Friday, June 14, 2024

Suffolk University created a non-congregate shelter for the unhoused last fall in unused rooms at its Nathan R. Miller Hall in Boston. (Photo: Michael J. Clark Suffolk/Suffolk University)

Unhoused people, housing advocates, concerned community members and students met to form the Right to Shelter organizing group in January, discussing plans to push for policies that would increase access to housing for all during the pandemic – the result of inaction by Cambridge’s government in the months prior. We should not have had to.

We are the Harvard Students for Housing Justice, a group of medical and dental students advocating for access to proper and dignified housing. In March 2020, we teamed up with city councillor Quinton Zondervan to petition Cambridge institutions to provide their vacant buildings as non-congregate shelters to address the combined homelessness and Covid-19 crises. Since this petition and the initial Right to Shelter meeting, hundreds of community members have expressed their frustration at council meetings for their neglect of unhoused people during the Covid-19 pandemic.

Cambridge, in conjunction with Harvard University and the Massachusetts Institute of Technology, opened a congregate shelter at Green Street designed to decongest and provide relief to some unhoused folks. As a new, more contagious strain of Covid-19 circulates, it is more urgent than ever to secure more non-congregate shelter for unhoused community members; know congregate shelters are a public health threat. Furthermore, the decision from the federal government to reimburse 100 percent of the costs of non-congregate shelters leaves the City Council and city manager no excuse to abstain from acting. We must learn from the mistakes of the first wave. Cambridge institutions actively neglected community members around them, but now have a chance to right their wrongs.

Public health experts have stated that congregate shelters for unhoused communities are not sufficient to prevent community spread of Covid-19. For example, a University of California, San Francisco, study of five shelters demonstrated that regular symptom screening, testing and universal mask wearing were not effective interventions for preventing outbreaks in high-risk settings. In the first wave, the average Covid-19 infection rate in congregate shelters of Cambridge and Greater Boston rose to 20 percent from early April to June, some even peaking at 40 percent.

While Harvard and MIT failed to provide non-congregate spaces in Cambridge, Suffolk University in Boston opened its doors for people experiencing homelessness.

Marisa Kelly, the Suffolk University president, championed the decision, saying “Boston is our home, and the university takes very seriously its responsibility to be a good citizen at a time when we are all being called upon to pitch in and help.” In partnership with Pine Street Inn, Suffolk University housed multiple people in one of its vacant dormitories, staffing the building with trained case management and homelessness service providers. This partnership was vital to reducing the number of unnecessary Covid-19 deaths among those who are most vulnerable.

One of us – Anand Chukka, a first-year medical student and member of Harvard Students for Housing Justice – was a housing case manager during the start of the pandemic. I saw that securing a spot at the Suffolk University dorms meant security in housing and health, and people were afraid to lose it. One woman at Suffolk was asked to go temporarily to a health care facility due to a potential Covid-19 exposure and expressed intense anxiety about losing her spot in the dorms. Above all, she was nervous about returning to a congregate setting where the Covid-19 prevalence was nearly 40 percent. With underlying chronic health conditions and constant stress from living in congregate shelters and on the street, she had a high risk of avoidable death. Her anxiety was justified.

The Suffolk University dorms also offered a much needed and deserved respite to many people living with the constant chaos of life between congregate shelters and the street. As a secondary health benefit, patients were able to rest and recharge. One man who stayed at the dorms expressed an immense amount of gratitude for the mental health benefits a non-congregate setting offered him. He felt more at peace, more interested in long-term supportive housing, and felt that staff in the dorms were more interested in connecting him with care. These benefits compounded the reduced stress from Covid-19; this man felt the safest he had felt in years, having spent much of the past five years between jail, street homelessness and shelter homelessness.

His experience corroborates the results of a Public Health-Seattle & King County early initiative to house people experiencing homelessness in hotels to stop the spread of Covid-19 in congregate shelters. The results of the initiative were reported by the University of Washington, noting that non-congregate hotel rooms successfully contained the spread of what otherwise would have become a public health disaster. The de-intensification strategy reduced rates of Covid-19 dramatically between March 2020 and August and came with a host of secondary benefits, including increased mental health and stability, increased hygiene access, decreased 911 emergency calls and, most importantly, increased exit from non-congregate hotel-based shelter to permanent supportive housing. The study showed that 60 percent of the hotel cohort transitioned to permanent supportive housing, compared with 13 percent of residents at a basic congregate shelter site. While it may be too early to draw conclusive evidence on the long-term impacts of this policy, the immediate primary and secondary health benefits cannot be overlooked.

As we approach the start of the second year of this pandemic, the large institutions of Cambridge and city government need to act differently than in 2020. Studies have shown that the non-congregate shelter option is the public health option, and neglecting it will only prolong the suffering that our unhoused neighbors and our communities face; after all, the health of all of us is intertwined.

Anand Chukka is a first-year Harvard Medical student. Lynn Hur is a candidate for a Doctor of Medicine degree at Harvard Medical School and former research fellow for the Stanford Center on Poverty & inequality. As members of Harvard Students for Housing Justice they have worked with city councillors Quinton Zondervan and Jivan Sobrinho-Wheeler on ensuring housing for the homeless.