Amid a record-high resurgence of COVID-19 infections in Thurston County driven by the delta variant, homeless shelters and service providers are scrambling to deal with a new outbreak.
Two cases have been confirmed among guests at the Union Gospel Mission, a homeless shelter in Olympia. One case was confirmed at Olympia's downtown homeless mitigation site. And more cases are likely among people living unsheltered or in tent encampments.
Thurston County Public Health Department operates quarantine hotel rooms for people who test positive for COVID-19 but have nowhere to isolate. According to the county, 16 of those 21 rooms were occupied last week.
People experiencing homelessness make up a relatively small percentage of the current infection spike: Thurston County reported 118 new COVID-19 cases on Friday, bringing the current week's total to nearly 500, with two days left to go. That's the most cases ever in one week in the county.
But the challenges of isolating without a home, and widespread suspicion and mistrust of the vaccine, has public health officials and service providers concerned about the potential for the virus to spread.
"I know that the health department is very concerned. ... There's great anxiety that if it were to get a foothold, it could really take off," said Loren "Skip" Steffen, executive director of Union Gospel Mission.
Outbreak at OUGM
A flier sent out by Public Health advises people who were at Union Gospel Mission between July 19-27 that they may have been exposed to COVID-19, and recommends they to get tested and stay away from others until Aug. 11.
In response, the Union Gospel Mission closed its indoor shelter and cafeteria last week, and between 15-20 male shelter guests were moved outside to a fenced-in gravel parking lot, according to Steffen. A separate room for seven or so female shelter guests was closed entirely out of "an abundance of caution."
The outbreak started with a person who was about to enter their residential recovery program, which requires taking a COVID test. Some, but not all, of the shelter guests have been tested since the outbreak began.
Steffen described the outbreak as a "wake-up call."
"We definitely let our guard down. We were vaccinated as soon as March, April of this year, and boy I was more than happy to take my mask off — but now I'm putting it back on," he said.
Staff at the shelter have tested negative, although Steffen expressed concern for several unvaccinated staff members who he hopes will be spurred by the scare to get the vaccine.
"It weighs on me what to do as an employer. I know I could mandate it, but then I'd lose some people that have really poured their heart into the mission," Steffen said.
"The people that do this work are called to it, it's not something you go into because the money's good, and most of them come from the streets so they know what it's like to be out there. So its kind of a unique setting made up of some very dedicated people, and yet some of them have some pretty strongly held beliefs about the vaccine, so what do I do?"
This is the fourth recorded outbreak at a homeless shelter since November 2020, the health department said. The previous three outbreaks included 14 total cases.
Suspicion about vaccine leaves many unprotected
Thurston County does not collect information on housing status during vaccination events, but estimates that 34 individuals have been vaccinated by the county during clinics at homeless shelters, including at Union Gospel Mission.
Although solid data is not available, local shelter and medical providers estimate that vaccination rates among the homeless community are significantly lower than the general population.
The Olympia Free Clinic, which serves people without insurance who struggle to access traditional medical care, has vaccinated 461 people at their location inside the Providence Community Care Center, according executive director Katie Madinger.
In mid-April, Olympia Free Clinic started doing weekly pop-up vaccination sites at homeless encampments on Deschutes Parkway, Wheeler Road, Percival Creek, and one near Martin Way, known informally as 'The Jungle.'
So far, they've jabbed 44 people with the Johnson & Johnson vaccine during the pop-up clinics at homeless encampments. Madinger said they've encountered a lot of vaccine hesitancy.
"There is definitely a lack of trust in the vaccine itself, and there's a lot of misinformation out there," she said. "It takes a long time for us as providers of the vaccine to earn the trust of folks who are living there."
Free Clinic staff typically spends about three weeks at each camp before moving on to the next. Sometimes people will decline a vaccine the first week, and accept it later, Madinger said.
Their reasons for declining the vaccine vary. Some people are concerned about side effects. Others don't believe it's safe, or think it will give them COVID.
Some at camps also believe because they live outside, they've developed a natural immunity, or they simply doubti that COVID is real. Encampments are often tight-knit communities where rumors can spread fast.
"Everything from fear of this will alter my DNA, to government microchips — we've heard the whole spectrum of hypotheses," Madinger said.
It's easy to offer a knee-jerk reaction to debunk those fears, but Madinger said that's rarely a successful approach.
"We know that a lot of our patients have had poor experiences in mainstream medical care," Madinger said. "They either feel like they're treated less well because they look a certain way or behave a certain way or can't keep their appointments, or their concerns aren't taken as seriously. It's really on healthcare providers to have that conversation in a way where people feel heard, and feel like they have access to the information they need to make that decision."
Madinger said many of the fears she hears about the vaccine are not unique to the homeless community.
"It's heartbreaking, it's really hard. But there's also that understanding from our perspective that if this is a choice, and we really need to respect people's choices, and really just committing to it taking the time it takes for people to feel comfortable being able to do that in an informed way," she said.
"We certainly don't want to force this on anyone."
