Friday, August 28, 2009

Shelter Workers Not Protected

H1N1 (Swine Flu) Planning for Homeless Shelters

I attended the meeting today to talk about plans for a flu outbreak within the shelters in Cleveland. Thanks to Care Alliance and the Office of Homeless Services for coordinating this meeting. I was shocked to learn that shelter workers are not on the list of first immunized with the vaccine when it comes out sometime in October. Shelter staff are not considered emergency front line staff. There may be immunization of shelter workers who are working with children or pregnant women who are high priority for vaccination. This leaves the men's shelters, which are some of the largest facilities in our communities, without coverage for staff. If there is an outbreak of flu, will these workers show up to work? Will they risk their families getting sick if they go to work? It just does not make sense that these 250 to 300 people in the community will not be the first to get the vaccine so that we do not have to close all these shelters. If there is an outbreak and staff stop showing up for work, the shelters will close and these sick people will be sent out into the community. These potentially sick individuals will try to stay with family and friends and risk spreading the illness throughout the community. This is not very good planning to not have these workers healthy and keeping the shelters open. It does us know good to plan and train these staff if they get sick or refuse to show up for work.

Other things I learned today that need some attention:
1. Based on CDC estimates, we will probably see 2 to 4 people die from the flu in our shelters in Cleveland.
2. Because of the high number of smokers and people with compromised immune systems, the homeless population is at especially high risk for both types of flu.
3. We do not have enough hospital masks for staff or those already infected staying in the shelters.
4. There were nine shelters who did not show up for this meeting (which is of some concern).
5. They will set up isolation units within the shelters for those who get sick.
6. The shelters cannot send people out if they have flu within the facility, so this will mean a change in the way shelters operate.
7. There is not much planning going on within the shelters to meet disasters or emergencies in general so this is going to take a lot to get ready in the next few weeks.
8. We do not know if there will be one or two shots for swine flu--this would mean two or three shots are going to be necessary this flu season. One for the regular flu virus and then another series in October for H1N1.
9. Care Alliance is stepping up its regular flu shot routine to cover more people, but the swine flu is the big unknown and a lot of questions remain. We do not know if there is going to be enough vaccine in the local community.
10. There are not a lot of resources right now specific to flu and homeless people on the net or circulating.
11. Shelters have to take people in who show up to the door, but what if they are sick? Do they risk infecting the rest of the population? These are questions that need to be addressed in the near future.

We will continue to track these issues.

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1 comment:

Community Voice Mail National Office said...

Hi. Thank you very much for bringing up this issue. We (Community Voice Mail, a free voice mail service for 40k low-income/homeless people in 45 cities) sent H1N1 flu information to all our clients last year. Much of it was the standard information about how not to get the flu, or what to do if you get it. It was not very well tailored to the specific needs of people who lack a stable place to live, or who live in shelters or other close quarters. We're again working with the CDC this year to craft language for our voice messaging and email messages. The CDC has a decent resource for people working with homeless populations (see

There is also some good material from the Public Health Department of Seattle/King County with specific flu recommendations for shelters and other entities working with homeless populations. It's from 2006 (I'm inquiring if there is an update), but you can read it here:

I'd be happy to keep you posted about our efforts to find the best materials about H1N1 for homeless populations and the agencies that try to help them.

Steve Albertson (