flu tests continue to rise. Dr. Justin Denny, the tri-county health officer, says that while they don’t have a tally on how many patients they see who are homeless, he’s sure it’s larger than usual. And that’s just the people who come in.

“I didn’t have insurance when I was sick, most other people out there don’t,” Atkins said. “It’s hard enough to get in to see a doctor, then to pay for it. We just ride it out on our own.”

With the foul blend of steep bills and flu-triggered weakness, it seems that many of Portland’s houseless end up without sufficient medical care, if any. So what options do exist for those struggling to survive the looming threat of flu season without shelter?

According to NancyAnne Mackaben, Transition Project’s’ Day Center Manager, not enough.

“I’m definitely struggling with where I refer people to who are sick,” Mackaben said. “The day center isn’t a living room, so we can’t let them sleep here, it’s against our policy. But it’s difficult to kick them out when there aren’t other options.”

Mackaben said that at least 65 percent of the center’s male visitors — who, unlike the women, have no warming center open for them this season — have hacking coughs and look “just not well.” And she’s running out of cough drop and ibuprofen rations.  The only place Mackaben can send them for aid is Central City Concern’s Old Town Clinic, but check-ups require appointments and are only offered to previous patients.

“I have nowhere to turn,” Mackaben said.

CCC’s Kathy Pape said that even though they can’t accept new patients, Old Town Clinic has extended its usual hours for appointments and urgent care to handle the influx of sick visitors.

“The biggest thing during this season is to try get a mask on them and get them to an exam room so they don’t spread the flu,” Pape said.

If Old Town Clinic visitors aren’t patients already, Pape added, staff usually turn them to the hospital or county health. But local hospitals are also faced with a heavy load of flu-ridden visitors and are dealing with a similar space-based predicament. 

“It’s hard. We can take care of everyone who comes in, but we don’t know where to tell them to go next,” said Dr. Jenny Aponte, director of the emergency department at Legacy Good Samaritan Hospital. “We can’t just tell them to lie in bed and recover. It’s not an option for most. We try to be as lenient as possible in letting them rest here.”

Aponte said that most of the doctors and on-call staff she’s spoken with have seen considerably worse flu conditions in homeless patients than others, since they lack a comfortable and healthy environment to take care of themselves. A few weeks ago, Aponte had to send a homeless 21-year-old man to the intensive care unit for his life-threatening flu symptoms, ones rarely seen in adults his age.

Ultimately, reliable recovery on the streets seems to come in one simple form: Companionship. Atkins said that while she was sick, her only dependable resource was her fiancé, Darren Alexander, who’s lived with her outside since September. He would bring her over-the-counter medication and make sure she kept warm during the brisk nights. Sure, he ended up catching her cold a week later, but it was worth knowing someone would take care of him.

“That’s really what it’s like out there,” Alexander said. “You got to have someone you trust to take care of you or you won’t get better.”

Atkins said that this time of year, most everyone’s looking out for each other on the streets with the flu in the air.

“But some people have no one,” she said. “I know that I’m blessed.”

Tags: 
Flu, health care, homelessness, Multnomah County Health Department, Old Town Clinic
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