As coronavirus pushes people inside, Miami’s homeless population faces great risk
Ron Jones used to spend his days at Miami-Dade’s public libraries and his evenings at the Miami Rescue Center’s homeless shelter. Then came the novel coronavirus.
Fear of the fast-spreading virus drove the 64-year-old cancer survivor back to the streets, on a bed steps away from a plastic hand-washing station the city set up last week. He feels safer alongside a busy road in Wynwood than inside the shelter, where men sleep in bunk beds or crammed together on the floor.
“If one of them caught it, I’d be right there,” he said, demonstrating with his hands how close other residents are at night. It’s nowhere near six feet. “I left because I was afraid of catching it.”
Jones, a former house painter driven to the streets after medical bills for his cancer bankrupted him two years ago, said the shelter has also stopped allowing daytime drop-ins for showers, and the library closing means he has no place to charge his phone or catch up on the latest news about COVID-19.
“We’re stuck out here with nothing,” he said.
Jones’ story underscores the difficulties of surviving a pandemic when the main directive from government officials is ‘stay home’ and you don’t have one.
Safeguarding against an outbreak of disease is a familiar concept to people experiencing homelessness in Miami, perhaps even more familiar to them than the masses who now are adjusting their lives so they can work from home, practice social distancing and generally isolate themselves in order to combat the spread of COVID-19.
For some people living on Miami’s streets and the medical workers who interact with them, “harm reduction” is part of daily life. Intravenous drug users fight the spread of HIV and hepatitis by exchanging used needles for clean ones at a facility run by the University of Miami on the edge of Overtown and the Health District.
But the disease caused by the novel coronavirus complicates everything from keeping shelters safe from the virus to continuing a longstanding effort to prevent other communicable diseases that can spread among homeless people.
Halting the exponential spread of COVID-19 has become a global priority during a pandemic that threatens some of society’s most vulnerable: the elderly and people with compromised immune systems. The homeless population, just like broader society, has people in either or both of these categories.
At a time when information is key, some rely on the newspaper or articles they find on Google through their phones. Others watch TVs in shelters to keep up with the latest. Some hear more about what’s going on through word of mouth.
Generally, the community is getting the message. And its members are worried.
In the close quarters of shelters, keeping six feet away from the next person can be difficult. On the street, access to sanitation and hand washing is limited. When cheap fast food businesses close their dining rooms and fewer volunteers come by to hand out meals, people go hungry. In Miami, they already are.
“They’re hungry. Very hungry,” said Emelina Martinez, community outreach manager for the IDEA Exchange, the UM program. “We were able to bring them sandwiches this weekend. Unfortunately, nothing’s open now.”
Wearing a mask and gloves, Martinez and her colleagues have been handing out hand sanitizer wipes and educating people about the pandemic. It takes a series of one-on-one conversations — at a distance — to get the word out about social distancing and hand sanitizing.
“I had to turn away a hug, and he was kind of heartbroken,” said Martinez, talking about a man she regularly interacts with through her work. “I said, ‘I’m sorry. It’s the coronavirus, man. I can’t do anything about it.’ ”
Preparing for COVID-19 in the streets and shelters
More than 560,000 people surveyed in one night in 2019 were experiencing homelessness, according to a report by the U.S. Department of Housing and Urban Development. Around the same time, about 1,000 people were counted as living on Miami-Dade County’s streets. That doesn’t include people living in shelters.
“With any public health or natural disaster emergency, those who are unhoused are often more at risk for poor health outcomes or other trauma,” says a post on the National Coalition for the Homeless’ website.
In a message to people experiencing homelessness, the group reiterated the advice from the U.S. Centers for Disease Control and Prevention to wash hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing one’s nose, coughing, or sneezing. When soap and water are not readily available, the CDC recommends using an alcohol-based hand sanitizer with at least 60% alcohol.
In Miami, the Homeless Trust began its coronavirus campaign weeks ago, passing out educational pamphlets in three languages, along with thousands of sanitizing wipes and mini bottles of hand sanitizer.
Then people started getting sick. There have been at least five “incidents” at homeless shelters where clients or staff members have been exposed to a person infected with the novel coronavirus, said Ron Book, head of the Homeless Trust. Last week, a woman came home to the shelter from her day job cleaning a nearby school and announced someone at the school had tested positive for the virus.
Book said he immediately sent the woman to a hotel and deep cleaned the shelter. The Trust pays to hold open hotel rooms around the county all year, but it has only so many available.
“If I’m faced with taking someone out of a shelter, I have to put them somewhere, and we don’t place people back on the street,” he said. “That is going to be a growing issue.”
Book told the Miami New Times that the people who were exposed did not meet the COVID-19 criteria testing.
But the situation is tough even for uninfected people inside the shelters. At the Trust’s two shelters, like others in the county, clients sleep in bunk beds.
“We know we’ve got problems on social distancing,” Book admitted. “It’s more difficult on the streets than in the shelters, but there are issues in the shelters.”
Keeping clients apart gets even more difficult by day. Staffers are constantly explaining the importance of distance to shelter residents, Book said. It’s increased the tension inside shelters, exacerbating mental health problems.
“The psychological issues our population deals with regularly, we have now multiplied it significantly,” he said.
At the Miami Rescue Center in Downtown Miami, shelter officials have stopped allowing nonresidents to come in for a shower, a meal and a change of clothes. Instead they offer bagged lunches outside, where they’ve set up two portable bathrooms and a water station.
“We’re trying to take care of the 300 that are here. We’re not cutting them off,” said Antonio VIllasuso, the center’s director. “We’re loving them, just in a different way.”
Wednesday’s closure of public libraries dealt another blow to the routine of many who live on the street and use libraries to apply for work, read or feel safe. The communal nature of libraries, where people share space, books and computers, makes them a public health concern during the COVID-19 pandemic.
Unfortunately, they’re also part of a social safety net but can’t keep their doors open during the virus crisis.
“It has a huge impact. That’s how folks get information. That’s how they spend their days in a relatively safe place,” said David Peery, chair of the advocacy committee of the Camillus Health Concern Consumer Advisory Board. “Libraries have effectively become day centers for people experiencing homelessness. It’s like a a safe zone.”
The individual resources necessary to combat the spread of the virus — a solo space to self-isolate, money to stock up on groceries, or even a sink to wash your hands — are often out of reach for a population defined by their inability to access them.
The Downtown Development Authority (DDA) acquired 1,000 small hand sanitizer spray bottles earlier this year, in anticipation of an outbreak. Working with the DDA chairman, Miami Commissioner Manolo Reyes, the agency gave the bottles to city homeless outreach staffers to distribute to people living on the street.
The authority, a semi-autonomous municipal agency, is also trying to fast-track the installation of public restrooms and sinks in downtown. The plan for more public toilets was already a priority due to concern over people relieving themselves on sidewalks and in other public spaces. The city has already installed 10 new hand-washing stations throughout downtown.
“The Miami DDA is doing its part to promote public health by keeping our city streets as clean as possible — through the work of our Downtown Enhancement Team, by installing additional public restrooms and sinks in our district, and by making free hand sanitizer available to anyone who needs it,” said Christina Crespi, executive director of the agency.
Penny Searcy, a 46-year-old woman who lives in her car with her dog, Max, said she carries the pink hand sanitizing spray from the DDA with her wherever she goes. She also washes her hands as often as possible at one of the hand-washing stations set up on her block.
She tries to keep up with the latest news on her phone. Each breaking news alert leaves her more worried about what life will be like if shelters stop offering feedings or more people get sick.
“I have no idea what I’m going to do,” she said. “This is my first time going through something like this.”
Coronavirus can compound existing disease prevention
Workers such as Martinez feel like they’re working against a clock that’s ticking faster each day. With mounting restrictions and food and entertainment businesses closed, the needle exchange has prepared for what would happen if the program’s operation were temporarily closed and workers went into isolation.
An interruption in the program’s work could have dire consequences. If workers can’t go out to exchange needles, intravenous drug users may resort to injecting with used needles — a major potential public health problem. The use of dirty needles can lead to more HIV and hepatitis infections, creating the conditions for an outbreak within an outbreak.
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Martinez said her team is doling out extra supplies and medication in case there’s a lockdown. From boxes to safely discard used needles to antiretroviral HIV medication to plastic bags so people can secure their belongings, workers on the street are preparing for the worst.
“It can become a compounding issue, but we’re going to do our best to make sure everybody has what they need to stay safe,” Martinez said.
Interruptions to care may become more common even without a broad order for most people to take shelter in their homes. Care Resource, a clinic that provides HIV testing and services, shut down for a couple of days after a patient tested positive for COVID-19.
The IDEA Exchange’s founder, Hansel Tookes, compared the preparation to the days before a hurricane. Just like with populations in nursing homes, assisted living facilities and prisons, if the virus spreads among the homeless, the risk to the broader population increases.
“The people we serve need us now more than ever,” he said. “All of the people who are at risk and living on Miami’s streets are vulnerable. If we have increased transmission, it will affect our whole community.”
At the Camillus Health clinic, where more people seeking care are walk-ins, healthcare professionals who treat the homeless have been trained to isolate and assess if clients are exhibiting COVID-19 symptoms. CEO Francis Afram-Gyening said his staff did role-playing to prepare for people who might walk in off the street with the disease.
Afram-Gyening said that on multiple fronts — education, supplies and protocols — the workers who care for Miami’s homeless are doing their best to prevent a potentially devastating outbreak.
“It’s the poor people, people who don’t have regular access to health care — that’s where it’s going to spread,” he said.
Book, with the Homeless Trust, said he has enough supplies to meet needs — for now.
“Currently at this moment in time the answer is yes, but in four hours, 10 hours, 30 hours from now, it very well might not be,” he said. “My concern is, what’s going to happen in a week or two.”
The Homeless Trust is seeking donations of hand sanitizer, disinfectant wipes, housing and food. To arrange a donation, call the Trust at 305-375-1490 or contact it online at www.homelesstrust.org.
Donations are “way down” at the Miami Rescue Center. To arrange a donation, visit www.miamirescuemission.com.
This story was originally published March 19, 2020 at 6:00 AM.
