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GALLUP – It’s a Thursday afternoon, and paramedic Christian Root-Bowman has just finished checking on his COVID-19 patients. He’s wearing three masks, one on top of another, a face shield, gloves, scrubs and a protective gown.
He’s not at the hospital. He’s at a Howard Johnson hotel in Gallup.
Root-Bowman came to Gallup from Albuquerque two weeks ago as a volunteer with the New Mexico Medical Reserve Corps and he said he’s been struck by the scale of the virus in McKinley County.
“In Albuquerque, I don’t personally know anyone who has gotten the coronavirus, I don’t know anyone who’s gotten sick from it, and I certainly don’t know anyone who has died from it,” he said. “But here in Gallup, it has touched everyone. You talk to anyone in the city … they know someone who has either gotten sick or died.”
Teams of doctors, nurses and paramedics have been working around the clock to staff four hotels around the city that are housing COVID-19 patients who have nowhere else to go.
While the pandemic has presented daunting challenges for Native American and border town communities, it has also prompted creative solutions. Over the past month and a half, medical professionals and community organizations say they have housed over 400 people in hotel rooms to try to keep them from infecting others with the virus.
Some staying in the hotels are experiencing homelessness and came from the Na’nizhoozhi Center Inc. detox center – where 170 people were exposed to the virus – and others live in group homes or are dealing with substance abuse issues. However, the rooms are also occupied by health care workers or those who have the virus, or have been exposed, but don’t have a place to quarantine away from their families.
McKinley County continues to have the highest number of cases in the state, despite having 3.5% of its population, and it’s too soon to tell whether the hotel initiative has lessened the spread of the virus. But municipalities across the country are also housing the homeless and other vulnerable populations in hotels during the pandemic. In California, Gov. Gavin Newsom secured funding from the federal government to house tens of thousands of the state’s homeless in hotels, in an effort to slow the spread of the virus. The effort, Project Roomkey, had over 2,000 clients housed as of last week, and a total of 3,100 rooms available across Los Angeles.
In New Mexico, state officials say there are a total of 2,000 hotel beds available for people who need to be isolated, and as of Tuesday night, 267 people were being housed, 60% of whom are getting some level of medical supervision.
In Gallup, the Indian Health Service, the Navajo Nation, New Mexico Department of Health, the nonprofit Community Outreach and Patient Empowerment, or COPE, organization and local hotels have been working to isolate people since late March, and they estimate there are about 120 people in quarantine in hotels and motels around the city, although that figure can change daily. The initiative is paid for and supported by the state Health Department and the Navajo Nation, and a reduced rate is given for the rooms for COVID patients.
Transients at high risk
McKinley County has some of the highest rates of homelessness in New Mexico, according to a 2017 study that counted 197 homeless people in the county. Advocates suspect there may be twice as many.
Since many of the people who were exposed to COVID-19 at the detox center are living on the streets, it was difficult to find them for testing after they left the facility. Many had gone home to their families on the Navajo Nation or didn’t have a telephone or fixed address where they could be reached.
Dr. Christopher Novak, medical director of the DOH Public Health Division, said state, tribal and federal experts launched an aggressive tracing and testing program after the initial outbreak. But there have been many challenges in keeping people from spreading the virus.
“Sometimes it’s not so easy for these people to follow our recommendations, like social distancing,” Novak said. “There’s also the chicken and egg problem of substance abuse issues for a lot of people experiencing homelessness, which does complicate things.”
Nitumigaabow Champagne, the executive director of COPE, said that although crowding in family homes, substance use disorders, or other behavioral health issues have led many Native Americans to start living transient lifestyles, they frequently return to their communities and don’t consider themselves homeless. This also contributed to COVID-19 spreading from people at the center to entire families.
“It’s customary for many of these individuals to bounce from community to community, with Gallup being a hub zone,” Champagne said. “… Everybody knows everybody.”
He said IHS has been testing transient people and others who are particularly vulnerable even if they don’t have symptoms, so they can isolate patients in the hotel rooms – which he calls “respiratory shelters” – before they come into contact with lots of other people. Champagne said that the virus has a higher infection rate among the city’s transient population than the general population but that housing asymptomatic people has prevented a high mortality rate among transients.
“There’s a risk for many of these people to be feeling fine and then have a quick turnaround to getting very sick,” he said. “When they have this access to health care, it’s a lot easier to dial 0 or dial 911 than to find someone on the street to help them get to a hospital.”
He said he thinks infection rates through the general population have been slowed, partly because the groups distributed masks and public health information early in the crisis.
“We were already working with this population, so we have built up that trust,” Champagne said. “We don’t just say, ‘Here, go get tested,’ because that would never happen. We transport them, and we go get them tested, and we’re there with them through that process. Then we let them know that they can come to a respiratory shelter.”
Tammy Arnold, a 29-year-old security guard at a casino east of Gallup, said that after she found out she had gotten COVID-19 she knew she couldn’t stay in her family’s small three-bedroom house near Yah-ta-hey, New Mexico, on the Navajo Nation.
Arnold, her mother, niece and aunt all contracted the virus from her cousin, who had stayed at the Na’nizhoozhi detox center in early April when there was an outbreak.
She said that a couple of days after she tested positive, a health official called and asked if she needed a place to stay. Minutes later, she was told they had a room for her and her 20-year-old niece, who also had the virus.
“I think if me and my oldest niece had stayed at home, they would have probably caught it,” Arnold said, referring to her sister and youngest niece. “They lived in the same house.”
Arnold and her niece checked into the Howard Johnson hotel in Gallup on May 1 and although neither got sick enough to go to the hospital, some days were better than others. Arnold said she had a severe headache and high fever and her throat and chest hurt from coughing. Her first interview with the Journal was punctuated with coughing fits, but she was feeling better by the end of last week and using her inhaler only once a day.
Arnold said she mostly spent her time in quarantine sleeping, watching television and scrolling through Facebook. She was given meals – bologna sandwiches or hot dogs on Mother’s Day – but just as often ended up ordering delivery from nearby restaurants through DoorDash.
Working out of the hotels, Root-Bowman and other medical personnel take note of an occupant’s blood pressure, oxygen levels, and any fevers or coughs, and they provide meals, clothing and medication. Some days, one or two people are transferred to the hospital as their symptoms worsen.
COPE is also running a “green shelter” to house people who don’t have the virus or who have recovered.
Nashat Khalaf, the owner of the Howard Johnson and Days Inn, both of which are participating in the program, said it has been an adjustment for him and his employees, but he sees it as a service to the community.
“It takes a lot of time and work for our staff to help take care of these patients and help this community,” Khalaf said. “It has changed our schedule. Everyone wears a full mask and gloves when going in to clean the rooms. I have other guests, but the traffic has changed quite a bit.”
All the hotel rooms being used as isolation sites must have a door that faces the parking lot, with restricted access to the lobby and other hotel areas because there are other guests in the buildings as well. Because there are multiple hotels participating in the program, no one facility exceeds the capacity level mandated by state public health orders.
The program may continue through July, depending on how the virus runs its course, Champagne said.
He said that although many have gone into quarantine, others have refused.
“Not everybody would come in,” Champagne said. “There was a very small minority who was positive who refused to. … There have been some individuals who have passed on in the streets, whether from COVID-19 or from elements or something else, we don’t know exactly.”
But he said others who were struggling with addiction were able to use the time to get the support, counseling and help they needed.
“When they came out of our respiratory shelters, many of them went home to their families clean and sober,” Champagne said. “Having that clear mind, it felt so good to restart their lives.”
EDITOR’S NOTE: This story has been updated to correct Christian Root-Bowman’s title.
This story has been supported by the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems.