Four medical student volunteers raised concerns this week with New Orleans city officials about health and safety issues — including lack of coronavirus infection prevention and treatment for serious existing medical conditions — at the hotel where the city and state recently put up nearly 200 homeless residents.
City workers picked up 190 homeless residents from nearby outdoor encampments last month and took them to the Hilton Garden Inn on Gravier Street in order to get them indoors and away from an unusual swarm of rats caused by the coronavirus crisis and subsequent business closures.
Two of the volunteers said that while there were issues, they believed people were doing the best they could considering the unprecedented and unfolding coronavirus crisis. City officials told The Lens that they are already taking steps to address those concerns, including moving half the population to a new hotel to reduce density.
The facility opened nearly two weeks ago on March 26. The volunteers sent emails this week to Meredith McInturff, emergency preparedness lead for the New Orleans Health Department. In those emails, and in follow up interviews with two of the volunteers, they described a lack of protocol for preventing the spread of the coronavirus within the hotel.
“From the moment I entered, it was clear that even the most basic infection prevention precautions that grocery stores across town have managed to successfully implement for weeks were not being enforced for residents, volunteers, nor staff,” wrote volunteer and fourth year medical student Alex Nic. He later published the entirety of his email in a Medium post. “This appears to be much more about the management and control of a population considered by the State to be surplus and expendable, rather than the preservation of the health and safety of some of the city’s most marginalized and at-risk citizens.”
He said that masks and gloves were rarely worn within the building and that people weren’t being routinely checked for symptoms, asked to wash their hands or offered protection when they walked in (although masks and gloves were available). He also said that when he went around room to room to check temperatures, he was in a group of seven people.
(The Lens observed a security guard sitting near the front entrance of the hotel on Wednesday afternoon. He was wearing a mask.)
Another concern among the volunteers was that regardless of the coronavirus pandemic, there wasn’t enough medical support to house 190 people, many of whom have serious physical and mental health issues. Simply putting a roof over their head is inadequate, they said.
“Per staff reports, this site has experienced 1-2 opioid overdoses per day, but thankfully no fatalities,” Nic said in his email. “While it has been made clear to me that this temporary housing site is not a medical establishment, I do believe that, in the midst of a health crisis, once people who have a 5-10x higher rate of all-cause mortality at baseline … are densely housed by an organization, it is that organization’s moral responsibility to systematically catalog and address their chronic health conditions.”
Nic told The Lens that he first went to The Hilton on Sunday to deliver Naloxone, a widely used drug to reverse opioid overdoses. He said he came back the next day to volunteer to do temperature checks and was able to look at a sheet detailing residents’ underlying conditions.
“The vast majority of people had either hypertension, diabetes, HIV, chronic health conditions, not to mention substance use disorders and psychiatric conditions. I mean people are homeless for a reason,” he said in an interview. Hypertension and diabetes are the number one and number two underlying conditions, respectively, most common among people who have died from COVID-19 in Louisiana, according to state data.
“So you take a bunch of people with chronic health conditions that aren’t controlled in one facility together and don’t do anything to systematically optimize their health to reduce their risk of poor outcome, then it’s kind of a ticking time bomb,” he said.
He also said that there was only one nurse on site for all 190 people. He said that was concerning, bringing up one moment in particular when a homeless resident was sent back from the hospital to the Hilton, even though her discharge form indicated she was still waiting on the results of a coronavirus test. After talking to her, he said he discovered that she was HIV positive and hadn’t had access to all her required medication in weeks.
“Oh so this is an immunocompromised person in the middle of the pandemic,” he told The Lens. “She has to go somewhere, she can’t stay here. And no one really knew. There was nothing to point to, nothing written … Her lungs sounded not great and she was breathing pretty fast. And she seemed to be in labored breathing.”
He said they were eventually able to transfer her back to the hospital.
Two of the volunteers, who wrote a joint letter, were less condemning but shared many of the same concerns “regarding things like infection control protocol and shortages of both staff and resources.”
“There are a lot of problems with the site, and a lot of things that could be done better,” it said. “However, we want to put it out there that it has been our experience that the staff … do care about the residents beyond fulfilling some state-mandated obligation for sheltering the homeless during the pandemic. … While we agree that things need to change at the facility, the way we see it is as a group of people who have presumably never dealt with something like this before figuring it out as they go.”
McInturff responded to the four volunteers Tuesday evening, saying that the city was working to improve the situation, including adding behavioral health resources and beefing up the infection control protocols.
“Rest assured, your concerns (and concerns from several other volunteers) have been heard and we’re actively working on this,” she wrote to the four medical school students.
A City Hall statement sent by David Simmons, deputy communications director for Mayor LaToya Cantrell, said that medical staff had visited the Hilton Wednesday morning to make suggestions.
“Many of the social distancing concerns are the reason why the City and State took initiative to move some of the residents to a second hotel in order to decrease the population at this location.”
Yesterday, the city moved 100 out of the 190 people at the Hilton to the Quality Inn motel in eastern New Orleans.
The Hilton was never meant to be a medical facility. And neither was it originally meant to house every homeless person during the course of the coronavirus crisis. The Governor’s Office of Homeland Security and Emergency Preparedness signed contracts with both hotels and is providing food service.
The city, meanwhile, indicated that there was a contract for security personnel with Pinnacle Security and Investigations. The city didn’t answer questions regarding what other city contracts had been signed for wrap-around services at the two sites.
It appears that the majority of the staffing is made up of hotel staff and security contractors. It was unclear whether the nurse was a volunteer or a paid contractor.
Leading homeless services nonprofit Unity of Greater New Orleans isn’t involved, according to executive director Martha Kegel. A spokesperson for Odyssey House Louisiana, a nonprofit focused on addiction recovery, said it sent outreach workers to the Hilton, but that it hadn’t been engaged formally by the city or state.
The city’s statement said that there were “highly qualified State personnel” at the site. The communications director for The Governor’s Office of Homeland Security and Emergency Preparedness, Mike Steele, said it was primarily a city project, and that his office had mainly stepped in to help to help secure federal disaster reimbursement funds.