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County health officials are shortening the required isolation period for people staying in county-backed hotels to try to free up rooms for newly positive cases in the wake of changing federal guidance and a surge in COVID-19 cases.
That means homeless San Diegans may return to packed shelters after only five days of isolation. And that conflicts with Centers for Disease Control and Prevention guidance to maintain a 10-day isolation period for people staying in shelters before they return after getting the virus. Recent changes in isolation guidance from the CDC did not address shelters.
Shelters in San Diego have reported more than 120 cases over the last three weeks and operators have been relying on hotel rooms to provide isolation. Two major city shelter providers are, for now, determined to try to adhere to the 10-day isolation period, even if that means they must facilitate that continued isolation themselves.
For nearly two years, the county has provided hotel rooms for people who have tested positive or been exposed to COVID-19 who do not have a safe place to isolate. Dozens of homeless San Diegans who contracted COVID-19 while staying in packed shelters have since moved to county-funded rooms for at least a 10-day isolation period. City shelters have also been hit with multiple large-scale outbreaks afflicting a particularly vulnerable population that includes many who have been hesitant to get vaccinated. The hospitalization rate for homeless San Diegans who have contracted COVID has also been much higher than the general population.
Hotel rooms haven’t always been immediately available when homeless service providers sought to move shelter residents into them, but the situation worsened late last month when 50 people staying at city homeless shelters tested positive. There wasn’t room in county hotels, forcing two providers to isolate shelter residents in makeshift outdoor party tents for days.
The county recently added 40 additional rooms in response to a spike in cases tied to the more transmissible omicron variant, but Housing and Community Development Chief David Estrella revealed at Tuesday’s Board of Supervisors meeting that the county is taking another step to ensure rooms were available.
“New guidance from the CDC and the California Department of Public Health has been released allowing shortened isolation periods from 10 days to five days for persons who are asymptomatic and have a negative COVID-19 test on the fifth day of isolation,” Estrella told supervisors. “This change will allow rooms to become available sooner for those newly diagnosed individuals.”
A county spokeswoman confirmed Wednesday that people previously staying in shelters who receive a negative test and do not have COVID-19 symptoms will return to those shelters. She noted that many who test positive don’t immediately move into hotel rooms – meaning they have more time to isolate – and that the likelihood of COVID-19 transmission is “significantly reduced after five days.”
“Given a negative test and lack of symptoms at five to nine days for some guests – whether they be from a shelter, private residence or health care setting – it was determined that those waiting for a room who were known to be positive should be prioritized,” spokeswoman Sarah Sweeney wrote in an email.
Newly released CDC guidance indeed allows asymptomatic people who test positive to leave isolation after five days, but the agency has not updated a long-held recommendation that shelter dwellers wait 10 days.
Dr. Margot Kushel, who leads UC San Francisco’s Center for Vulnerable Populations and has provided input as the state has crafted guidelines for protecting the homeless population during the pandemic, said the county’s policy change isn’t ideal.
Still, she said, its decision to require a negative COVID-19 test before releasing people who stay in hotels from isolation appears to reflect an attempted balancing act in a time of strapped resources.
“I think it’s imperfect for sure, unquestionably outside the current CDC recommendations, but it does seem they are at least trying to thoughtfully mitigate that risk,” Kushel said.
Two major city shelter providers say they are planning to stick with the 10-day isolation period for now – and even if it means temporarily isolating people with their own resources after they leave county hotels.
Dr. Jeffrey Norris, Father Joe’s Villages chief medical officer, told Voice of San Diego that the agency which has seen more than 70 COVID-19 cases among residents since late December plans to try to keep shelter residents who move out of county hotel rooms in isolation until the 10-day period is up. They will also isolate those who remain on their premises for 10 days.
“At this time, Father Joe’s Villages will be maintaining 10-day isolation whenever possible for an added layer of precaution and in accordance with CDC guidelines,” Norris wrote in an email. “When a neighbor exits a hotel room, we will be isolating them for the remainder of their 10-day isolation period within the tent on our campus.”
Alpha Project, which has seen about 50 COVID-19 cases in the past few weeks, said it plans to maintain the 10-day period for residents for similar reasons.
“We like the 10-day period, and as much as we can control that, we’re gonna stick with that,” Alpha Project CEO Bob McElroy said.
Housing Commission spokesman Scott Marshall told VOSD the county’s guidance for now only applies to people who move into hotel rooms and that the county has directed city shelter providers isolating people themselves to keep them in isolation for at least 10 days as recommended by the CDC.
The city has thus far reported fewer COVID-19 cases in shelters this week and more people who have tested positive have been moving into county hotels.
As of Thursday, city officials reported that 22 people staying at Father Joe’s Golden Hall shelter had tested positive while two residents tested positive at Alpha Project’s 17th Street and Imperial Avenue shelter. The city is still awaiting some test results. City shelters had reported about 50 cases each of the last two weeks.
Meanwhile, Sweeney said as of late Wednesday the county had moved about four dozen people into hotels since last Friday – up from 17 as of late last week.