Posted Jul 30, 2020 at 12:01 AM
Published by The Gainesville Sun
A community partnership between GRACE, the University of Florida Mobile Outreach Clinic, the Alachua Area Medical Reserve Corps, the Alachua County Health Department, Grace Healthcare Services Corp and the city of Gainesville has emerged as a model for how to continue providing services to the most vulnerable while preventing the spread of the virus.
As the first cases of COVID-19 appeared in the U.S., homeless shelters across the country scrambled to find ways to protect their clients from the impact of the virus. Shelter guests — many of them elderly and with severe underlying medical conditions — were particularly vulnerable to the virus, and the congregate settings many lived in could facilitate rapid transmission among this vulnerable population.
In March, when the virus first appeared in Alachua County, testing was hard to come by. But homeless advocates knew that if the virus hit the homeless shelters, it would hit hard due to the same combination of congregate facilities, age and health problems that created so many problems in nursing homes.
In San Francisco, cases among the homeless population jumped from one to 70 in only a week. Three weeks after the first case appeared in a New York shelter, 23 people had died and 371 in the shelter system had tested positive for the virus.
The rapid response locally, however, has so far minimized the impact of the virus in the city’s largest shelter. Working with the UF Emerging Pathogens Institute and the Mobile Outreach Clinic, doctors and medical students provided widespread COVID testing for all residents and staff at GRACE in March.
The Alachua Area Medical Reserve Corps, working with the Alachua County Health Department, has provided ongoing COVID testing since April. GRACE was the first North Florida shelter to make major operational changes — including a voluntary quarantine and the suspension of all volunteer programs except onsite medical clinics — to allow the agency to continue to provide services without putting residents at risk.
The Gainesville City Commission approved funds to move the most vulnerable people in the shelter into hotels, and GRACE and county staff have since moved each of those individuals into permanent housing. Outreach teams consisting of UF medical students and Meridian Behavioral Health staff, with support from Alachua County Community Support Services, have also been providing evaluations and medical care to the unsheltered homeless population.
To date, partners have conducted more than 550 tests (200 by UF Emerging Pathogens Institute and 350 by the Alachua County Health Department) of staff and residents at GRACE. On a typical night, about 180 people live on the GRACE campus, which includes four emergency shelter programs and a temporary outdoor campground set up as part of the closure of a nearby encampment.
At the writing of this piece, 20 weeks in, there has been only one confirmed case in GRACE shelter programs. The contact tracing performed by GRACE staff immediately afterward led to additional testing for all exposed individuals, and to date it appears to be an isolated case.
While the initial steps we’ve taken have been invaluable to protecting our most vulnerable citizens, and thereby the community at large, we’re still likely closer to the beginning of the pandemic than we are the end. The public health response at GRACE represents the combined effort of shelter staff, the UF community, local government, the Alachua Area Medical Reserve Corps and Grace Healthcare Services Corp.
This partnership — a community-wide commitment to our most vulnerable residents — is a bright spot among local efforts to adapt to the new realities imposed by the pandemic.
Jon DeCarmine is the executive director of GRACE. Dr. Harvey Rohlwing is president of Grace Healthcare Services Corp and a volunteer physician with the Alachua Area Medical Reserve Corps and UF Mobile Outreach Clinic. Dr. Grant Harrell is the medical director of the UF Mobile Outreach Clinic.