We think it’s safe to assume that everyone is familiar with the home isolation concept after half a year of it. With domestic (and few international) flights becoming available once more.
When the pandemic hit, and COVID-19 infiltrated the tropical paradise, the city went dead while the government tries to figure out what to do next and finally set up isolation centres in hotels, where those experiencing homelessness can safety self-isolate and recover.
But how well are these sites working, actually? Are there any unintended harms? What can be done to improve them?
These are among the questions that a team of scientists and community partners is probing as part of a collaborative and urgent effort to improve the lives of those on the margins, who have been hit hardest by the pandemic.
“What we’ve learned during the past few months is that the current context within the pandemic often makes people who are already marginalized even more marginalized,” said Dr. Michelle Firestone, a scientist at MAP Centre for Urban Health Solutions, which is leading the project. “It exacerbates a lot of the pre-existing or systemic issues a lot of communities face.”
Dr. Ahmed Bayoumi, a scientist at MAP and Firestone’s co-principal investigator of the project, said it grew out of the need to “think broadly about how the pandemic response, in particular, was having an effect on the lives of people in the communities we work with.”
“We recognize that COVID is going to be with us for a while — certainly for the rest of this year and into next year,” he said. “We’re looking at programs that have been initiated … to try and learn from that, in terms of how can we move forward to both improve current responses but also inform future responses.”
Previously, hospitals had to refer patients to hotels when they were discharged — a program that was put on hold after a handful of people died in the hotels. When the city’s contact tracing program ramps up at the beginning of next month, contact tracers are also expected to refer people to isolation hotels.
Anyone who cannot isolate at home without exposing their family to infection — including anyone who does not have their own bathroom — will be eligible for a hotel room. They will offer to deliver food and medicine so people who test positive for Covid-19 don’t have to leave their homes and expose others to infection.
“If we take care of them, we help them get well, but of course we also help them to not spread the disease,” de Blasio said. Officials say they have the power to use mandatory quarantine orders to force people to stay in isolation — which were used early in the outbreak, but largely abandoned as the disease spread widely — but expect voluntary instructions to be enough in most cases. “No one wants to inadvertently infect a member of their family and risk lives. No one wants to see one of their elders in danger.”
The recent spike in COVID-19 infections among 18- to 34-year-olds has put multigenerational households, common in the county, at a particular risk of having an older member end up in the hospital.
This is a critical step to stop the spread of the virus in multi-generational households, especially for families that do not have sufficient room for a family member to isolate from others. With the additional hotel rooms, the county is expanding the criteria.
“The current program, the hospitals refer folks to the Department of Health, they screen them and then we provide transportation to the hotels. The expanded program will also include provisions for people who aren’t at the hospitals to get into the hotels,” explained the person who is in charge of the program.
Mayor Carlos Gimenez says he wants to see all of the rooms occupied so the spread of infection can be reduced, adding, “they haven’t had that many referrals in the first hundred.”
The expansion of the program will also help families with a member who has tested positive for the virus but does not necessarily have symptoms, though that person can still spread the virus to family members.