When Anthony returns to the St. Elizabeth men’s emergency shelter after finishing his shift at the Market Street grocery store, a staff member takes his temperature at the door and looks for signs of coughing or shortness of breath.
Then, “they have you wipe down your phone. They have you go directly to wash your hands,” he said. “It’s not forced; it’s encouraged.”
Meanwhile, staff members wipe down the shelter’s sinks, doorknobs and light switches about every two hours, said Anthony, who declined to give his full name to The New Mexican due to privacy and safety concerns. It’s all part of the shelter’s new daily protocol amid the COVID-19 pandemic.
As coronavirus spreads across the state, shelters and agencies that serve the homeless struggle to keep up. In facilities where social distancing is nearly impossible, so is screening for illness and planning for the unknown.
Now more than ever, organizers said, it’s critical that guests are monitored closely, to ensure the safety of those around them — and ultimately the entire community of Santa Fe.
“My biggest fear is if one person comes into the shelter who’s infected with coronavirus, it could spread rapidly,” said Edward Archuleta, executive director at St. Elizabeth. “It’s a scary situation. It’s got me very concerned.”
This is why staff made the decision to implement a quarantine Thursday for guests. While guests at the men’s emergency shelter typically leave from 8 a.m. to 3 p.m. each day, they are now asked to stay indoors, except to go to work or if they need to get some fresh air. Guests are encouraged to take one hour for outdoor exercise a day, but they must check in and out with personnel at the front door when doing so.
On Wednesday, staff members were still accepting new guests but were not allowing anyone to come indoors who was not staying overnight. Within 24 hours, the shelter tightened access further, deciding not to allow new guests over the 20 who were staying there.
“Things are changing every day,” said Dusti Nichols, the shelter’s program manager.
Looking for symptoms
All week, the shelter had been taking each guest’s temperature and looking for symptoms of COVID-19 — a protocol they continue as any guest leaves and returns to the shelter, Archuleta said. If anyone has a temperature higher than 100 degrees Fahrenheit or is coughing and has shortness of breath, staff will call the Department of Health hotline “and they take it from there,” he said.
“They can’t stay here and risk infecting everybody else. We’re not going to take anybody who’s ill,” Archuleta said.
Joe Jordan-Berenis, executive director of the Interfaith Community Shelter at Pete’s Place, said if a guest were to show symptoms of the virus, he also would contact the Department of Health for clearance. Then, paramedics with the fire department would screen the guest on a separate phone call. If they determined the guest could have coronavirus, the department would take them to Christus St. Vincent Regional Medical Center’s south-side emergency room, where they could be tested, he said.
The problem is there’s still no clear plan on where a homeless individual would go if they were to test positive for the virus, shelter organizers said.
‘Where are they gonna go?’
Anyone who has contracted COVID-19 is “told to stay home and don’t have contact with anybody,” said Archuleta. “That’s fine and dandy, but if you’re homeless, you don’t have a home to stay at.”
“If someone does test positive and is not hospitalizable, then where are they gonna go? It’s a big question right now,” agreed Jordan-Berenis. “If we get it spread into the community, where do all these people go?”
As of Friday, city leaders didn’t have an answer either.
Kyra Ochoa, the city’s community services director, said her team had “been working on this issue all week” in collaboration with state and county agencies, as well as La Familia’s Healthcare for the Homeless.
On Thursday, she said, the city had “identified a place where people go instead of going to the hospital” to be quarantined but did not know how it would be staffed. By Friday, she said, plans were in place to have the city fire department on-site, with security guards monitoring the building and city personnel scheduled to deliver meals. She declined to provide the location out of concern for potential guests’ safety.
For a longer-term solution, “which in this era is within the next week,” Ochoa said, she hopes to partner with a motel where people could be quarantined. If this went into effect, she said, only homeless people with the coronavirus would stay at the motel.
Solidifying a longer-term solution, she said, “is a big concern. It’s a top priority.”
Jordan-Berenis said another option he has considered is applying for the Santa Fe Community Foundation’s COVID-19 Response Fund, in which nonprofits can apply for up to $5,000 in funding. He said that if the shelter is accepted, one possibility would be to use the money to provide private motel rooms himself.
Hospitals will not provide rooms, as “we cannot take up hospital space to be quarantining people who are sick,” said Kathy Armijo Etre, vice president of Christus St. Vincent. While people can be tested for coronavirus at the hospital — only after first being cleared via the Department of Health’s screening process — the hospital does not have capacity to house those who test positive.
So far, no homeless shelters or organizations that work with the homeless have reported any coronavirus cases.
Archuleta said a guest arrived at the shelter recently with a temperature higher than 99 degrees but was cleared at an urgent care center for what was believed to be a cold. If anyone were to contract the virus, most clients’ medical costs would be covered by Medicaid, he said.
If a guest at St. Elizabeth were to test positive and not have a place to go, one option would be to put the sick person in the shelter’s smaller dorm, which can sleep up to six guests, and move all others into the larger dorm, which fits up to 22 people, Nichols said.
But the goal is to avoid anyone getting sick, she said.
Thermometers, sanitation, outreach
Because many guests at crowded homeless shelters fall into the category of elderly people with compromised immune systems — those at highest risk of contracting the virus — it’s important that the shelter sanitize “everything,” Archuleta said.
“We’ve always been aware of germs around here, but now we’re sanitizing the building over and over and over again, and I’m not exaggerating,” he said, noting staff and volunteers will clean every doorknob, desk, table and window with bleach water and a rag some 20 times a day, and clean bed linens twice a week as opposed to once a week. “At first everybody laughed at me, but I said, ‘No, we really need to disinfect this place.’ ”
Anthony said these efforts aren’t ignored.
“I’ve noticed they’ve been really stepping up making us aware as far as sanitation goes,” he said, pointing to diagrams around the shelter showing folks how to wash their hands. “Now even after [the virus] is gone, we’re more aware of germs and how important sanitation is.”
The Interfaith Community Shelter also has increased cleanliness in the dining area, kitchen and dorms, and it has signs reminding guests to regularly wash their hands, Jordan-Berenis said.
Administrators also ordered thermometers, just as St. Elizabeth did, Jordan-Berenis said, noting a fever is “the dividing line” between a common cold and potentially having the virus. As of Thursday afternoon, he said, guests were having their temperature taken upon entering the shelter for dinner or an overnight stay. It’s possible that, moving forward, the shelter will only use the thermometers on guests showing symptoms or those new to the shelter because “when you’re trying to get 120 people in the building, taking temperatures of everyone backlogs everything,” Jordan-Berenis said.
New guests also are asked where they are coming from, to ensure they have not traveled from an area with a higher number of COVID-19 cases, Jordan-Berenis said.
As it has done for years, La Familia’s Healthcare for the Homeless is helping to screen any guest who isn’t feeling well in a segregated area.
“Once they’re cleared, they can come in,” Jordan-Berenis said.
For now, the Community Shelter has no plans to quarantine guests or turn anyone away, he added.
“We’re a come-as-you-are shelter. We accept everyone. As of today — and anything can change — we are continuing to accept anyone who needs shelter,” he said.
Though Nichols said the decision to quarantine at St. Elizabeth “was a really hard call” — they had to turn away three or four new guests between Wednesday and Friday — she noted “every new person adds more risks.”
Anthony said he’s grateful for the shelter’s precaution.
“It’s helpful in this situation because you don’t know what they’re bringing in. … Here, we know no one has it, so that’s what makes us feel safer,” he said. “But I do feel bad for the people who are out there — it’s cold.”
Nichols said guests who are employed are still allowed to go to their jobs and are encouraged to “get out and get space” as needed. Otherwise, they are asked to stay inside and practice social distancing.
Still, if someone in need requests something like mail or sack lunches, if available, they can call staff and volunteers via an intercom at the front door with any requests. Then, someone from the shelter will bring down what they need and set it on a curb, having the individual wait on the sidewalk, about 6 to 8 feet away. They are not providing toiletries or clothing — unless absolutely needed — to those not staying overnight at the shelter, to minimize contact, Nichols said.
“We’re trying to put it out there that we’re not the place to come for those things,” she said.
For overnight guests who come inside the shelter, keeping even just a few inches between each person can seem like an impossible task.
“We can’t social distance anybody. We’re in very close proximity of each other,” Archuleta said, noting that before the quarantine there were about 50 people indoors at any time; now, with volunteers, guests and staff, that number hovers around 30.
Paige Kitson, street outreach program director for Youth Shelters & Family Services, said she is able to practice social distancing in her efforts to serve youth 21 and under who are experiencing homelessness by hosting case management meetings outdoors and continuing to deliver items — groceries, snacks, condoms, diapers — to those in need wherever they are. As usual, she said, “everything has been sanitized a gazillion times,” and in general, most operations are running the same as always.
A couple of minor changes, Kitson said, include sending only her healthiest staff members to homeless shelters for “resource days” and transforming the drop-in center to a walk-through, where people can grab items they need from a window, rather than come indoors. For the most part, “I think clients are really taking the precautions [necessary],” she said.
What Kitson fears most is that the virus is adding to preexisting stressors.
“They are really vulnerable. It really takes a toll on your system to be out on the streets and to not have a safe and stable place to sleep every night,” she said. “It’s already exhausting to be homeless, so to have all this added pressure is so stressful for our clients.
“It’s really scary too because when they’re looking for work, all the restaurants are shutting down, the stores are closing down. It’s an added stress,” she said. “We’re gonna continue doing everything we possibly can [to help].”
Jordan-Berenis said his biggest fear is not that the virus would enter the shelter via a guest, but through a volunteer who has traveled out of state to cities with a higher count of COVID-19 cases. He said if the volunteer were to not self-quarantine for two weeks, they might “subsequently inadvertently bring it in here.”
“The other fear I have,” he added, “is that when guests are out in the community, our guests go to places like McDonald’s, the gas station” and similar public spaces, where they could also contract or spread the virus.
The bottom line, he said, is that everyone must take COVID-19 seriously and do their part to stay healthy and protect others. After all, it’s not just about avoiding sickness; it’s potentially about life or death.
“People are dying across the country from this virus,” said Archuleta. “People need to be taking it seriously. I know some folks still aren’t, and they’re going to pay a price for that.”