Pierce, King counties approaching coronavirus and the homeless differently
Nathaniel Stewart says he’s been spreading the word.
Stewart, 43, currently lives in a large, makeshift shelter under the shadow of state Route 509, along the eastern bank of the Puyallup River.
The muddy, wooded area represents a tangled web of jurisdictions. Between the city of Tacoma, the state, the port and the Puyallup Tribe, it can be difficult to know who owns the land under foot.
Stewart, who grew up in Tacoma and attended Lincoln High School, became homeless about three years ago, he said, after the death of his mother. He’s lived in the area roughly six months along with his girlfriend and what he estimated at times to be anywhere between 50 and 75 other homeless individuals.
Stewart told The News Tribune on Wednesday morning he first heard about the state’s novel coronavirus outbreak a day before, while visiting the Dome District stability site for people experiencing homelessness.
He came home with a meal, a new jacket and information to share with his homeless neighbors about preventing the spread of COVID-19.
So far, Stewart said, no outreach workers had visited the camp specifically regarding the novel coronavirus or the spread of COVID-19, and his neighbors are largely unaware of the illness and steps to take to prevent its spread.
Many were far more concerned with the notice they’d recently received from local law enforcement to vacate the area, he said.
“The most that someone’s been out here talking about it is me,” Stewart said. “I told people to wash your hands as much as possible, try not to touch your face, stuff like that.”
In response to the coronavirus outbreak, King County officials have taken several emergency response measures to protect that county’s large homeless population and prevent the spread of the illness.
As The Seattle Times reported Monday, King County’s measures include setting up modular units for the potential isolation of homeless patients.
As of Wednesday, there had been 39 cases of coronavirus reported in Washington state and 10 deaths. Thirty-one of the cases, and nine of the deaths had been reported in King County.
In Pierce County, meanwhile there have been no confirmed cases, and according to Tacoma-Pierce County Department of Health spokesperson Edie Jeffers, there’s no evidence of “community spread.”
Jeffers said Tacoma-Pierce County Health Department has been working with the city, the county and the state to appropriately respond to the potential spread here, including following guidelines for the Centers for Disease Control and conducting outreach efforts at local shelters and other area homeless service providers.
The response is focused on disseminating accurate information, Jeffers said, stressing that in Pierce County, the illness is “not here yet.”
“Everything that we’re doing, everything we’re planning, how we’re communicating, it’s all trying to center people on our local situation,” Jeffers said.
Acknowledging the challenges — including significant community concern — Jeffers said local health officials are “really working around the clock to make sure our community is safe and that people have reliable, trusted and accurate information.”
“The entire public health system in our state is really in the limelight, but this is the work that we do every day. We track and monitor and control the spread of disease in our community,” Jeffers said.
According to the Centers for Disease Control, coronavirus is spread through contact between people within six feet of each other, especially through coughing and sneezing that expels respiratory droplets that land in the mouths or noses of people nearby.
The CDC says it’s possible to catch the disease COVID-19 by touching something that has the virus on it, and then touching your own face, “but this is not thought to be the main way the virus spreads.”
Symptoms of COVID-19 include fever, cough and shortness of breath, which may occur two days to two weeks after exposure. The disease is especially dangerous for the elderly and others with weaker immune systems.
So far, more than 94,000 cases have been reported worldwide, with about 3,200 deaths, the vast majority of them in China.
‘Vulnerable population’
As King County ramps up its efforts to prevent the spread of coronavirus among homeless residents, officials in Tacoma and Pierce County are taking a more measured approach, at least so far.
Broadly, the risk presented by the coronavirus is similar to influenza, said Dr. Anthony Chen, director of Tacoma-Pierce County Health Department.
To prevent the local spread of the illness, Chen recommended people adhere to standard preventative measures, like hand washing, the use of hand sanitizer and staying home when sick.
“The guidance that we’re giving people is, ‘Do what you would do during flu season,’” Chen said Tuesday.
Taking those steps can become far more difficult if you’re homeless, Chen acknowledged, which is one of the reasons the county’s homeless population is vulnerable to COVID-19.
Chen said coronavirus appears to pose the greatest risk to “the elderly and those with chronic illness” and that people living without shelter often suffer from the latter.
“We are all acutely aware … that the homeless are one of the vulnerable populations. They’re not the only vulnerable population, but they certainly are a vulnerable population,” Chen said.
“In addition to the obvious things — like no roof, sleeping outside, in a car, or the cold — we know that the unhoused have a lot of physical health issues. It all adds up,” Chen said.
Pierce County’s 2019 Point In Time Count identified 1,486 individuals as homeless throughout the county, including 420 living outdoors in tents or on the street. Another 51 were found living in abandoned buildings, while 158 were living in a vehicle at the time.
Nearly 700 people were found staying in crowded emergency shelters.
On Tuesday, Chen sought to diffuse potential fear mongering and stigmatization, noting that the majority of those experiencing homelessness in Pierce County are not living in unauthorized encampments.
It’s important to understand the context, Chen said, and people should be aware that the spread of coronavirus presents a risk to the county’s homeless population
“We are concerned about them,” Chen said, describing the health department’s response as “coming from a standpoint of compassion and understanding of their risk.”
“They’re the ones who are more likely to get sick,” Chen said. “It’s not that they’re going to get us sick. We will get them sick.”
Response and preparation
According to Jeffers, Tacoma-Pierce County Health Department is responding to the evolving outbreak by taking pages out of “the public health playbook.”
Protecting the county’s homeless population and preventing the spread of the illness has been a team effort that also includes the state, the city of Tacoma and the county’s human services homeless team, she said.
This week, health department officials have been in regular contact with both agencies, Jeffers said.
Together, officials have focused on making sure homeless services providers in Pierce County are up-to-date on the latest CDC guidelines and are providing accurate coronavirus information to the homeless individuals they come into contact with, she said.
While there are currently no plans to establish coronavirus specific isolation sites for homeless individuals who might fall ill, similar to what King County has pledged to do, Jeffers said the health department and its partners already have the capacity to provide such services.
The state is also a resource, Jeffers said.
“Tacoma-Pierce County Health Department would ensure appropriate isolation and quarantine for any person who cannot be isolated at home. This could include working with the Department of Health for accommodations or elsewhere,” Jeffers said. “We currently ensure isolation in cases where a person living homeless has tuberculosis.”
When it comes to those living outdoors, Emily Less, a public health consultant with Tacoma-Pierce County Health Department, described the coronavirus-related outreach as similar to the agency’s “ongoing work” to prevent the spread of all infectious disease, like measles.
Like Chen, Less said that individuals living without shelter are exposed to increased risk for the spread of illness and disease. Some “don’t really have the basic things they need to be healthy,” she said, including access to proper hygiene and sanitation.
“We really work together all year long to try to reduce the spread of communicable disease,” Less said.
Kari Moore, a spokesperson for Pierce County’s Human Services Homeless Team, said the agency’s efforts so far have been “proactive” and focused on “providing our community partners with a basic tool-kit of resources and practices that include links and information to assist providers in taking every precaution necessary.”
Moore said that additional coronavirus-related training will be provided to area housing and homeless service providers during a meeting of the county’s continuum of care on Friday.
Meanwhile, the city has reached out to area shelters, service providers and faith based organizations who serve the homeless to ask potential needs, according to city of Tacoma spokesperson Megan Snow.
So far the providers have adequate cleaning supplies and hand sanitizer, Snow said, though the city is continuing to monitor the situation. She noted that hand-washing resources are available at Catholic Community Services’ Nativity House shelter downtown.
Snow also said the Tacoma Police Department is continuing to visit known unauthorized encampments, including under State Route 509, “conducting outreach and connecting individuals with shelter and other resources.”
“Tacoma-Pierce County Health Department, Pierce County, the city and community partners are all concerned and developing the appropriate responses,” Snow said.
At Tacoma Rescue Mission, executive director Duke Paulsen said the emergency shelter has taken steps to increase cleaning and disinfection of high-traffic areas and also opened a hand-washing station outside.
Hand sanitizer is also available at the shelter, Paulsen said.
On Tuesday, Paulsen described the steps taken at Tacoma Rescue Mission as “basic precautions,” which have included educating staff and preparing for the potential of staff illness or area school closures.
For the last month or more, the 160-bed Tacoma Rescue Mission emergency shelter had been operating at capacity, turning people away on a nightly basis, Paulsen added.
According to the CDC, coronavirus can be spread through close human contact, which poses a challenge at the shelter, Paulsen said.
“When you have 160 people in a shelter, we’re going to have tight quarters,” Paulsen said. “We spread out as much as we can, and we offer as much in sanitation and support as we can.”
‘I’ve got enough on my plate’
Back under Route 509, 45-year-old Brian Anderson said he wasn’t too worried about the spread of coronavirus.
Anderson has been homeless since 2016, he said, and staying in the general area for about a year.
A welder by trade, Anderson said a criminal conviction from a decade ago has made it hard to find work.
His latest shelter site is tucked into the woods not far from the Puyallup River, where the sound of cars passing on the highway overhead serves as white noise.
Anderson has been staying in the spot for only four or five days, he said, but on Wednesday morning he was preparing to move once again.
“I was farther up the river, but they came in with bulldozers and just bulldozed everybody’s place down,” Anderson said. “Now, they just came in this morning telling us we have to be out.”
Asked about the potential risk of coronavirus, Anderson said he currently has more pressing concerns.
“I got enough on my plate right now,” Anderson said. “You’re the first person I’ve heard come out here and say anything about (coronavirus). I don’t know anything about it.”
Deeper in the woods, 54-year-old Clarence Clark, who reported being homeless in Tacoma for “about a year,” said he has heard about coronavirus, and he’s concerned about the potential spread of the illness.
Clark recently learned about coronavirus “by word of mouth,” he said.
Like the others, Clark said no outreach workers have contacted him with information or resources to help prevent the spread of the illness.
Before heading down a gravel path and into the clear morning, Clark said he’s not surprised there hasn’t been more effort to look out for those living in the encampment around him.
“They could care less,” Clark said of the response. “And they’re only making it obvious.”
This story was originally published March 5, 2020 at 5:05 AM.
