Even the good guys need to be criticized when they hurt our most vulnerable populations
Denver Mayor Michael Hancock and the Denver Joint Task Force recently asked the state of Colorado for permission to change Covid vaccination strategies, so that the city could move people experiencing homelessness up the eligibility list. The current state strategy focuses on age-based prioritization for vaccine; Denver asked for approval to adjust that approach so that they could serve all people at the same time when vaccinating at a given shelter, motel, managed campsite, or unsanctioned encampment, regardless of age. The Task Force argued that “this would be a much more effective and efficient way to vaccinate an estimated 6,151 guests and staff of shelters, unsheltered people living in encampments, and service providers across Denver.” Polis said no.
The reasons for accelerating vaccination for Denver’s homeless are compelling. CDC has a FAQ page highlighting some of the particular vulnerabilities of homeless populations to Covid. UCLA Public Health researchers early in the pandemic highlighted the heightened risks facing homeless people. Our homeless neighbors are at risk through presence in congregated settings like shelters or encampments, many have underlying medical conditions that increase their vulnerability, and they have less access to non-emergent medical treatment that could improve their outcomes.
Protecting our homeless populations is not only the compassionate action to take in protecting vulnerable community members, but also will help reduce community transmission as well as the strain on the city’s hospitals which jeopardizes treatment for all those who may need it. Denver’s Joint Task Force noted that the hospitalization rate for people experience homelessness is three times higher than the general population.
The Task Force memo summarized the situation:
There is an urgent need to vaccinate people experiencing homelessness and service provider staff to induce herd immunity to protect people at risk and prevent large outbreaks in congregate settings ... Prioritization of people experiencing homelessness will also benefit our Denver metro region population by decreasing the rate of community transmission.
Despite the clear and compelling reasons to provide for greater flexibility in vaccine administration so as to accelerate protection for Denver’s homeless, Governor Polis rejected the Task Force request.
"It would cost lives to divert vaccine from people that are in their 70s to younger healthier people just because they happen to be homeless," he said — ignoring the options many retirees who do not live in communal care facilities have to safely isolate, an option that our homeless communities do not have. He also pits one vulnerable population against another, instead of providing Denver the flexibility to serve both to the city’s best ability. It is hard not to see his choice as raw political calculation: housed seniors vote in high numbers; homeless residents do not.
Cathy Alderman with the Colorado Coalition for the Homeless criticized Polis’ decision as “dismissive of the real health risks people experiencing homelessness living in shelters face on a day-to-day basis”, stating:
We are very disappointed that the Governor decided to waive the age-based requirements for so many groups in Colorado but will not do so for people who are living in congregate settings like shelters where the risk of exposure and COVID-complications is very high. When an outbreak happens in a shelter where people are sleeping, eating, and sharing space together, hundreds of individuals are at risk of getting the virus and experiencing health complications which will significantly impact our hospital system and result in loss of life.
This is especially disappointing because I’ve admired many of Governor Polis’ efforts in his first two years — from his strong and early actions in addressing Covid transmission (including the politically difficult choice to close ski resorts), to his environmental stewardship, to his work toward providing full-day kindergarten statewide. But we need to hold our friends accountable, not just our adversaries.
In hearing this story, I could not help but think of Mahatma Gandhi’s famous statement that “A nation’s greatness is measured by how it treats its weakest members.” Similarly, President Roosevelt in the midst of the Great Depression said, “The test of our progress is not whether we add more to the abundance of those who have much, it is whether we provide enough for those who have little.”
By that standard, Governor Polis, you have failed this test.
Update: one commenter correctly noted that the Governor cited as a reason for his decision the challenge of tracking down recipients for their second dose, suggesting that vaccinating the homeless should wait for the one dose J&J vaccine. If availability of that vaccine was imminent and prioritized for the homeless, that argument might be more compelling - but as it is, the Governor simply chose to leave unprotected - for who knows how long - a population that is highly vulnerable, has disproportionate hospitalization from infection, and lacks options to safely isolate. I stand by my criticism of his uncompassionate choice to block Denver's proposal. Here is coverage describing the Governor's comments on this at his press conference, from Westword:
"It would cost lives to divert vaccines from people who are in their seventies to younger, healthier people just because they happen to be homeless," said Polis, stressing that homeless individuals ages 65 and up already qualify to be vaccinated, as does everyone else in that demographic, "regardless of whether they have a home or don't have a home."
Furthermore, Polis contended that vaccinating the homeless is more difficult, given the requirement of second doses for currently available vaccines made by Pfizer and Moderna, since it's difficult to communicate with people about getting shot number two "if they lack a regular address." As a result, he argued, it will be logistically easier to give the homeless the one-dose Johnson & Johnson vaccine. (There's a problem with that concept, though: The Johnson & Johnson vaccine still hasn't been approved by federal authorities.)
