A coronavirus outbreak is growing in Skid Row. Are shelters safe?

Skid Row’s Union Rescue Mission—a shelter that can house more than 1,000 people per night—was well stocked with hand sanitizer.

Hand-washing stations were set up at the shelter’s entrances. Staff consulted with public health officials and encouraged residents to follow social distancing guidelines, says CEO Andy Bales.

But that wasn’t enough to prevent an outbreak of COVID-19 that has left one resident and employee, Gerald Shiroma, dead. On Tuesday, Los Angeles County Public Health Director Barbara Ferrer announced that at least 42 other people at the mission have contracted the virus. Bales says an additional 13 positive tests have come in since then.

“This has been the biggest challenge of my life,” he says. “We were not prepared for this monster.”

In a nightly address Tuesday, Mayor Eric Garcetti suggested the outbreak was the result of overcrowding at the shelter and that a reduction in the number of people living at the mission would help contain its spread. “That was a danger... to have people crammed in that much,” he said.

The city is continuing to build and open new shelters, but a growing number of researchers and advocates are questioning the wisdom of those plans.

“We’re not sure the shelters are safe,” says Randall Kuhn, associate professor of community health sciences at UCLA.

A new report co-authored by Kuhn highlights how vulnerable homeless residents are to the virus. It finds that people experiencing homelessness are twice as likely to be hospitalized with COVID-19 and two to three times more likely to die than the general population.

The report’s authors suggest that, compared to shelters, hotel rooms and other “private accommodations would dramatically reduce the likely transmission of disease.”

That’s a position supported by No Vacancy, a newly formed coalition of homeless advocates demanding that California commandeer enough hotel rooms to house the more than 150,000 homeless residents who reside within the state.

“I’m not going to say the shelters are bad,” says No Vacancy spokesperson Jed Parriott. “But if someone gets [the virus], it can spread to everyone else so quickly.”

Earlier this month, Gov. Gavin Newsom rolled out Project Roomkey, a plan to secure empty rooms for those exposed to the virus or at the greatest risk of severe illness. In Los Angeles, local officials aim to lease 15,000 rooms for people who are over the age of 65 or suffer from chronic health conditions that could make them more likely to develop a life-threatening case of COVID-19.

Parriott says a better goal would be to find rooms for anyone who needs one.

“Every unhoused person is vulnerable,” he says. “Why aren’t we at least committing to getting everyone into a room?”

Many shelters in Los Angeles, including emergency housing sites established at local recreation centers, have open layouts in which residents share living spaces and bathrooms.

To safeguard residents from exposure to the virus, shelter operators are spacing beds at least six feet apart. Kuhn says these precautions are necessary, but that there are still so many unknowns about how the virus spreads that it’s difficult to guarantee that they will be fully effective.

Parriott says he’s spoken with unhoused residents who’ve avoided shelters because they’re worried about getting sick.

Even before the arrival of COVID-19, some homeless residents were reluctant to stay in shelters. A 2018 KPCC investigation found evidence of “bedbugs, rats, foul odors, poor lighting, harassment,” and other issues in some of the 60 shelters funded by the Los Angeles Homeless Services Authority at that time.

But finding individual rooms for the nearly 60,000 people in Los Angeles County who experience homelessness on a given night could be challenging.

Roughly three out of four unhoused residents sleep on streets and sidewalks, or in vehicles. A spokesperson for the Los Angeles County Department of Public Health says the shelters are “a valuable resource” because they provide those residents with access to soap and water, food, and medical care.

Kuhn acknowledges these are important resources that are particularly difficult to find on the street. He says the pandemic should be a “wakeup call” for California leaders and homeless service providers—one that illustrates the need to prioritize permanent housing for all Angelenos.

“It’s unfortunate that the wakeup call is coming at a time when shelters might not be the answer,” he says.

After a major outbreak at one of San Francisco’s largest homeless shelters, the city’s Board of Supervisors ordered Mayor London Breed to secure enough hotel rooms to house nearly all of the city’s 8,000 homeless residents.

Chris Herring, a PhD student at the University of California Berkeley who works with the San Francisco Coalition on Homelessness, says the speed at which infections multiplied at the shelter—jumping from five to 70 in just three days—illustrates just how tough it is to contain the virus once even a single case is identified.

“A lot of us were hoping that if you test everybody weekly you can control the shelter setting,” he says. “This really upended some of the key assumptions we had that could have made shelters workable.”

Herring is a co-author of a new UC Berkeley report that finds that “high-density congregate settings” like shelters “are not safe,” even if operators follow current guidelines from the Centers for Disease Control and Prevention—such as spacing beds at least six feet apart from one another.

“Residents of these shelters need the types of physical barriers provided by single-occupancy units to protect themselves from infection or to protect others from their presumed or test-confirmed infection,” the study authors write.

Still, finding enough apartments or hotel rooms for nearly 60,000 homeless residents in Los Angeles could be difficult. As of Tuesday, just over 2,500 hotel rooms had been leased by county officials—but fewer than 750 were occupied.

Kuhn points out that local officials face difficult financial and logistical hurdles when securing rooms.

“They have to get these hotel rooms ready, train staff, install computer systems—it’s not like they can just use the Hilton guest registration system,” he says. “It’s painful to say, but I don’t know if there’s anything more they could be doing. Even 15,000 rooms could be a stretch.”

Bales says that the hotel rooms already available came just in time. Nearly 200 people previously residing at Union Rescue Mission moved into those vacant rooms earlier this month.

“Who knew that hotels would all be empty and they would be available to address this situation?” he says. “It really took the pandemic for us to make places for people to go.”