Isolation shelter sees few visitors, at least for now 

Empty cots

click to enlarge The City Auditorium could house 100 homeless people presumed to have COVID-19. - FAITH MILLER
  • Faith Miller
  • The City Auditorium could house 100 homeless people presumed to have COVID-19.

When local service providers began brainstorming how to set up an isolation shelter for people with COVID-19 who had nowhere to quarantine, they anticipated they’d need to house dozens of sick individuals.

But since the isolation shelter opened in City Auditorium (after several delays), it’s housed a total of 17 people, says Jennifer Mariano, director of homeless programs at Community Health Partnership (CHP). That includes seven who were staying there April 19.

“They currently have 70 beds, cots and blankets set up, but we do have the capacity to grow to 100,” Mariano says. “We are much happier with a smaller number in there, because it means that we can distance people farther apart, which is ideal.”

So far, it’s a mystery why COVID-19 hasn’t hit the homeless population quite as hard as expected. The unsheltered population is especially vulnerable because many are older than 60 and suffer from chronic medical conditions that could put them at greater risk of experiencing severe symptoms from the coronavirus.

“Individuals who have been experiencing homelessness, particularly chronic homelessness, have a high burden of chronic diseases that make them more susceptible to getting a severe infection,” says Dr. Heather Cassidy, community engagement director at the University of Colorado School of Medicine’s Colorado Springs branch. Health problems coupled with high-density shelter environments create a “perfect storm” that could allow the virus to wreak havoc on the homeless population, she adds.

Without testing, it’s impossible to say how many people actually have had the virus. Often, people who’ve been infected with the coronavirus show only mild symptoms, and some show no symptoms at all. Most of the people at the isolation shelter so far haven’t been tested for COVID-19 — instead, they’re “presumed positive” for the virus based on their symptoms.

Cassidy theorizes that a screening tool for people visiting one of the city’s two low-barrier homeless shelters, which was implemented before the isolation shelter opened, may have prevented a larger outbreak.

“We looked at the most common symptoms related to coronavirus infection, which are fever, shortness of breath, cough, body aches, diarrhea and chills,” Cassidy explains. Given the limited availability of thermometers, the tool, which the shelters are still using, doesn’t require taking someone’s temperature.

Eventually, the screening could be expanded. El Paso County Public Health is “definitely looking at” the possibility of setting up testing for COVID-19 outside Springs Rescue Mission at some point, says Dr. Robin Johnson, the health department’s medical director.

But for now, intake staff at the Springs Rescue Mission and the Salvation Army Shelter & Services at RJ Montgomery have been screening each person who enters the facility using the CU School of Medicine’s tool. The questions allow them to determine whether someone is suffering from a chronic condition, like emphysema, or has recently gotten sick.

Shelter staff had to turn away a handful of people before the isolation shelter was open, “which was tough,” Cassidy says.

“Is anybody going to be honest about their symptoms if they feel like they’re just going to be left out in the cold that night if they say yes? You know, I would venture to say that that’s a hard ask,” she points out.

“But if we were able to identify a place that somebody could go if they identified symptoms, then maybe we’d get a really nice, honest response and be able to provide a really humane and kind response for where that person who is ill could stay,” she says. “And that was what led to the development of the homeless isolation shelter at the City Auditorium.”
The isolation shelter — a collaboration between local government agencies, nonprofits and a medical staffing company — doesn’t provide medical care like COVID-19 patients would receive in a hospital. However, Mariano says, there’s a licensed practical nurse and certified nursing assistant present at all times, and Peak Vista Community Health Centers brings its mobile van to the shelter each morning to provide basic care.

Meanwhile, medical students and staff from CU School of Medicine remotely advise the shelter staff on health-related questions — and guide decisions on whether people are ready to leave or need to be transferred to a local hospital.

People recovering at the isolation shelter also have access to hot meals from Catholic Charities of Central Colorado and Springs Rescue Mission, books and DVDs from Pikes Peak Library District, heated showers, laundry services and fresh clothing from Discover Goodwill.

Initially, El Paso County Public Health, CHP and local service providers had identified Springs Rescue Mission’s campus as a possible location for the isolation shelter.

The Rescue Mission cleared out one of its buildings and moved in cots and
blankets, says Chief Development Officer Travis Williams, before a liability issue with the nonprofit’s insurance provider nixed that possibility.

Then, after City Auditorium was identified as a potential location, the Colorado Springs Fire Department had some concerns.

“The auditorium itself is somewhat of an older building,” Johnson explains. Eventually, the service providers settled on a solution: Use only designated areas to house sick people.

“The only restriction is we don’t expand beyond that auditorium floor,” where the cots are currently set up, Johnson says.

Insurance issues arose again with the staffing company the city initially planned to use for the isolation shelter. The shelter’s opening, which was initially scheduled for April 1, was delayed until April 6 — after medical staffing company Zactly Employment Solutions was hired. A Springs Rescue Mission staff member manages the location.

“As I’m hearing from colleagues across the country, the liability insurance has been a challenge for a number of folks trying to stand up isolation units or isolation shelters, just because this is an unprecedented time,” Mariano says. “There’s not a lot of knowledge about what all this entails, and so I think insurance companies are responding the best way they can, but unfortunately it’s created some extra challenges and barriers in getting things open.”

The staffing costs will be submitted as part of an overall request for funds from the Federal Emergency Management Agency, Mariano says. The Pikes Peak Community Foundation’s COVID-19 emergency relief fund provided $63,000 to cover the costs of showers, laundry and over-the-counter medications.

But the service providers’ initial cost estimate of $750,000 for three months of operation is looking too high, Mariano adds.

“We were anticipating around 75 to 100 people a night for three months,” she says. “...We just haven’t seen as many people, so the food costs won’t be nearly as much as we had anticipated, but we still have to provide staffing regardless of whether there’s five people or 55 people.”


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