Roy Coleman, a 69-year-old living in a homeless shelter on Wards Island, was taken away by ambulance after showing symptoms of Covid-19. The other shelter residents were relieved — until Mr. Coleman was allowed to return last week after testing positive at Harlem Hospital.
At another shelter, Alphonso Syville, 45, said that as much as he tried, he could not block out the incessant coughing that he heard from a man a few feet away.
At Delta Manor, a shelter in the Bronx, Christian Cascone recalled how a roommate confronted another resident who had poor hygiene and would not wash his hands. The resident “said something like, ‘Well, if God chooses for me to die, I’ll die,’” said Mr. Cascone, 37.
“My roommate said, ‘Well, the good Lord also wants the rest of us to be healthy, too,’” he said.
While much of New York City is staying inside, a crisis has taken hold among a population for whom social distancing is nearly impossible: the more than 17,000 men and women, many of them already in poor health, who sleep in roughly 100 group or “congregate” shelters for single adults. Most live in dormitories that are fertile fields for the virus, with beds close enough for people sleeping in them to hold hands.
And rather than keeping people away from shelters, the virus has driven them in.
Some inmates released from Rikers Island to control the outbreak in the jail have wound up in shelters. And with the outdoor safety net falling apart — few pedestrians to beg for change; public bathrooms shut; many soup kitchens closed for lack of food and volunteers — the nightly shelter population has consistently reached levels seen only a few times in the last decade, and usually only on the most frigid nights of winter.
“When all of those systems simultaneously break down, you’re going to get this influx into congregate situations,” said Joshua Goldfein, a staff attorney at the Legal Aid Society. “It’s a time bomb.”
Officially as of Sunday, 23 shelter residents have died in hospitals, among them 14 men and two women from assessment centers and shelters for single adults where multiple, unrelated people share rooms, according to the Department of Homeless Services.
And 371 people in shelters had tested positive for the virus, about 80 percent of them from the single-adult facilities, though those adults represent less than a quarter of the homeless population. The rest are mostly families who often stay in studio-like units by themselves.
While total prevention is impossible, the city has been scrambling to at least lower the risk.
Paying an average cost of at least $174 a night, it has been renting hotel rooms, empty for lack of tourists, to isolate shelter residents who have symptoms or tested positive as well those potentially exposed. On Saturday, Mayor Bill de Blasio announced that 2,500 more shelter residents would be moved to hotels by the end of April, in addition to 3,500 who were already sharing rooms in hotels before the virus hit because there was no room in traditional shelters.
Residents who are at least 70 years old, and some residents in the 10 most densely packed shelters, are also being moved to hotels, whether they have symptoms or not. Some homeless families previously staying in hotels are being moved to make room for those residents.
Steven Banks, the commissioner of social services, said the city also has purchased 24 hand-washing stations and 36 portable toilets to be installed in 12 street locations, for those homeless people who refuse to go to shelters.
Shelters are staggering meal times, and temporarily dropping rules that require residents to leave during cleaning, to reduce the chance the residents will go out and then return after having been exposed.
Simply closing the shelters to stop the spread, as if they were dining halls or Broadway theaters, is not an option.
“We’re still open and offering services,” Mr. Banks said. “Others have shut their doors.”
The number of New York shelter infections does not capture the scope of the peril; they reflect mainly people who had been so ill that they had to be taken to city hospitals to be tested and treated. The figures do not include people staying in shelters run by charities or other public agencies.
Other cities with significant homeless populations have begun to see similar problems. San Francisco tested everyone inside its largest shelter last week, and so far 68 residents and two workers have been confirmed as infected. The city has lifted its ban on tent encampments as long as the tents are at least six feet apart.
Even before the pandemic hit, homelessness was an intractable problem for Mayor Bill de Blasio. He took office in 2014 vowing to reduce the number of homeless, but it has only grown, to an estimated 79,000 people, in part because of rising rents beyond the reach of low-income families.
Since 2014, the budget for homeless services has doubled to about $3.2 billion, according to the city comptroller’s office.
The shelter system is a patchwork of 450 buildings, including studios for families with children, hotel rooms with double beds, privately owned but decrepit apartments and cavernous spaces with rows of beds, like the mammoth Bedford-Atlantic Armory shelter in Brooklyn.
The decentralized nature of the system, and the transience of its clients, have made the application of new policies somewhat ragged.
Some residents in shelters and peace officers working in them say some of the preventive measures have not been put into practice or are being ignored by residents.
“If this is a worldwide epidemic, we should have a fair chance to protect ourselves,” said Roberto Mangual, 27, who stays at the Clarke Thomas shelter on Wards Island, where Mr. Coleman was allowed to return. “We don’t really have that chance in a men’s shelter, to be honest.”
Mr. Coleman said that after he spent a night back at Clarke Thomas, the staff gave him a MetroCard to travel to one of the quarantine hotels in Long Island City, Queens.
After an inquiry by The New York Times, the homeless services department sent a message to shelter providers reminding them that anyone returning from a hospital with symptoms of Covid-19 should be put in isolation and not placed on public transportation.
In a phone interview from the hotel on Saturday, Mr. Coleman said he believed he had contracted the virus at the shelter. “I was around a lot of people coughing, throwing up, sneezing,” he said.
He said that he was happy to now be in a room by himself, where he said he was getting round-the-clock medical attention. “If I need medication, I call them and they send up some aspirin,” he said. On Sunday he was moved to another hotel specifically for seniors.
Stephen Mott, chief of staff for HELP USA, which operates Clarke Thomas, said the shelter has been under a great deal of strain but acknowledged that it needed to do better. “We’re up against something huge,” he said. “Things that we used to let slide we can’t let slide anymore.”
At the city-run Catherine Street Shelter in Lower Manhattan, where 100 women live, many residents are not taking precautions, like washing their hands and staying six feet apart, one woman who lives there said. They brush against each other when walking in a narrow stairwell.
The staff changed the configuration of the cafeteria so that there were only two chairs per table, but some residents simply moved chairs so they could sit together, said the woman, who did not want to be identified because she feared retaliation from staff in the shelter.
Derek Jackson, director of the law enforcement division in Teamsters Local 237, a city employee union, said about 550 peace officers work in the shelter system, and as of early last week, 26 had tested positive. Another 41 shelter workers also had tested positive as of last week, according to the city.
“We’re not sure they are being transparent with how many clients are sick with this disease,” Mr. Jackson said of the city homeless agency. “We don’t know who is putting us at risk at the shelters.”
Mr. Jackson said the city was slow to provide masks, gloves and other personal protection equipment to the officers.
The homeless services agency has been dealing with the same supply shortages as everyone else, said Mr. Banks, the commissioner. Last week, after finding masks to purchase, the agency began distributing 100,000 masks to shelters for employees, including peace officers, and now has an additional shipment of 500,000 masks, along with sanitizer and gloves to give to peace officers. Mr. Banks also tapped into Robin Hood, the philanthropic foundation, to donate masks for shelter residents and people living on the street.
But the inability of shelter residents to self-quarantine is still taking a toll. There is no staying at home when you do not have one.
At Opportunity House, a charity-run shelter in Brooklyn, many residents are older and have serious health issues, including problems with vision, said David Gaynor, 60, who is staying there. “Some of the literature, you have to be an ant to read it,” he said.
Mr. Gaynor, who was interviewed while wearing a green bandanna around his neck that he could pull over his mouth, recalled one resident who did not speak English well and had trouble explaining his symptoms.
The staff finally took action when they saw him bowled over and heard the man say the words he knew in English. “Am-bu-lance. Hos-pi-tal,” Mr. Gaynor said, enunciating each word.
“Everybody understands sick,” he said.
William K. Rashbaum contributed reporting.