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Homeless shelters see outbreaks as COVID-19 spreads across Spokane
Spokesman-Review - 1/7/2021
Jan. 7—Several homeless shelters have experienced coronavirus outbreaks in recent weeks, a reflection of the broad and continued community spread of COVID-19 in Spokane.
Three shelters in Spokane have active outbreaks totaling dozens of cases, just as shelter operators and health leaders have warned would likely happen since the pandemic began last March.
Still, early fears of uncontainable transmission have not materialized. Shelters had largely been spared from the coronavirus until recently, partly due to aggressive COVID-19 prevention protocols and because there was insufficient testing for asymptomatic carriers of the disease.
The city-owned warming center on Cannon Street, the Salvation Army's The Way Out shelter and Catholic Charities' House of Charity have all dealt with what the Spokane Regional Health District categorizes as a COVID-19 outbreak.
Meanwhile, the health district is hoping to expand the capacity of its isolation facility at the Immaculate Heart Retreat Center in the coming days.
As of Dec. 31, there were 55 documented cases at The Salvation Army's The Way Out shelter, 47 cases at the House of Charity and 31 cases at the Cannon Street shelter in their respective outbreaks, according to a summary of outbreaks in congregate settings compiled by the health district.
The health district does not consider an outbreak contained until the facility goes at least two incubation periods — 28 days in total — without a new positive case.
"It's a vulnerable situation when you live in congregate settings ... you can't necessarily follow the recommendations to the utmost degree on distancing and limiting your interaction," said Kylie Kingsbury, the homeless outreach coordinator at the Spokane Regional Health District.
Public health officials and shelter officials girded for the worst in the early days of the pandemic, when the Spokane Regional Health District, then under the leadership of former Health Officer Dr. Bob Lutz, implemented strict new protocols at shelters, including a requirement that guests sleep at least 6 feet apart.
That increased spacing between beds forced shelters to reduce their capacity, prompting Spokane County to eventually purchase the Mission Avenue shelter with federal funding and take other steps to maintain capacity in the shelter system. Meanwhile, the health district also formed an outreach team that entered shelters on a nightly basis and screened guests for COVID-19 symptoms.
With federal coronavirus funding, the county established isolation facilities at the My Place Hotel in Spokane Valley and Immaculate Heart Retreat Center in Spokane. The centers serve to isolate people who are COVID-positive or possibly exposed to the disease, but are otherwise unable to do so, such as those experiencing homelessness.
Many assumed that shelters would be the first and hardest hit by the disease.
"That's definitely not what happened, so I think having months and months of time to prepare and to really develop partnerships with the these providers has put us in a pretty good spot to respond to these cases," Kingsbury said.
The outbreaks in shelters have occurred as the entire Spokane community grapples with its most substantial wave of COVID-19 infections yet.
Kelli Hawkins, a spokesperson for the health district, said that the outbreaks at shelters are not out of the ordinary compared to the level of virus spread throughout the community, as there are outbreaks in several sectors and settings. She said the district continues to work with shelters, providing guidance and testing as well as providing transportation for when people do need to go to a quarantine facility.
Meanwhile, the health district has pivoted its approach to shelters as it's gained access to rapid COVID-19 tests and no longer conducts nightly checks for symptoms, leaving that work to the service provider. According to updated Centers for Disease Control and Prevention standards, "if there is moderate or substantial transmission in the community, initial and regular facility-wide testing may be considered as approaches to limit the virus's spread in homeless shelters."
Every week, the health district offers the rapid antigen tests to anyone who will take them, with results turned around in about 15 minutes. Previously, the health district was focused on testing symptomatic people and waited 24 hours for results.
The new system allows the health district to more quickly identify COVID-19 patients and isolate them, Kingsbury said, crediting people experiencing homelessness for being extremely compliant with guidelines and working to stop the spread of the disease.
"Before, we were definitely missing people," Kingsbury said. "Finding those people and being able to notify them definitely bumps up those (case) numbers. Also, there's significant spread in the community. People who are experiencing homelessness in shelters are not immune to the spread that's in the community."
The health district hopes to add beds to its Immaculate Heart isolation facility in the coming days to help deal with the rise in cases. How full the isolation facilities are can vary from day to day. Some referrals to the facility have been delayed, but nobody has been turned away, Kingsbury said.
"It's an ebb and flow of when we're reaching capacity," Kingsbury said.
Steve Smith, division director at SRHD, told the COVID-19 Recovery Task Force on Monday that there are 34 people at the Immaculate Heart Retreat Center, which is close to 85% capacity. There are also 15 individuals using the MyPlace hotel in Spokane Valley to quarantine as of Monday.
House of Charity's outbreak topped out at about 20 cases in a single day but has since waned, according to Rob McCann, the nonprofit's president and CEO. Given House of Charity's capacity of more than 100 nightly guests for the more than 300 nights it has operated during the pandemic, 47 positive cases is a better infection rate than McCann had initially expected.
"The fact that we have so few cases in the homeless population has been a miracle and a blessing," McCann said.
House of Charity implemented a number of new policies after it suffered a severe norovirus outbreak in early 2017 — such as stocking up on masks and gloves and building quarantine units into its housing developments — that McCann credited for helping prevent the spread of COVID-19.
McCann also credits the Providence Health Care'sHouse of Charity Clinic, located across the street from the shelter, for providing ample testing throughout the pandemic, and the shelter's guests for voluntarily isolating when necessary.
Maj. Ken Perine of The Salvation Army said its case numbers spiked when the health district expanded its testing.
"They found a lot of people with COVID, but the experience we've seen is not all of them had active symptoms," Perine said. "It's quieted down, and a lot of the people who were taken out have come right back."
Jewels Helping Hands is operating a shelter without city or county funding inside City Church on Garland Avenue. Only one of its guests and one staff member have tested positive for COVID-19, said the nonprofit's founder, Julie Garcia.
Though it embraces the low-barrier shelter model, Jewels Helping Hands, due to the pandemic, is not allowing new guests who have stayed at another shelter within the last 14 days.
Despite stringent standards, Garcia does not expect to be able to stave off the virus forever.
"It will come, but we've been really strict about our rules because we're in one room and we know the effectiveness of masks when you're living in a household with somebody," Garcia said.
COVID-19 transmission in Union Gospel Mission's shelters is currently limited, but its residential recovery center for women, Anna Ogden Hall, experienced an outbreak last fall that hampered operations for about two months.
"All of the UGM Shelters and shelters in Spokane have seen a significant increase in positive COVID-19 cases during the latest uptick across our community," said Joel Brown, UGM's director of ministries, in an email. "Prior to Sept. 2020 the only UGM facility that had a confirmed positive COVID case was the Crisis Shelter for Women and Children. Since November 2020 every UGM facility has had at least 1 confirmed positive COVID-19 case."
Family Promise, which operates the Open Doors shelter on Mission Avenue, experienced firsthand how rapidly the disease can spread when it endured an outbreak in November.
Within days of the first positive test of a guest on Nov. 5, 39 guests and three staff members had tested positive for COVID-19.
The nonprofit had long planned for the coronavirus to enter the shelter, but leaders were still taken aback by its spread once inside.
"It looks like somebody got infected on Halloween, brought it back to the shelter and then by (Nov.) 7th, basically everybody had it," said Joe Ader, executive director of Family Promise.
The shelter entered a collective quarantine that it emerged from on Nov. 26th. Nobody died in the outbreak, but one guest was hospitalized for one night, Ader said.
"Because basically everybody had it, we could quarantine all together and then get through it quicker, basically," Ader said.
One lesson from the outbreak, Ader said, was that masks work. Staff members who wore medical-grade KN95 masks did not test positive, despite being in close quarters with people who did, Ader said.
"What I can say is we've definitely gotten a lot more stringent on our mask wearing procedures, which we already had in place, but (we're) just getting really a lot more intense with enforcement of it," Ader said.
Family Promise requires guests to quarantine before they enter the shelter.
"We have three quarantine spots that we're housing people in for at least a week, and a negative COVID test," Ader said.
S-R Reporter Arielle Dreher contributed to this story
Arielle Dreher's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper's managing editor.
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