Advocates: Conn. homeless shelters should be COVID vaccine priorities
When will the COVID-19 vaccine come to homeless shelters?
As the first doses of Pfizer’s COVID-19 vaccine entered the arms of workers in Connecticut hospitals this week, government officials and health experts have been busy with the next step in the vaccine rollout process: deciding who gets it next.
One group in particular — people experiencing homelessness — is on the minds of social services workers who say their clients can be at high risk of contracting COVID-19, but are often difficult to connect with basic health care, let alone two doses of a vaccine that has been made the subject of widespread misinformation campaigns and political bickering.
An early push to keep people out of shelters and relatively isolated in hotel rooms has helped keep the transmission of COVID-19 relatively low among homeless populations statewide, said Richard Cho, CEO of the Connecticut Coalition to End Homelessness.
In the shelters that stayed open, regular testing has alerted staff to one or two client cases at a time, allowing them to isolate. But a recent outbreak of three cases at a Connecticut shelter last weekend illustrated the urgency of making a vaccine available to staff, Cho said.
“All the staff in that facility have been potentially exposed,” he said. “The vaccine couldn’t come soon enough — people who work in these settings most definitely need to get priority access.”
While other states, including Massachusetts, have explicitly included those living in homeless shelters in their timelines for distributing the vaccine, Connecticut’s Department of Public Health has not said exactly who will be included in the next phase after it has been made available to medical workers and nursing home residents.
At the urging of the Connecticut ACLU last month, Gov. Ned Lamont said he would include the more than 9,000 people incarcerated in Connecticut in the second phase.
Av Harris, a state Department of Public Health spokesman said Wednesday it’s too early to say beyond that how the state will prioritize people after the first phase of vaccinations is underway.
A federal panel of vaccination experts will take up the question of who they’ll recommend gets the vaccine next at an emergency meeting this weekend, weighing so-called “essential workers,” people over the age of 65 and people with certain medical conditions, the Associated Press reported.
CDC experts and state officials will be weighing several factors, “including maximizing the benefits of vaccine access, mitigating the spread of the pandemic, and mitigating health inequities,” Harris, said.
Either way, homeless services directors say most of their clients aren’t actually living in shelters.
In March, the state Department of Housing quickly moved shelter residents ages 62 and older into empty hotel rooms. As it became clear that group housing was the perfect environment for the virus to spread, roughly 1,000 homeless people were transitioned to about 15 hotel sites across the state. This summer, Connecticut began a federally funded push to move roughly
An overnight overflow shelter for men in Danbury.
1,800 people living in hotels and shelters into apartments and homes.
Not all agencies were able to close their shelters as demand for emergency housing stayed high.
Data collected by the Connecticut Coordinated Access Networks, the regional bodies that assist local agencies in reducing homelessness, show that just over 1,200 individuals or families lived in emergency shelters in Connecticut in November, down from about 2,500 during the month of March. About 100 of the people living in shelters in November were over the age of 62.
Shelter staff visit clients in their hotel rooms and on the streets, putting them at a high risk of contracting or spreading COVID-19, said Margaret Middleton, the CEO of the New Haven-based homeless services agency Columbus House.
“Every day of the pandemic the staff … show up to work and they work with clients with a cotton mask on,” Middleton said. “We can’t run homeless shelters from home.”
That’s why Cho and shelter directors said this week that they’re prioritizing pushing for staff to get access to the vaccine as soon as possible.
Cho said he has advised DPH officials that homeless services workers should be vaccinated early alongside other essential workers during Phase 1b, and said he feels confident they’ll be included in the next round, whenever those doses are available.
State officials initially said that Phase 1b could begin as early as late January, but on Thursday announced that the state would be getting fewer vaccine doses than anticipated, delaying the process by about a week.
Rafael Pagan, Jr., the executive director of the Stamford agency Pacific House, said he’s focused on getting his staff ready to take the vaccine, and addressing any worries they might have about its safety or efficacy.
Homeless shelter staff and clients are not immune either to the vast quantities of misinforma
tion circulating online about the vaccine or mistrust of the medical system based on historical and ongoing discrimination, he said.
“If we have staff that are apprehensive, that’s going to trickle down to the consumers,” he said. It’s important to them to be open to getting vaccinated as quickly as possible.”
Educating staff about the vaccine — and convincing some skeptics that it’s safe to take the shot themselves — will be crucial to the agencies’ next challenge: encouraging their clients to get vaccinated.
Whether they’re considered at high risk of catching COVID-19 because they live in a shelter or they’re particularly vulnerable to serious illness because of their age or medical conditions, Cho said outreach workers across the state will soon be having conversations with people experiencing homelessness about the vaccine.
Some of those conversations will be complicated by mental illness, substance use disorders, or negative experiences with the medical system that have made people mistrustful or apathetic about health care.
“A lot of them haven’t been engaged in primary health care for a long time, and there’s a lot of anxiety,” Cho said.
The outreach workers will be able to draw on some of the techniques they learned enforcing mask wearing and social distancing in shelters, he said. Lesson one: keep it simple. He said one shelter resident refused to wear a mask inside. After several unsuccessful reminders, shelter staff changed tactics and asked what was wrong. The mask was too small, he told them, and hurt his ears. He got a bigger mask, and wore it happily, Cho said.
Lesson two? Make it about other people.
“The kind of resistance you’ll hear is like, ‘eh I’m fine. ... I’m not worried about getting sick,’ ” he said. “That’s when the outreach workers will have to say, ‘It’s not just about you. It’s about keeping other people safe.’ ”