Mission battles to keep flu at bay

Tom Cogsdell, 42, an off-and-on resident of the Northlands Rescue Mission in Grand Forks, has a bed in the fifth-floor men’s dormitory.

Influenza may live there, too.

“There are 33 beds and three cots in that one room,” Cogsdell said. “You hear the coughing all night.”

Homeless shelters — like day care centers, schools, jails, colleges and nursing homes — put many people in close quarters and may act as petri dishes, potential breeding grounds for a virus like H1N1 flu.

According to a national council on health care for the homeless, people in shelters “may bear particular risk of contracting influenza because of crowded and unsanitary living conditions, stressed immune systems, and close contact with highly transient persons.”

Like Cogsdell, Northlands resident Alan Arnold, 54, praises Northlands for making the refuge as sanitary and healthy as possible, given the circumstances. They also take what steps they can to keep themselves healthy in flu season.

“I keep Germ-X (hand sanitizer) in my pocket, and I use it pretty regularly,” Arnold said. “After I use the toilet and wash my hands, I use it. Whenever I use utensils … whenever I shake hands with someone …

“I always cover a cough,” he added. “I make sure my hygiene is at high levels.”

Some shelters across the nation require temperature checks when clients check in, to make sure they don’t bring fever into dorms. Some establish isolation wards for sick residents, and some reduce the number of beds they offer or space beds to increase “social distancing” and lower the chance of H1N1 flu spreading.

But managers at Northlands don’t have all those options, and in fact they have appealed in recent weeks for donations of additional beds to accommodate record numbers of clients. On Tuesday, the daily counts stood at 95 men and 17 women.

“We can put some people in smaller rooms, where we can segregate the sick,” said Dave Sena, executive director of the mission. “But we have very limited space for moving beds around.”

The mission maintains high health and sanitary conditions, Sena said, and a van and driver are available to carry residents to a clinic or hospital if someone needs quick medical attention.

“We’ve talked about the what-ifs,” he said. “We haven’t developed a set plan, but we have some experience in dealing with sickness. We have to deal with sickness every year.

“We’re trying to keep people off the street, out of the cold, and that can be a life or death thing. I don’t mean to minimize the flu, but the risk (from this strain) appears to be moderate.”

Cogsdell and Arnold both gave mission managers and cleaning crews high marks.

“The halls are continually getting mopped, and the bathrooms are continually getting cleaned,” Cogsdell said.

“But this is flu season. I had the aches and pains last week. It lasted two or three days, and I just took it as I caught something.”

One H1N1 case so far among staff

At least one member of Sena’s staff was out for several days this fall with H1N1 flu, he said. That person has recovered and returned to work.

“There have been quite a few other cases of flu and colds, more this year than in past years,” he said. “I’d say that a third to a half of the shelter’s staff has been sick. At Bible study this morning, a number of people were sick. We encouraged them to stay home, stay in bed, and not come back until they’re well.”

Without lab testing, there’s no way to know for sure whether a flu-like illness is H1N1. But medical authorities have said that the “swine flu,” as it’s also called, is by far the primary flu strain circulating here now.

“There is a heightened awareness among the staff because of the H1N1 flu,” Sena said. “We try to keep track of our guys, keep an eye on them to monitor their health.”

Few of the residents are in established priority groups for receiving H1N1 vaccinations, so they will have to wait until supplies are available for the general population, Sena said. Vaccination against seasonal flu also remains “a work in progress.”

Sena said he expects the Grand Forks City Council to act soon on a community development block grant that would provide a new ventilation system for the shelter’s dormitories, which would have health benefits.

“We have had contact with other missions about H1N1 and how they’re handling it,” Sena said. “Some are being a lot more diligent about this, but most appear to be operating normally.”

Normal at Northlands Rescue Mission includes providing residents with over-the-counter medications to fight colds and flu. “People in the community donate those, and that’s very helpful,” Sena said. “But they have to be alcohol-free.”

All prescription drugs brought by residents are confiscated, safeguarded in the office and dispensed by staff.

Hand sanitizers are available, and cleaning crews use disinfectant on doorknobs, stairwell railings and other common surfaces. “Those are procedures we’ve been doing a long time because we’re a confined area, a high-risk environment,” Sena said. “All new residents are required to be tested for tuberculosis, and staff members are tested once a year.”

Health students from UND routinely work with mission residents on hygiene issues and managing chronic diseases, he said.

Isolating cases can be difficult

The Centers for Disease Control and Prevention has issued guidelines for preventing or controlling the spread of H1N1 in the diverse, transient and often packed populations of homeless shelters.

Most of the guidelines parallel those suggested for the general public, including vaccination, the covering of coughs and sneezes, hand washing, using sanitizers and cleaning all common areas within the shelter.

The CDC urges shelter clients, staff and volunteers “to immediately inform shelter management if they have an influenza-like illness,” and those people should be directed to alternative care sites, if available.

Staff and volunteers with influenza-like illnesses should stay home for at least 24 hours after their fever is gone except to get medical care. The fever should be gone without the use of a fever-reducing medicine.

Shelter managers should have a plan for evaluating the health status of residents and staff — such as daily temperature checks for clients who may have been in contact with people with influenza-like symptoms — and for treatment, including the isolation of suspected and confirmed cases.

Winnipeg homeless get vaccine

In Toronto, a coalition of community groups has asked the city to open new, less crowded shelters for the homeless to help prevent the spread of the H1N1 virus. Cathy Crowe, a street nurse and co-founder of the Toronto Disaster Relief Committee, told the Canadian Press news service last week that many existing shelters aren’t equipped to fight the flu.

“It’s never been a healthy environment,” she said, describing crowded church-basement shelters where people generally sleep on floor mats.

In Winnipeg, a traveling vaccination clinic visited downtown homeless shelters last week and distributed 120 doses of the H1N1 vaccine.

In Salt Lake City, advocates for the homeless are promoting an overnight ward for transient patients with H1N1, the Salt Lake Tribune reported.

“We don’t have the ability to say, ‘Get in bed and rest for five days,’ ” said Jennifer Hyvonen, spokeswoman for a nonprofit clinic for the homeless. “Instead, they’re going to go to an overcrowded shelter or they’re going to go onto the street.”

She said the clinic hopes to raise $80,000 in cash donations and $75,000 in donated supplies and labor to open the new wing by Thanksgiving.

Reach Haga at (701) 780-1102; (800) 477-6572, ext. 102; or send e-mail to chaga@gfherald.com.

Tags: northlands rescue mission, homeless shelters, swine flu, h1n1 flu, gf and egf, local news, grand forks, influenza, health