Beds at Franciscan Outreach. Credit: Provided

NORTH LAWNDALE — A coronavirus outbreak at a West Side shelter for people who are homeless reveals housing must be a priority when addressing public health, shelter leaders said.

With dropping temperatures driving up demand for shelter beds, a crisis could be on the horizon for people experiencing homelessness and the organizations serving them.

About 65 guests have tested positive for COVID-19 since September at the Franciscan Outreach shelter in Lawndale, which currently houses 130 people, said Executive Director Richard Ducatenzeiler. Franciscan has stopped taking referrals for guests until the outbreak is under control.

The shelter put in place precautions to ramp up testing, sanitation and protective gear in early spring with the help of experts at the city’s health department and local medical centers. But the unavoidable challenges of running congregate housing plus the high medical vulnerability among people experiencing homelessness created a “perfect storm,” Ducatenzeiler said.

“Just from the sheer number of additional cases in Chicago … we had to believe that it was going to resurge within our shelter,” he said.

Social distancing is difficult in congregate living quarters at shelters for the homeless. Credit: Provided

Whether they are living in outdoor encampments or staying at a shelter, people experiencing homelessness typically can’t practice social distancing, making it difficult to control exposure. Guests share sleeping quarters and bathrooms, and while Franciscan Outreach screens people during intake and constantly monitors guests for symptoms, shelters usually don’t have the space to isolate and quarantine people.

“Where they’ve been staying and who they’ve been around — it’s very difficult for us to be able to control all of those factors …,” Ducatenzeiler said.

Social conditions often cause people experiencing homelessness to be especially vulnerable to catching COVID-19 and developing a severe infection, Ducatenzeiler said. Homelessness makes it tough to live a healthy lifestyle, eat nutritious food and manage stress, so pre-existing medical conditions and underlying mental health challenges are common, he said.

“We’re working with individuals that already don’t have access to health resources. They’re not getting ongoing regular medical care,” he said. “Many individuals are over the age of 60, or have health conditions, have comorbidities already.”

Franciscan Outreach’s center in Lawndale typically serves up to 200 guests, but it reduced its capacity by a third to reduce crowding and promote social distancing.

The staff installed partitions to create cubicles between beds and redesigned the layout of the shelter to separate those with symptoms.

Barriers were installed to separate beds at the shelter.

When the outbreak was identified, many of the most vulnerable guests at Franciscan were taken to isolation facilities that had been created with city support at a nearby shelter run by A Safe Haven Foundation to prevent spread.

A Safe Haven’s medical respite is available for anyone who has tested positive for COVID that needs a safe place to isolate, but it also connects people to wraparound services that address the deeper issues that make some people, especially those who are homeless, so vulnerable.

“Once they’re out of the woods … we are able to discharge them to the next level of care,” said Neli Vazquez Rowland, president of A Safe Haven. “The medical respite is able to start healing them from a nutrition level, a mental health level … to heal what’s at the root of what’s ailing these individuals.”

But the isolation center at A Safe Haven has only 50 beds, which is not enough to control the outbreak at Franciscan Outreach. Though the medical respite is a powerful short-term resource for shelters, hospitals and individuals, Rowland said a more complete solution requires a reimagining of how health care and social services are delivered to the communities that need them.

For that to happen, housing must be a priority because homelessness is a public health issue, Ducatenzeiler said. Conditions that create homelessness allow COVID-19 to spread in shelters and throughout communities, he said.

“Housing is health care. Housing leads to improved health care outcomes,” he said. “Until we are able to find a viable housing solution, it will be very hard to come up with any public health solutions.”

Pascal Sabino is a Report for America corps member covering Austin, North Lawndale and Garfield Park for Block Club Chicago.

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