Homeless shelter operators are worried the coronavirus might move quickly through Hawaii’s homeless population and have stepped up prevention strategies in case COVID-19 becomes more of an issue here.

The Institute for Human Services has intensified daily cleaning and disinfecting regimens and is keeping an eye on existing clients for any symptoms. If someone is found with a temperature higher than 100.1 degrees, IHS will refer patients to a medical clinic.

“Pretty much everyone is on alert and if anyone is not feeling well, they’ll get evaluated ASAP,” said IHS Director Connie Mitchell.

IHS is also screening new residents for fever, cough and travel history.

On Oahu, there have been only two confirmed cases of COVID-19 and both of those were related to travel. To date, 28 other tests have been conducted by the state laboratories division, all of them negative. Test results of two others are pending.

Not all shelters in Hawaii have been instructed to conduct such screenings, and the state is not mandating temperature checks at shelters.

Scott Morishige, the Governor’s Coordinator on Homelessness, said his office is following guidance from the federal Centers for Disease Control and Prevention and the state Department of Health. His focus is on ensuring all homeless service providers in each county have an updated emergency preparedness plan.

“This is a situation that is developing day to day and there’s constantly new guidance coming out,” he said, adding that the goal is to get that information to providers as quickly as possible.

But a lack of emergency medical supplies and bed space for homeless patients who potentially would have to be isolated makes nurses like Elizabeth Glenn, health services manager for the Institute for Human Services, feel ill-equipped to handle a potential outbreak.

Her clinic at the Sumner Men’s Shelter in Iwilei sees about 20 patients a day, not including visits for psychiatry and medication.

“We don’t have things like isolation gowns and stuff for the staff — the stuff they use in hospitals to isolate people would be really nice because we’re basically more crowded than a hospital,” she said.

Amid national shortages, the clinic’s medical mask supplier has limited them to one box of 50 masks per month.

Glenn has a growing wish list of items that could help her staff prepare for COVID-19 if it begins to spread in the community: disinfectant wipes, masks, gowns and other materials for isolating people and protecting staff members from transmission.

“If you don’t have a home, how do you self quarantine? That’s the biggest thing,” Glenn said. “They need to seriously consider opening a specific facility for people who are homeless because the shelter is not the best place to do that. It’s simply too crowded and there’s a lot of transient people who come and go every day.”

People without permanent housing have a higher risk of catching COVID-19 and dying from it, doctors say. Close sleeping and living quarters in small shelters and lack of hand-washing stations outside can contribute to the problem.

“We have to remember they’ve been unsheltered for a while and they’re already under a lot of stress, which depletes your immunity and you become more vulnerable,” said Mitchell. “We’re trying to help make sure people feel cared about and ensure them that there are some strategies they can use to stay well.”

Hawaii service providers could use financial assistance, Mitchell said. Earlier this week, San Francisco dedicated $5 million to homeless shelter providers to help them keep doors open 24-7.

“I know we don’t have as many people as they do, but I really think it would be helpful to get a little extra funding to deal with some of this, like when we needed the extra equipment to do the screenings, and personal protective equipment and extra masks,” Mitchell said.