“Where can we go? The overflow shelter’s not even open,” Jason said. For now, the two are sleeping in an abandoned building. At night, Jason takes off his clothes, piling his shirt, overcoat and hoodie on the ground with blankets to create a makeshift bed for Mandy.

 Mandy worries about her child and the future of their family. She wants to keep her baby, but with limited food and no housing, she’s had to consider adoption. “Who thinks about giving their first child up for adoption because they don’t have a place to let her sleep?” she said, her voice breaking.“Who thinks like that?”

Living on the street has always been tough, but since COVID-19 arrived in New Haven, Mandy said that “now it’s even harder.”

FINDING FOOD ON THE FRONTLINES

On weekday mornings, before the pandemic began, Jason and Mandy liked to sit in the corner of Sunrise Cafe. A popular soup kitchen in the basement of St. Paul & St. James Church, Sunrise Cafe serves restaurant-style breakfasts to New Haven’s homeless and impoverished. For Jason and Mandy, it was about comfort and a sense of community.

Now, the tables, often set with brightly colored tablecloths and vases of flowers, are in storage. The folding chairs have been stacked away. Guests — who used to sit and socialize, drinking coffee and catching up with friends — are now only allowed to pick up prepackaged breakfasts from gloved and masked volunteers.

“It was a place where people could first of all just hang out and relax,” said André Medeiros, the executive director of Sunrise Cafe. “The real thing you don’t want to do is to lose contact with the population.”

The transition to grab-and-go meals has become the new norm for most of the city’s soup kitchens and pantries. “There is a need for community and solidarity in a time like this,” said James Cramer, the executive director of Loaves and Fishes, a food pantry that operates out of the same space as Sunrise Cafe. “We used to be really proud of the fact that we were a space where people could come and have a conversation and feel safe. That’s just not possible anymore because of COVID-19 concerns.”

Like Sunrise Cafe, Loaves and Fishes is more than just a place where people can get food. It provides an opportunity for guests who are disconnected from social services to interact with health care providers and outreach workers. For people who are new to homelessness, soup kitchens and pantries are usually the first points of contact for help with services such as housing and medical needs. With the COVID-19 outbreak, most of these services have all but evaporated.

Over the past two months, food pantry usership has doubled. Last week, Downtown Evening Soup Kitchen, or DESK, served more than 260 households, an increase of 120 families compared to this time last year. According to Connecticut’s Department of Labor, in March, over 7,600 Connecticut residents lost their jobs and food stamp applications quadrupled, putting additional strain on an already overburdened network of emergency food resources. Pantry numbers are projected to increase in the coming months.

Since the outbreak, hundreds of people have been turned away from large food distribution sites in New Haven after food ran out — at a recent distribution at Hamden Middle School organized by the Connecticut Food Bank, the line of waiting cars stretched almost a mile. Four hundred families left empty-handed.

“We are noticing a bunch of new people that we’ve never seen before,” said Dave O’Sullivan, the coordinator of Community Soup Kitchen across from the Yale bookstore on Broadway. “We are assuming they are people who were laid off from local restaurants or small businesses that are no longer operating.”

Many pantries are also operating with limited staff. Most volunteers used to come in with local religious service organizations and school groups. These days, those that come trickle in alone. For organizations like Sunrise Cafe, whose volunteer base is largely comprised of retirees and university students, the transition has been especially tough. Older residents have been advised against volunteering for their own safety and, with campus closures, most student volunteers are gone.

Others are concerned about interruptions in the food supply to pantries. For now, fresh produce and nutritious options are still available. Some pantries rely heavily on donations from restaurants and households. But with shutdowns, restaurants are no longer carrying a surplus of food and individuals are less likely to donate. The Connecticut Food Bank has stepped up to fill the deficit, but concerns remain about the nonprofit’s ability to meet the surging demand.

 “I think our greatest concern right now is what is going to be happening to the food supply in the coming months,” O’Sullivan said. “Meat processing plants are shutting down, truck drivers are getting ill. Is the food system in America on the edge of falling apart?”

 So far, there are large food distribution sites in Hamden, Dixwell, Fair Haven and West Haven. Food in Service to the Homebound, Mutual Aid, and Integrated Refugee & Immigrant Services have rolled out home delivery services, mainly for those who are elderly or immunocompromised. Many food pantries are transitioning to delivery as well. “We are moving toward eventually shutting down the kitchen in exchange for focusing on the deliveries,” said Steve Werlin, the executive director of DESK.

The city’s new Pantry to Pantry program, created in response to COVID-19, is working to coordinate food deliveries and ensure that no one is left out. Housed out of the Coordinated Food Assistance Network, or CFAN, Pantry to Pantry is helping transition clients — many of them newly in need of food assistance — from regular pantry programming to receiving their meals at home, serving 750 to 950 people each week in the Greater New Haven area.

 “We still don’t know the size of the problem,” said Maria Markham, the CFAN COVID-19 Response Program director and coordinator of the Pantry to Pantry program. “We just know from what we’re seeing that it’s emerging and it’s going to be really, really huge.”

CFAN has helped prepare New Haven for this crisis, setting up emergency protocols that predate the pandemic. With the help of CFAN, New Haven recently created a searchable geographic information system (GIS) map with all the city’s active soup kitchens, food pantries and school distribution sites. The eventual goal is to coordinate a network of larger, weekly grab-and-go distribution sites for pickup across the city available to the unsheltered. As the pandemic grows, CFAN will continue to collaborate with the city to address food insecurity.

Nowhere is that food insecurity felt more strongly than among the city’s unsheltered.

At the Amistad Catholic Worker hospitality house on Rosette Street in the Hill, Mark Colville and his wife, Luz Catarineau-Colville, have always opened up their home to those without one. At Amistad, guests can shower, do laundry and receive a hot meal. They still allow people to enter the house, sit and eat, but are strict about upholding social distancing policies and hand-washing — guests are given everything from packets of sugar to plastic silverware, and are not allowed to touch anything. The Colvilles struggle to provide a sense of normalcy and keep up morale, trying hard to maintain the sense of community that defines Amistad.

 “We don’t want homeless people to feel disposable,” Catarineau-Colville remarked. “We want them to sit down, we want them to be comfortable. So everything was always our best: the coffee mugs, silverware and so on. But now everything is paper.” Amistad is the Colvilles’ home, and they worry that if either of them gets sick, they will have to close. But for now, they are determined to remain open.

“We treat our friends like family,” Catarineau-Colville said. “These are our friends, our family coming here to eat. We won’t stop serving meals unless we’re mandated by the city to do so. We don’t see ourselves as a shelter or a soup kitchen. This is our home, and all people are invited.”

HEALTH ON THE STREETS

Before the outbreak, Emma Lo, a street psychiatrist and assistant professor of psychiatry at the Yale School of Medicine, drove around the city each week to deliver on-the-spot care to the unsheltered homeless, meeting them in soup kitchens, at encampments or on the streets. Her goal was to offer mental health services and basic treatment often overlooked by providers.

In the field, Emma wore hospital scrubs to identify herself as a doctor and carried a medical kit to check blood pressure and pulse, screening patients for any potentially serious conditions. Her job was as much about building trust as it was about treating people. Along with her medical kit, she brought along granola bars, cough drops, water bottles and fresh socks to protect against infection and frostbite. But with the first case of the coronavirus in Connecticut, Lo’s priorities suddenly changed. Instead of outreach, her concern was now containment.

 These days when Lo goes out, she wears a mask along with scrubs and carries a thermometer and hygiene kits. In the car, she and her colleague sit diagonally, one in the driver’s seat and one on the opposite side in back, trying as best they can to maintain six feet of distance. Since the outbreak, they only go out once a week for two hours. It’s harder to find people now. As libraries, shelters and soup kitchens shut their doors, everyone scattered. The train station, one of the last places still open, now only allows ticketed passengers inside.

For those without shelter, the concern is not self-isolation or social distancing — it’s survival. Already May has produced some of the coldest weather on record for the East Coast, and at night the temperature continues to dip into the low 30s.

 “[The unsheltered homeless] don’t have a safe place to isolate on the street and often don’t have a place to social distance either,” Lo said. “They’re often relying on one another to stay warm.”

 Weather conditions have made unsheltered individuals even more vulnerable to the virus. For those sleeping outdoors, pneumonia is already a worry.

Lo explained that most of those who are homeless are too busy worrying about meeting their daily needs to focus on preventative care, and only seek help when the situation becomes desperate.

Many of the unsheltered also suffer from underlying conditions that put them at a greater risk of contracting and dying from the disease. Statistically, three-fourths of the homeless are cigarette smokers, a population that’s two times more likely to die from COVID-19 than nonsmokers. Additionally, as of 2019, more than half of the homeless in the U.S. are over 50 years old. In the past few years, New Haven in particular has seen an increase in the homeless population between the ages of 40 and 60. Those who make it past 60 are rare. On average, people who experience homelessness have a life expectancy of around 50 years old, almost 18 years shorter than that of the general population.

“There’s already a problem without COVID,” said Lo. “There’s just a huge amount of health disparity in the first place and it’s certainly magnified by the current situation.”

 So far, very few cases of COVID-19 have been reported among the homeless. But that doesn’t mean people don’t have it. After learning about a group of cases in the Pine Street Inn homeless shelter in Boston, the Boston Health Care for the Homeless Program sent kits to test everyone entering the shelter. Out of the 397 people tested, 146, or 36 percent, received a positive result, as reported by WBUR, Boston’s NPR affiliate. All of them were asymptomatic.

At Hill Regional Career High School, the city of New Haven has set up an emergency shelter for homeless individuals who test positive for the coronavirus but are not sick enough to require hospitalization. The shelter gives them a place where they can quarantine and recuperate, freeing up ICU beds desperately needed for others who are ill. So far, there are 9,260 coronavirus cases in New Haven County. On May 5, the city opened a drop-in resource center at Blake Field which offers COVID-19 testing for those on the streets. In a virtual press briefing that same day, Mayor Elicker said that more drop-in centers are still needed.

“If we did test everybody who was homeless, we might find the same thing as in Boston,” Lo said. “We haven’t had a lot of homeless people with symptoms, but if you consider the asymptomatic cases, we totally don’t know.”

Lo’s presence itself could pose a risk. If infected, she could expose those living in encampments to the virus, endangering the very population she’s trying to protect. “I’m more likely to have it myself, based on my own exposure in a hospital, and to give it to them by accident,” Lo admitted. “I think it’s a tough balance. What’s really important is not to abandon our people on the street, because, in a crisis like this, they’re probably the first people to be ignored and tossed away.”

Phil Costello, colloquially known as “Dr. Phil,” an advanced practice registered nurse and the clinical director of homeless care at New Haven’s Cornell Scott Hill-Health Center, has moved many of his services to telehealth in order to minimize contact while continuing care through phone calls and virtual visits. Part of Lo’s team has as well. But, while telehealth is successful for some patients, Costello fears that much of the homeless population, who either don’t have a phone or struggle to find an outlet to charge theirs, may fall through the cracks.

For mental health services, the challenges are more than just logistical. Much of Lo’s work depends on social contact and intimacy, neither of which translate through a screen. “It’s really hard because street medicine relies on longitudinal, intimate, regular relationships and that’s certainly not really possible with this pandemic,” she said.

Despite the risks, Lo and the rest of the team have continued to go out each week, visiting as many encampments as they can, simply to remind people that they have not been forgotten.

“There’s less outreach going on in general, so people are more disconnected from the services they once had. There’s a lot of anxiety that I think is more related to the shutdowns of services than to the actual virus. They’re much more concerned about their housing and the future of what COVID is going to bring them,” Lo said. “It’s just more instability on top of instability.”

SEARCHING FOR SPACE, A HAVEN FOR THE HOMELESS

For over 38 years, Columbus House has provided a continuum of services for those experiencing homelessness in the Greater New Haven area. John Brooks, the Columbus House chief development officer, has worked with the organization for 16 years. “We’re a housing-first agency. Housing is health care. When someone is housed, they are better able to take care of their health,” Brooks said.

Columbus House provides shelter for single adults and families with children, offers a medical respite program, and helps people get back on their feet by connecting them with a variety of social services. Employment specialists help clients prepare resumes and look for work. Case managers connect some with substance use counselling. And on-site medical staff ensure residents’ medical needs are met.

As one of New Haven’s largest homeless service providers, Columbus House has helped thousands of homeless clients over the last three decades in New Haven and its surrounding communities.

When the COVID-19 pandemic first arose, Columbus House quickly started thinning out shelter space. With limited room between bunk beds, adhering to the Centers for Disease Control and Prevention’s social distancing guidelines was impossible. At the time, the main shelter on Ella T. Grasso Boulevard housed 100 residents. The men’s seasonal overflow shelter housed 75 more. Others were housed in an emergency shelter in Wallingford.

Shelter staff started asking health screening questions of visitors and clients —  “How are you feeling?” “Have you been exposed to anyone who has tested positive for COVID-19?” After a couple of weeks, they began taking the temperatures of everyone who came inside. Soon, all volunteer activities were suspended, and outside visitors were barred. Staff were encouraged to work remotely.

The main shelter installed hand-washing stations in the lobby and dining room. Meal times were staggered. Masks, gloves, sanitizer and face shields were rationed out.

As the pandemic grew, 20 of the most vulnerable residents — those over 60 with underlying health issues — were rehoused in hotels in the area. Others were urged to temporarily stay with friends or family members. Those remaining in the shelter were encouraged not to leave.

“We were all holding our breath,” Brooks said, “We’re relieved it didn’t get into the shelter because it would have spread like wildfire.”

With the help of the city, Columbus House worked quickly to relocate its guests. Since March 15, Columbus House has moved over 95 people into permanent supportive housing, an unprecedented number. All other residents in congregate living spaces have been rehoused in area hotels.

To facilitate the transition, Columbus House and other shelters cooperated with the Coordinated Access Network, or CAN, a regional homeless crisis response system of 20 homeless and housing providers, municipalities and social service agencies. Prior to the pandemic, the Coordinated Access Network used the 2-1-1 hotline to assist callers in finding available shelter beds. Now, the hotline is also helping to connect the homeless with hotel beds.

In the past, callers could expect to schedule with a CAN specialist within a day. But due to the increase in demand, most people have had to wait at least a week for a phone appointment. “The biggest challenge with the homeless delivery system is there’s always more demand than supply,” said Kelly Fitzgerald, the director of CAN. “That’s true when it comes to CAN appointments, shelter space and housing resources.”

 According to Fitzgerald, as of May 6, there are still 365 people seeking shelter. 83 of those are unsheltered and do not want longer-term shelter space, but have agreed to enter a hotel to help them stay safe during the pandemic. Many of those on the waitlist were asked to leave the shelters voluntarily to reduce congestion. Some, who left temporarily, doubled up with friends or acquaintances in the area. Others have been sleeping on the streets. CAN is currently working with Columbus House, the Connecticut Mental Health Center and Liberty Community Services to organize outreach for those who remain unsheltered.

“The thing that’s been challenging is that we always seem to be waiting,” said Fitzgerald. “It might be we’re waiting for a contract to come through; we’re waiting for a funder to approve something; we’re waiting on staffing. We’re doing our best to have all of our ducks in a row, so that as soon as we get the green light, we can quickly put people into hotel rooms.”

More rooms may be opening up. The city’s initial deal with the Best Western in West Haven faltered after West Haven Police Chief Joseph Perno insisted that the hotel pay for police security. However, the deal was revived after Perno relented, and 96 rooms were set aside to house the homeless. According to Fitzgerald, the Best Western and the New Haven Village Suites will offer an additional 26 rooms for the homeless by next week. 

Alison Cunningham, former executive director of Columbus House and a consultant for the city’s COVID-19 homeless response efforts, praised the state’s swift action in relocating residents from shelters to hotels before the situation became dire.

 “What the state of Connecticut has done to protect and support people that experience homelessness is nothing less than extraordinary,” Cunningham said. “Look at what New York is doing and how long it took them to begin to hotel people. I’ve watched my colleagues scream and clamor for assistance. One of the first things that New York City did was to sweep people off the streets and tell them to go into shelters where 800 and 900 people are staying in very tight quarters.”

 Still, Cunningham recognizes that despite the city’s best efforts, housing everyone is an impossible task. “It’d be great if we could house 50 percent of the folks in the hotels,” Cunningham said. “That would be an amazing feat for Connecticut.”

Even with the added rooms, the demand for housing continues to outpace the supply. Providers are beginning to notice a change in the demographics of New Haven’s homeless population. With shutdowns and layoffs, many people are now living on the edge of homelessness. Others are arriving in New Haven from New York, taking the train from Grand Central and riding north until the end of the line.

 “We are seeing people from outside our region coming to Greater New Haven. So whether that’s people fleeing New York or people fleeing other parts of the state, we are starting to see people that we’ve never seen before,” Fitzgerald said.

Fitzgerald suspects that the newcomers are arriving in search of services. Despite the challenges, providers in New Haven have pushed to remain open and continue to offer resources and support to the community.

 In the months ahead, however, those resources may dry up as the economy slows and more people find themselves out of work. Since Connecticut declared a public health emergency on March 10, it has accrued over 472,000 jobless claims, causing a five-week backlog in processing these applications. In 2019, only 180,000 claims were filed. Gov. Ned Lamont has extended the moratorium on evictions through July 1, but once the grace period ends, countless tenants could find themselves in debt or out on the street.

 “There are going to be new homeless folks over the next year, two, three, until the economy recovers,” Cunningham said. “Are we prepared for that? Right now, no.”

HOUSING FIRST 

For Jason and Mandy, who are both still living on the streets, help can’t come soon enough. “Housing is definitely number one.” Jason said. “But at the end of the day, we’re still out here.”

 Mandy’s recovery worker from Columbus House has continued to check in and bring her hand sanitizer, bottles of water and granola bars. “She cares,” Mandy said. “There are people that actually do and go above and beyond.”

 Jason misses Saturday mornings at Loaves and Fishes where they could get a cup of coffee, groceries and a bag of clean clothes. “It’s the little things you take for granted,” Jason said. “But, now they matter even more — now you gotta walk an hour and pray to God that you’re going to find food somewhere.”

Mandy’s due date is in August. At night, lying on the ground at Jason’s side, she can feel her daughter kicking. “It’s exciting, but I am also scared for my child,” Mandy said.

A representative from 2-1-1, Connecticut’s housing hotline operated by United Way, had promised that someone would call them about a hotel room. But, when Jason checked, there was no new message — just an old one from the CT Alert system with the recorded voice of Gov. Ned Lamont. “This is Governor Ned Lamont. I’m calling to urge you personally: Stay safe, stay home.”

But for those like Jason and Mandy, there’s no home to return to.