Widening COVID-19 outbreak reported at Sonoma County’s largest homeless shelter

Sonoma County health officials are scrambling to understand the extent of a COVID-19 outbreak that has engulfed the county’s largest homeless shelter, infecting potentially more than half the shelter’s 156 residents.

At least 59 COVID-19 cases had been confirmed at Sam Jones L. Hall homeless shelter in Santa Rosa by Tuesday, officials said.

An additional 26 positive cases are still being reviewed by local public health staff, potentially bringing the total to 85 infections — nearly twice the sum reported last week, when city and shelter officials first acknowledged the outbreak.

Nearly half of the affected residents were vaccinated, officials said.

The growing outbreak has posed a difficult question for government officials and shelter operators left to determine how so many residents have become infected at this stage in the pandemic.

Until this month, only 13 infections had been detected inside the shelter, all in a cluster of cases in January, shelter officials said.

“Something is different. This is different than what we’ve seen the entire pandemic,” said Jennielynn Holmes, head of homelessness services at Catholic Charities in Santa Rosa, which manages the shelter.

Holmes and city officials had previously said the outbreak was caused by the delta variant, which is far more contagious than the original strain of the virus. County officials said that was not confirmed and that they needed more time to determine whether any of the results are indeed the delta variant.

Throughout the pandemic, Holmes said, operators followed federal health guidance for homeless shelters — testing residents for COVID-19 every few weeks, site cleaning and making sure everyone wears a mask, regardless of vaccination status.

But Clarissa Millarker, a Sam Jones resident since March, said that prior to the outbreak, shelter staff had been lax in enforcing health protocols, in particular masking. Millarker was not tested for COVID-19 until the shelter detected the recent positive cases, she said.

“I feel like it’s entirely likely that I'm going to turn up infected,” said Millarker, who is vaccinated.

Millarker, 38, said staff have since ramped up sanitation, been more vigilant about masks and started testing every few days. Still, there is confusion and anger over how the situation was handled by shelter operators, she said.

“People are upset, and they’re right to be,” she said.

The outbreak in the 213-bed homeless center and a broader surge of cases in the local community spurred county officials to reopen an alternative care site for pandemic cases at the Best Western Dry Creek Inn in Healdsburg. The site, closed only on June 30 amid an ebb in virus cases, reopened Wednesday — a reflection of the sudden uptick in COVID-19 infections after a monthslong decline in the county.

The alternate care site, which is expected to remain in operation at least 30 days, can house up to 60 residents. Residents will have access to an onsite physician 24 hours a day, officials said.

Many of the infected shelter residents were moved to the site on Wednesday, and will continue to be moved over the next few days, Holmes said. The rest of those who tested positive were isolating in the shelter’s 60-bed shelter annex, which opened in January. Everyone with a negative test is staying in the 153-bed main hall.

Catholic Charities staff first became aware of a potential exposure on July 2 when two people who were staying at the shelter tested positive. The shelter was subsequently closed to new residents that same day and county public health staff began testing current shelter residents and staff.

In a joint briefing by city and county officials about the shelter outbreak, Dr. Sundari Mase, the county’s health officer, said the outbreak at the shelter was not surprising given the close living quarters and the number of people who have not been vaccinated.

Mase has repeatedly stated in recent weeks that the current wave of pandemic infections is partly being driven by unvaccinated individuals. She said many of the 150 residents at the shelter were not vaccinated, though she could not provide an exact number.

“The fact is that the virus is more likely to spread in congregate settings like homeless shelters,” Mase said. “Vaccinated individuals are more likely to experience a breakthrough in COVID if they're gathered with groups of unvaccinated individuals who become positive.”

Mase said that while COVID-19 vaccines do provide protection against the worst medical outcomes, including severe illness and death, they don’t necessarily prevent someone from contracting the virus.

Sonoma County since late May has reported a steady increase in new COVID-19 cases in the general population, largely driven by the virus spreading among local residents who have not been vaccinated as well spread of the delta strain.

During the Wednesday briefing, officials said 61% of the 59 shelter cases were people age 50 or older. Of those infections, 28 occurred among people who had been vaccinated, officials said.

The majority of the county’s vaccinated homeless residents were inoculated with the Johnson & Johnson vaccine, officials said.

Dr. John Swartzberg, UC Berkeley infectious disease expert, said there isn’t precise data on the effectiveness of the Johnson & Johnson vaccine against the delta strain. Its effectiveness against the delta variant is likely somewhere in the “low 60% range,” he said.

Health officials said genetic sequencing is being conducted by new equipment at the county’s public health lab to determine whether the delta variant played a role in the outbreak.

Nine of the 59 shelter residents infected were hospitalized, including one who was treated in intensive care. That person has been discharged. The county said four of the nine have been discharged and the other five remain in the hospital.

Six of the nine hospitalized residents were fully vaccinated. At least two of the nine were hospitalized for conditions other than COVID-19 illness.

Officials said it was unclear if the outbreak at Sam Jones started among an unvaccinated individual and spread to those who had been vaccinated.

Throughout most of the pandemic, the shelter had been operating fewer beds to allow for social distancing. But over the past few months, Catholic Charities has slowly increased to full capacity as vaccines became more available and the nonprofit relocated people from a separate, emergency shelter at the Sandman Hotel in Santa Rosa, which closed last month.

The 156 people staying at the shelter Wednesday accounted for about 70% of total bed space.

When accepting new residents, Catholic Charities did a symptom screening but didn’t require a negative COVID-19 test, Holmes said.

And it didn’t turn people away if they weren’t vaccinated. Holmes on Wednesday defended that decision.

“At the end of the day we are an emergency service,” Holmes said, pointing out the hospitals don’t turn away unvaccinated patients. “But we do commit to a safe environment.”

You can reach Staff Writers Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com and Ethan Varian at 707-521-5412 or ethan.varian@pressdemocrat.com.