On April 19, 2020 an individual with COVID-19 staying at King County’s Kent Isolation and Quarantine facility passed away. The King County Medical Examiner will investigate the cause of death. We are deeply saddened by the news of this loss as well as two confirmed COVID-19 deaths among people living homeless.

As of Sunday April 19, 2020, Public Health has received reports of over 100 confirmed cases of COVID-19 among people who live or work in King County’s homeless community.

People who cannot safely self-isolate at home usually have less access to the resources needed to stay healthy, a challenge exacerbated by the current pandemic. For this reason, preventing and slowing the spread of COVID-19 within people living homeless continues to be a high priority in our pandemic response.

Monitoring cases among people living homeless
The Washington State Department of Health conducts follow-up interviews with people who test positive for COVID-19, including asking whether the person lived or worked in a homeless shelter. In addition, we’ve directed homeless services providers and health care providers to notify Public Health if they learn of a case of COVID-19 or COVID-19 like illness in someone living homeless. Even with these proactive measures, it can be difficult to have a comprehensive count of COVID-19 cases among people living homeless given the ever-changing population.

About COVID-19 response
The COVID-19 homelessness response is a collaboration between Public Health, King County Department of Community and Human Services (DCHS) and the City of Seattle Human Services Department (HSD) working closely with homeless service providers. This includes shelters, day centers, permanent supportive housing sites, health care providers, jail release coordination, outreach workers, nurses in shelters and permanent supportive housing. We’re grateful to the many homeless services and behavioral health staff and providers who are essential workers at this time.

Starting early in the outbreak in King County, Public Health worked with homeless services providers to give guidance to prevent outbreaks before there were cases. Since that time, we have continued to provide information on infection control and prevention in briefings to 200+ providers each week.

We’ve also deployed clinical support teams to homeless services sites to provide guidance on sanitation and hygiene as well as recommended spacing in facilities. These teams also help to coordinate needed disinfection and hygiene supplies through a centralized order and distribution process.

Response to confirmed cases
When Public Health learns of a case of COVID-19 at a homeless services site, a clinical “strike team” quickly visits the site. They assess the level of contagion, coordinate testing, talk with individuals exhibiting symptoms, offer recommendations for swift action to contain the outbreak, and refer people to isolation or quarantine or recovery sites as needed. We deployed the first strike team on April 3 and strike teams continue to respond to outbreaks in the homeless community.

Isolation, quarantine and assessment/recovery facilities
Strike teams connect people to isolation, quarantine and assessment/recovery sites to help people recover from illness while slowing the spread of the virus and preserving hospital beds for the most acutely ill. For individuals living homeless (and for others unable to self-quarantine or isolate in their homes), the county has opened five facilities for isolation, quarantine and assessment/recovery, and has four additional sites in the works. The sites provide space, health and behavioral health care, food and other necessities for individuals to isolate or self-quarantine safely.

“Testing, isolation and quarantine are all important elements in slowing the spread of COVID-19,” explained TJ Cosgrove, lead of the COVID-19 homelessness response group for Public Health. “That said, there’s no substitute for keeping people healthy in the first place. That’s why we’ve invested so much work in early guidance, technical assistance and in de-intensifying shelters so people living homeless – particularly those with underlying medical conditions – have less exposure to others.”

Additional prevention measures
Reducing the density of people in existing shelters to allow for greater social distancing is an important strategy to reduce the risk of infection—a strategy known as “shelter de-intensification.” King County has created temporary shelter space at the King County Administrative Building and the King County International Airport. City of Seattle also opened the Seattle Center Exhibition Hall, Fisher Pavilion and two community centers to support shelter social distancing and is on track to open 95 new beds and tiny homes by months end.

King County also recently supported shelters in moving staff and guests into hotels, further slowing the spread of illness while also providing hotel operators with income during a difficult economic time.

Temporary sobering and recovery center
Preserving hospital resources for the most acute cases is an important element in protecting the healthcare system during the COVID-19 pandemic. To assist people who need health monitoring and a safe place to sleep off intoxication, King County opened a temporary enhanced shelter at the Recovery Café in SoDo on April 6, offering 45 beds and 24/7 access to onsite services. This action relieves the need to take people who are experiencing health issues due to alcohol or other drug use to local emergency rooms, leaving those emergency spaces for people with acute needs. The county will continue to seek a permanent site for a sobering and recovery facility.

Originally posted 4/20/20