The process of getting in and out of the Salvation Army’s COVID-19 care wing at its Sodo shelter is serious. People entering through the plastic curtains should put on hand sanitizer, gown, gloves, N95, surgical mask, face shield. The start is a carefully choreographed dance, so that the skin does not touch the outside of the gown or gloves: first remove the shield, then the gown and finally the gloves.
But inside, the atmosphere is less serious.
People lie on the beds and look at their phones. It’s quiet except for the hum of the HVAC system in the pipes above. Dressed and armored personnel – who must be vaccinated in this wing – sit at computers or walk around checking everyone every 30 minutes.
Although every patient inside has tested positive for coronavirus, none are symptomatic and if anyone starts coughing regularly, staff members call an offsite nurse.
In previous waves, residents of sick shelters had the option of staying at a King County isolation and quarantine hotel with on-site nurses. But while the omicron variant is driving up infection rates in Seattle and across the country, shelter providers like the Salvation Army have dealt with outbreaks mostly on their own.
“Just as other providers have seen, it has become extremely difficult to get people into I and Q as they face their own challenges,” said Simon Foster, Seattle social services director for the Salvation Army, referring to isolation and quarantine.
But at those county hotels staffed with medical staff and services where nonprofits would normally send their positive cases, dozens of rooms sat empty for weeks.
The King County government, which until this year has been successful in containing mass outbreaks and deaths among the homeless, largely gave up last month as the coronavirus spread through the homeless population. .
The dashboard that followed Cases of COVID-19 in Homeless Populations for almost two years, it has been dark since January 4th. Many homeless shelters in King County have seen half their residents infected in the past few weeks, a shelter doctor said, but there is no current official tally. The entire King County Jail West Wing Shelter had to be closed due to a COVID outbreak.
“I don’t believe we will ever be able to track the number of cases that are occurring,” Dr. Jeff Duchin, of Public Health – Seattle & King County, said in early January, as public health officials told the shelters that they would basically need to figure out how to isolate their positive cases themselves. “The large number of infected people will exceed the ability to move everyone into a separate isolation and quarantine setting.”
Last week, someone died in a county isolation and quarantine hotel. The last time this happened was in April 2020.
“Dealing with Omicron’s infection rates has been a struggle for everyone across the country, and all of our systems are strained. We are no exception,” Semone Andu, regional health administrator for Healthcare for the Homeless Network, said in a statement. “We have individuals who have barely taken any days off in two years. Our staff continue to do this work, without rest, as they are committed to supporting our most vulnerable people.
Here’s how it worked, for the most part, in 2021 when a homeless person tested positive for coronavirus, didn’t need hospital care, but couldn’t isolate themselves safely: a case manager, outreach worker, or shelter worker would call a public health line, and review the person’s symptoms and how long they’ve been sick. If the infected person qualifies, that person will travel to one of the few facilities available with medical care and separation between residents, including a motel in Kent that the county purchased at the start of the pandemic for this purpose. .
As omicron spread, the county converted a hotel in Auburn for this purpose, bringing the number of isolation and quarantine beds available to 179.
However, local hospitals filled up and hotels went into “emergency mode,” Chase Gallagher, a spokesman for Dow Constantine County Executive, said in an email.
“This means that these [isolation and quarantine] facilities are shifting from a focus on helping control the spread of COVID to protecting against the collapse of hospital systems,” Gallagher said.
This forced the county to “quadruple” staffing ratios at shelters because residents had serious medical conditions but could not get to hospitals.
Public Health was unable to staff every room in the hotels and the bar to enter one of the pink beds. Staff at homeless nonprofits, who had struggled in the past to isolate and quarantine people, found it even more difficult. Some said they spent hours trying to place one or two people in isolation and quarantine wards, to no avail.
“I’m counting I and Q. That’s not even an option,” Dawn Whitson, system coordinator for the homeless outreach arm of Evergreen Treatment Services, said in mid-January. “I won’t waste my time on this until I hear something from public health. [about the guidelines]. They take a long time and I won’t even try.
Meanwhile, as mid-January approached, there were more than 60 empty rooms in Kent and Auburn.
Shelters are also likely filled with many unvaccinated residents. Although the King County Regional Homelessness Authority sent out a survey of vaccination rates at shelters, few shelter operators responded, according to a spokesperson. The authority’s best estimate is that about 55% of shelter residents are vaccinated.
It would roughly correspond to a vaccine study conducted in King County shelters a year ago on vaccine acceptance, which found that 53% of respondents would receive the vaccine, but 17% were still considering it.
Although public health has relaxed guidelines again, it still faces labor issues, Gallagher said.
Some hospitals have also struggled to find places for COVID patients to go if they don’t have a home but aren’t sick enough to stay. The county said it would pay for hotel rooms for all homeless people with COVID and released a list of hotels created by the regional homeless authority. The county has paid out 80 hotel vouchers so far, Gallagher said.
But public health stopped releasing that list after healthcare providers and homeless people said it wasn’t helpful. The general manager of a Comfort Inn said he doesn’t know how he ended up on the list or why he was suddenly bombarded with hospital calls this month.
“Why are they asking me for rooms? said Jason Kim, manager of two Americas hotels, who was also added to the list and received calls. “They got them. It’s not even complete there.
A social worker at the hospital said that since none of the hotels on the list had rooms, she had to let people leave the emergency room and go who knows where.