By Erica C. Barnett

An alarming increase in COVID cases among people experiencing homelessness has been exacerbated in recent weeks, homeless service providers say, by rumors that if people enter a county-run isolation and quarantine site, they won’t be allowed to leave.

And even before these rumors began circulating widely, many unhoused people who tested positive for COVID were reluctant to enter isolation and quarantine, for reasons that ranged from active substance use to the fear that if they left an encampment, they would lose everything they had—a not unreasonable assumption, given the recent uptick in encampment sweeps.

“The resistance, in my experience, has been across the board,” Dr. Cyn Kotarski, medical director for the Public Defender Association, said. “I haven’t met anyone so far who doesn’t have some fear and some resistance to go, and that’s mostly just because it’s overwhelming. It can feel pretty scary to think that you don’t know where you’re going or why, especially when you’re taking someone out of their own environment and their own community,” Kotarski said. The PDA is a partner on several efforts to move unsheltered people into hotels during the pandemic, including Co-LEAD and JustCare.

Although early reports suggested that people living outdoors are less susceptible to COVID infection than those living in group quarters like congregate shelters, the more contagious delta variant could lead to more infections in both indoor and outdoor locations. During the week that ended September 10, King County counted 41 people experiencing homelessness who tested positive for COVID—an undercount, since it only accounts for county testing events.

According to King County Public Health spokeswoman Kate Cole, as of last week, there were 22 active COVID cases associated with encampment outbreaks, defined as two or more people who have tested positive at an encampment—an “increase from baseline” of “one to four cases per month associated with encampments.” A review of the county’s weekly reports shows a steady increase in cases that began in early August and hasn’t abated.

The increase in COVID cases has impacted every part of the county’s service system. The county’s public health department offers testing and transportation for people who test positive, but service providers and county officials say the system is stretched thin, with long waits for transportation and even testing. According to Cole, the current wait for a test by the county’s HEART E Team, one of two teams that performs testing at homeless encampments, can be as long as five to seven days. When someone living in an encampment tests positive, an outreach provider often must wait with them for hours until a county vehicle arrives to take them to isolation and quarantine, increasing the likelihood that they’ll give up and decide not to go. 

Just getting someone on the phone, outreach workers say, can be a challenge. “You call in and they take your number, but if you call back, it’s an automated line and you have to try to reach the person you were talking to,” Dawn Shepard, the south district outreach coordinator for REACH, said. If an outreach worker or unsheltered person misses a call from the county’s COVID hotline, Shepard says, they’ll have to start the whole process over again, “and by that point the person’s just losing interest.” Currently, Shepard added, “It’s taking us about eight hours from coordination to pickup.”

The county, through a partnership with T-Mobile, has handed out about 500 cell phones for outreach providers to distribute to clients, according to Cole, but Stewart says they need more, along with rapid COVID tests so that people don’t have to wait for days to get tested. Currently, rapid tests are hard to come by and expensive when they are available.

Meanwhile, the number of people staying at the Kent isolation and quarantine site, where 60 rooms are currently available, has increased from zero to 50 virtually “overnight,” King County COVID Emergency Services Group director Hedda McClendon said, stretching resources thin. If all the rooms fill up, the county will have to start triaging people based on test results, exposure, and other qualifications, turning people away if their cases aren’t severe.

Shepard said that in the early days of the pandemic, “we really didn’t see folks that were living outside contracting the disease…  largely because the viral load is much lower when you’re outside. Now, though, I think it’s safe to say that with the delta variant, our clients don’t have the same protection, because we’re seeing it all over the city.”

Shelter providers, including Compass and WHEEL, also confirm that they’ve seen an increase in cases; according to WHEEL organizer Michele Marchand, COVID “is ripping through many, many homeless programs and communities,” including WHEEL’s women’s shelter at First Presbyterian Church on First Hill, which has seen at least 11 positive cases in the past few weeks. “We’ve had to stop doing intakes now because of this outbreak,” Marchand continued, adding that the organization is seeking funds for hotel vouchers “to meet the immediate need during this current crisis.”

Charlene Mitchell, the program manager at the Compass Housing-run women’s shelter Jan and Peter’s Place, said that the shelter requires people who test positive to stay “in their bed area” while they wait to be taken to the site in Kent, a process that’s considerably faster than testing and moving people living unsheltered. (Currently, the county uses Yellow Cabs for this purpose). She can remember one recent case when a woman left the shelter for the Kent site and decided not to stay. “She turned around [after arriving] and stayed outside in the streets and at the bus stop” after family members refused to take her in. “She recovered, but I don’t know who all she infected” while she was contagious, Mitchell said.

Shepard says that she’s encountered an increasing number of unsheltered people who tell her they have COVID-like symptoms but don’t want to be tested or go into isolation and quarantine because they’re afraid they won’t be allowed to leave. “There was this big push, when isolation and quarantine opened, that they were not going to hold people against their will, but now there are stories coming out about that happening to people.” Shepard says she takes these stories “with a grain of salt—when I’ve asked who has had that experience, it’s just like, ‘everyone knows'”—but says they’ve had an impact nonetheless. “The big thing I’m hearing right now is, ‘No, I don’t want to go because they won’t let me leave.'” Continue reading “As COVID Cases at Encampments and Shelters Rise, Many Are Reluctant to Enter County Quarantine Sites” →