​Kitsap County COVID-19 Guidance for Homeless SERVICE Providers

First, we want to thank you so much for all your work to keep the homeless shelters and day rooms open during this incredibly challenging time.  We know this is never easy, and that the heightened uncertainty and new realities of day to day life are making it even more difficult.

Last updated 4/1/2020 1pm

  Recent Updates

We will post recent news, changes, or updates as they become available here.

Added KPHD "What to do if you have symptoms" and Mental Health and Crisis Hotline information sheets.

Volunteer Request

Kitsap County Department of Emergency Management has sent a formal request to recruit volunteer to help staff quarantine/isolation shelter sites for COVID-19 patients in Kitsap County. Read the formal request here. To apply complete an application and submit to volunteer@kitsapem.org. Severe Weather Shelter volunteers do not need to complete the application and may simply email to participate.

  Shelter/Day Room Guidance:  COVID-19 Precautions

At this point, our best tools in preventing the spread of COVID-19 are simple ones:

Stay calm.

Wash hands often for 20 seconds using soap/water or use alcohol-based sanitizer.

Cover coughs and sneezes with an elbow or tissue.  Throw tissues away immediately.

Avoid close contact with people who are sick, avoid hugs, touching, keep a distance of 6 feet.

Clean and disinfect frequently-used objects and surfaces.

Stay home when sick and avoid close contact with others.

  How these precautions apply to Shelters and Day Rooms

Below are some general steps and suggestions for modifications to check-in procedure, based on the best known information at this time from local and state health departments.  These steps and changes will vary site to site depending on the layout of the facility and the availability of supplies.  To the extent possible:

 

Modifications to Check-in/Entry Procedures

Ask screening questions (see next section) and encourage guests to report illnesses and exposure to COVID-19 to staff prior or upon entry to the facility. Reassure guests that they will not be denied or lose a bed if they report symptoms.

Staff, volunteers, and guests should wash their hands or use hand sanitizer before signing-in, entering the common areas, or returning from the bathroom.
(How long is 20 seconds?" The time it takes to hum or sing the ABC's or Twinkle Twinkle Little Star.)

Provide options to increase social distancing at the check-in area and throughout common areas.  Have staff, volunteers, and guests keep extra space between people wherever possible.

Provide tissues, trash receptacles, and washing stations or hand sanitizer in waiting areas.  Encourage everyone in the facility to cover their cough or sneeze with a tissue and have trash cans available to dispose of tissues immediately.

If possible, offer masks to persons who are coughing.

Separate persons with respiratory symptoms or illness. Keep guests which have respiratory illness or are sick separated from common areas, waiting areas, and other high traffic areas.  If possible, place them into a separate room or section of the shelter or space and encourage sick guests to maintain 6 feet of separation from those not providing services or care.

Clean and Disinfect frequently touched surfaces - see guidance under the topic "Cleaning, Disinfecting, and Sanitizing"


  Screening Questions and Responses:

Ask the following screening questions upon check-in before entry:

  1. 1. Do you have a fever?
  2. 2. Have you been in contact with anyone that has the Corona virus?
  3. 3. Do you have a recent dry cough?
  4. 4. Are you having difficulty breathing?

Severe Symptoms: If the answer to any of the above questions is "yes" and the guest has severe symptoms (high fever AND at least 1 of the following: cough or difficulty breathing or shortness of breath) or other symptoms including: (rapidly worsening illness, complaining of being very sick or unable to get around as they normally would, severe sore throat, or chest pain) .

  1. a. Ask the guest to contact their Primary Care Provider (PCP) to discuss their symptoms*.
  2. b. If the guest reaches their care PCP, their care provider will tell them what to do.  If the guest is advised to stay at the shelter, give them a mask and isolate them from other shelter guests as best as possible.  Advise the guest to follow the suggestions listed below:
    1. i. Encourage these guests to wash their hands frequently.
    2. ii. Cover coughs and sneezes with a tissue or elbow.
    3. iii. Use social distancing – keep 6 feet from other guests, no hugging, touching, stay away from common areas if possible.
    4. iv. If available, provide a mask to guests with coughs and separate them as best you can.
    5. iv. Just as with other rules for your shelter or day room, if a guest refuses to follow the above rules or wear a mask (if available) they may be asked to leave.         
  3. c.If the guest has severe symptoms listed above and does not have a PCP or cannot reach their PCP, call 911.  Let the 911 operator know the symptoms that the guest is reporting.

Coughs, Respiratory Symptoms and other Mild Symptoms: If a guest has a cough or respiratory symptoms, give them a mask if available and separate them from others as best you can.  If the guest has other mild symptoms (runny nose, nasal stuffiness, mild headache/body ache, mild upset GI), these symptoms do not typically require medical attention. 

  1. a. Encourage these guests to wash their hands frequently.
  2. b. Cover coughs and sneezes with a tissue or elbow.
  3. c. Use social distancing, keep 6 feet from other guests, no hugging, touching, stay away from common areas if possible.
  1. d. Just as with other rules for your shelter or day room, if a guest refuses to follow the above rules they may be asked to leave.

Primary Care Providers and Insurance Coverage*

If the client does not have health insurance or a PCP, ask them to call Peninsula Community Health at (360) 377-3776 to enroll for a PCP.  If the guest has insurance, but no PCP, ask them to refer to their insurance card about establishing a primary care provider (PCP).

  Cleaning, Disinfecting, and Sanitizing

Additional Cleaning: Do additional cleaning of frequently touched surfaces, such as tables, chairs, doorknobs, furniture, bathrooms, light switches, and countertops.  Each location may have different cleaning solutions or disinfectants; Program Managers should provide instruction as to the available cleaners at your site and their proper use.

Detailed Guides

  Public Education and Information

Information Posters: Posters from the CDC and Health Department regarding COVID-19 should be displayed at check-in areas and other locations around the site.  You can download these posters at https://kitsappublichealth.org/CommunityHealth/CoronaVirus.php and https://www.cdc.gov/coronavirus/2019-ncov/communication/factsheets.html

  Separation and Isolation  

Separation or Isolation: Depending on the physical site, there may be opportunities to provide additional spacing between beds.  If possible, for symptomatic guests, use separate rooms, spaces, or opposite ends of a room to separate sick guests from other guests without symptoms. Most persons with COVID-19 infections will likely have mild symptoms and not require hospital care.  It might not be possible to determine if a person has COVID-19 or another respiratory illness just based on symptoms. Refer to https://deptofcommerce.app.box.com/v/Covid-19-Shelter-Guidelines/file/635030853862 pages 3-4 for more detailed steps for Isolation Considerations.

If possible, sick clients should be confined to individual rooms with separate bathroom and eating facilities and should avoid common areas. In the bedroom/bathroom dedicated for an ill person consider reducing cleaning frequency to as-needed (e.g., soiled items and surfaces) to avoid unnecessary contact with the ill person.

As much as possible, an ill person should stay in a specific room and away from other people in their home, following home care guidance.

If individual rooms for sick clients are not available, consider using a large, well-ventilated room specifically for sick persons, especially for people with respiratory disease symptoms.

In isolation areas, help reduce spread by:

Arranging beds at least 6 feet apart

Creating temporary physical barriers between beds using sheets or curtains.

Arranging beds so that individuals lie head to toe relative to each other.

If a separate bathroom is not available, the bathroom should be cleaned and disinfected after each use by an ill person. If this is not possible staff should wait as long as practical after use by an ill person to clean and disinfect the high-touch surfaces.

  Mask Use for Shelter Guests and Staff

Masks are in very limited supply and should be used for guests with coughs if available.

Shelter staff should identify guests who have a new, worse or different cough. These guests should wear masks to contain secretions or droplets. Shelter staff can demonstrate correct mask use in order to assist guests.

Masks are only effective in their intended use if they are used properly. The following rules must be followed for correct mask use:

The mask should fit snugly over the face.

The colored side of the mask faces outwards.

The strings or elastic bands are positioned properly to keep the mask firmly in place.

The mask covers both your nose and mouth.

The metallic strip is molded to the bridge of your nose.

Shelter staff and volunteers should not come in if they are feeling sick. Any staff or volunteers who become sick at work should be sent home and should remain at home until they are well.

Healthy staff and volunteers should not wear masks unless they are spending extended time in an area designated for guests with coughs or providing direct care to sick guests. Staff and volunteers should wash or sanitize hands frequently and try not to touch their face.


  Staff Considerations

Plan for staff and volunteer absences. Staff (and volunteers) may need to stay home when they are sick, caring for a sick household member, or caring for their children in the event of school dismissals.

Encourage ill staff and volunteers to stay home (or be sent home if they develop symptoms while at the facility), to prevent transmitting the infection to others.

Plan your staffing to minimize the number of staff members who have face-to-face interactions with clients with respiratory symptoms.

  Working with People Experiencing Unsheltered Homelessness

The Centers for Disease Control and Prevention (CDC) has issues interim guidance is based on what is currently known about coronavirus disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) will update this interim guidance as needed and as additional information becomes available.


 


​Posters,
Fact Sheets, and Guides

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Kitsap Public Health District - COVID-19 Fact Sheet

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Kitsap Public Health District - What to do if you have COVID-19 symptoms

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CDC - Stop the spread of germs

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CDC - COVID-19 Symptoms

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CDC - Share facts about COVID-19

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CDC - What to do if you are sick with COVID-19

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HUD - Infectious Disease Toolkit - Preventing and Managing the Spread of Infectious Disease Within Shelters

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HUD - Shelter Cleaning Checklist

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Infectious Disease Control for People Experiencing Homelessness

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WA State Dept of Health - Provides updated information about symptoms, testing, information, guidance, and current situation 

The Washington State Department of Health has established a call center to address questions from the public. If you have questions about what is happening in Washington, or how the virus is spread, please call 1-800-525-0127. Phone lines are currently staffed from 6 a.m. to 10 p.m, seven days a week. Please note that this call center can not access COVID-19 testing results. For testing inquiries or results, please contact your health care provider. 

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Centers for Disease Control and Prevention