Claude Martin has been through all this before. “The first couple of years of HIV, we all thought you could get it casually,” he says, not unlike how coronavirus appears to spread today. Tragically, the rigor of responding to the 1980s AIDS epidemic prepared Martin for how to crack down on the virus for the protection of his staff and his clients at Acadiana CARES, the outreach center he runs and that for three decades has specialized in HIV care.
“In some sense, [responding to coronavirus] was a much more stable reaction. I know what we’ve been through in the past,” he says, admittedly somewhat jaded, while hedging his bets on the outlook going forward. “We’ve got our fingers crossed.”
Martin took action early and seriously. No part of CARES’ services, which run a gamut of health and wellness services for vulnerable people, has been spared at least some disruption. The result? No one CARES houses on site has tested positive for the virus.
In fact, no one living in shelters for the homeless across Acadiana has tested positive, even as the number of people experiencing homelessness in the region has swelled in recent months and shelters are at capacity.
Housing advocates say it’s a testament to the swift action taken to stand up emergency housing, isolate people at risk, rearrange facilities to allow for social distancing and communicate the threat to the people they work with. Ahead of COVID’s landfall, it seemed a foregone conclusion that they would have an outbreak on their hands. Cautiously, they’re declaring a small victory.
“It’s flat out miraculous. I never would have expected that,” says Leigh Rachal, director of the Acadiana Regional Coalition on Housing and Homelessness. Nationwide, shelters have worked a similar playbook — informed by guidance from the Centers for Disease Control — to some success. Others haven’t been so lucky. In Boston, one shelter saw 49 of 114 residents test positive for the virus, many without symptoms. That’s led CDC officials to call for expanded testing in America’s shelters.
Testing in Lafayette remains somewhat limited. With supplies still lagging demand, guidelines recommend that only vulnerable people with symptoms be tested. Those criteria apply to the homeless population as well. It also means the victory comes with something of an asterisk or a shrug of cautious optimism. Only a small number of shelter residents have been tested, and exact figures were not available.
In early March, coronavirus was something of a distant threat to Louisiana. The state reported its first “presumptive” case March 9. Lafayette confirmed its first three March 18. Gov. John Bel Edwards ordered people to stay home on March 22.
But CARES leapt into locking things down at its five-acre facility that houses up to 80 people at any one time, including many who would otherwise be homeless. Staff began to work from home. Twelve-step meetings were shut down. Case management went online. Food bank and out-patient services were trimmed into a four-hour window. Patients and clients coming in for antiviral therapy or addiction treatment were scanned for fever and COVID symptoms. Where possible, CARES shifted housing to move people in independent rooms or off campus. The program maintains a network of apartment housing, too.
Many of the people CARES works with would meet the conventional definition of homeless, but most come in from the community for a variety of treatments. That’s a lot of people coming and going, often in close proximity and from environments with varying levels of risk. The center’s substance abuse unit isn’t requiring people to work. Quite the opposite.
“One of the big things we did, we told them they could not work and live here,” Martin says as of the policy, intended to keep CARES sealed off. That caused a mixed reaction.
“Some left because they were freaked out. Some didn’t want to be here. Some we kicked out,” he says. Others were placed in emergency hotel housing and told to hunker down. For rule breakers: “You’re banned from the property until this is over with,” Martin explains. That meant some people moved on to the mainstream shelter system or back onto the streets.
And just before the pandemic struck Acadiana, the number of people experiencing homelessness had grown. Area shelters track people coming and going to calculate an average census. The most recent “point-in-time” count hit 414, a 15% increase over last year, according to ARCH. Shelters were already strained and faced with losing even more bed space to make room for the virus.
Heeding public health guidance in early March, Catholic Charities of Acadiana, the largest shelter provider in the region, rearranged its three facilities to put in as much social distance as they could. Staff moved furniture out of the diner cafeteria to spread beds into the dining room at a safe distance. They got buy-in from their clientele — at the beginning of March, Catholic Charities sheltered 140 to 150 people nightly — to keep them from coming and going.
Every needless trip outside put the people inside the shelter, staff included, at risk. Catholic Charities stopped taking volunteers and in-kind donations, reshuffling staff across its suite of services to shelter duty. Many are working longer hours into overtime. Relying on more paid labor and buying more food is putting a strain on Catholic Charities’ bottom line, but so far the results have made it worth it.
“We’ve dealt with flu outbreaks before. We’ve dealt with sickness. We know what to do when that happens,” says Catholic Charities Communications Director Ben Broussard. “We’ve never dealt with a worldwide pandemic.”
One way to do that is to get board games in the mix. Catholic Charities’ staff works hard to keep everyone in their care occupied. That means movie nights and three square meals each day. “It probably looks pretty similar to what [social distancing] looked like in a lot of homes in Acadiana,” Broussard says. “At the end of the day, the folks we serve bought into staying safe.”
But these aren’t homes. And ARCH’s Rachal says this episode has brought forward some glimpse of what better solutions for addressing homelessness and housing instability could look like, even if these measures are unique to an emergency and unsustainable out of it.
From her perch at ARCH, Rachal has spearheaded an emergency housing program with seven area hotels. With meager private donations, ARCH was able to land 128 households in hotel rooms for 30 days at a time. It’s a stopgap measure, to be sure. Even at bargain prices, hotel rooms cost $900 a month. But the temporary stability comes with access to hygiene, an essential weapon in the fight.
“Hotels are not housing,” Rachal says. “But they do help stabilize an individual in one location.”
Still, the ability to house families in something that’s like a rudimentary home has been transformative for many of the people ARCH serves. Access to showers, to food, to safety gives the people in emergency hotel shelter a reason to stay put and avoid stacking a debilitating illness on top of tangled dimensions of social problems — mental illness, chronic addiction and sudden poverty. Many of the people now coming to Rachal are homeless for the first time, knocked into instability by the coronavirus-caused economic slump.
By and large, keeping households out of conventionally close-quartered shelter has been beneficial. However successful, it’s not clear that it’s sustainable, even as state and federal funding — from the $2.2 trillion CARES Act and other sources — is coming down the pike to prop up programs like ARCH’s. People get 30-day vouchers, and government dollars tend to take a lot longer than that to be distributed. Whether it gets here in time is a cause for concern.
“That’s the million-dollar question,” Rachal says about the outlook from here. “Ideally we use hotels as short-term as possible. Federal funding, timing-wise, is several weeks or so away. Finding the funding to get the hotels funded long enough to get people rental deposits and rental assistance to move into permanent housing is a little bit nerve-wracking.”
Like the rest of the state, shelter organizations here are starting to look at next steps. Back at CARES, Claude Martin says they’re working through which antibody tests to order to start tracking risk at the facility going forward and make way for something resembling normalcy.
Last week, some CARES residents put together a get-well card for a fellow client who was hospitalized with diabetes. A huge card was laid out near the center entrance, with a collection of markers and pens available for residents to ink their love and well-wishes. It was charming, Martin says, until it hit him: The card and markers could be vectors. He shut it down diplomatically, kindly asking the residents to figure out a safer way to collaborate on the act of kindness. They’re still working on it.