Created April 2020, Updated September 8, 2021
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Shelters provide vital spaces for unhoused members of the community to rest, sleep, get a meal, and connect with others. People without permanent shelter may have medical conditions, substance use, or mental health challenges exacerbated by homelessness, and may not have adequate access to hygiene facilities. These conditions make our unhoused residents particularly vulnerable to the spread of infections.
The following guidance aligns with recommendations for homeless shelters from the Centers for Disease Control and Prevention
How COVID-19 spreads
The virus spreads mainly indoors between people who are in close contact with one another (within about 6 feet). This happens when droplets from an infected person who coughs, sneezes, or talks get 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.
Prevent the introduction and spread of illness
Provide information about getting vaccinated:
Place signage in visible locations with these messages:
Wear a mask
Know the symptoms of COVID-19
Keep physical distance
Proper hand washing
Inform visitors that they will not be allowed to enter the facility if they are ill.
When possible, facilities should use their virtual communication channels to inform prospective visitors of these rules before they travel to the facility.
Staff and volunteers
Encourage staff and volunteers to get vaccinated.
Staff should wear well-fitted masks or face coverings in accordance with CDC guidance and State of Oregon requirements (see below).
Assure staff and volunteers do not come to work sick. “Sick” is purposefully defined at a very low threshold: anyone who feels unwell. This could include fever/sweats/chills, cough, shortness of breath, sore throat, body/muscle ache, headache, fatigue, gastrointestinal symptoms, fever, chills, congestion/sneezing not caused by allergies. Any staff or volunteer who becomes sick at work should be sent home immediately. See the CDC’s full list of COVID-19 symptoms.
Staff should wash or sanitize hands frequently, and try not to touch their faces.
Staff should wear gloves when touching personal belongings of guests.
Staff and volunteers at high risk of severe COVID-19 (those who are older or have underlying health conditions) should not be designated as caregivers for sick clients or those clients who have difficulty keeping a mask on.
The CDC recommends that employees and volunteers who have been out sick (regardless of whether they were tested for COVID-19 or not) should only return to work when:
- 24-hours have passed with no fever—without the use of medicine to reduce fever, and
- Other symptoms have improved, and
- At least 10 days have passed since symptoms first appeared.
The local health department may follow up with those who may have been exposed to the sick person and make sure they receive the right information to watch carefully for symptoms and self-isolate if symptoms develop.
Mask and face coverings guidance
It is well known that many people with COVID-19 never show symptoms and that infected people may pass the virus to others before they know they are sick.
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 still required in Oregon for everyone 5 and older, including fully vaccinated individuals, in all indoor public spaces and in outdoor spaces where it's not possible to maintain physical distance. 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 >>
We recognize that even in shelters that are able to provide six feet of distance between people who are sleeping, it may be difficult to ensure six feet of distance between guests and staff at all times. There may be shelters where individuals share smaller cooking, eating, and hygiene areas.
Both staff and guests should follow State guidance on face coverings (see above). The state’s guidance acknowledges that some people may not be able to wear a face covering due to health conditions, age, or differential ability. Children under 2 years old should not wear face coverings.
Individuals wearing reusable face coverings should refrain from touching the outside of the covering, as this may transfer the virus to the wearer’s hands. It is important to remove and replace your face covering if someone coughs, sneezes or otherwise has likely caused droplets to be deposited on it. Reusable face coverings should be machine washed daily or as often as possible.
Wearing a face covering is NOT a substitute for physical distancing. It remains essential that everyone maintain 6 feet of distance from each other whenever possible.
The Joint Office and shelter operators have been providing face coverings for people experiencing homelessness, whether in a shelter or not, as part of their shared COVID-19 response. Multnomah County is collecting cloth face coverings for distribution to residential congregate settings and other high-need groups.
Hand sanitizer and hand washing
Keep hand sanitizer (minimum 60% alcohol) available near points of entry. Washing with warm water and soap is as effective. Promote both.
Make sure that you have adequate supplies for good hand hygiene, including:
- Hand sanitizer (minimum 60% alcohol) available near points of entry.
- Clean and functional hand washing stations
- Paper towels
- Trash receptacles
Routine symptom screening of shelter guests
Please use the Decision Tree for Respiratory Illness, dated 2-17-2021 to identify if someone is a good candidate for entering a shelter program or for remaining in the shelter, or should be referred to a Voluntary Isolation Motel.
All new prospective shelter guests should be screened prior to entry, and all current shelter guests should have a basic symptom check at least once a day.
Anyone observed with a new cough or worsening chronic cough should be referred to a Voluntary Isolation Motel. They do not need a temperature check.
Make sure the sick person is masked and have them move as far away from others as possible while you call the Voluntary Isolation Motel intake worker at 503-318-9262.
People without a cough complaint should be asked if they feel feverish. If a guest affirms feeling feverish, check their temperature.
If there are concerns about a guest’s ability to perceive feeling feverish or their ability to communicate whether they feel feverish, check their temperature.
No-touch thermometers are available from the Joint Office of Homeless Services as needed. Disposable thermometers are also permissible. Facilities may also use their own discretion and allow guests to take their own temperatures, so long as staff is careful to disinfect any items touched by more than one person.
Both the staff person and the guest should be wearing a face covering or mask at all times, including while temperatures are being taken.
Anyone with a temperature of 100 degrees F or greater should be referred to the Voluntary Isolation Motel.
When tracking outcomes as guests are screened, use the following categories: “screen negative” (meaning no symptoms) or “screen positive.” Do not note the actual temperature or symptoms. This is personal health information and should not be documented.
Physical distancing in shelter settings
The virus that causes COVID-19 is most likely to be transmitted to someone within 6 feet of the infectious person. Staff and guests should practice physical distancing (6 feet of space) from others whenever possible.
Staff and guests should reduce face-to-face interactions with others. Use bulletin boards, posters, brochures, emails, and phones where possible. Slide information under someone’s door.
In common spaces and transit, create distance between individuals in these ways:
- Schedule staggered use of common spaces.
- Avoid activities that bring residents or staff close together.
- Stagger bathing schedules.
- In transport, limit people per trip, increase space between passengers, and open windows to boost airflow.
Shelters may need to reduce their census to improve spacing in sleeping areas to follow these recommendations:
- Create at least 6 feet of space between beds.
- Space out units or dorms, when possible.
- Arrange beds so individuals lay head-to-toe.
Since individuals need to unmask to eat, maximum spacing from others will be important to consider, as well as hygiene.
Be diligent in following hygiene and food safety rules about keeping food covered, not using personal utensils in shared containers, washing hands before eating and handling shared objects, and cleaning kitchen surfaces and dining areas between use.
Also consider these recommendations:
- Stagger mealtimes.
- Stagger scheduled use of shared kitchens.
- Mark off sections on the floor in 6-foot increments for lines to collect food.
- Have meals already prepared on separate trays or bags.
- Maximize ventilation, including eating outside if necessary or offering meals to go.
- Add sneeze guards to shared condiment locations.
A person who is identified as feeling feverish or with a new or worsening cough should use a paper medical procedure mask or cloth face covering and be separated from other shelter guests until they are able to be relocated to one of the motel shelters for people who are symptomatic. It is appropriate to exclude an individual who refuses to mask and/or to be relocated.
Regularly clean and disinfect frequently touched objects and surfaces such as water coolers, desks, countertops, doorknobs, computer keyboards, faucet handles, phones and toys.
Use standard procedures for cleaning and disinfecting, and use an Environmental Protection Agency (EPA) registered disinfectant with a claim for human coronaviruses.
Custodial or EVS staff should follow the disinfectant manufacturer’s instructions for use including:
Using the proper concentrations of disinfectant.
Allowing required wet contact time.
CDC Hand Hygiene Posters
CDC How to Wash your hands poster
CDC Clean Hands for 20 seconds poster
Cover your cough poster