As the country heads into winter and it becomes more difficult for people experiencing homelessness to safely remain outdoors, shelters face a major challenge preparing for the increased demand the drop in temperatures will bring while observing restrictions to prevent coronavirus outbreaks.
Homeless shelters have had to adapt this year, with most reducing the number of people allowed inside to limit virus exposure for guests and staff members, said Donald Whitehead, executive director of the National Coalition for the Homeless.
The coming winter and the expiration of the federal eviction moratorium at the end of the year have advocates concerned that a big wave of people will need shelter in a system that is already strained.
"That influx of people is something we haven't seen in my lifetime. Both will cause an influx of people into a system that does not have the ability to absorb a really huge increase in the number of individuals," Whitehead said. "Right now in the country, there's not one city that has enough shelter space for all the homeless people in their community."
About 568,000 people experienced homelessness on a single night in the U.S. in 2019, according to findings from the Department of Housing and Urban Development.
Homelessness has increased in many communities because of the economic downturn created by the pandemic, Whitehead said. A study by a Columbia University professor projected that the number of people without permanent housing could climb by 45 percent this year because of the mass unemployment.
As the numbers climb, shelters have transformed their spaces to meet Covid-19 guidelines from the Centers for Disease Control and Prevention, reducing capacity, providing personal protective equipment, increasing places for people to wash their hands or use sanitizer and frequently checking temperatures, Whitehead said.
"It could be an absolute disaster if there wasn't that rigid adherence to CDC guidelines," he said.
Some facilities have random or scheduled coronavirus testing, as well, he said.
Some states have turned to hotels, renting rooms for the homeless as a way to separate people in part with funding from the CARES Act, he said.
Los Angeles, Denver and the state Minnesota have even started buying hotels to use for the homeless, he said.
Even so, sporadic outbreaks have been unavoidable.
"Our world has really been turned upside down the last several months," said Richard Ducatenzeiler, executive director of Franciscan Outreach, the second-largest provider of emergency shelter in Chicago.
This year has been "easily the most challenging" in the 20 years he has worked in homelessness services for himself and his staff, he said.
"You're fighting an invisible war," he said.
Early on in the pandemic, Franciscan Outreach reduced capacity at its shelters by 25 percent, giving it the ability to put more space between beds and add partitions to keep people separate, Ducatenzeiler said. It also has been using personal protective equipment, providing incentive pay for staff members and screening shelter guests with temperature checks and medical questionnaires. Rapid coronavirus testing is available on site for any guests who exhibit symptoms, he said.
Recently, the shelter restricted its guests' activity and travel to only essential work, doctors' appointments or treatment, he said.
Even so, Franciscan Outreach has had two outbreaks, one of about 20 people in the spring and another of about 55 people in November, he said. In the latest outbreak, the majority were asymptomatic, he said.
While previously it was able to refer cases to a medical respite isolation center, this time it did not initially have capacity to treat the patients from the shelter, so it was forced to figure out how to isolate people within the facility for the first time, he said.
The organization converted one of its three dormitories in the shelter where the outbreak occurred into an isolation space, temporarily moving guests into a school sports complex while it repurposed the space and brought in a deep-cleaning company, he said. In addition, the city gave the organization a separate shower and restroom trailer for people who had the virus, he said.
Beds eventually opened up in the medical isolation wing, and some patients were sent there while about 20 remained in the southern dormitory, Ducatenzeiler said.
Ducatenzeiler said the organization has also lost good, dedicated staff members over the last few months because of concerns about their age or about pre-existing conditions and exposure to the virus.
The strength of his remaining staff members, whom he called "front-line heroes," gives him the drive to "continue to do our work and work towards our mission, but yes it's been a tremendous challenge."
Whitehead said such staffing issues have become a common concern for shelters, as many people who volunteer or work for them may be older or have pre-existing conditions, putting them more at risk.
Bill Russell, executive director of Union Gospel Mission of Portland in Oregon, said the organization had a recent outbreak of about 20 people at a transitional housing and services center where people live together. The group also runs a separate shelter.
It believes the outbreak probably began when a part-time staff worker who was asymptomatic and wearing a mask came in to work a shift in preparation for Thanksgiving, he said.
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About 30 men were still living at the facility, 18 of whom tested positive for the virus and were being isolated on a separate floor with its own showers and bathrooms, he said.
Russell said the organization reduced capacity. While the transitional housing center could normally house about 50, its capacity is now down to 30, and the temporary shelter for homeless people has a capacity of 40 with social distancing, down from 80 to 100.
He said people need to take the virus seriously with the colder months coming.
Russell noted a push to convert the Los Angeles Convention Center into a shelter for the homeless as an example for cities seeking to deal with surges in homelessness this winter while trying to house people in a socially distanced way.
"It has high ceilings, it's a massive space, and they can adequately space people apart," he said.
He said that as the pandemic continues, shelter providers have a significant role in providing a critical service to a very vulnerable population.
"The first priority is safety, keeping everyone safe and healthy. The next priority is help people who are marginalized with the basic life essentials," he said.