Community Voices

At Home with the Homeless

Meet the new protocols–same as the old?

As this column goes to press, the viral trifecta that is COVID-19, RSV and influenza will be old news, but hopefully not dropped from the headlines. It would take something on the order of a DefCon 3 nuclear threat or a truly shocking revelation from the Trump Files (a propitiation to the Elder Gods by DJT, perhaps?) to knock this story completely off the 24/7 news feed.

It started with Respiratory Syncytial Virus (RSV), which, as the name suggests, affects the respiratory system by infecting the lungs and respiratory tract. It is a seasonal virus. Its symptoms resemble those for other respiratory ailments: fever, coughing, headache, etc. It particularly affects the elderly, children and the immunocompromised. Most important: there is no vaccine. Yet.

It’s not hard to picture what happened: with the seasonal focus on the flu and the latest COVID variants, RSV snuck in under the radar and by November 17, a week before Thanksgiving, the nation’s emergency rooms were filling with patients young and old suffering from one or two or even three of these viruses. In my case, as in many others, it was exposure to RSV, followed by COVID. I partly blame myself: carelessness with personal hygiene, especially dangerous in an environment like a shelter, where you are literally surrounded by hundreds of people with varying ages, health conditions and hygiene issues. But perhaps it was inevitable.

As you can imagine, this trifecta is an even bigger problem amongst the unhoused than in the general population. As hard as shelter providers work to sanitize their facilities–and they work their asses off, as your correspondent can attest–housing masses of men and women in dorm-like situations is by its nature going to create huge Petri dishes of bacteria and viruses looking for their next hosts.

In any event, I was diagnosed by symptoms –not an antibody test, although there is one–with RSV. (Why not an antibody test? You’ll have to ask the good folks at Kaiser.) I was returned to the shelter, staying there until testing positive for COVID. Then, and only then, was I put in a quarantine situation. Apparently coughing up lungfuls of phlegm, nausea and fever were insufficient. Before being quarantined, I isolated as much as possible, wore masks, and washed hands. But in the interim people may have been infected by yours truly.

Of the nine days in quarantine (I was told it would be 10) I have this to say: I was only tested once for COVID during my time there. I was not tested prior to my departure (Completion of Quarantine), nor were either of my two roommates. The beds were comfortable. Air quality was excellent, with a HEPA filter in the room. The food was first-rate, prepared at a local restaurant. Vitals (blood pressure, pulse, temperature and respiration) were taken twice daily. There were regular bed checks after hours, and smoke breaks for the nicotinics.

This was not special treatment for a VIP. This was the standard operating procedure for this particular recuperation facility; an amalgam of considerable care and baffling negligence. The quarantine period is dictated by how many days you’ve been isolated, not whether you test positive or negative before completion.

And this echoes the history of our response to COVID and its fellow travelers: shock, followed by panicky responses, then complacency. Ads seen constantly on social media: “We’re sick of COVID.” Do you think COVID gives a flying f@#$? Viruses don’t think. They replicate in order to exist. They don’t care if they kill babies and old people along the way. They don’t care if they take out artists and politicians who have great works yet to accomplish.

There is some good news. There are several promising vaccines for RSV currently undergoing clinical trials. And, hopefully, we’ve learned that over focusing on one or two nasty bugs can be a recipe for public health disasters.

But there’s still the matter of the long game. Dealing with the social and financial costs of the fallout from long COVID–everything from brain fog to organ failure. Creating vaccines for RSV and any other bugs that could make the jump from perennial nuisance to next pandemic. And trust me, if you’d heard the kid next to me in the ER, you’d be all over this. When he wasn’t making the barking cough so indicative of RSV, he was sobbing with exhaustion and fear.

The next time you see people wearing masks, whether alone in a car or in a store, give them slack. They’re doing it to protect you as well as themselves. You want to call them snowflakes on your social media? Go ahead. But in public, you respect an individual’s right to self-care, especially when it not only doesn’t infringe on yours, but acts to secure it.

Better days are coming… if we work for them.