Yale vs Covid

Richard Borge

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Homeless in the pandemic

By Dylan Walsh ’11MEM

An estimated 3,000 men, women, and children in Connecticut are homeless on any given night. Under ordinary circumstances, having a bed in one of the state’s 63 crowded shelters would provide a baseline of safety, comfort, and dignity. Today, as a highly contagious respiratory illness sweeps through cities and towns worldwide, the calculus is different, the benefits of a shared roof over one’s head less certain.

“The purpose of these places is to sleep lots of people,” says Alison Cunningham ’84MDiv. It’s a design goal at sharp odds with the recommendations from the Centers for Disease Control and Prevention. Keep space between yourself and other people, the CDC says. Stay out of crowded places. “The first real crisis,” Cunningham adds, “was that our shelters are not set up for this and we needed to get people out.”

This concern in mind, New Haven mayor Justin Elicker ’10MEM, ’10MBA, called Cunningham one Sunday in mid-March to ask if she would help his office devise a solution. For two decades, Cunningham served as CEO of Columbus House, the city’s largest shelter and provider of support services for homeless men and women. Though she now works at the Divinity School, the issue of homelessness “is never far from my heart and mind,” she says. She talked with Elicker about what the job would entail, got permission for partial leave from the Divinity School, and joined the city.

In close consult with New Haven’s Community Services Administrator, Mehul Dalal, Cunningham and Velma George, Coordinator for Homelessness, created a plan to “decompress” New Haven’s shelters and warming centers, cutting the number of people they accommodate by at least half. The first task was to move people from shelters into hotels, prioritizing those who were most vulnerable to COVID-19. Once people were safely in hotels, case workers pushed doggedly to find them permanent housing. Coronavirus complicates this work by making standard bureaucratic hurdles, like obtaining a government-issued ID or filing paperwork, more formidable: “If somebody needs a birth certificate, you can’t call a hall of records in a rural town and expect to find a person on the other side of the phone,” Cunningham says. The New Haven region nonetheless moved swiftly: from March through May of this year, 164 people received housing—almost 25 percent more than last year. Cunningham expects 1,000 people to be housed by October.

One hitch in this process was how to handle men and women diagnosed with COVID-19. The hotels had negotiated with the city about providing shelter, and they had not agreed to accept anybody who tested positive. Yale medical school assistant professor David Rosenthal, who works with the Connecticut VA to provide care for homeless veterans, noted: “For those without housing, that presents a problem.” Where would contagious men and women without homes go to self-isolate?

Toward the end of March, Rosenthal, Cunningham, and ten other experts in medicine and homelessness drafted an 80-page document outlining the physical blueprints and clinical protocols for a medical center—one in which homeless men and women with COVID-19 could recover. Known as Shelter One, it opened in mid-April in the gymnasium of Hill Regional Career High School. It’s consistently had between four to eight patients under observation.

Reconfiguring a gym on short notice to function as an infectious disease ward required heroic effort on many fronts. But most striking to Rosenthal was the volunteer army that stepped forward to staff the facility. More than 60 doctors, nurses, nursing and PA students, medical fellows, and Yale and Quinnipiac undergrads have spent “weekends and nights volunteering, to make this place happen,” he says. They also received more than $5,000 in donations—along with supplies from snacks and clothes to tablet computers. “The generosity of the community has been overwhelming.”

Emma Lo, an assistant professor at the School of Medicine who founded and coleads New Haven’s street psychiatry program, has kept tabs as best she can on those who, whether by choice or necessity, remain outside the shelter system: men and women who live in encampments, who sleep on benches and under bridges. Many of them are harder to track down given that centers of congregation—the library, Union Station, coffee shops—are closed, and she has been forced to scale back her rounds on the street from several hours most days of the week to just two hours twice a week. And she notes that despite the pandemic, the criminalization of homelessness continues. A few weeks ago, representatives from the city forced one of her clients from his encampment. They loaded what belongings he couldn’t carry into a dump truck and carted them to the landfill. “Most frustrating is that they haven’t given him any alternate place to be,” she says. “This is not an appropriate time to be clearing encampments.”

But otherwise, says Lo, so much was done: shelters emptied, housing quickly secured, accessible testing sites, Shelter One. Agencies that one way or another touch on the issue of homelessness have united with unusual efficiency and vigor. “There’s suddenly more attention,” Lo says. “That’s one of the good things to come out of this, if we can keep the momentum.”

Cunningham agrees. “If, in this moment, we’ve been able to get folks from shelters to hotels and housed, then surely we could find some thoughtful way to keep people from ever coming into the system,” she told me. Her voice was reflective, almost hesitant, as if speaking the words might erase the possibility. In more than 20 years, she says, she has never seen such a large-scale, abrupt, heartfelt response to the issue of homelessness. It had always remained one of those insoluble facts of American life. But under the universal threat of a pandemic, solutions were discussed pragmatically, the usual reactive policies became encouragingly proactive, and emergency budgets materialized where before there had been gross underfunding.

Could these good turns, she wondered, endure? “That’s my utopian vision.” 

Dylan Walsh ’11MEM, a freelance writer based in Chicago, covers science and criminal justice.