Historically poor air quality brought increasing health risks to the forefront of the houseless community in Portland this week as local government agencies and nearly 30 different community groups rushed to distribute thousands of KN95 masks and help people sleeping outside secure shelter away from the toxic air.
But hold times exceeding an hour for callers to the regional helpline and hesitancy among people experiencing homelessness to leave the safety of their established camps and their belongings amid a pandemic means that hundreds, if not thousands, of people continue to live and sleep outdoors as thick smoke blankets the region.
“In a weird way, COVID-19 has prepared us to be very nimble and scale up so quickly, and bring in a lot of partners” said Denis Theriault, communications coordinator for the Joint Office of Homeless Services between Multnomah County and the city of Portland. “If we’re going to find silver linings, I would argue that is one of them.”
The Joint Office helped coordinate the opening of two 24-hour smoke relief shelters with a capacity for 99 people each late last week, one at the Charles Jordan Community Center in St. John’s and another at the Oregon Convention Center — separate from the pandemic shelter opened in March and from the evacuation shelter for Clackamas County residents currently operated by the American Red Cross.
A third site, the Mount Scott Community Center, remains prepped in case other sites reach capacity. But so far, Theriault said, they hadn’t.
Tuesday night, the adults-only shelters saw 40 people at the Charles Jordan Center and nearly 90 at the convention center. Theriault added that the Joint Office and groups providing outreach were able to house nearly a dozen families with children in existing shelters. That’s out of the more than 2,000 people who are likely sleeping outside in Multnomah County, according to the 2019 Point-in-Time count, the most recent estimate on the number of people sleeping unsheltered in the county.
“It takes time for people to decide, they have their things with them. Do they want to pack up somewhere else, leave their belongings behind, what’s that calculus look like?” Theriault told Street Roots. “They’re toughing it out in a way they might not during regular severe weather.”
Theriault added that the shelters do not require identification upon entry, and that people did not need to call the county’s information hotline, 211, before showing up for intake however they could call the line to help arrange transportation to the site.
Some organizations on the ground providing outreach in coordination with the Joint Office expressed fear that long hold times for people calling the 211 line were hindering access to shelters and supports for houseless people in search of help.
“Because of the recent fires, we do tell people they can call into 211,” said Benji Vuong, a community organizer who coordinates outreach for the grassroots organization Free Hot Soup. “The only common consensus that we’re hearing from different places is that it takes a long time for people to get (through).”
Since the start of the pandemic, Free Hot Soup, which usually operates a hot meal service in Director’s Park downtown has worked to mobilize its efforts and distribute prepared food to people across the city camping alone and in encampments. And when wildfire smoke coated the city in a thick sheet of gray, Vuong and other organizers battled headaches, pain and fatigue alongside the people they brought meals and masks to this week.
Vuong told Street Roots he’d been helping one person, who requires translation services to use 211, try and connect with the hotline. But he said that with wait times upward of an hour, he couldn’t assist because that would mean leaving more than 90 hot meals waiting to be delivered in order to provide guidance to the man.
“It becomes a problem because I can’t sit there with the person to translate and wait on the call for an hour,” he said.
He fears the wait was caused by a capacity issue that the county hasn’t provided a solution for yet.
Cara Kangas, director of partnerships at 211info, told Street Roots that as anticipated in an emergency event, a large influx of phonecalls impacted wait times primarily during the daytime for callers statewide over the last week and a half. Kangas added that there are staff specifically dedicated to handling calls related to shelter and transportation arrangements, and that as media reports urge the public to call the line, wait times tend to increase.
211info data revealed that on Sept.15, 21 calls were place to the line regarding clean air shelters for unsheltered people in the wake of the wildfires. In total the call line recieved 234 contacts relating to the fires statewide, more than 100 stemming from Clackamas and Multnomah County, on top of general 211 information calls.
Street Roots spoke with one person who told organizers at Free Hot Soup they were denied service at the Charles Jordan Community Center on Friday night, but Theriault confirmed that the incident — which he said circulated widely on social media — was false and that the person was asked to leave Saturday morning after pulling out a knife at the center.
Gov. Kate Brown issued an executive order to halt price-gouging among hotels across Oregon as evacuees fled the state’s coastal and southern rural counties after reports of unusual price influxes at some hotels. But those involved in issuing pandemic relief motel vouchers to vulnerable populations sleeping outside say the ability for people to get rooms has not been impacted.
“At any given time, our motel vouchers are limited resources. We don’t make them available for necessarily anybody who calls,” said director of homeless and housing support at Cascadia Behavioral Health Care, Kim James. “I could say that rooms were scarce, yes. I could also say that because of the resources that we have, not just in terms of crisis, we are able to navigate differently. The folks that we serve were able to access what they needed to in the moment.”
James added that outreach workers reportedly had no issues during the week getting people sleeping outside into the county’s smoke relief centers, although many chose to remain in place out of concern for the coronavirus or not wanting to leave their belongings behind.
She said not much has changed since the smoke rolled into town, but that experience has only further highlighted the resilience of the houseless people in Portland already struggling through a pandemic.
“My thoughts are the overall impact of people living their personal lives out in public hasn’t really changed,” she said. “The resiliency, the ability to adapt to these ever-changing, unprecedented times is something we try to recognize, encourage and applaud.”
Air quality remains a health concern for houseless communities
The Air Quality Index, which measures the level of health risk associated with air quality on a 1 to 500 scale, registered a hazardous and historic 477 (the previous high was 157 in 2017, during the Eagle Creek gorge fire) in the metro area Saturday but the smoke was even thicker in communities south of the city and along the coast — areas where the majority of Oregon’s houseless families remain, according to the state’s most recent Point-in-Time count.
Oregon isn’t the first place to be bathed in a cloud of unbreathable smoke this year. Roughly 80% of Australia’s total population spent months inhaling smokey air between last October and this February after major bushfires burned through the southeast portion of the country. Research out of the University of Tasmania, published in March, used data modelling to estimate that the air pollution may have led to more than 400 premature deaths and thousands of hospitalizations at the height of the fire crisis.
The impact of pollution caused by wildfires is particularly concerning among houseless communities, who are disproportionately impacted by respiratory diseases. In the Bay Area last month, air quality was considered “unhealthy” for weeks and remains high. Director of University of California San Francisco’s homeless and housing initiative, Margot Kushel MD, told Salon that the intersections between the coronavirus pandemic, homelessness and wildfires represented a “crisis within a crisis within a crisis.”
Those layers are not lost on Bill Toepper, MD, medical director at Portland Street Medicine, a non-profit organization composed of volunteer medical professionals who provide aid to people living outside in and around Portland. He acknowledges that no one knows for certain how the high levels of smoke may impact the health of Portlanders.
Toepper told Street Roots that Portland Street Medicine has continued its regular outreach amidst the poor air quality, and that eye irritation, coughing — and perhaps most prominently — requests for asthma inhalers were on the rise since the smoke rolled in last week as public areas like libraries that might usually provide respite from hazardous air remained shut due to smoke and pandemic concerns.
“The incidences of chronic lung disease is so much higher in the houseless population compared to the general population, and we know for example, when the houseless population does contract a respiratory illness, their likelihood of going into intensive care is so much higher than the general population,” he added.
Toepper told Street Roots it’s reasonable to anticipate that if people living outside with chronic lung diseases exacerbated by this week’s smoke were to contract COVID-19, they’d face a higher likelihood of getting a severe case. And, he said that many people may be avoiding medical care at this time to avoid learning their COVID-19 status, which could bring an added layer of stress related to contact tracing.
But, that’s not the only barrier houseless people are facing amidst a pandemic compounded by lowered air quality. The moment highlights the inequities inherent in health care systems that are increasingly relying on virtual and telephone-based appointments to lower the risk of spreading the coronavirus.
“If you really did want to see your (primary care physician), so many of the visits are now telephonic or electronic and that’s not doable for much of the houseless community,” he added. “The barriers that have always been there are greater now in COVID and even just the effects of the smoke.”
Portland Street Medicine is working to get an electronic medical record in place that would allow its volunteer doctors to not only prescribe, but distribute albuterol asthma inhalers, which treat symptoms associated with asthma and chronic obstructive pulmonary disease to the people sleeping outside who need them. Toepper said that even without the fires, the need for inhalers, and particularly albuterol inhalers, remains tangible.
“If there was one medicine we could hand out to people that would be it,” he said.
Tom Roick, air quality monitoring manager for the Oregon Department of Environmental Quality told the Willamette Week this month that due to increasingly warm and dry summers, Portland could expect to see a more prominent pattern of air pollution sparked by fires in the future.
Vuong, of Free Hot Soup, told Street Roots Wednesday that he felt the city and county government, outside of the Joint Office of Homeless Services, should better discuss climate change emergency preparedness for the houseless communities in Portland and possibly consider using vacant buildings for smoke shelters in the future.
“We know with climate change this is something that’s going to be ongoing and recurring every year, and get worse every year.” Vuong said. “If we’re going to talk about the security of this issue, the number one thing, the number one factor that I feel like is on almost everyone’s mind is, where are we going to go from here?”
The Joint Office of Homeless Services is accepting donations of supplies including blankets, tarps, hygiene products and water. To learn more about how to donate these supplies, contact Celeste Duvall, outreach coordinator for the Joint Office, at celeste.duvall@multco.us or 971-940-5582.
This article was updated on 9/16/2020 to include comments and information the helpline 211info.
Correction: A previous version of this article stated 211info recieved 234 calls relating to wildfires in Oregon since Sept.15. These calls were all made on Sept.15. We regret the error.
Email Street Roots Staff Reporter Jessica Pollard at jessica@streetroots.org. Follow @JessicaJPollard on Twitter.