Across Washington state and the country, there have been outbreaks of COVID-19 in many settings. Some of the most difficult outbreaks to control and manage are those in congregate settings. Washington state and Spokane County have had their share of these outbreaks to manage. In Spokane County, the Spokane Regional Health District (SRHD) epidemiology team has managed outbreaks in homeless shelters, family shelters, drug treatment centers, behavioral health facilities, county correctional facilities, supported living facilities and group homes.

To mitigate spread in these difficult-to-control settings, SRHD’s communicable disease and epidemiology team provided staff at these facilities with guidance on and assistance with key mitigation measures. These measures largely focused on implementing protocols for masking, physical distancing, testing, infection prevention, isolation and quarantine, and vaccination. SRHD provided training and support on testing in various settings, including at treatment centers and correctional facilities. Personnel at these facilities have since been able to implement testing programs of their own, following the guidance and recommendations of the health district.

In addition to guidance and training, SRHD mobile teams have provided rapid antigen tests at homeless shelters since fall 2020. This aggressive testing approach in congregate facilities found asymptomatic COVID-19 cases who could then be quickly isolated and their contacts quarantined to prevent risk of further transmission. If a COVID-19 case was experiencing homelessness, SRHD provided transport to one of Spokane county’s isolation facilities while the individual was infectious. At this time, a county isolation facility remains in use for these situations.

Outbreaks in shelters and other congregate settings have decreased significantly since vaccinations began. Correctional facilities and treatment centers now have on-site vaccination programs in place and SRHD mobile teams have been vaccinating in shelters and other community locations to improve access for certain populations since early spring 2021. SRHD vaccine teams have given over 1,300 COVID-19 vaccines to individuals experiencing homelessness. Several other community partners are also vaccinating populations that can be difficult to reach. This work has been a great success and a central focus in efforts to prevent these challenging outbreaks from occurring.

Critically important to the implementation of these measures was the development of close relationships with the City of Spokane, shelter directors, treatment facility directors, county detention services, and many other community partners. To our partner providers, thank you for all you are doing to help our county move through the pandemic. As our healthcare partners in Spokane County, please:

• Continue to encourage vaccination for anyone who is eligible.
• Continue to report any COVID-19 cases to SRHD if you believe the individual may be experiencing homelessness or living in a congregate setting.