Care providers for Ohio’s homeless population, which faces unique risks of COVID-19 outbreak, are among those taking steps to prepare for the days ahead.
Research shows people experiencing homelessness are at an increased risk of respiratory illness due to the high prevalence of underlying chronic health conditions, poor ventilation and crowding in shelters, and limited access to health care.
These underlying conditions increase risks of contracting the novel coronavirus, according to guidance from the CDC.
The heightened vulnerability of residents, limited access to health care, shuffle of people in and out of a shelter and proximity to others inside can make for rapid transmission of the virus.
“Frankly, their risk exposure is worse when they come inside a congregate setting,” said Sara Loken, community relations director for the Community Shelter Board, which assists homeless care providers in Franklin County.
“The bigger risk is that a lot of times people who have experienced homelessness over any lengthy period of time have not had access to medical care. So they’re going to fall into that category of people with vulnerable or untreated health conditions that are at risk of having worse consequences from contracting the virus.”
On Thursday, a fifth Ohioan, a 55-year-old man in Trumbull County, tested positive for COVID-19. State health officials say given two instances of community spread, the working assumption is that about 1% of the population — more than 100,000 Ohioans — are infected. That number could reach as high as 40 percent.
Gov. Mike DeWine issued executive orders Thursday closing schools, banning mass gatherings of more than 100 people, and and prohibiting visitations at nursing homes.
Loken said the board is heeding guidance from the CDC and U.S. Department of Housing and Urban Development for shelter operators facing an outbreak. She said shelters are increasing sanitation practices and closely monitoring the virus’ spread.
While the whole situation is “frightening,” she said the board is still awaiting training to detect early symptoms of the virus in shelter residents.
“That’s an open question we have with them: We need them to train us on the earliest possible identification of people who are symptomatic and what we do at that point,” she said.
Media representatives with the Wexner Medical Center at Ohio State University deferred comment on shelter preparations to the local health department. An epidemiologist with the Franklin County Department of Public Health could not be reached. However, spokesman Zach Watson said the department is working with the community board to develop a plan, but could not offer specifics.
At The City Mission shelters in Cleveland, Heather Foote, director of project management, said the organization’s shelters are scaling back programs with outside agencies and suspending volunteer programs to try to restrict traffic into its locations.
Foote said she’s confident in the planning the shelters have undertaken, but at a certain point, there’s only so much that can be controlled.
“There is a degree of this that we have control over in our responses, and then there’s a degree in this that we would really be reliant with medical teams at the CDC to come in,” she said. “At some point, if there were an outbreak, they’d be the ones who are dictating, and we would be in partnership in response to them.”
The total number of homeless Ohioans is tough to pin down. Federal data, measured via a one-night count, estimates the state’s homeless population at 10,345 in 2019. State data, however, found about 70,000 Ohioans accessed services provided for homeless people in 2017.
Homeless children face unique risks as well. State data shows there are about 25,600 homeless students enrolled in Ohio schools. DeWine on Thursday ordered all schools to close starting Monday afternoon for at least three weeks.
The state’s homeless education coordinator declined an interview, citing the workload of a rapidly evolving situation.
A spokeswoman with the state Department of Education said Ohio has applied to the U.S. Department of Agriculture for a waiver that would allow schools to consider to serve meals for students in a “non-congregate setting,” even if schools are closed.
In Akron, The Homeless Charity operates two homeless transitional houses with 12 residents total. Director Sage Lewis said several residents are older with medical problems. He said he plans to ask volunteers with any symptoms of any illness to stay home and is encouraging enhanced sanitation and awareness among residents.
“Our situation is not great,” he said in an email when asked what would happen if someone tested positive.
“But we would likely try quarantining people within their rooms in our houses. We don’t have anywhere else for people to go.”
When asked about special precautions for the state’s homeless people at a media event, Ohio Department of Health Director Dr. Amy Acton offered a meandering response.
“Addressing the needs of the homeless population and also communities where, I’m thinking of the Nepalese community, for instance, where it’s much more common to share a bedroom, and part of quarantine and isolation is you need to be alone in a room,” she said. “So there are going to be interesting caveats to this.”
According to data from Johns Hopkins University, there were more than 128,000 worldwide confirmed cases of COVID-19 around 10:30 p.m. Thursday. More than 4,700 have died.
Jake Zuckerman is a statehouse reporter. He spent three years chronicling the West Virginia Legislature for The Charleston Gazette-Mail after covering cops and courts for The Northern Virginia Daily.