SARS-CoV-2 is a novel coronavirus that has emerged and caused coronavirus disease (abbreviated as COVID-19). Public health experts continue to learn about SARS-CoV-2, but based on current data and similar coronaviruses, spread from person-to-person happens most frequently among close contacts (those within about six feet) via respiratory droplets. Transmission of SAR-CoV-2 to persons from surfaces contaminated with the virus has not been documented yet, but current evidence suggests that SARS-CoV-2 may remain viable for hours to days on surfaces made from a variety of material. One primary measure discussed in this guidance will be cleaning of visibly dirty surfaces followed by disinfection – a best practice for prevention of COVID-19 and other viral respiratory illnesses in homeless shelters.
This CDC guidance provides recommendations for homeless shelters and is intended to support response planning by homeless service providers, including overnight emergency shelters, day shelters, and meal service providers. The Before, During, and After sections of this guidance offer suggested strategies to help homeless service providers plan, prepare, and respond to this emerging public health threat.
COVID-19 is caused by a new virus. There is much to learn about the transmissibility, severity, and other features of the disease. Everyone can do their part to help plan, prepare, and respond to this emerging public health threat.
Actions for Homeless Shelters
- Establish ongoing communication with your local public health department to facilitate access to relevant information before and during an outbreak.
- Connect to community wide planning and find out if your local government has a private-public emergency planning group that meets regularly.
- Discussions should include what homeless service providers should do if cases of COVID-19 are suspected in their facility, if a confirmed case of COVID-19 is identified in a client, or if a confirmed case of COVID-19 in a person experiencing homelessness is discharged from a local hospital.
- Identify if alternate care sites are available for clients with confirmed COVID-19 or if service providers should plan to isolate cases within their facility.
- Identify a list of key contacts at your local and state health departments and nearby healthcare facilities where clients with respiratory illness can seek appropriate care.
- Discuss reporting procedures ahead of time with a contact person at your local health department.
- Develop contingency staffing plans for increased absenteeism caused by employee illness or by illness in employees’ family members that requires employees to stay home. These plans might include extending hours, cross-training current employees, or hiring temporary employees.
- Address key prevention strategies that includes health messaging from credible health sources such as IDPH and CDC.
- Have supplies on hand for staff, volunteers, and those you serve, such as soap, alcohol-based hand sanitizers that contain at least 60% alcohol, tissues, trash baskets, and disposable facemask.
- Identify space at a minimum, a room with a bathroom, that can be used to accommodate clients with mild respiratory symptoms and separate them from others.
- Plan for higher shelter usage during the outbreak.
- Identify short-term volunteers to staff shelter with more usage or alternate sites.
If COVID-19 Is Reported The Homeless Shelter Or Commmunity
If cases or clusters of COVID-19 disease are reported in your community, put your emergency plan into action, to protect your clients, staff, and guests.
- Early action to slow the spread of COVID-19 will help keep staff and volunteers healthy and help your organization maintain normal operations.
- Plan for absences and develop flexible attendance and sick-leave policies.
- Isolate those who are sick immediately from those who are not sick and givea the person a clean disposable facemask to wear while staying at the shelter.
- Be prepared to report cases of respiratory illness that might be COVID-19 to your local health department and to transport persons with severe illness to medical facilities.
- Most persons with COVID-19 infections will likely have mild symptoms and not require hospital care.
- Continue healthcare services, if applicable for residents
- Get up-to-date information about local COVID-19 activity from public health officials.
- Be aware of temporary school dismissals in your area because these may affect your staff, volunteers, and families you serve.
- Implement everyday preventive actions and provide instructions to your workers about actions to prevent disease spread.
- Keep your clients and guests informed about public health recommendations to prevent disease spread and about changes to services that might be related to the outbreak
- Minimize the number of staff members who have face-to-face interactions with clients with respiratory symptoms.
- Use physical barriers to protect staff who will have interactions with clients with unknown infection status (e.g. check-in staff).
- Provide Just-in-time training for use of personal protective equipment to staff and volunteers
- Enforce shelter visitor restriction policies
- Ensure bathrooms and other sinks are consistently stocked with soap and drying materials for handwashing.
- Ensure that beds/mats are at least 3 feet apart, and request that all clients sleep head-to-toe.
- If individual rooms for sick clients are not available, consider using a large, well-ventilated room.
- Provide alcohol-based hand sanitizers that contain at least 60% alcohol (if that is an option at your shelter) at key points within the facility, including registration desks, entrances/exits, and eating areas.
- At check-in, provide any client with respiratory symptoms (cough, fever) with a surgical mask.
- Monitor clients who could be at high risk for complications from COVID-19 (those who are older or have underlying health conditions) and reach out to them regularly.
- Follow CDC recommendations for how to prevent further spread in your facility.
- If you identify any client with severe symptoms, notify your public health department and arrange for the client to receive immediate medical care. If this is a client with suspected COVID-19, notify the transfer team and medical facility before transfer.
- Ensure that all common areas within the facility follow good practices for environmental cleaning. Cleaning should be conducted in accordance with CDC recommendations.
After COVID-19 Has Cleared From the Shelter or Community
- Ensure all areas of the facility are terminally cleaned
- Continue to allow for residents to reside in the building once normal operations resume
- Continue to monitor for symptomatic person(s) as recommended by local and state public health
- Continue to monitor CDC and state public health resources for further information