On Easter Sunday in New York City, the Rev. Charles King, the cofounder and CEO of the sprawling 30-year-old HIV and homelessness nonprofit Housing Works, found himself in a hazmat suit cleaning the hotel room of a mentally ill homeless man sick with COVID-19. The hotel, in an undisclosed location for safety and privacy, was one of five such commercially empty inns obtained by the city, with a total of several hundred available units, and converted into medical-care shelters for homeless New Yorkers with either a positive test for or symptoms of COVID-19, whether they come from the shelter system (where people often sleep eight to 12 to a room), hospitals, or the streets.
“We cleaned eight rooms that were really in a bad way,” says King, whose Housing Works is one of a handful of service agencies (including the LGBTQ-serving Callen-Lorde clinic) that the city has contracted with to provide medical and other care at the shelters. “Folks in those rooms were very ill, couldn’t get up, and also many of them have mental health issues—and their rooms were disheveled. I thought to myself, ‘This is the perfect way for me to celebrate Easter Sunday,’” said King, a Yale Divinity School grad whose activism has always been informed by a radical Christian service ethic.
According to King, the hotel shelters were rapid-response solutions that he and other homelessness advocates, including Shelly Nortz at Coalition for the Homeless, devised with the city after they realized that homeless folks with confirmed or suspected COVID-19 discharged from hospitals were not being allowed back into shelters without confirmation of COVID-negative status. “In order to prevent the spread of COVID among homeless folks, the system was basically taking people suspected of having COVID and making them homeless again,” he said.
As of mid-April, at least two dozen homeless New Yorkers had died of COVID-19, with nearly 400 having been reported as diagnosed COVID-positive—very likely an under-count, with that number reflecting only the single homeless population, not those who live in family units.
According to King, shortly after he and Nortz brought the problem to the attention of Steve Banks, an official at New York City’s Human Resources Administration and Department of Homeless Services (DHS), Banks said he’d been authorized to lease as many hotel rooms as needed for the problem—but quickly needed qualified operators for them.
Springing Into Action
Housing Works took on one (it’s currently trying to take on another), reaching out to Callen-Lorde to help with the medical staffing and opening it on April 3. In a way, it was perfect timing: Callen-Lorde had been ready to open up a new clinic in Downtown Brooklyn when the COVID crisis brought that to a halt, so the agency was able to deploy the new clinic’s staff, as well as staff from its Chelsea and Bronx sites, to the COVID shelter hotel.
Currently, about 20 to 25 staff are working in the shelter, said Callen-Lorde executive director Wendy Stark. “We placed there staffers who were the most eager to work there,” she said, adding that they are not just treating patients for COVID but for preexisting conditions including diabetes, HIV, kidney failure, and mental illness. “For many folks, COVID is the least of their health issues.”
Callen-Lorde is doing this work, she added, while carrying on its usual health services, now with the use of more telehealth to enforce social distancing. “We’re worried financially,” she said. “We’re waiting to hear if we’re going to get federal loans, and we’re having to start thinking about whether we’ll have to furlough staff.”
Personal protective equipment (PPE) for the Housing Works/Callen-Lorde site is being provided by Soho’s Rhonda Roland Shearer, a longtime New York City artist (and widow of legendary scientist Stephen Jay Gould) who, back in 1990, turned over her own studio for King to use as Housing Works’ first office for half a year before it got its own space—then raised $100,000 to open the first of Housing Works’ several lucrative thrift stores throughout the city.
According to Shearer, she is reprising something she did for Ground Zero responders during 9/11—working her own vendor contacts to bring PPE and other crucial supplies directly to sites of need, bypassing the city’s central location for PPE. Currently, she says, she’s doing this with a $300,000 line of credit from her own home-equity loan—money she hopes to recoup via fundraising.
“I filled Housing Works’ wish list within 48 hours,” she said. “Thousands of units, from gowns to Tyvek suits to respirators to hand sanitizers. Different vendors are helping me get products and aren’t upcharging me.”
But don’t call her a hero, she says. “I’m doing this all from the safety of my home. It doesn’t even compare with the folks on the frontlines at the shelter itself. Let’s get real here.”
In a statement, Isaac McGinn, press representative for the city’s Department of Social Services (DSS), said, “In this fight of our lifetimes, our City is moving mountains to support New Yorkers in need, from developing protocol with [the public hospital system] for connecting our clients quickly to assessment and care to opening more than 700 isolation units for symptomatic and confirmed positive individuals to utilize as they recover. To date, thanks to these efforts and the vital work of our essential frontline personnel, including provider partners, shelter staff, and outreach teams, 67 individuals have resolved their condition and departed isolation.”
He added: “In unprecedented times, we’re developing and implementing unprecedented solutions at a speed and scope never before seen. And in all of this, our staff are on the frontlines—social services ‘first responders,’ reporting for duty every day, around the clock, in support of our City’s most vulnerable residents.”
Homeless folks cannot just “show up” at the hotel shelters, whose locations, again, are undisclosed. DSS said that a call to 311 will dispatch to anyone who appears homeless and/or sick an outreach team that will bring willing individuals to the hospital if needed, and will work with them on transitional and long-term shelter options. According to DSS in mid-April, such teams had already made 12 referrals to care, with none of the individuals in question testing positive.
Additionally, a group of organizations including VOCAL-NY, Neighbors Together, and Picture the Homeless has (as of April 17) nearly reached a $50,000 goal for a fund to bypass the city system and book as many vulnerable homeless people as possible into available hotel rooms around the city. Jeremy Saunders, co-director of VOCAL-NY, said that the effort was meant to address immediate need while the city scales up its own efforts.
“We have housed a few people already,” wrote Saunders in an email on April 17. “We did run into some issues with a hotel because our people didn’t have adequate documentation, but we figured it out and now they’re in there. And while I can’t speak to all the people being housed, we are checking in on and continuing to provide services to our crew.”
But King said that the current crisis lays bare the city’s preexisting lack of shelter for homeless people that isn’t congregate—meaning several to a room, not only heightening illness risk but serving as a strong deterrent for many homeless folks to come off the streets into the shelter system in the first place, especially if they belong to vulnerable groups, such as LGBTQ folks, who are often harassed in such settings.
Said King, “I’ve seen lots of posts during COVID about how we can’t go back to how we were [as a society], so I’m hoping that something different happens [with New York’s homelessness problem]. We need to completely rethink the city’s idea of huge congregate shelters. We’ve never been serious enough about the fact that what homeless people need are not more case managers but a real place to live.”
Daily Life at the Shelter
Meanwhile, staff at the shelter, which was full as of April 16, distribute daily to residents clean towels, as well as brooms, mops, and other cleaning gear for those able to clean their own room. Staff includes case managers and residential aides as well as medical workers. “DHS and hospitals alert us to folks who are COVID-positive confirmed as well as symptomatic,” said King, “and we pick them up in our own vans and intake them at our own registration desk.” All residents have access to cable TV and landlines in their rooms, as well as to three meals a day.
“Nobody has died here,” said King. “When people [worsen], we call EMS.” Since the shelter opened, he added, residents have already been discharged—often, back to shelter beds that have been held for them. Among those who came in from the streets, only a few upon discharge did not accept a shelter placement. “This has really scared people who got sick.”
For most who are open to help, King said, “we have to work with DHS to find placement for them. Someone just disclosed that he’s HIV positive, so we’re working to make sure he gets a placement with HASA [the city agency that provides single rooms or small apartments to income-qualifying people with HIV/AIDS] and not DHS.”
The bigger goal, said King, was to thin out the number of people per room in the entire shelter system, to avoid more infections—mainly by getting them into empty hotel rooms. He mentioned San Francisco, where more than 90 residents and about 10 staffers from one very large and crowded open-space men’s shelter got COVID, amid pressure on the city to disperse shelter residents into hotel rooms.
The Housing Works shelter is also governed by harm reduction, a public health model pioneered by Housing Works in the 1990s that gave people a stable place to live and wraparound health services without requiring that they abstain from drug use. The approach, sometimes called “housing first” and backed by ample research, has gone from being edgy to standard practice among service providers nationwide in the ensuing decades.
That means that people in the COVID shelter are allowed to use drugs if it’s not disruptive. Condoms and lube are also available, on the understanding—certainly learned from decades of HIV prevention—that some people will have sex, even in an epidemic.
There are even cigarettes going around for residents who request to be escorted from their rooms down to the back garden for a smoke. It’s better than the alternative, said King.
“We can’t prohibit people from walking out,” he said, “and the number-one thing that people walk out for is to go get cigarettes.”
In order to encourage people to stay indoors as much as possible, Housing Works is raising money to help support their ability to buy personal items for folks that would normally require them to go out.