Guilford County officials have unveiled a plan for providing emergency housing to unsheltered individuals who test positive for COVID-19 or present with symptoms of the virus.

Staff at the 12 shelters in Greensboro, High Point and other parts of Guilford County will screen clients. Those with a fever of 100.4 degrees or higher and at least one COVID-19 symptom — cough or shortness of breath — will be referred to the county Department of Public Health, local officials told shelter providers during a conference call on Thursday. Once the health department, a hospital and the client sign off on an isolation order, the client will be transported to a hotel in Greensboro for isolation.

Guilford County interim Public Health Director Iulia Vann said the clients might have to wait three or four days before they receive their test results back.

“If they’re negative, they will be allowed to leave the hotel,” she said. “If those test results come back positive, that is going to extend the amount of time that they’re gonna stay. We’re anticipating an average of 14 days. However, this is going to be a case-by-case determination, since they cannot leave if they still have symptoms. It might be after the 14 days — we’re going to be in constant communication with them — they’re still experiencing some symptoms, they might need to stay in the hotel for longer….”

The county is not disclosing the name and location of the hotel, Emergency Management Director Don Campbell said after the conference call.

The county will provide transportation through two Department of Social Services vans retrofitted to create a barrier between the driver and patient. The county will also ensure that the clients are fed during their hotel stays.

Campbell said the isolation orders are legally enforceable, but the county’s security plan heavily emphasizes education.

“If we have individuals who decide they cannot follow the isolation regulations as they are written in the isolation order,” he said, “then we have the ability to use our law enforcement system and our justice system to enforce those acts as needed. Clearly, that is a step of last resort.”

Vann acknowledged that many shelters aren’t staffed with medical professionals. She said she would prefer that the screenings were performed by someone with a medical background, but understands it’s not a realistic expectation. The health department will provide training to any shelter employee who wants it, she said.

Some providers and advocates had hoped the county would take a more proactive approach by providing emergency housing in hotels and motels for anyone who needs it, including those who are still healthy.

“We all know congregate settings are not safe, as evidenced by what’s happening in nursing facilities,” Michelle Kennedy, a member of Greensboro City Council and executive director at the Interactive Resource Center, told Triad City Beat. “Large groups of people staying together is not ideal.”

Kennedy’s staff is operating an emergency shelter opened by the city at the Greensboro Sportsplex two weeks ago. The shelter has been at capacity for at least a week, Kennedy said.

“The Sportsplex was always intended to be a temporary fix as we work on more permanent, safer solutions,” she said.

Kennedy said she and others have been making the case for the past two weeks that the county could use funds from the Coronavirus Aid, Relief and Economic Security, or CARES Act, to cover the cost of housing healthy people in motel rooms.

“That very well might be the case,” Campbell said during the conference call. “We have not been given access to any of those dollars. Those dollars are still at the federal level, much like the dollars that we are all expecting to receive through the IRS. We keep hearing about them, but we haven’t seen them. So, currently that funding is not available for our current project.”

Marcus Hyde of the Homeless Union of Greensboro lacerated the county’s plan in an email on Thursday. “Instead of putting people in housing before the virus spreads and possibly containing the spread, it asks homeless people to stay in overcrowded shelters until they get sick, and then offers them 14 days in a hotel room (only if they test positive) or longer until they don’t have symptoms.” He added that the plan represents “a terrible waste of an opportunity to get ahead of the crisis when COVID-19 breaks out in the homeless opportunity and overwhelms our service providers.”

Guilford County Commission Chairman Jeff Phillips anticipated the criticism in remarks made during the conference call.

“We must not allow the distractions of a few critics and naysayers to distract us from our focus to do all we can do together to protect the safety and health of our homeless friends across the county,” he said.

Kennedy said on Thursday evening that she was aware of four people experiencing homelessness who “have been referred to care with COVID-like symptoms.” None, to date have tested positive.

As of noon on Thursday, Guilford County had 125 confirmed cases of COVID-19, including a Greensboro police officer, and nine people have died from the virus.

Vann said the coronavirus pandemic is still very much in the “acceleration phase” in North Carolina, and the state likely won’t hit the peak until the end of April.

Staff at the Interactive Resource Center began handing out tents after the Sportsplex reached capacity, but Kennedy said she’s run out of supplies. She said her staff has moving people from the shelter into about 50 hotel and motel rooms, paid for the Interactive Resource Center.

Another point of contention is that the county’s plan to house symptomatic or COVID-positive patients in hotel rooms makes no accommodation for substance-use disorders. A document entitled “Bill of Rights/Rules for Hotel Guest” informs those subject to the isolation orders that they must stay in their room at all times and that the hotel is non-smoking facility.

“How are you advising the health department on harm reduction strategies and who will provide those in quarantine with needed supplies, in addition to food?” Kennedy asked in an April 4 email to Brian Hahne, executive director of Partners Ending Homelessness. “What about people whose alcoholism will put their lives at risk if they are cut off to access while in quarantine?”

Campbell said during the conference call on Thursday that patients in isolation should not be requesting deliveries to their rooms.

“We understand that is a real challenge, but if they were admitted as patients at Cone [Health], it would be the exact same limitations of no tobacco and no alcohol and those types of things,” he said.

Kennedy dismissed the comparison.

“Except if you’re in the hospital, there would be a medical plan to deal with your addiction,” she said. “It is completely irresponsible for the department of public health to have no medical plans in place to support people with addiction issues.”

Campbell said in an interview after the conference call that nurses from the health department who administer COVID-19 tests at the hotel will be in a position to assess whether patients need addiction-support services. But during the conference call, he suggested that the county might call on emergency services in some scenarios.

“So, if we end up running into problems where they’re creating a major issue from a health standpoint,” he said, “we would work with EMS and the health system to potentially look at that.”

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