Salt Lake County’s only quarantine hotel lacks food and medical support, guests and visitors say

Making the program sustainable is “really tricky,” concedes Fourth Street Clinic, the hotel’s operator, as COVID-19 cases among the unsheltered mount.

(Image courtesy of Fourth Street Clinic) Jeff Abbott, a registered nurse with Fourth Street Clinic’s Mobile Health Care team administers a COVID-19 vaccination during a clinic on April 30, 2021.

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When Heavenly Finau tested positive for COVID-19 in late August, she was staying at one of Salt Lake County’s homeless shelters with her three children, ages 4, 5 and 7.

“Someone was bound to get sick,” given the shelter’s close confinement, Finau said.

With nowhere to separate themselves and prevent the virus from spreading to others, Finau and her family had to take up temporary residence at the only quarantine and isolation hotel in the county.

She calls it a “negative experience.”

Fourth Street Clinic, the hotel’s operator, brought them only two meals each day, and only on weekdays. Her kids, picky eaters like many young children, found the meals inedible.

(Image courtesy of Heavenly Finau and Susi Feltch-Malohifo’ou) One of the meals Fourth Street Clinic provided Heavenly Finau and her young children while they recovered from COVID-19 at Salt Lake County's only quarantine and isolation hotel.

“We were told they provide food. So in my head I was like, they must bring water and breakfast, but no,” Finau said. “We weren’t prepared for any of this.”

Instead, the family drank tap water and Finau spent about $500 getting juice, noodles, eggs and snacks delivered from Walmart. Worst of all, a man staying in the room below them called multiple times a day to demand the children pipe down, Finau said.

“I can’t really tell my kids to be quiet all the time, especially when they’re stuck in a room” with only a TV for entertainment, Finau said. “Sometimes I would unplug the phone to get peace of mind.”

Another single mother staying at the hotel called her case manager at Pacific Island Knowledge 2 Action Resources, or PIK2AR, to complain they were hungry.

“We’d [also] been case managing Heavenly for housing, and we didn’t even know she was there,” said PIK2AR Executive Director Susi Feltch-Malohifo’ou.

Feltch-Malohifo’ou said she was troubled by the conditions reported.

“These people going there are sick. They’re not even getting three meals a day,” she said. “I’m trying to not throw Fourth Street Clinic under the bus, but … even prisoners get three meals a day.”

Two of Finau’s children ended up also testing positive for COVID-19, and the family’s stay lasted 20 days, she said. Fortunately, she had packed extra diapers and Tylenol. “My youngest daughter had it bad, she couldn’t sleep through the night,” said Finau.

But others weren’t given adequate instruction by Fourth Street to prepare for their stays, Feltch-Malohifo’ou said, finding themselves without medications like insulin.

And it’s not like patients can just leave the hotel and walk to a corner store to grab supplies — that defeats the purpose of quarantine and isolation.

Tile Fagatele, a case manager for PIK2AR, said he saw the hotel’s accommodations firsthand when he went to check on four Pacific Islander families staying there.

“The conditions, it’s nice they had somewhere to go, but the environment wasn’t conducive for them to recover,” Fagatele said, also raising concerns about limited on-site medical staff. “It was scary to see.”

PIK2AR’s catering service, called Premier Catering, has since signed a contract with Fourth Street, a document shared with The Salt Lake Tribune. The nonprofit started providing lunches and dinners to the hotel on Oct. 25, relieving clinic staff of the task, at a rate of $6.50 a meal for five days each week.

But the nonprofit didn’t raise concerns in order to get a business deal, Feltch-Malohifo’ou said, adding that stepping in was “the right thing to do.”

(Trent Nelson | The Salt Lake Tribune) John Tuutau, Mapu Rahman, and Sioeli Tuutau of Pacific Island Knowledge 2 Action Resources (PIK2AR) make box dinners for residents at Salt Lake County's Q&I hotel, in Salt Lake City on Thursday, Oct. 28, 2021.

A shift as cases dropped

The Tribune is not reporting the location of the hotel to protect patient privacy.

Salt Lake County managed the quarantine and isolation program from the time the pandemic hit in March 2020 until mid-June this year, at first using county facilities like recreation centers, then later transitioning to traditional hotels.

Over that period, the county sheltered 2,220 people who couldn’t quarantine otherwise, either because they were homeless or because they lived in group housing where isolation wasn’t possible. Some of the quarantine and isolation guests were travelers who had nowhere else to go, but the vast majority were Salt Lake County residents, according to county staff.

Individuals who checked in to the hotel ranged in age from infants to 82-year-old seniors, according to information obtained by The Tribune through a public records request. All received three daily meals. The average stay lasted seven days, but dozens remained there 20 days or more before getting discharged.

The county spent $2.5 million for the quarantine and isolation program, covering items that included food, laundry, janitorial supplies, transportation and medical needs.

(The county also operated a separate vulnerable population hotel, which housed 368 people at high risk from COVID-19 infection for long-term stays — some lasting a year or more. That program cost $4.4 million.)

Nurses and medical professionals staffed the hotel 24 hours a day, according to Jorge Mendez, the county’s supervisor for the Division of Environmental Health, who temporarily redeployed to oversee the program as part of the pandemic response.

“In November 2020 we saw a spike in the number of intakes at the Q&I hotel,” Mendez said. “We had the plans in place to activate and mobilize a different location, had we reached capacity.”

But by spring, vaccines were widely available. Cases dropped. Reassigned county employees went back to their regular jobs. The Q&I patients moved to a smaller hotel, and the county began to wind down its program.

“At that point is when Fourth Street Clinic became involved,” Mendez said. “They came several times to observe how we run quarantine and isolation intervention so they’d be somewhat prepared to take it on.”

‘These people would be quarantining in the street’

Fourth Street has an annual budget of about $1 million to run the program, according to communications manager James Jarrard, and it primarily caters to the unsheltered.

“It seemed like in June, everyone kind of assumed COVID would be ending soon,” Jarrard said. “But our medical director saw it wasn’t going to end, which is one reason why we took over.”

About 65% of Salt Lake County residents have had at least one dose of vaccine, according to the Utah Department of Health. But among the unsheltered visiting Fourth Street, the rate is 25%, Jarrard said.

“We’re still having a lot of difficulty getting this patient population having trust to get vaccinated,” Jarrard said.

(Trent Nelson | The Salt Lake Tribune) John Tuutau and Mapu Rahman of Pacific Island Knowledge 2 Action Resources (PIK2AR) load up meals to deliver to residents at Salt Lake County's Q&I hotel, in Salt Lake City on Thursday, Oct. 28, 2021.

And shortly after school started — around the same time Finau and her kids had to hole up in the quarantine and isolation hotel — the clinic saw a surge in cases. The number of people needing a room quadrupled.

“It’s also been such a heavy lift for us and challenging because we’ve been pretty understaffed,” Jarrard said, noting the clinic has about 20 open positions. “It’s just been difficult to hire in the health care realm lately anyway … my co-workers are working so hard, and are so burnt out.”

The current staff overseeing Fourth Street’s quarantine and isolation program includes two case managers as well as an intake team, which includes an admissions coordinator, community health worker and a behavioral health specialist. And the clinic has contracted with the Association for Utah Community Health for on-call providers after hours.

The clinic raises its own funds for the program through grants and donations. Its limited budget means Fourth Street can only afford two meals a day, Jarrard said, but staff provides canned food and produce from the Utah Food Bank and other charities to supplement those meals.

(Trent Nelson | The Salt Lake Tribune) Mapu Rahman and Sioeli Tuutau of Pacific Island Knowledge 2 Action Resources (PIK2AR) make box dinners for residents at Salt Lake County's Q&I hotel, in Salt Lake City on Thursday, Oct. 28, 2021.

“We understand there are a lot of moving pieces Fourth Street is maybe overlooking because we’re so overwhelmed, but these people would [otherwise] be quarantining in the street,” Jarrard said. “It’s really tricky to figure out how to make this a sustainable program.”

Last month, the Salt Lake County Health Department cut a $100,000 check to help Fourth Street operate the quarantine hotel, recognizing “the need for the resource still exists,” according to a department spokesperson.

Mayor Jenny Wilson’s office is also looking at funds to support the program, a spokesperson confirmed.

Jarrad said the clinic is seeing COVID-19 cases mount again, echoing the wave from 2020 that almost put the county’s hotel at capacity. The end of the pandemic — at least for the unsheltered — appears nowhere in sight.

“This Q&I program might be something we have to take on indefinitely,” Jarrard said, “but hopefully it’s something we’re not always understaffed for.”