Last updated September 14, 2021
Dear Shelter Provider and Congregate Living Community,
Thank you so much for your service and commitment during this time. To share information that expands upon existing MDH and CDC guidance for shelter providers, we are hosting a Q&A (question and answer) page that will be updated regularly based on what we are hearing from communities. Please note that this, like the MDH and CDC guidance, is interim guidance. We are attempting to move quickly and be responsive to urgent needs, but guidance may change as the situation evolves. If there are changes to questions we’ve already answered, we will provide updated answers here.
Answers are provided by the the Minnesota Interagency Council on Homelessness (MICH), Minnesota Department of Health (MDH), the Minnesota Department of Human Services (DHS), and Minnesota Housing Finance Agency (MHFA).
If you need to report a COVID-19 case or have additional questions, you can email a member of the homeless and sheltered response team or email Health.R-Congregate@state.mn.us. If the situation is urgent and it is a weekend, call the Minnesota Department of Health at 651-201-5414.
This page is split into the following sections:
- Quarantine and Isolation
Q: Can you tell us about the Delta variant and what we need to do?
We are seeing an increase in COVID-19 cases and know that Delta is the dominant strain in Minnesota. Delta is far more transmissible. That means it’s even better at finding unvaccinated individuals than previous strains. The Delta variant is spreading 50% faster than Alpha (B.1.1.7), which was 50% more contagious than the original strain than the virus. People infected with Delta have about 1,000 times the viral load in their respiratory tract compared to those infected with the original strain. This means that those infected may be able to infect others soon after being exposed. The World Health Organization (WHO) has referred to this version of the virus “the fastest and fittest.” This news is especially troubling for people experiencing homelessness and the settings and programs that serve them, since we know that vaccination rates for people experiencing homelessness remain low.
Vaccination remains the most important tool to stop the spread. Breakthrough cases – instances of people who are vaccinated contracting COVID-10 – remain rare, but the chances increase with so much community transmission happening across the country. Once infected, vaccinated people are as capable of spreading the virus as people who are unvaccinated, so it is very important that everyone continue to wear masks when they are working in congregate living settings, regardless of their vaccination status. Vaccination is also the best way to reduce the risks of the virus. So far, 97% of individuals being hospitalized due to COVID-19 are unvaccinated.
Recommendations for mitigating COVID-19 spread
In an effort to prevent COVID-19 cases onsite, we recommend the following:
Encourage staff and clients/residents to:
- Get vaccinated. Vaccination is the best way to prevent infection, and the chances of getting seriously ill due to Delta after being fully vaccinated are super low.
- Wear a mask when in shared spaces, even when fully vaccinated. If you allowed staff to remove masks in staff only spaces (e.g., break rooms, meeting rooms), reinstate masking.
- Remain socially distanced.
As soon as you learn of a case:
- Notify local public health or MDH.
- Start symptom screening for all staff and clients/residents. Some sites have started symptom screening at program entrances. Staff have also been paying close attention to how guests have been feeling and have pulled people who appear to be unwell aside for a more expansive screening.
- Limit the number of people who can be in a communal spaces at the same time and close spaces where social distancing is difficult (dining, television, game rooms, etc.).
- Offer testing. We are recommending offering testing if there is a single staff or client case on-site.
In preparation for cases:
- Identify where you could isolate a client who tests positive for COVID-19.
- Assess how you might be able to offer testing to all staff and clients quickly.
- Reach out to MDH if you aren’t sure about testing or isolation, or have any other questions or concerns.
Viruses will continue to mutate if they continue to spread. The best way to protect yourself and your community (including children who aren’t eligible for vaccine yet) from Delta and future variants is to get vaccinated now.
The United States Interagency Council on Homelessness released CDC-informed guidance on August 18, 2021.
Q: Are COVID-19 symptoms different with the Delta variant?
Symptoms are the same. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus.
People with these symptoms may have COVID-19:
- Fever or chills
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.
Please consult a medical provider for any other symptoms that are severe or concerning.
Here is a local example of a screening protocol has been approved by the CDC. We recommend you review the screening document below for steps your shelter can take.
Q: Is contact tracing different with the Delta variant?
The CDC has not changed their definition of a close contact–being within 6 feet of someone for a cumulative total of 15 minutes or more over a 24-hour period.
Q: Do staff and residents/clients still need to wear a mask in homeless settings if they are fully vaccinated?
Yes, the Delta variant spreads more easily, so CDC and MDH recommend that all people in homeless shelters (and similar congregate settings) wear a well-fitted face mask indoors, regardless of a person’s vaccination status.
Q: Have guidelines for cleaning and disinfecting facilities changed?
A: Review the CDC Recommendations for determining when and what to clean and disinfect.
Quarantine and Isolation
Q: Are quarantine and isolation the same thing?
You quarantine when you might have been exposed to the virus. You isolate when you have been infected with the virus, even if you don’t have symptoms. For more guidance, review CDC’s COVID-19 Quarantine and Isolation page.
Q: What should we do if someone tests positive for COVID-19 or has symptoms?
Any person who tests positive for COVID-19 or develops symptoms compatible with COVID-19 should stay away from other people (isolation), even if they’ve been fully vaccinated. Staff should isolate at home and not come into work. Clients/residents should be moved to a separate space, away from other clients/residents who are not sick. Staff and clients/residents should isolate until all of the following are true:
- 10 days since symptoms first appeared and
- 24 hours with no fever without the use of fever-reducing medications and
- Other symptoms of COVID-19 are improving*
*Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation
Q: What should we do if someone is identified as a close contact?
A person who is fully vaccinated does not need to quarantine and/or stay out of work, but they should get tested 3-5 days after their last contact with the person who has COVID-19.
A person who tested positive for COVID-19 within the past 3 months and recovered does not need to get tested or quarantine following an exposure as long as they do not develop new symptoms.
A person who is not vaccinated or partially vaccinated should quarantine and/or stay out of work for 14 days after their last contact with the person who has COVID-19. See the following example if you need help calculating a quarantine period.
Example: Staff A develops symptoms and gets tested the same day, Sunday, August 22. They learn they tested positive on Monday, August 23, notify their work, and identify clients and staff who they were in close contact with starting 2 days before their symptoms developed (or test date if they’re asymptomatic). Staff B, who is partially vaccinated (received their 2nd dose of vaccine 1 week ago) is identified as a close contact and was with Staff A on Friday, August 20 (2 days before Staff A’s symptoms started). Staff B should:
- Leave work as soon as they learn they were in close contact with someone who has COVID-19
- Get tested as soon as possible
- Quarantine and stay home from work for 14 days after their last contact with the person with COVID-19
- Day 0 of quarantine: Friday, August 20
- Day 14 of quarantine: Friday, September 3
- Since Staff B tested negative with their first test, they should get tested again 5-7 days after their first test (or sooner if they develop symptoms)
- As long as they haven’t developed symptoms or tested positive, Staff B can resume normal activities and go to work as early as Saturday, September 4
Q: If someone returns from travel, should they quarantine?
Q: Are fully vaccinated staff and clients still required to isolate and quarantine?
Fully vaccinated staff or clients should isolate if they become symptomatic/test positive for COVID-19.
Fully vaccinated staff or clients do not need to quarantine if they are identified as a close contact, but they should get tested 3-5 days after they were with the person with COVID-19.
Q: How should we prepare for isolation?
If you need assistance identifying or creating isolation space for clients/residents, review:
Q: What is the new testing guidance?
MDH recommends facility-wide testing as soon as you learn of a staff or client/resident case that interacted with other staff or clients/residents at your facility.
Review MDH’s COVID-19 Testing Recommendations one-pager for recommendations on how often someone should get tested depending on their vaccination status.
People who are fully vaccinated should get tested if they in close contact to someone with COVID-19, living/working in a setting that is experiencing an outbreak, or if they have symptoms.
People who have tested positive for COVID-19 within the past 3 months and recovered do not need to get tested or quarantine following an exposure as long as they do not develop new symptoms.
Q: How can we bring testing to our facility?
Delta is more contagious than previous strains of COVID-19, so MDH recommends facility-wide testing as soon as you learn of a staff or client/resident case that interacted with other staff or clients/residents at your facility. If you learn of a case, please notify an MDH response team member or email Health.R-Congregate@state.mn.us as soon as possible.
As we begin to see an increase in cases and greater need for testing, some local testing services may reach capacity. MDH recommends exploring and/or securing multiple testing options, so your facility is able to offer testing rapidly.
- Connect with your local or tribal health department.
- Sign-up for testing through the Midwest Coordination Center (MCC). Review the next Q&A for more information. It takes about 7 days to complete registration. You can register here.
- Request Cue tests from MDH. Review MDH’s Cue webpage for more information. Facilities are required to report all positive and negative test results to MDH. You can order tests here.
- Request saliva tests from MDH. Email an MDH response team member or email Health.R-Congregate@state.mn.us.
Q: What is the Midwest Coordination Center?
The Midwest Coordination Center (MCC) is a federally funded COVID-19 testing program through the Department of Health and Human Services designed to meet the needs of non-healthcare congregate settings. Testing under the program is free including testing supplies and shipping materials. As we move into this surge and local testing services reach capacity, MCC is a great supplemental service in providing access to on-site testing to reduce opportunities for transmission. Their Coordination Center and liaisons can register your site and walk you through the testing process. It takes about seven days from inquiring with their team to get testing up and running at your site. You can tailor testing to meet your needs such as weekly, biweekly, or monthly. MDH is here to support mitigation and infection prevention efforts following testing events should there be a positive result.
For more information and to register for testing, please visit their website at www.testedandprotected.org.
If you have additional questions, contact the Minnesota State Lead, Maleah Slaughter, at firstname.lastname@example.org / Phone # 614-424-3381 or the Minnesota Liaison, Nicole Keirsey, at email@example.com / Phone # 614-424-4468.
Q: What is the guidance for transporting someone to get tested?
Ideally, testing will be brought onsite to avoid the need for transportation. If you have exhausted all testing options and transporting someone to get tested is the only option, review MDH’s Transportation Guidance for non-emergency transport. It covers general considerations, as well as specific recommendations for personal vehicles, multi-person transport, and public transportation.
Q: Can you get the flu and COVID-19 vaccines at the same time?
Yes! The CDC’s guidance is that COVID-19 vaccines and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 vaccine and other vaccines on the same day, as well as coadministration within 14 days.
Q: Are boosters or additional doses of vaccine available?
Additional doses of Pfizer and Moderna are available for people who are moderately to severely immunocompromised. Because the Johnson & Johnson vaccine wasn’t given in the United States until 70 days after the first mRNA vaccine doses (Pfizer and Moderna), the data needed to make this decision aren’t available yet.
Boosters are not available for the general public, but are expected to become available this fall. If all goes to plan, individuals will be eligible starting 8 months after they received their second dose of Pfizer or Moderna. We are still waiting for data from Johnson & Johnson.
Q: Are vaccines working against Delta?
Yes, they are working very well to prevent severe illness, hospitalization, and death, even against the widely circulating Delta variant. On Mondays, MDH updates data on breakthrough cases. As of July 25, 2021, 0.321% of fully vaccinated people in Minnesota tested positive for COVID-19.
Q: I lost my vaccine card, how can I get this information?
You can request your vaccination record from the Minnesota Immunization Information Connection: https://redcap.health.state.mn.us/redcap/surveys/?s=FPMPPRFAWF
Q: If someone already had COVID-19, why should they get vaccinated?
Data shows that unvaccinated individuals are more than twice as likely to be reinfected with COVID-19 than those who were fully vaccinated after initially contracting the virus.
Review this data on CDC’s website.
If a person tests positive for COIVD-19 and wants to get vaccinated, they should wait until they have completed their isolation period.
Q: Have any homeless service providers required vaccinations for staff?
The National Health Care for the Homeless Council released a statement with considerations for requiring vaccines for staff in the Healthcare for the Homeless (HCH) community:
- Immunizations are a standard best practice and health care providers have an obligation to deliver high-quality care in an environment where patients feel safe.
- People experiencing homelessness are especially vulnerable to COVID-19 transmission and illness, are likely to have lower vaccination rates than the general public given traditional barriers to care (in spite of valiant and ongoing outreach efforts), and are more likely to have adverse health effects from COVID-19 (such as hospitalization and death).
- As regulated health care entities, HCH programs have existing policies on staff immunizations (flu, TB, etc.) that appropriately accommodate exemptions.
- Staff are an essential, valued asset for the HCH community, and attitudes toward COVID-19 vaccines are widely varied; hence, a vaccine mandate may pose challenges for retention/recruitment.
You can read the official statement on their website at nhchc.org.
CDC and MDH do not recommend requiring vaccinations for clients/residents using homeless services.
MDH does not provide guidance about requiring vaccinations or collecting information from staff/clients about vaccinations. Facilities should talk with their legal and HR teams.
Q: Where can I find the COVID-19 Trusted Messenger trainings?
You can find materials on this website under Training Materials: https://headinghomealliance.com/training-materials/