This interim guidance is based on current information about the transmission and severity of coronavirus disease 2019 (COVID-19).  The U.S. Centers for Disease Control and Prevention (CDC) will update this guidance as needed and as additional information becomes available. Please check the CDC COVID-19 website periodically for updated guidance. Because conditions vary from community to community, disaster shelter managers should look to their state and local health officials for information specific to their location.

  • Alternatives to opening disaster shelters, such as sheltering in place, should be considered during the COVID-19 pandemic.
  • Hotels/dormitories and small shelters (fewer than 50 residents) should be prioritized over larger shelters. Large congregate shelters should be a last
  • Officials should demobilize large congregate shelters as soon as possible after the emergency phase and relocate residents to hotels/dormitories or small shelters for better social
  • Shelter managers should maintain contact with state and local public health agencies and emergency management for updates on local COVID-19
  • Shelter health staff should monitor residents daily for symptoms of COVID-19 and other illness, including mental health concerns, and provide a daily status update to the local health department and other relevant agencies. View resources on daily life and coping .
  • Body temperature monitoring should be conducted for all persons entering the shelter and in food distribution
  • Shelters should provide separate areas, including restrooms, to isolate residents with symptoms of COVID-19.
  • Shelter staff and residents should wear a mask at all times except when not practical, such as when eating or showering. NOTE: Masks should not be placed on babies or children younger than 2 years of age or anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the covering without
  • All shelter residents, even those without symptoms, may have been exposed to COVID-19 and should self- quarantine after leaving the shelter in accordance with state and local
  • If testing for COVID-19 is available, shelter staff, volunteers, and residents should be tested in accordance with state and local health department guidelines.

During disasters, resource availability may limit the ability to apply this guidance. Best efforts should be made to implement this guidance to the extent possible.

Target audience

This document is intended for use by federal, state, local, and tribal jurisdictions in the United States. It should be used in conjunction with existing shelter operation and management plans, procedures, guidance, resources, and systems, and is not a substitute for shelter planning and preparedness activities.

Purpose

This document provides interim guidance to reduce the risk of introducing and transmitting COVID-19 in general population disaster shelters before, during, or after a disaster.

For the purposes of this document, “shelters” include small-, medium- and large-scale, organized, and temporary accommodations for persons displaced by disasters. Facilities may be residential (e.g., dormitories, campsites) or non-residential (e.g., sports stadiums, schools, churches), with varying degrees of sanitary infrastructure.

General population emergency shelters

Individuals housed in shelters share living spaces and sanitary facilities and may be exposed to crowded conditions. Emergency managers, shelter coordinators/managers, and public health professionals should understand the risk of introduction and subsequent transmission of COVID-19 and other infectious diseases in these settings. These recommendations were developed to assist shelter staff in taking appropriate actions for reducing the possibility of transmission among shelter staff, volunteers, residents, and visitors.

People who need to take extra precautions

View additional information for groups who need to take extra precautions.

People at higher risk for severe illness from COVID-19 may include:

  • People 65 years or older
  • Persons of any age with serious underlying medical conditions including chronic lung disease, serious heart conditions, and diabetes. See CDC’s website for a complete list of people at higher risk, and check regularly for updates as more data become available.
  • Higher risk shelter residents should be prioritized for COVID-19 testing and personal protective equipment if resources are available but limited.
  • Some staff and volunteers may be at higher risk for severe illness. Plan for alternative staffing resources to replace high risk staff and volunteers during the COVID-19 Consider pre-deployment of additional healthcare workers and mental health personnel to shelters.

Other people who may need to take extra precautions include:

  • People with disabilities
  • Pregnant or breastfeeding mothers
  • People experiencing homelessness
  • Racial and ethnic minority groups

Screening, monitoring, and isolation

Shelters should monitor and record possible COVID-19 cases and perform periodic assessments of all shelter policies and procedures related to lowering transmission on COVID-19 (e.g. isolation area, social distancing, meal service, cleaning, disinfection). Case numbers should be shared with local public health officials daily to alert them to increasing numbers.

Intake area and waiting room

Provide handwashing stations or alcohol-based hand sanitizer that contains at least 60% alcohol, tissues, and wastebaskets. See additional information on CDC’s handwashing recommendations.

  • Utilize trained medical or healthcare staff to conduct medical screening.
  • Provide additional personnel for medical screening to decrease intake time.
  • Staff who are checking client temperatures should use a system that creates a physical barrier between the client and the screener.
    • Screeners should stand behind a physical barrier, such as a glass or plastic window or partition that can protect the staff member’s face from respiratory droplets that may be produced if the client sneezes, coughs, or talks.
    • If social distancing or barrier/partition controls cannot be put in place during screening, screeners should use PPE (i.e., facemask, eye protection [goggles or disposable face shield that fully covers the front and sides of the face], a single pair of disposable gloves) when within 6 feet of a client.
    • However, given PPE shortages, training requirements, and because PPE alone is less effective than a barrier, staff should try to use a barrier whenever possible.
  • Conduct thorough cleaning and disinfection of the area every 4-6 hours. See additional information on CDC’s entry screening

See additional information on CDC’s entry screening recommendations.

Isolation area

Discontinuation of isolation

The decision to discontinue isolation should be made in the context of local circumstances. Options include:

For additional information please refer to the CDC interim guidance Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings, which includes, but is not limited to, at home, in a hotel or dormitory room, or in group isolation facility.

Information in all common areas of the shelter

Ensure signage is understandable for non-English speaking persons and those with low literacy. Make necessary accommodations for those with cognitive or intellectual disabilities and those who are deaf, blind, or with low vision.

CDC print materials developed to support COVID-19 recommendations are available and free for download.

Social distancing

Food service

Increased use of supplies

Plan for a significant increase in use of supplies including:

Cleaning and disinfection

The risk of exposure to cleaning staff is inherently low. Train staff members who perform cleaning functions using CDC recommendations for cleaning and disinfection. These recommendations will be updated as additional information becomes available. Instructional materials for custodial and other staff should be provided in languages other than English as locally appropriate.

  • Disinfection should be done using an EPA-registered disinfectant external icon.
  • Cleaning staff should wear disposable gloves and gowns for all tasks in the cleaning process, including handling trash.
  • Solid waste (trash) such as tissues, food items, and drink containers should be considered as potentially “infectious waste.”
  • Waste receptacles with non-removable, no-touch lids, should be placed a reasonable distance away from any populated areas.
  • Place a handwashing station or hand sanitizers containing at least 60% alcohol next to any waste receptables. Disinfect the lids and handles of receptacles on a regular basis.
  • Outdoor waste receptacles should be covered with lids.
  • Areas and items that are visibly soiled should be cleaned immediately.
  • All common areas should be cleaned and disinfected every 4 hours with a focus on frequently touched surfaces like tables, doorknobs, light switches, handles, desks, toilets, faucets, and sinks.
  • Linens (such as bed sheets and towels), eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but they should not be shared without having been thoroughly washed. Wash linens using laundry soap and tumble dry on the warmest setting possible.
  • Staff should wash their hands with soap and water or use hand sanitizer containing at least 60% alcohol immediately after handling dirty laundry or used eating utensils and dishes.

Air Filtration

If possible:

Special considerations for children

  • Educate parents and caregivers about how to reduce the spread of illness.
  • Help parents understand that children may feel stress and fear while in the shelter. Information on coping with stress can help parents manage their own stress and that of their children.
  • Encourage parents and caregivers to monitor children for symptoms of illness and to report any suspected illness immediately to shelter staff.
    • The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally shown mild symptoms.
    • Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported.
  • Instruct parents/guardians to assist children to stay at least 6 feet away from other residents.
  • If possible, at nap time, ensure that children’s naptime mats (or cribs) are spaced out as much as possible, ideally 6 feet apart. Consider placing children head to toe in order to further reduce the potential for disease spread.
  • Assign the same mat/crib to one child or disinfect mat/crib between use by different children.
  • Thoroughly clean common play areas or temporary respite care areas every 4-6 hours with a focus on items that are more likely to have frequent contact with the hands, mouths, or bodily fluids of children (e.g., toys).
  • Clean and disinfect toys
    • Toys that cannot be cleaned and disinfected should not be used.
    • Toys that children have placed in their mouths or that are otherwise contaminated by body secretions or excretions should be set aside until they are cleaned by hand by a person wearing gloves. Clean with water and detergent, rinse, disinfect with an EPA-registered disinfectant, rinse again, and air-dry. You may also clean in a mechanical dishwasher. Be mindful of items more likely to be placed in a child’s mouth, like play food, dishes, and utensils.
    • Machine washable cloth toys should be used by one individual at a time or should not be used at all. These toys should be laundered before being used by another child.
    • Do not share toys with other groups of infants or toddlers, unless they are washed and disinfected before being moved from one group to the other.
    • Set aside toys that need to be cleaned. Place in a dish pan with soapy water or put in a separate container marked for “soiled toys.” Keep dish pans and water out of reach of children to prevent risk of drowning. Washing with soapy water is the ideal method for cleaning. Try to have enough toys so that the toys can be rotated through cleanings.
    • Children’s books, like other paper-based materials such as mail or envelopes, are not considered a high risk for transmission and do not need additional cleaning or disinfection procedures.
  • Require hand hygiene for children, parents, and staff before entering and leaving the children’s temporary respite care area.
  • Hand sanitizer should be kept out of reach of children.

Find additional information on caring for children during the COVID-19 pandemic.

Animals in emergency shelters

These recommendations outline special considerations for lowering COVID-19 transmission risk in human shelters that also house animals. While the risk of transmission from animals to humans is believed to be low, precautions should be taken to prevent possible transmission.

NOTE: Do not put masks or other face coverings on animals, even if they appear sick.

Companion animals (pets)

The scope of these recommendations is limited to special considerations for pet-friendly disaster shelters during the COVID-19 pandemic. Information on general shelter operations can be found in the FEMA Best Practice “Shelter Operations: Pet-Friendly Shelterspdf icon” document. Detailed recommendations on handling exposed animals is available in the “Interim recommendations for intake of companion animals from households where humansexternal icon with COVID-19 are presentexternal icon” developed by the American Veterinary Medical Association (AVMA), with support from CDC One Health.

Animal areas

Note: Recommendations for operating the human shelter should be applied by any person in the animal areas. Use of masks, frequent handwashing, social distancing, and frequent cleaning and disinfection should be maintained in the animal areas. Do not put any type of face covering on animals.

If yes, the animal should be sheltered in the animal isolation area.

  • Collect information about COVID-19 exposure status of pets at entry, as well as any clinical signs in pets consistent with COVID-19, to aid in triaging and proper isolation.
  • Separate animals by a distance of at least 6 feet at all times, including during pet registration and exercise.
  • Limit access to animals to one healthy family member for the duration of the stay.
  • Provide handwashing stations at entry and exit to the animal areas.
  • All people should wash their hands with soap and water for 20 seconds upon entry and exit to the area.
  • Anyone handling animals who may have been exposed or show signs of illness should wear gloves and a mask. Gloves should be disposed of after each use.
  • If an animal gets sick while in the shelter:
    • Call a veterinarian and let them know the animal may have been exposed to a person with COVID- 19.
    • Contact local animal health and public health authorities to determine if the animal should be tested and if other precautions should be taken.

Service animals

In accordance with the Americans with Disabilities Act (ADA), service animals must be allowed to stay with their handlers.

It is important to keep in mind that:

If the handler shows signs of illness:

If the service animal shows signs of illness:

View additional information on what to do if an animal is sick and keeping animals protected against COVID-19.



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