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With hundreds of homeless shelter residents testing positive for COVID-19 in recent weeks, the city has allowed those deemed to have “mild” symptoms to self-quarantine inside shelter units or isolation hotel rooms.

But at least four people in those situations have succumbed to the virus in the last two weeks, THE CITY has learned — raising stark questions about who’s diagnosing and then keeping an eye on some of New York’s most vulnerable coronavirus patients.

On April 9, a resident with what the Department of Homeless Services labeled “mild” symptoms suddenly took a drastic turn for the worse, and died due to COVID-19 while self-quarantining within a city-run family shelter.

It happened again the next day: a resident who’d tested positive and was shipped off to an isolation hotel died.

Then on Friday, DHS learned from the city’s chief medical examiner that two more homeless people who passed away while living in city-run shelters had died from coronavirus.

DHS wouldn’t discuss these two cases, except to say the people had gone through isolation or hospitalization and were then “cleared” for re-entry to a shelter. The two people were either never tested or had tested positive, the agency said.

Monitoring Required

How all this came to be is not clear: All homeless shelter residents are supposed to be carefully monitored for symptoms, and those who have tested positive and been assigned to isolation are required to be checked regularly by medical staff on site 24/7.

But the virus is known to cause patients’ conditions to drastically worsen quickly, and appears to have foiled the city’s attempts to keep shelter residents out of harm’s way.

The Franklin Avenue Women’s Shelter in The Bronx. Credit: Google Maps

The resident who died April 9 had tested positive for coronavirus, but, according to DHS, had been “only exhibiting mild illness” and did not require intensive hospital care. The resident was allowed to self-isolate within a family shelter.

“Individuals who present with mild illness are advised by their health care provider to self-isolate and self-monitor. This individual, who was part of a family household, was doing so in their own unit,” Isaac McGinn, a DHS spokesperson, wrote in response to THE CITY’s questions.

At some point, the resident’s condition suddenly worsened.

“While we cannot disclose confidential case details, we can confirm that EMS was contacted but was unable to revive the individual,” McGinn wrote.

“As health experts have said, individuals who are COVID-positive who also have underlying conditions may be more susceptible to COVID-related complications, which can manifest suddenly,” he added.

Unanswered Questions

Questioned about the circumstances around these recent deaths, DHS officials disclosed few details — including declining to identify the victims or the shelters where they stayed. Officials also wouldn’t say who made the determinations of “mild illness” — and how long each resident had been in quarantine before passing away.

They also could not give definitive answers to questions about the two deaths found after the fact by the medical examiner to have been caused by COVID-19.

McGinn wrote that those two cases were either:

• A resident “who never expressed/experienced symptoms (and) passed away from what appeared to be another condition (i.e. heart failure), but whose death was later determined to be COVID-caused.”

• A resident who had tested positive, was deemed a mild case or was found “medically appropriate for discharge” back to a shelter after being hospitalized. After returning to shelter, the resident “took a sudden turn for the worse.”

McGinn wrote that the protocol for releasing an infected resident who’s gone through isolation back to shelter is “based on the latest guidance from city health experts. This includes: no symptoms for the past seven days, no fever for the past three days, survey client to ensure they are feeling better.”

More Than 40 Dead

Since the first New York City resident tested positive for COVID-19 on March 1, the managers of the city’s homeless shelters have watched as the number of residents infected with the virus has risen markedly.

As of Monday, 617 homeless New Yorkers — including 23 living on the streets and in subways — had tested positive, according to DHS. Some 123 had been hospitalized and 43 had died of complications wrought by the deadly pathogen.

As THE CITY has documented, social distancing has been nearly impossible at the 30th Street Men’s Shelter, the city’s biggest, with residents crowding around cafeteria tables during mealtime.

A cafeteria in the 30th Street Men’s Shelter was packed with people in late March. Credit: Obtained by THE CITY

The protocol of shipping those deemed to have “mild” symptoms out of shelters and into isolation hotels, or allowing them to quarantine within shelter units, has been the foundation of DHS’ effort to contain the spread of the virus within crowded city-run shelters.

When a COVID-positive resident winds up in a quarantine unit, they are supposed to be regularly and carefully watched by trained medical workers through “wellness checks.”

According to the latest DHS protocol, dated April 3, each resident is to get two checks per shift each day. During each check, “medical staff must ask about symptoms, including the presence of fever, cough, sore throat, or shortness of breath.”

Staff must call 911 if a client reports or displays symptoms. The same holds true if a resident doesn’t respond to staff trying to make a wellness check. Staff must enter the room and try to wake the patient, and if the patient doesn’t respond, staff must call 911.

For each of these interactions, medical staff are required to fill out DHS COVID-19 Isolation Site Wellness Check forms and submit them each evening to DHS.

‘Just Dumped There’

A worker at the Franklin Women’s Shelter in The Bronx’s Morrisania neighborhood — the city’s main intake shelter for women — told THE CITY that clients placed in isolation units in the last few weeks have said they were not monitored, and that medical staff was only on the premises periodically.

“There’s no intervention,” said the worker, who spoke on condition of anonymity. “They’re just dumped there. If you have all of these health problems, you’re just sent there until the symptoms worsen.”

The worker said within the last week the shelter sent a 79-year-old shelter resident with a fever of 101 degrees and emphysema to an isolation hotel. She wound up back at Franklin after about a week in quarantine there.

A resident of an isolation hotel in Queens described similar circumstances while she was staying there, saying medical workers barely interacted with residents.

McGinn emphasized that all residents placed in isolation hotels or self-quarantine within shelters are carefully monitored on a daily basis.

“Care in these settings is observational, with wellness checks provided at a distance,” he wrote. “If any individual expresses that their symptoms have worsened or needs more care, we connect them to a hospital.”

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