Bunks at Transition Projects Willamette Center Shelter.
Bunks at Transition Projects' Willamette Center Shelter. Motoya Nakamura / Multnomah County

One of health officials' top recommendations for people at risk of catching the quickly-spreading respiratory coronavirus is to stay home. That's not an option, however, for the hundreds of houseless Portlanders living outside, in a car, or in homeless shelters.

"Not everyone has the luxury to just stay home," says Alexa Morris, a spokesperson for the local Salvation Army chapter, which runs four homeless shelters in Portland. "For our clients, our shelters are home. We have to make it feel that way right now."

The Salvation Army is one of dozens of shelter providers that received new instructions from the Multnomah County Health Department this morning on how to prevent the spread of COVID-19, the strain of coronavirus that has gained momentum across the Pacific Northwest in just the past several days. There has yet to be a confirmed COVID-19 case in Multnomah County.

The county recommends shelters post signs promoting effective hand hygiene and offer adequate supplies—like soap, clean hand washing stations, and alcohol-based hand sanitizer. It also recommends staff keep tabs on guests who have a "new, worse, or different cough," and require any guests with a cough wear a face mask.

According to the Centers for Disease Control and Prevention (CDC), COVID-19 is most likely to be transmitted between people if someone is within six feet of an infected person.

While the county acknowledges that guidance can't be applied in all shelter areas, it recommends shelter staff create a six-foot buffer between the beds of people showing signs of COVID-19—coughing, fever, and shortness of breath—and those who are not.

Denis Theriault, a county spokesperson for the Joint Office of Homeless Services (JOHS), says the county doesn't expect this will have a "drastic reduction" in the number of available shelter beds.

The new guidance also suggests separating people with COVID-19 symptoms from others while eating and while spending time in other shared common spaces.

Elderly populations and people with pre-existing health conditions have been hit the hardest by COVID-19. In China, when the COVID-19 originated, 2.3 percent of all people who contracted the virus died—but that number jumped to 14.8 percent in people 80 or older. Of the 11 Americans (one in California, ten in Washington state) who've died from the virus, the majority have been over 70 or had other health conditions that complicated their symptoms.

It's those populations living in shelters that the county is most worried about.

"This is about protecting folks in congregate shelters who are particularly vulnerable," said Theriault. "We have people living in shelters with cancer, diabetes, heart conditions... We need to look out for them."

Theriault noted that 30 percent of people staying in shelters run by Transition Projects, one of the county's largest shelter providers, are aged 55 and older.

George Devendorf, executive director of Transition Projects, said all Transition Projects shelters have stopped accepting new visitors out of safety precautions.

"We've put a temporary hold on new intakes and admission into our shelters until we have a better handle on how its playing out in our community," Devendorf said. "It'll give our programs a minute to pause and decongest... and allow more space for folks who are symptomatic."

Devendorf said Transition Projects has increased its janitorial staff to disinfect its common areas more frequently, including its resource center at Bud Clark Commons, which can serve up to 500 people each day. He said his staff are proceeding "under the assumption that the virus is already here."

Lisa Frack, a spokesperson for shelter provider Human Solutions, says that shelter staff are focused on working with the county to plan for COVID-19's possible spread. That includes making sure employees and volunteers are staying home if they're sick, or wearing masks if they have COVID-19 symptoms.

"At this point, we're being as cautious as possible," says Frack.

Morris said the Salvation Army has begun handing out travel size hand sanitizers to all of its guests, and is encouraging members of the public donate hand sanitizer (minimum 60 percent alcohol) at its Happy Valley headquarters.

Until Barbra Weber's February move into Hazelnut Grove, a peer-run tiny home village, Weber had been homeless for five years. She's not too worried about the virus spreading in her community, but she is concerned about its spread between friends who rely on shelters, due to the number of people they come in contact with on a regular basis. She's also worried that the public's fears around COVID-19's spread could further stigmatize the homeless population.

"A lot of us sleep outside, meaning we live in pollution day in and day out," says Weber. "That's going to make our eyes water and that's going to give us a cough. But that doesn't always mean we're sick."

"It's just one more reason to be scared of us, to treat us differently," said Weber. "That's what I'm afraid of."