First came the flyers.
Around the time health officials confirmed the first Covid-19 infection in the United States, local homeless service providers shared tips on basic hygiene and infection prevention. Shortly later, shelter operators began stepping up daily cleanings and doling out hand sanitizer.
Now as the global coronavirus pandemic continues to grow, city officials and advocates for the homeless are scrambling to develop a plan to head off a potential spread of the virus among this especially vulnerable group.
The estimated 5,600 people who spend nights in the city’s emergency shelters are particularly at risk. The shelters provide respite from the dangers of sleeping on the streets and increased access to basic hygiene and sanitation. But they are, by design, facilities that prompt people to gather in large groups — which in a viral outbreak can cause infection to spread like wildfire.
What’s more, about half of the nation’s homeless people are over 50 years old, many of them suffering serious medical conditions. Covid-19 has proven far more dangerous to the elderly and those with weak immune systems.
“This is where the vulnerabilities of this population really come into play," said Pine Street Inn spokeswoman Barbara Trevisan.
It’s unclear to what extent the virus has affected the local homeless population. Citing privacy concerns, a spokesman for the Boston Public Health Commission declined to say if any homeless residents have been tested, or exposed to the virus.
Several shelter operators declined the Boston Globe’s request for access to shelter facilities and employees.
As of Friday morning, the city had yet to finalize a comprehensive coronavirus plan for the homeless. Boston housing director Sheila Dillon defended the efforts, saying the region’s planning has evolved as understanding of Covid-19 has increased. Dillon said state and city health authorities have been in talks for weeks with a committee of service providers about a longer-term strategy.
"We’re confident we can be ready when we need to be,” Dillon said.
Any homeless person who shows signs of a coronavirus infection today will have a place to go for treatment, she added.
A tentative plan calls for screening everyone seeking nightly shelter, according to two people who took part in the discussions. The city is also looking for additional space that can be used to quarantine people showing signs of infection. Officials are looking to secure isolation beds in several locations, including the Barbara McInnis House at Boston Medical Center, a 104-bed short-term recovery center for homeless patients, those people said.
Dr. James O’Connell, head of the Boston Health Care for the Homeless Program, said he wishes authorities reacted more quickly.
“I do wish they’d been alarmed earlier,” he said.
O’Connell added that authorities said the window for preventing the spread of coronavirus has likely closed. The urgency now lies, he said, in determining who has it and how to treat them. O’Connell’s group, which operates medical clinics at several public homeless shelters, plans to help conduct the screening of shelter guests.
As the crisis mounts, Boston’s homeless residents are struggling to deal with the added challenges posed by coronavirus.
On a seasonably warm morning Wednesday, Brenda King panhandled for change in front of the Park Street Church, just off the Boston Common. King, 53, said she first heard about the virus weeks ago while listening to a news report.
Since then, she has seen an uptick in homeless outreach workers inside Boston Common. She’s watched them hand out fliers and sanitizing wipes, and received some herself. But King says those donations can only last so long, and her first priority is getting enough money to buy food.
“It makes you nervous, yeah” King said. “It seems like it’s just so easy to catch this thing, and when you’re on the street or in a shelter there’s a lot of ways to get sick.”
Vernal Coleman can be reached at firstname.lastname@example.org. Follow him on Twitter @vernalcoleman.