Last weekend, a man I'll call Joseph was feeling feverish, had a few aches and pains, and was developing a cough. He checked and rechecked the CDC’s list of potential symptoms of COVID-19, making sure he hadn’t caught the virus everyone is afraid of. But when Joseph—whose name I am withholding for privacy reasons—felt an itching sensation inside his head that he attributed to increased sinus pressure, he decided it was time to see a doctor. On Tuesday night, the 34-year-old walked to the nearest medical center, but was told to return the next day. When he did, the nurse said they couldn’t do anything unless he was having difficulty breathing, and that instead he should go back home and self-isolate. This is where it gets complicated for Joseph.
Joseph is a resident of a shelter in New York City, the town where he was born and raised. He’s been in this shelter for nearly two years after he was illegally evicted from his previous residence, he said. Simply staying away from others—the usual advice for anyone suspected of having the virus—isn’t an easy task for Joseph. “[The nurse] said not to worry about it and just try to self-isolate as much as possible,” Joseph told me. “But I was concerned about exposing others.”
The Brooklyn shelter houses somewhere between 130 and 150 people, and since the COVID-19 outbreak there have been new protocols in place to aid self-isolation. Mealtimes have been staggered to cut down on gatherings, but still, lines form—there are only three microwaves and, Joseph said, “only one of them is really any good.” There are also bottlenecks at the entry and exit points to the shelter where people sign in and out. Joseph has a roommate who sleeps in a bed three feet away.
Despite these impediments to Joseph’s attempted self-isolation, he’s still in a much better position than many Americans experiencing homelessness. Many shelters are dormitory-style, meaning many people sleep within the same large room. Others continue sleeping in street encampments, putting them at risk of sweeps—despite the CDC’s recommendation that encampment sweeps cease during the COVID-19 outbreak, NYC’s Department of Homeless Services continue to post notices to vacate.
But there is, advocates argue, an obvious solution to the concerns felt by Joseph and others. As the tourism industry has been frozen by shelter-in-place orders, hundreds of thousands of hotel rooms remain vacant in cities across the United States. People experiencing homelessness need spaces of their own during the COVID-19 outbreak, and yet cities largely have not provided these spaces, instead settling for wholly inadequate half-measures. Las Vegas, a town famous for its hotels, painted "social distancing" boxes on a concrete parking lot. Why not simply put these people in the empty rooms?
Officials have the power they need to do this
“If the bottleneck is negotiation with hotels, it shouldn't be an argument,” said Chris Herring, a PhD candidate in the department of sociology at the University of California Berkeley, who recently co-authored a piece arguing that hotels should be commandeered in the San Francisco Examiner. “States have the power to take hotels, even to engage the National Guard to help work on this. But it seems like it will be slow-moving until we get to emergency mode, which we all know is too late if we’re trying to stop a pandemic.”
While laws differ state by state, advocates argue that all could invoke emergency powers to use hotel rooms immediately, and then work out “reasonable payments” afterward. If hotels aren’t available, college dorms, vacant apartments, or otherwise empty units can be looked at. If there was a will to give homeless people the ability to self-isolate, there would be a way. But the same prejudices that pollute housing politics still persist, even during a pandemic.
“Nobody wants this to happen in their neighborhood. People don’t want a large number of people coming off the street to live in a hotel or dorm near them,” said Miriam Komaromy, medical director of the Grayken Center for Addiction Medicine at Boston Medical Center, Boston University, who recently co-authored a piece arguing the need to use vacancies to house homeless people. “There’s a stigma and unwillingness on the part of building owners to rent to those who are homeless, for fear of property damage or a stigmatizing image, that it will hurt their ability to bounce back to their former business model.”
Hotel-type shelters would require a lot more staff
Political will isn't the only obstacle, however. A shelter needs workers for cleaning, security and managerial duties, among other things. If a shelter shifts from a dorm-style layout to a model where every person gets their own room, this would necessitate a larger staff—but there's already a staffing shortage in shelters. Shelters have been hemorrhaging employees since the outbreak began. The work is often underpaid, and now workers have to deal with the lack of personal protective equipment (PPE), as well as schools and childcare centers closing, increasing the burden on those with families.
“Workers are already showing signs of strain,” said Catherine Trapani, executive director of the NYC-based coalition Homeless Services United. “There are call-out rates that are around 15-20 percent, depending on the site.”
These call-outs create added stress for other workers, while leading to an unsterile environment for staff and shelter clients. “One of the cleaning ladies [in my shelter] quit because she didn't want to work through the pandemic, so my room hasn't been cleaned since Saturday,” Joseph said. “And I’d heard they had run out of hand sanitizer for the staff. When I went to get some, one of their jokes was, ‘If we ain’t got it for us, you know we ain't got it for you.’”
The ways to fix this are obvious: raise wages and give shelter staff and clients priority access to PPE. And there’s really no good reason why this isn’t happening, in New York or in other cities in need—Trapani points to a federal stimulus package providing $3 billion for emergency shelters and to expand testing and treatment. “We really just have to put forward a plan and the feds will pay for it,” Trapani said. “Frankly, I don’t understand why this isn’t happening.”
Politicians haven't moved quickly enough
Largely missing from the conversation about COVID-19 and our country’s homeless population is the necessity to shift the definition of what “shelter” means. Previously, especially in a state like New York where there’s a legal “right to shelter,” it focused on keeping people out of the elements. That has not yet been modified in light of the pandemic, and so you still have shelters holding large groups of people in close quarters.
Not all leaders have ignored this problem entirely. San Francisco Mayor London Breed recently signed an order to lease over 400 hotel rooms for homeless folks who have either tested positive for COVID-19 or are experiencing symptoms—but this isn't enough, advocates say, since the virus is often spread by people who have it but do not exhibit symptoms. On Thursday, the first resident of an San Francisco shelter tested positive for COVID-19.
“This is why we have been demanding that the City house homeless people in hotel rooms BEFORE they are infected + infect 150+ people staying there,” wrote the San Francisco-based Coalition on Homelessness on Twitter.
If city and state governments continue to refuse to provide homeless folks with a places to self-isolate, then the virus will continue to spread among the most vulnerable population in the country. Ultimately, that's bad for everyone.
"We're in a situation where there are various motivations beyond simply a baseline of compassion for fellow human beings, where we have the self-interest of trying to avoid rapid spread of the virus,” Komaromy said. “If it spreads anywhere, it will increase the spread everywhere."
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