Competence and Compassion In Housing

“I live in an apartment building with 55 units, and at last estimate, 12 people are sick with COVID-19, and one is on a ventilator in hospital. I am now in my 6th day of quarantine with the virus and it hasn’t been fun,” wrote one of us, Lynn Costello, a tenant in Lowell Public Housing for elderly and disabled persons, early in December, 2020.

In February, 2021, Lynn is well but she notes that 3 tenants were seriously ill and hospitalized with COVID, and two of them have died.

“Although I was completely aware of the possibility of catching COVID-19, there was still some little voice, deep inside me that was whispering in my ear, ‘It will probably never happen to me.’" she wrote to Halberstadt. "I was wrong.”

In the early months of the pandemic, Costello had been diligent in following COVID-19 protocols, and the management of her building had been actively cleaning the premises and reminding tenants to be careful. But over time, the community efforts diminished, cleaning protocols were ignored, and people walked in public areas without masks. Costello let down her guard with a friend who didn't yet know she was infected.

Costello’s experience is not unique. Indeed, another one of us, Halberstadt, got COVID despite extreme caution in following the protocols. Jerry thought he had recovered when complications forced a trip to hospital at the Brigham, where excellent care restored him to health.

“No one can beat this virus alone. Why did I become infected? My neighbors at Fairweather in Peabody failed to follow the protocols including masking. The landlord (Preservation of Affordable Housing) and management failed to enforce the rules for the protection of all tenants, and some elements of our national culture fail to respect every life and thus enable the virus to thrive.”

“Until we come together as humans in a community of care and concern for each other, we will fail as individuals.”

“In the hospital, I marveled at the competence and compassion of the whole team caring for me. I vowed to protect them from inundation by COVID-19 cases by pushing for a better public health response to keep people from being infected. And I came home with a prescription for compassion, the medicine that is in such short supply in housing.”

The Commonwealth is under tremendous stress from the pandemic, and the failings of our personal and communal actions and values are reflected in our government's inadequate response, especially in keeping elderly and disabled persons safe. Although public health professionals provide a clear road map for action, the Baker administration has failed to heed their warnings.

Elderly and disabled tenants living in public and subsidized housing, as well as in other multi-unit housing, are at high risk from COVID-19. Their housing creates conditions for rapid spread of this infection because they share public areas like the lobby, mail room, and the elevator.

Unfortunately, some tenants and landlords fail to comply with public health guidance. Public health officials must enforce compliance to reduce the threat of multiple infections and deaths in these facilities. Although public health officials and local health departments have the authority to oversee and to sanction those who fail to follow the public health mandates, egregious behavior is allowed to flourish and threaten the health and lives of everyone in a housing facility.

The Department of Public Health and the Commonwealth have failed to provide the support needed to crush the virus and empower citizens to respond. The level of community infection is allowed to continue to rise, and efforts to limit the kinds of social interactions that are the sources of infection are only initiated when disaster is imminent or is taking place. It is as if we were building elegant sandcastles at low tide, and then surprised when the rising tide sweeps them away.

Although the Department of Public Health has data to identify the specific multi-unit housing where there are known cases and deaths from COVID-19, this information is not available for timely use as a warning and guide.

Landlords of both subsidized housing and local housing authorities have received significant COVID-19 funding from federal as well as state budgets, but in some instances, these funds are spent on projects that are unrelated to protecting tenants from COVID-19. This became clear in the December 9, 2020 meeting of the Salem Housing Authority during a review of their audit, and although there were unmet needs for supporting tenants, yet about $100,000 of unspent COVID funding was about to be returned to the Department of Housing and Community Development.

Often the landlords and managers of public and subsidized housing complain they are hampered by lack of funds. Yet, when Beacon Hill, the Governor, and the Department of Housing and Community Development provide COVID-19 funds despite the dire economic circumstances, money remains unused although so much could be done to benefit tenants and protect them from the pandemic and the harsh impact of isolation.

This may seem shocking, but tenants and advocates are used to such lack of concern and respect. The health and safety of tenants would be better served in many ways, including the following:

• Provide inexpensive internet-capable devices and internet connectivity to tenants to enable better communication between landlords and tenants; between tenants and friends and family; and to connect tenants with sources of information and entertainment.

• Provide an adequate supply of high-quality surgical and KN95 masks; many tenants cannot afford this essential protection.

• Provide hand sanitizer stations at key points, not only to provide hygiene but to emphasize the importance of protection against infection.

• Develop, through research, a better understanding of what enables compliance, and what leads to non-compliance.

• Develop and implement effective programs of education and enforcement. Life with COVID is weird, we need to be helped and reminded how to survive this new world. A posted notice is not the answer!!

• Make available resources to support individuals and the community: a number to call for delivery of food and medicine; wellness-checks for neighbors; calls from a social worker and/or neighbors and volunteers to provide human contact and support.

• On-site testing for COVID-19 and transparent information about COVID infections.

• On-site vaccination, the only way to provide this vital protection to everyone who lives and works in housing. Some of us can’t travel to some central vaccination site.

We challenge the governor and the public health commissioner to drastically eliminate the risk of community exposure by restricting all known situations that lead to transmission. We call on the governor to shut down restaurants, gyms and casinos and to institute appropriate measures to protect residents of multi-unit housing. Some landlords shirk their responsibilities, they need to be sanctioned.

The Commonwealth is ultimately responsible for protecting the lives and essential human rights of every resident of the state. Step up to your responsibility, Governor Baker.

We demand that public health officials, including local health departments, act to oversee programs of mitigation and enforce that landlords and tenants follow the orders and mandates of the governor and public health commissioner; and to publish available data on COVID-19 infections and deaths, providing alerts about specific housing sites to enable landlords and tenants to better mitigate risk.

Absent that information, we risk the kind of tragedy that took place at the Holyoke Soldiers Home and in many nursing homes.

Indeed, without that data, we cannot know if such a tragedy is already taking place in multi-unit housing for elderly and disabled persons.

Jerry Halberstadt is Coordinator and co-founder of the Stop Bullying Coalition. Governor Baker appointed Halberstadt commissioner to represent the Coalition on the Commission on Bullying. Michael Siegel MD, MPH, is a professor in the Department of Community Health Sciences at the Boston University School of Public Health. Siegel is a physician who completed his residency in Preventive Medicine at the UC Berkeley School of Public Health and trained in epidemiology for two years at the Centers for Disease Control and Prevention in Atlanta before coming to Boston. Lynn Costello is a co-founder of the Lowell Anti-Bullying Coalition. She lives in Lowell Public Housing.