The city’s largest men’s shelter experienced a massive COVID-19 outbreak this weekend when more than half of its 63 guests and staff members tested positive for coronavirus.
At Sunday Breakfast Rescue Mission, located in Center City, 35 people received positive test results for COVID-19 on Friday and Saturday, according to Jeremy Montgomery, CEO and president of the mission. The facility, which normally has room for 260 beds, was below capacity at the time, Montgomery said.
According to Montgomery, all of the people who tested positive were asymptomatic. This is a particular concern to homelessness service providers because social distancing is challenging in congregate settings, he said. Additionally, COVID-19 testing sites in Philadelphia will not test people unless they display symptoms, such as a cough or fever.
The local outbreak mirrors outbreaks reported in other congregate settings, like a Montgomery County jail and a Boston shelter, where everyone in the facilities was tested, and hundreds of asymptomatic people tested positive for the virus. As of May 7, thousands of Bucks, Chester, Delaware, and Montgomery County nursing home residents had tested positive for COVID-19, and at least 900 had died from coronavirus, too.
“That sent shockwaves amongst the homeless provider network because up until now, the guidance and protocols [have been] that you can’t get a test unless you have symptoms,” Montgomery said in an interview on April 27, referring to the Boston outbreak. “In a homeless situation, in which congregate sleeping arrangements are still the norm, it makes them truly vulnerable and at risk of containing this thing without knowing it.”
While Montgomery was aware of the risks, receiving so many positive test results in his shelter still came as a shock.
“We never anticipated 35 out of 63 to be testing positive,” Montgomery said. “The public health department, and the CDC, and the local, state, and federal public health officials, and the rest of us [are] still not understanding how this virus is evolving and infecting, and being spread.”
Tracing the outbreak
On April 30, Sunday Breakfast began contact tracing, a process used in public health to identify people who might have come into contact with a person infected by a disease, after two guests tested positive for COVID-19. Those guests were immediately hospitalized and quarantined in the Holiday Inn Express upon their discharge.
Through contact tracing, they were able to identify and quarantine 17 more guests who were in contact with the two people who tested positive. Eventually, the shelter workers discovered that all the guests and workers throughout the building were exposed to COVID-19, and they put the whole building under quarantine.
On May 7, the Philadelphia Department of Public Health tested everyone inside the facility because there were several positive cases and it was a congregate setting, according to city spokesperson Mike Dunn. It was the first time the Department of Public Health conducted a full building test, Dunn said.
Test results started trickling in on Friday evening into Saturday, Montgomery said. According to Montgomery, the 35 people who tested positive with the virus this Saturday included seven staff members and 28 guests. All of the guests and five staff members were transported to the Holiday Inn Express in Center City to quarantine, he said.
Sheltering in place
The Sunday Breakfast facility is now under a lockdown until May 23, meaning that they cannot admit any new guests, and no existing guests can leave. External services like meal and clothing distribution have been suspended until further notice.
Before the outbreak, Sunday Breakfast had taken various measures to protect their guests and staff and prevent the spread of the virus. They were giving masks to all the guests, using a non-touch thermometer to check guests’ and staff’s temperatures whenever they moved from room to room, and separating beds and dining areas more than six feet apart for social distancing. These measures are still in place within the facility, Montgomery said.
Additionally, all staff members except Montgomery and Erin Linden, the director of homeless services for Sunday Breakfast and Montgomery’s wife, are staying in the shelter overnight to limit exposure to others outside the facility. Montgomery and Linden both work in the shelter and live together, so they decided it’s safe to go back home at night, Montgomery said.
During the day, Montgomery has opened up the parking lot of the facility as a courtyard for the men and purchased two sets of cornhole that they can use to pass the quarantine time.
“They can’t go anywhere, and we don’t want this to feel like prison,” Montgomery said. “We’re trying to make things as comfortable as possible.”
As of now, the shelter does not have plans with the city to retest the people in the building unless someone displays symptoms, Montgomery said.
Utilizing city partnerships
In early April, before the Holiday Inn Express was available for individuals who needed to quarantine, Sunday Breakfast served as a city quarantine site. The facility sectioned off a room for people experiencing homeless and displaying symptoms of COVID-19, so they could isolate as a group with others showing symptoms. Other shelters, like Sacred Heart Recovery Residence, were also used as quarantine spaces during this time.
Sunday Breakfast housed six men who displayed symptoms of the virus in their quarantine room. Two of the people tested positive and were transferred to a hospital. One person, after they were medically cleared, returned to the shelter. There is no confirmed connection between previous cases and the current outbreak, Montgomery said.
So far, Philadelphia’s Office of Homeless Services has advocated for people who are experiencing homelessness to seek shelter and not sleep outdoors during the pandemic.
“We think that people are safer indoors,” OHS Director Liz Hersh said on April 28, stressing the importance of accommodations like protection from harsh weather and the ability to receive three meals a day. “They have a bed; they’re safe.”
Still, the unknowns of COVID-19 leave room for mistakes and confusion, she added.
“The fact of the matter is, nobody has really figured this out,” Hersh said. “There’s no scientific study, no set of values that we have. We work very, very, hard to have our shelters be safe places for people.”
The Philadelphia Department of Health is now reviewing its policies regarding testing in congregate settings to determine if they should change, Dunn said.
Translator: N/A / Editors: Zari Tarazona, Jillian Bauer-Reese, Erin Blewett / Page Designer: Jillian Bauer-Reese