Handshakes are out; fist bumps are in.
That’s the flu-fighting advice public health nurse Heather Barr has for Real Change vendors and anyone else who comes in contact with dozens of customers a day.
Minimizing hand contact can help lower the risk of spreading infection this flu season, which came earlier this year and is expected to hit harder.
Normally by this time, about a dozen nursing and senior homes have reported people with flu-like symptoms. As of Jan. 14, residents in 32 of these facilities have reported flu-like symptoms.
Barr, head of King County’s Health Care for the Homeless program, oversees the 100 employees who administer flu vaccinations at shelters and social services and trains people on how keep from spreading the flu.
Barr brought a supply of the latest flu vaccine, which protects against three strains of the virus, to Nickelsville in West Seattle last week.
The vaccine helps, she said, but the bulk of her work can be summed up in a single sentence.
“Wash your hands a lot. Goodbye, my work is done here,” Barr said with a laugh.
For those surviving on the streets and in shelters across the region, this simple advice is much harder to follow than for those with permanent housing. For some, even being able to wash or sanitize their hands is difficult.
“We have drop-in centers, but there aren’t tons of them,” Barr said.
Hand-washing is especially critical for some populations. Low-income people, especially those living in shelters, are at higher risk of infection due to greater exposure to other populations and heavy use of public transportation.
The City of Seattle’s newly-enacted paid sick time legislation will no doubt help, but low-income people who are working and struggling to survive cannot often take off work and will show up sick and spread the flu. And those living in shelters can have lowered immune systems because of the stress of being homeless. They frequently have no place to rest during the day, when shelters are closed.
“When you’re running 300 people plus through a facility a day, half of whom have been living on the street, you have an expectation that there’s going to be a reasonable amount of germs,” said Wayne Wilson, manager of Compass Housing Alliance’s Day and Hygiene Center.
Although low-income people are at greater risk of flu exposure, these days service providers are better prepared to help them, Barr said.
When H1N1 flu virus, sometimes called “swine flu,” started spreading in 2009, Healthcare for the Homeless began collecting data from six large shelters around King County to determine if there was a spike in flu-like symptoms.
Barr has been collecting data ever since. This year she’s heard about fewer than 10 cases of flu-like symptoms in the shelters, but she’s still watching.
If the number ever spiked, Healthcare for the Homeless and several of the large shelters would take action. Some would stay open during the day to let sick clients rest; at night they would create separate bed space for anyone with symptoms.
The county held emergency vaccination clinics last weekend for anyone who was not insured. This is one of the few ways homeless people without insurance can get a vaccine. Most vaccines for adults are distributed through doctor’s offices and the private market, according to the Department of Health.
Barr and several nursing interns are visiting shelters and encampments offering vaccinations. She gave a few shots at Nickelsville Jan. 17, but some people were wary.
A group around the campfire recounted their reasons: They’ve never had the flu, a flu shot gave them the flu, vaccines are just another way for pharmaceutical companies to make money.
Barr has heard all this before, but she still set up her food cooler filled with a stock of vaccines to give the shots to anyone willing to take one. And she advised them, once again, to wash their hands.