Covid-19 and Respiratory (Airborne) Illness Guidance

Covid-19 and Respiratory (Airborne) Illness Guidance

COVID-19 and Respiratory Illness Guidance for Homeless Shelters and Services Providers

View the Alameda County Health Care for the Homeless (ACHCH) COVID-19 and Respiratory Illness Guidance for Homeless Shelters and Services Providers. 

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COVID-19, as well as other airborne respiratory illnesses such as influenza, RSV, colds, and many other viruses, can spread among shelter and homeless services participants and staff. As we collectively work to ensure safer, healthier living environments in shelters and homeless programs, we recognize that COVID-19 is an ongoing presence, just like flu, RSV, and colds. Our shared goals are to prevent serious illness and death from respiratory diseases and support the health and wellness of all shelter residents and staff.

ACHCH will continue to work closely with our partners in the Alameda County Public Health Department (ACPHD) to coordinate responses and communicate with our community partners. Positive cases (or “case counts”), hospitalizations, outbreaks, and wastewater monitoring all inform countywide responses to COVID-19. County Health Officer and ACHCH guidance will be posted on our webpages and actionable updates to guidance will be emailed to our provider community.

The following ACHCH Homeless Provider guidance is aligned with the more detailed and informative ACPHD Preventing & Controlling Outbreaks in Unlicensed Congregate Living Facilities guidance.

Vaccination to protect against COVID-19 and Flu

Staying up-to-date with all recommended COVID-19 vaccine doses is the best way to protect against serious illness and death caused by COVID-19. For information on where to get vaccinated, visit the Alameda County Community Vaccination Clinics. If your site is interested in potentially hosting a mobile vaccination team, submit a request here.

Screening for Contagious Illness

Shelter and homeless services provider staff should screen program participants AND staff daily for symptoms of potentially contagious illnesses and maintain a log of participant and staff screenings:

  • Shelters should accept clients with symptoms and/or who are positive for COVID-19 if the risks of transmission can be mitigated on-site.
  • Post signs reminding staff and visitors of the importance of masking, hand hygiene, and symptoms of COVID-19.

Testing for COVID-19

Shelter and homeless services providers can have over-the-counter (OTC) COVID-19 rapid test kits available for staff and residents to use. Larger-scale screening testing of possibly exposed asymptomatic people may be recommended when Alameda County CDC COVID-19 levels are medium or high or when there is an active outbreak in your facility.

  • You can register with the Alameda County Emergency Services warehouse to order free OTC rapid COVID-19 test kits. In the Resources section, you can “Create Account and Request COVID-19 Supplies.” Supplies are limited.
  • Homeless Services Providers can access OTC rapid COVID-19 test kits from the ACHCH program. To order and pick up, please contact a Regional Coordinator in your region or email achch@acgov.org.
  • Get familiar with and share tips and techniques for self-testing with resources from the ACPHD COVID-19 website.
  • Community testing is still available in Alameda County. Many of these sites provide PCR and rapid testing, free test kits, onsite COVID-19 treatment, and health care enrollment and other services.
  • Clients who are symptomatic but test negative should be retested at least once, ideally three times in total.
  • Clients with persistent symptoms who are COVID-19 negative should be referred to a health care setting for assessment, including testing for influenza.

Treatment for COVID-19 and Flu

Don’t delay treatment for COVID-19. Be prepared to help staff and/or participants contact their health care providers AS SOON AS THEY TEST POSITIVE. Treatment is effective and free.

  • People who are uninsured or can’t reach their provider can speak with a health care provider for FREE by phone at (833) 686-5051 (6 a.m. – 4 p.m. PST, seven days a week) or by video appointment at sesamecare.com/covidca.
  • There are also treatments available for influenza. Staff and/or participants should be supported in contacting their primary care provider.

Respond to Positive COVID-19 Cases

First steps for someone who is confirmed to be COVID-19 positive are to (1) provide a well-fitting mask or respirator for the ill individual (or PWC – person with Covid) to wear at all times, (2) separate the ill individual from others as much as possible, especially those at risk for severe disease, (3) refer ill individual for antiviral treatment, (4) provide KN95 masks to those individuals with unavoidable close contact with ill individual(s).

Shelter or Program Participants

  • A resident or client with symptoms of possible COVID-19 should be masked and placed in a separate space and tested for COVID-19. If a person tests positive for COVID-19, they should follow instructions for isolation from CDPH and CDC.
  • Facilities should be prepared to accept and isolate residents on-site who either have or are symptomatic for COVID-19. Ideally, a client would be placed in a private room or co-horted in a room with other COVID-19-positive clients to avoid the spread of the virus within a facility. The client should wear a well-fitting mask or respirator when using shared facilities such as restrooms.
  • If a designated space for isolation is not available, reduce transmission by optimizing ventilation in the infected client’s area and maximizing the physical distance between the infected client and others. Work to clearly separate more medically fragile or vulnerable residents from potentially infected persons.

Staff

  • Staff with symptoms of possible COVID-19 should be excused from on-site work around other people pending COVID-19 test results. If symptoms persist, consider self-isolation and retesting daily for two days as recommended by CDPH.
  • Staff who test positive for COVID-19 must be excluded from the workplace until they meet all return-to-work requirements.

* For additional specific guidance on on-site isolation and quarantine, please review these documents: ACHCH Ventilation Toolkit (Appendix 5); ACPHD Guide for On-site Isolation & Quarantine for Unlicensed Group Living Settings, and CDPH Best Practices for Ventilation of Isolation Areas.

Reporting COVID-19 Cases

Improve Ventilation and Physical Distancing

Improving Ventilation

Services providers can develop on-site isolation and risk-mitigation capacity using the toolkits below. Healthy strategies that mix, filter, and dilute the air in your facility reduce the risk of airborne transmission of infectious diseases such as COVID-19, RSV, Flu, and colds:

Maintain Distancing

Ensure that physical distancing is carried out as much as possible:

  • Beds should be positioned head to toe, with heads positioned as far apart as possible.
  • Consider serving meals or gathering people in a staggered manner to reduce the number of people crowded together.
  • Review the above toolkits for more details on physical distancing in shelter and congregate settings.

Masking for Shelter Staff and Residents

Shelter and homeless service programs should purchase KN95 and surgical masks for use when indicated to prevent the spread of respiratory illnesses. Masking is not currently mandatory but may be helpful in limiting the spread of any respiratory illnesses.

  • Anyone who is coughing or sneezing should wear at least a surgical mask around other people and while in an indoor congregate setting.
  • People with positive COVID-19 tests should continue wearing a well-fitted mask until 10 days after symptoms began.
  • Anyone who has close and regular contact with someone symptomatic should consider wearing a KN95 mask.
  • Anyone, especially those at very high risk for severe respiratory disease, should consider wearing a KN95 mask in crowded indoor settings.
  • Clients and staff may be required to wear masks during an outbreak or in times of high community transmission. County indoor mask-wearing rules and recommendations will change based on conditions. Updates are posted here.
  • You can register with the Alameda County Emergency Services warehouse to access COVID-19 PPE and other supplies when available (see “Testing for COVID-19” and “Resources” sections for link).

Keep Up-to-Date: COVID-19 Guidance and Surveillance

Please keep up on emerging trends with the below resources, and by staying in contact with the ACHCH program.

ACHCH Homeless Provider COVID-19 Community Calls

Zoom Meetings are held on the 2nd Wednesday of the month from 10:30 – 11:30 a.m. ACHCH will answer questions, share updates, and provide resources to the community of homeless services providers. If you are a homeless services provider and would like to be added to this email distribution list, please email achch@acgov.org.

ACHCH Regional Coordinators

Homeless services providers can reach out to the following ACHCH Regional Coordinators as needed for consultation, questions, and issues related to concerns about respiratory illnesses, including COVID-19, among people experiencing homelessness:

Resources