Chelsea, Mass., Creates COVID-19 Hotel Offering Residents a Safe, Free Place to Isolate
Feature: 2017 Culture of Health Prize community
To enable the sick to quarantine, Chelsea and neighboring Revere, Mass., converted a nearby hotel into a safe isolation facility for people kicked out of their homes because of their COVID-19 diagnosis.
A Q&A with Dr. Dean Xerras, medical director of MGH Chelsea Healthcare Center
This spring, Chelsea was hit harder by COVID-19 than any other community in Massachusetts. Partners in the city say the reasons for the high rate of infection are easy to see. About 8 in 10 residents are employed in essential jobs. Many also rely heavily on public transportation. Because of the high cost of housing, people may live crowded together under one roof. All of which made social distancing to avoid infection difficult for a large proportion of the population. And many Chelsea residents are immigrants, some of them undocumented with limited access to health care. More than 60 percent are Latino.
To enable the sick to quarantine, Chelsea and neighboring Revere, Mass., converted a nearby Quality Inn hotel into a safe isolation facility for people kicked out of their homes because of their COVID-19 diagnosis, or who feared being asked to leave. Dr. Dean Xerras, medical director of MGH Chelsea Healthcare Center, provided clinical oversight until the hotel closed on June 9, after the city's surge in infections had ended.
RWJF spoke with Xerras about how leaders from across sectors communicated with residents about the pandemic, how the hotel project came to be, and what the city has learned.
We already knew that chronic disease burden affects patients in vulnerable communities more. There’s often delayed diagnosis and worse health outcomes due to delayed access to health care. We were seeing this magnified with COVID-19 infection in Chelsea and other communities with similar demographics.
We focused on a strategy of investigation with testing, isolation, and mitigation, the latter meaning things like food deliveries, masks, and care kits. There were roughly 30,000 masks delivered. Partners Health Care and the state donated the masks and the city of Chelsea, along with community-based organizations, handled coordination of delivery. Communication was key every step of the way with (city manager) Tom Ambrosino and his team holding Facebook Live forums every Monday where many community leaders participated, including myself, the superintendent of schools, the police and fire and many community based organizations. Our goal was to give the residents information in real time, as we were getting it from the state and health care organizations.
We also communicated to all the Chelsea residents that were infected. There were roughly 4,000 phone calls that went out over several weeks, following up on positive test results. “How are you doing? Can you isolate? If not, here’s a referral to the hotel, a number for food. Do you need masks? We can deliver masks to you.”
People who came in for testing talked about extended families, crowded apartments, crowded living. We knew the best way to reduce spread of Covid-19 was to not send them home if they tested positive. So Tom Ambrosino and the mayor of Revere came up with the idea to develop a safe isolation facility, with support from the state.
We started with 10 or 12 patients during the first week. At the peak, there were 85 patients at the hotel. The clinical oversight was provided by Mass General Hospital We made it a safe environment for patients and staff. In addition to the clinical care provided to each patient, food was also provided. The cities of Revere and Chelsea paid for rooms up front, and for laundry and linens, with the understanding they would get reimbursed 75% by FEMA at some point.
We heard from patients that coming to the hotel was not an easy decision to make. There’s not much interaction with others when you’re in isolation. And it’s hard for parents to leave their children.
There was a point when we realized we needed to make it more appealing to enter isolation. There is a lot of fear in a community like Chelsea, where many of its residents are immigrants, and concerned about having to identify their immigration status. With the city, we created videos in Spanish and English, reminding people that immigration status does not matter and that they wouldn’t be responsible for any cost. We wanted people to know they could come to a safe environment where they could isolate and prevent further spreading of infection to their family and friends. We pushed this message out on social media, through nonprofit partners, on the community cable station and on city websites.
If there is a COVID-19 resurgence in fall or winter and a safe isolation site needs to be erected again, we’ll make sure we remind people of these things early on and get people who have been here to tell others about their experience.
And things need to be culturally appropriate, like the food! We learned this during the process.
Chelsea, Massachusetts
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