Despite coronavirus outbreaks at shelters in other cities, the county isn’t changing its practices, citing measures in place to separate sick people
When the novel coronavirus was first confirmed in Oregon, details about its transmission and its symptoms were unclear. Amid school and business closures, followed by a stay-home order from the governor, officials in Multnomah County and the city of Portland had to act fast to find ways to protect the region’s most vulnerable.
Guidelines were needed to safeguard people experiencing homelessness, many of whom are older and have chronic, underlying illnesses. Multnomah County’s health officer, Dr. Jennifer Vines; its communicable disease director, Kim Toevs; and the city and county’s Joint Office of Homeless Services worked with area shelters and people experiencing homelessness. One of the guidelines they developed was to move beds in shelters 6 feet apart, the distance recommended by the U.S. Centers for Disease Control and Prevention.
The county soon began working with shelters to ensure beds in existing spaces were spread 6 feet apart. A new shelter was opened at the Oregon Convention Center, where 130 people who lost beds from the new spacing requirements were given cots to sleep on, also spaced 6 feet apart. Nearly 300 additional beds have been spaced apart in community centers, and about 120 hotel rooms have been secured to house people who become symptomatic, to separate them from people who appear well.
But since this plan was set in motion, new evidence has emerged suggesting that 6 feet of separation is not sufficient and that people who’ve contracted the illness are contagious before ever showing symptoms. It has also been learned that many people who have contracted the virus are asymptomatic.
In Boston, 146 people staying at a homeless shelter have tested positive for COVID-19 without showing any symptoms, Boston public-radio station WBUR reported this week .
Multnomah County will not say whether the two people experiencing homelessness who tested positive for COVID-19 stayed at a shelter at any point during their illness, but it did confirm that testing for COVID-19 has not been conducted at any of Portland’s homeless shelters or camps. Testing is conducted only on those who are sick and showing symptoms, after they’re removed from the shelter setting.
In recent weeks, multiple homeless shelters in other cities, including Seattle and New York City, have experienced outbreaks of COVID-19 among residents and staff.
An outbreak of more than 100 positive tests at a San Francisco shelter, where beds were spaced 6 feet apart, illustrates how fast the disease can spread in a congregate setting, despite spacing measures.
In shelter settings, common areas such as bathrooms and dining areas are shared. The shelter where San Francisco’s outbreak occurred was located inside a convention center, created to house people who had been moved out of existing shelters when their populations were thinned — as the Oregon Convention Center is being used in Portland.
Before the outbreak, San Francisco’s street paper, Street Sheet, sounded an alarm . Street Sheet editor Quiver Watts reported that Mayor London Breed planned to house nearly 400 people in the mass shelter, with no additional handwashing stations and limited bathroom facilities that were shared.
Less than 24 hours later, Breed changed course, working to secure hotel rooms instead. San Francisco Hotel Council offered up to 10,000 rooms. But the shift didn’t happen in time to prevent the outbreak.
In Portland, the convention center shelter offers hand sanitizing stations near the entrance and dining area, according to residents at the facility, in addition to shared bathroom facilities where sinks are available. Harbor of Hope provides showering facilities outside.
On Tuesday, San Francisco’s Board of Supervisors voted to require the city to procure 8,250 hotel rooms by April 26, with 7,000 of those rooms designated for people experiencing homelessness. It’s enough rooms to house 87% of the city’s homeless population, based on last year's Point-in-Time count.
With hotel rooms offering each guest their own bathroom, and with walls between beds, they appear to be the safest respite from the pandemic for people who don’t have homes.
Given the outbreaks among shelters in other cities, Street Roots asked Multnomah County why it’s still housing people in shelters. Its communicable disease director, Toevs, answered our questions via email.
Toevs pointed to how some shelters in the county have some form of barrier between beds.
“By design, many of our existing shelters — the Laurelwood Center, the Willamette Center, the Navigation Center and the Walnut Park Shelter — were laid out when they opened with partial walls and barriers in place, dividing beds into bays. Those spaces were designed well before COVID-19, and those dividers were meant to help with privacy and other concerns. And those dividers can help reduce the risk of spreading germs, especially in areas where bed arrangements are closer than 6 feet together,” she said.
“In addition, some of our other existing shelters — the 5th Avenue Winter Shelter in the Mead Building, the Wy’east Shelter and the Gresham Women’s Shelter — have always had beds or mats spread among different rooms, instead of close together in one large sleeping area.”
But barriers have not been added between beds at the Oregon Convention Center shelter or between beds at other shelters in the county’s system that did not already have them. Originally, placing barriers between beds was among the county’s COVID-19 guidelines for shelters, but that recommendation has since been removed .
Toevs has said the guidelines were written when it was expected that sick and well people would be housed together.
However, because the virus often presents as asymptomatic and testing hasn’t been conducted at shelters, it’s unknown whether Multnomah County has effectively separated those with COVID-19 from those who are well.
“Some shelter systems allow people with symptoms of cough illness in those cities’ shelters to remain in congregate settings, and isolate as best as possible. Some jurisdictions struggle with limited space, that may require beds and mats to be close together and not allow for any physical barriers to section off sleeping areas,” Toevs said.
This was a factor in Boston, where shelters remained crowded amid COVID-19 exposure.
Toevs told Street Roots previously that because the Convention Center shelter is in such a large room, it’s similar to being outside. The additional airflow, she said, lessens the risk. Additionally, the county distributed 5,000 bandanas, 25,000 coffee filters and 10,000 rubber bands among shelters and camps this past weekend, so that residents could fashion face masks.
Wearing face masks inside the shelters is "not required but strongly encouraged," according to the Joint Office of Homeless Services spokesperson, Denis Theriault. But, he said, people who are symptomatic are required to wear a medical grade mask while waiting to be transferred to a hotel.
Street Roots asked again whether the two houseless people who tested positive stayed at a shelter, and again the county said it would not answer that question as it related to specific cases.
“We can share our current practice for any case,” Toevs said. “We determine whether that person has been in shelter. If so, we ask the case detailed questions about anyone they spent time with, and we ask the shelter operator for information about space layout and how people commonly move through the space, about names of individuals sleeping next to or in close contact with the case. We try to identify and directly communicate with anyone who has had prolonged close contact so that we can educate those individuals about symptoms of COVID-19 and how to get help immediately if they develop symptoms.”
Email Senior Staff Reporter Emily Green at emily@streetroots.org . Follow her on Twitter @greenwrites . Street Roots is an award-winning, nonprofit, weekly newspaper focusing on economic, environmental and social justice issues. Our newspaper is sold in Portland, Oregon, by people experiencing homelessness and/or extreme poverty as means of earning an income with dignity. Learn more about Street Roots . Support your community newspaper by making a one-time or recurring gift today .
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