Staffers at Health Care for the Homeless (HCH) had been relieved Thursday when less stringent COVID-19 screening criteria went into effect as well as a promising arrangement with the Mayor’s Office of Homeless Services (MOHS).

A client with symptoms that fit the criteria – cough, fever, fatigue, shortness of breath – could be scheduled to be tested for the new coronavirus at Johns Hopkins Hospital and the city would transport them there.

Should the test be positive, the city would provide the person with temporary quarantine housing.

But when two clients came to HCH’s facility on the Fallsway with enough symptoms to qualify for testing for the novel coronavirus, things didn’t go as planned.

“The Hopkins part went beautifully. It’s the part with the city where it all fell apart,” said a person close to the situation who was present and involved and spoke with The Brew.

“We got all this pushback.”

Two people who screened positive left the building because they could not get transportation to Hopkins.

According to this person, staff at the Mayor’s Office of Homeless Services said they were unable to provide the promised transportation to the hospital. After hours of waiting, the two clients left the building.

“Two people who screened positive at the door left – they ‘eloped,’ as we say – because they couldn’t get any transportation to Hopkins,” The Brew’s source said. “It was a nightmare.”

The two clients are known to sleep on the street, with one of them occasionally spending the night at Baltimore-Washington International Airport. One of the clients had a cough, fatigue COPD and was elderly; the other person had a fever and a cough.

“We were told we should find someplace to put them if they needed to be housed – but that wasn’t the agreement – that’s what the city agreed to do,” the source said.

City and HCH officials have not yet provided a response to questions about the problems encountered Thursday.

UPDATE:

Kevin Lindamood, HCH president and CEO, said he was “not at liberty to discuss specific clinical matters” referenced in the story. But he provided the following statement:

“We are working together with public and private partners who are trying very hard to stand up a plan toward a common goal of slowing the spread. In this difficult environment, everyone is operating in overdrive with incomplete information, and emotions understandably run high.”

Email: “Yesterday was challenging”

Emails from HCH officials obtained by The Brew confirm this narrative.

Kevin Lindamood, president and CEO of Health Care for the Homeless, alluded to the incident in one email.

“Let’s not mince words, yesterday was challenging, he wrote. “We identified two clients in need of testing at our Fallsway clinic. They were masked and isolated: our screening process is working.”

“We will provide guidance to further assess suspected positive screens and trigger city transport to partner hospitals,” he added.

The failure to get testing for symptomatic homeless persons illustrates the issues raised this week by a coalition of advocates, community groups and academics who wrote an open letter calling on Mayor Bernard C. “Jack” Young and other city leaders to act more urgently to protect Baltimore’s homeless and poor citizens during the global pandemic.

Persons living on the street, in encampments and in congregate shelters are considered high risk for transmission of COVID-19, which has claimed more than 10,000 lives worldwide and is spreading rapidly across Maryland.

Those who test positive for the virus are advised to self quarantine until the danger of transmitting it is past.

That’s an effective strategy for someone in good health and with a home, but not so much for a person experiencing homelessness, living on the street or in close quarters in an encampment or shelter, lacking access to soap and water and suffering from a variety of medical conditions.

City officials have said they are taking strong measures to deal with the problem.

On Wednesday, Young declared a state of emergency in Baltimore, a mechanism that relaxes procurement rules in order to expedite emergency purchases.

The purchase of hotels to house homeless people is one kind of procurement the city wants to be able to accelerate, Acting City Solicitor Dana Moore told reporters after Young’s press conference.

Over-stringent Standards

Like many other entities responding to the pandemic, HCH has been updating its screening criteria.

Until recent days, a testing referral required more than just symptoms  – an HCH client had to either have traveled out of state in the last two weeks or come in close contact with someone who had tested positive for the virus.

“The reason no one in the homeless population has tested positive for coronavirus is because we haven’t done any testing.”

Screening standards before March 6 were even more stringent, requiring a person to have traveled to a CDC Level 2 country and tested negative for the flu and for respiratory illness as well as get permission from the Maryland Department of Health.

“Those criteria for homeless people are pretty much impossible to meet, they would have had to stay around until the results came back,” The Brew’s source said.

Stressed by efforts to care for clients during the current coronavirus crisis, the source was particularly angry about media reports quoting people saying that no one in Baltimore’s homeless facilities so far has tested positive for the virus.

The picture is not so rosy, the source said, given the failure of political leaders in Baltimore and beyond to require widespread testing and and isolation earlier.

“The reason no one in the homeless population has tested positive for coronavirus is not because we don’t have a problem. It’s because we haven’t done any testing.”