Perlia Bell, an outreach worker with JOIN, talks to a woman about services after handing her gear.
Perlia Bell, an outreach worker with JOIN, talks to a woman about services after handing her gear.

Interim guidance updated November 26, 2021

COVID-19 vaccination is the best way to prevent serious illness, hospitalization, and death from COVID-19. All Oregonians age 5 and older are now eligible to get the COVID-19 vaccine. Where to get a COVID-19 vaccine >>

Local officials are continuing efforts to reduce the spread of COVID-19 and protect vulnerable community members who are experiencing homelessness, including people in congregate shelters, where close quarters can increase the risk of passing illnesses, as well as people who are surviving without shelter.

Following the preventative steps listed on this page can lessen the chance of introducing or spreading diseases like COVID-19.

COVID-19 symptoms

COVID-19 has many possible symptoms. People can have a cough, difficulty breathing, muscle aches, headache, chills, or fever. Many people have no symptoms or mild symptoms.

Basics about how COVID-19 is spread

The virus spreads mainly indoors from person-to-person, between people who are in close contact with one another (within about 6 feet). This happens by droplets from an infected person’s coughs or sneezes getting into another person’s mouth, nose, or lungs. 

The virus can also spread between people who are sharing the same airspace, and less often by touching surfaces that have the virus on it. People can be infected and spread the virus to others even if they don’t have symptoms. 

What we know about how the virus spreads (CDC)»

Most people recover without needing to go to a doctor or the hospital.

But certain people do face a higher risk of having more severe symptoms, including serious lung infections. Those people tend to be older, have weakened immune systems or have underlying medical conditions (things like diabetes, heart, or lung diseases).

We have learned a lot about how to prevent COVID-19. Here are some steps to limit the spread of infections

  • Get vaccinated and provide information about getting vaccinated:
  • Wear masks or face coverings. (See more info below.)
  • Outreach workers and volunteers should not work when they are feeling sick and should not spend time with potentially vulnerable people.
  • Wash hands frequently, if possible, or use hand sanitizer.
  • People should do what they can to avoid touching their noses, eyes, and mouths.
  • Cover coughs: Any cough, even if someone otherwise feels well, should be covered — not with someone’s hands but by a mask, scarf or bandana.
  • As much as possible, encourage those you’re working with to limit sharing personal items, particularly cigarettes, food, phones, utensils and other items.
  • Routine cleaning: focus on high-touch surfaces, such as phones.

Medical Masks and Cloth Face Coverings 

We know that many people with COVID-19 never show symptoms and that some people can spread the virus before they show symptoms. A well-fitted face covering can block droplets from someone coughing, sneezing, or talking before they know they are ill. It protects the person wearing it AND those around them.

Face coverings are required in Oregon for everyone 5 and older, whether vaccinated or not, in indoor public spaces. OHA’s face mask recommendations and requirements.

Masks and face coverings should fit snugly to cover the mouth and nose. Simple ways to get the best protection.

Medical masks

Medical masks, also known as surgical or procedure masks, are effective when they are used properly.

Watch this video ( about correct medical mask use.

Cloth face coverings

If someone doesn’t have a medical mask, a bandana or other cloth face covering is fine. Here are some tips for creating and wearing face coverings:

  • The tighter the weave, the thicker the cloth, and the better it fits your face, the better the protection. In a pinch, you can use bandanas or scarves.

  • See the CDC webpage for images and directions showing how to make a homemade cloth face covering.

  • Homemade cloth face coverings should be washed daily or as often as possible with warm water and soap.

  • Make sure you can breathe easily through them.

  • Cloth face coverings can be itchy. Don’t reach under the mask to touch your nose or mouth.

Setting up a campsite to limit the spread of infection

As much as possible, people who are camping should work to separate individuals with respiratory illness symptoms (coughing, fever, shortness of breath or difficulty breathing, muscle aches, headache, or chills) from those without. This will stop the sick person’s respiratory droplets from getting into a well person through the air.

This is helpful even if coughing people are wearing masks or face coverings.

As much as possible, people who are sick should avoid sharing a tent with those who do not have symptoms of respiratory illness (like coughing). 

If space is constrained, then the guidance that Public Health has provided for shelters and other congregate spaces can be helpful. Create a six-foot buffer to separate those who have symptoms of respiratory illness from those who do not.

As much as possible, people who are coughing should try to keep their tissues, bedding and worn clothes and trash separate.


The risk of companion animals, including pets, spreading COVID-19 to people is low, based on the information available to date.

To be safe, the CDC recommends that we treat pets as we would other humans – do not let pets interact with people or animals outside your family or group. As much as possible, keep pets away from people who are actively sick. 

Caring for someone with respiratory symptoms

Most people with COVID-19 recover without medical intervention. People are probably most contagious when they have symptoms like cough and fever.

Someone who’s mildly sick may have the following symptoms: coughing, sneezing, sore throat, a fever and aches.

Offer basic care to help the person feel better:

  • Ensure they rest. And offer non-prescription medicines, like acetaminophen (Tylenol) and ibuprofen (Advil) for symptoms like fever and aches.

  • Keep the sick person in a separate, well-ventilated space and apart from other people and pets as much as possible. If that’s not possible, keep a distance of at least six feet from people who are well. People who are sick should avoid sharing a tent with people who are well.

  • Avoid sharing bedding and clothing if someone’s been coughing or sneezing on them. 

  • A sick person who is coughing or sneezing should wear a medical mask or cloth face covering. Everyone around that person, especially the person taking care of them, should wear a mask or face covering or cover their nose and mouth when close to the ill person and especially inside a small space like a tent.

When to seek additional medical care 

Testing for COVID-19 is available at various sites around Multnomah County.  Find a testing location >>

Someone should get medical help right away if they develop any of the following symptoms: difficulty breathing, pain or pressure in the chest or abdomen, or if they’re unable to drink or keep liquids down.

An ambulance will come like usual when someone calls 911. The paramedics will be wearing extra masks and coverings to keep themselves healthy so they can keep working.

If someone knows someone who needs medical care but won’t seek it, they should urge them to do so — ask them to wear a mask or face covering and help them stay at least 6 feet away from others. 

Guidance for caregivers

The risk of catching a virus from a sick person is highest for their direct caretaker. But others who share space with a sick person should also take the same precautions to limit risk.

First, people should check their own health regularly, as best they can, to watch for the development of similar symptoms.

Caretakers and close contacts should always follow guidance around wearing masks, hand-washing and sanitizer, and touching their faces — particularly after sharing space with the ill person and handling their belongings.

As much as possible, clean frequently touched surfaces on a regular basis, using everyday cleaning products.

Avoid sharing personal items, utensils, towels or bedding with an ill person.

If laundry access is available or is being provided, items from a sick person and someone who’s not showing symptoms can be shared. But to avoid germs, people should avoid shaking dirty laundry or “hugging” dirty laundry to their chests to carry it.

Additional questions

What if someone asks why they should take these precautions if they feel well right now?

It’s true that many people who get COVID-19 may never develop serious symptoms or may never even know they had it in the first place.

It’s also true that the reality of trying to survive outside, day in and day out, all year, is life-threatening and deeply traumatic and challenging all on its own. 

It’s important to acknowledge that.

But because some people do face a higher risk of serious symptoms from COVID-19, including some of the people you might be camping with or spending time with, we’re asking everyone across the community, no matter where they live and who they are, to do their part and do whatever they can to limit the spread of infection.

We also know that so many people have already been stepping up, checking on their neighbors and campmates, taking steps to protect and watch out for one another.

They have been taking those steps all on their own, caring for one another with a deep sense of community, without waiting for official guidance. That agency and initiative is powerful and it will continue to be important in the days to come.