This is the press release from the National Law Center on Homelessness and Poverty that says what we should be doing in our community, according to the CDC.
Hopefully a more humane shelter is available soon, but is that the right solution?
PRESS RELEASE
CDC: Housing, Not Handcuffs Is the Way to Stop COVID-19 Amongst Homeless Populations
Advocates Hail First Step, Call for More Help
(March 23, 2020, Washington, DC) – Late Sunday, the Centers for Disease Control and Prevention (CDC) issued official guidance stating, “Unless individual housing units are available, do not clear encampments during community spread of COVID-19.” The National Law Center on Homelessness & Poverty (the Law Center) and our Housing Not Handcuffs Campaign members agree with the outlined recommendations and are grateful that the CDC has laid out actions that will help, not harm, people experiencing homelessness.
“We thank the CDC for emphasizing that from a public health perspective, stopping sweeps of homeless encampments and providing housing, or at least sanitation for encampments, is a necessary immediate step in addressing the COVID-19 crisis,” said Maria Foscarinis, Executive Director at the Law Center. “But now Congress and our communities need to do their part to ensure housing and other aid make it to people experiencing homelessness and those who are caring for them.”
The Law Center put out its top-10 recommendations on constructive ways that cities, states, and the federal government should be addressing homelessness in light of the COVID-19 crisis last week. The CDC adopted a few of these recommendations, and now we turn our focus to other issues that need addressing:
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- None of the COVID-19 relief bills to date have provided additional funding for those serving homeless populations;
- Congress has not yet placed a nationwide moratorium on evictions and foreclosures;
- As Congress debates sending direct relief checks, Sens. Schatz, Hirono, Wyden, Sanders, and Durbin issued a letter to Senate leadership expressing concern that people experiencing homelessness who may not have a permanent address or ID may not be able to access such relief;
- Schools and universities need additional resources to ensure students experiencing homelessness are able to receive equitable access to the same online curriculum and are provided continued meals programs;
- Shelter is still inadequate; vacant federal, state, and local surplus properties, as well as hotels and cruise line recipients of any bailouts, should be made available for housing, safe parking, and service distribution.
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“The message from the public health experts at the CDC is clear: housing, not handcuffs or forced congregate sheltering, for those experiencing homelessness, is the way to best ensure we all remain safer in the face of the COVID-19 crisis,” said Eric Tars, legal director at the Law Center. “And to get them into that housing, Congress must make clear that any hotel or cruise line that wants our public dollars in a bailout must offer to put to their rooms to public good!”
The CDC Guidance is available here: https://www.cdc.gov/coronavirus/2019-ncov/community/homeless-shelters/unsheltered-homelessness.html.
The Law Center’s recommendations and other best practices from across the country are available here: https://nlchp.org/coronavirus/.
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The National Law Center on Homelessness & Poverty (the Law Center) is the only national organization dedicated solely to using the power of the law to prevent and end homelessness. With the support of a large network of pro bono lawyers, we address the immediate and long-term needs of people who are homeless or at risk through outreach and training, advocacy, impact litigation, and public education.
CDC GUIDANCE
Here’s some of the highlights:
Partnerships
- Homeless outreach teams and public health outreach workers will often be the front lines. These workers need to be prepared to protect themselves and their clients, provide health education information, and help direct their clients to care as necessary (see box).
- State and local health departments, homelessness service systems, housing authorities, and emergency planners will need to identify where people without housing can be isolated and receive care if they are suspected to have COVID-19, are awaiting COVID-19 testing results, or are confirmed to be positive COVID-19 cases. These plans should also include transportation protocols.
- Hospitals and healthcare facilities should ensure that they are involved in planning the logistics for safely discharging COVID-19 patients to a designated location if they do not require hospitalization but lack housing.
- Law enforcement should be apprised of plans related to protecting people experiencing unsheltered homelessness from COVID-19 in order to best work in coordination with homelessness service systems and state and local health departments.
- People experiencing homelessness themselves are an important resource to help navigate their communities and keep their friends and family members safe. Consider developing an advisory board with representation from people experiencing homelessness to ensure plans are implementable in the community.
Prevention measures
Encampments:
- Unless individual housing units are available, do not clear encampments during community spread of COVID-19. Clearing encampments can cause people to disperse throughout the community and break connections with service providers. This increases the potential for infectious disease spread.
- Encourage people staying in encampments to set up their tents/sleeping quarters with at least 12 feet x 12 feet of space per individual.
- Ensure nearby restroom facilities have functional water taps, are stocked with hand hygiene materials (soap, drying materials) and bath tissue, and remain open to people experiencing homelessness 24 hours per day.
- If toilets or handwashing facilities are not available nearby, provide access to portable latrines with handwashing facilities for encampments of more than 10 people.
Communications:
Provide straightforward communications to people sleeping outside in the appropriate language. Identify people who are influential in the community who can help communicate with others. Post signs in strategic locations to provide information on hand hygiene, respiratory hygiene, and cough etiquette. Request up-to-date contact information for each person.
Information to share includes:
- The most recent information about COVID-19 spread in their area
- Advice to avoid crowded areas if COVID-19 is circulating in their community
- Social distancing recommendations
- Hand hygiene instructions, cough etiquette instructions, and advice not to share personal items
- How to recognize the symptoms of COVID-19 and what to do if they are sick
- What to do if their friends, family, or community members are sick
- How to isolate themselves if they have symptoms
- Updated information on where to find food, water, hygiene facilities, regular healthcare, and behavioral health resources if there have been local closures or changes
People at Higher Risk of COVID-19
Some people who are experiencing unsheltered homelessness may be at higher risk of moderate to severe disease because of certain conditions. Pay particular attention to preventing disease among these individuals.
Isolation Housing
Local partners should plan for where individuals and families with suspected or confirmed COVID-19 experiencing unsheltered homelessness can safely stay. These should include places where people who are confirmed to be positive and those awaiting test results can be isolated. Additionally, if a person needs to be hospitalized, a plan should be in place for how they will safely recover after discharge. Ideally, these individuals will be housed for the duration necessary, as outlined in the recommendations for discontinuation of isolation. Isolation housing could be units designated by local authorities or shelters determined to have capacity to sufficiently isolate these individuals. If medical care is not necessary and if no other options are available, advise the individual on how to isolate themselves while efforts are underway to provide additional support. In each scenario, identify how to safely transport patients to and from healthcare and housing facilities.
Behavioral health teams should be involved in the planning for these sites to facilitate continued access to support for people with substance abuse or mental health disorders. In some situations, for example due to severe untreated mental illness, an individual may not be able to comply with isolation recommendations. In these cases, community leaders should consult local health authorities to determine alternative options.
Homeless services outreach staff
When COVID-19 is spreading in your community, assign outreach staff who are at higher risk for severe illnessto other duties. Advise outreach staff who will be continuing outreach activities on how to protect themselves and their clients from COVID-19 in the course of their normal duties. Instruct staff to:
- Greet clients from a distance of 6 feet and explain that you are taking additional precautions to protect yourself and the client from COVID-19.
- Screen clients for symptoms consistent with COVID-19 by asking them if they have a fever, new or worsening cough, or shortness of breath.
- If the client has a cough, immediately provide them with a surgical mask to wear.
- If urgent medical attention is necessary, use standard outreach protocols to facilitate access to healthcare.
- Continue conversations and provision of information while maintaining 6 feet of distance.
- Maintain good hand hygiene by washing your hands with soap and water for at least 20 seconds or using hand sanitizer (with at least 60% alcohol) on a regular basis.
- Wear gloves if you need to handle client belongings. Wash your hands or use hand sanitizer (>60% alcohol) before and after wearing gloves.
- If at any point you do not feel that you are able to protect yourself or your client from the spread of COVID-19, discontinue the interaction and notify your supervisor. Examples include if the client declines to wear a mask or if you are unable to maintain a distance of 6 feet.
- Provide all clients with hygiene products, when available.
- Street medicine and healthcare worker outreach staff should review and follow recommendations for healthcare workers.
- Review stress and coping resources for yourselves and your clients during this time.
