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As the coronavirus spreads across the United States, health professionals have offered two main pieces of preventative advice: that people wash their hands more frequently and that they try to distance themselves from large groups of people.

But those suggestions may be particularly hard for Utah’s homeless population to follow, since people who live in encampments often have limited access to hygiene services, while those who rely on shelters find themselves in cramped rooms packed with dozens of others seeking refuge from the elements.

Experts agree that these and other realities place people experiencing homelessness at a higher risk of contracting COVID-19 than the general public. And once one person in the community has it, the unique conditions of homelessness may lead the virus to more easily spread among the population as a whole.

“We feel it’s not an ‘if,’ it’s going to occur," Pamela Atkinson, a homeless advocate and a member of the Utah Coronavirus Task Force, said in an interview Friday. “We feel it’s going to occur shortly.”

Homeless service providers, local health departments and state leaders say they’re bracing for that reality and are working together to establish measures to both prevent and eventually stem the spread of the virus among unsheltered groups.

The Salt Lake County Health Department has put a special emphasis in recent days on finding a place to put people experiencing homelessness if they’ve been exposed to the coronavirus but are not ill enough to be hospitalized, according to spokesman Nicholas Rupp.

“People experiencing homelessness don’t have a great place to isolate if they are worried about having been exposed or if they’re ill," he said. “If they need to be quarantined, we can’t send them home.”

As of Friday afternoon, the Health Department had secured two government-owned facilities to temporarily house people experiencing homelessness in such circumstances. One building will be explicitly for the unsheltered, while the second will remain an option for them if needed but will also be available for other situations, Rupp said. Both will be county operated.

The Health Department did not disclose the location of those buildings out of concern for the privacy of health-related personal information.

Rupp said the county believes it has “enough capacity to meet any immediate needs that arise in coming days” but said officials would “continue to work to expand that capacity in case it becomes necessary.”

The Health Department is also working with The Fourth Street Clinic, which provides medical care for the homeless, to put up a tent in its parking lot so health officials there are able to segregate people who have respiratory illness symptoms, according to Laurel Ingham, the clinic’s development director.

The organization is also suspending patient groups and seeking additional supplies from the county as it prepares for the weeks ahead, she said.

It’s important to act early, Ingham noted, since many people experiencing homelessness are more vulnerable on multiple fronts to the coronavirus than the general population is.

“If it does hit the homeless population, you’re going to have people living in very close quarters, people that are already immune compromised, have a lot of chronic illnesses,” she said. “They might not be sleeping inside. So they tend to be compromised, period — from a financial standpoint to manage it, from an emotional standpoint and from a medical standpoint to be able to really recover from it.”

‘If it hits, I’m probably dead’

In an encampment on Library Square in downtown Salt Lake City on Friday, several people experiencing homelessness said they’d heard only sporadic information about the spread of the coronavirus in Utah, which has so far seen six confirmed cases.

But many were aware of the mass cancellations by city governments, arts groups, public schools and entertainment venues following a call from Gov. Gary Herbert on Thursday to limit mass gatherings statewide to no more than 100 people in an effort to stem the spread of the virus.

For some, their primary concern was the possibility that a closure at the downtown library would follow — and with it, the end of their ability to wash their hands and help prevent the spread of the virus.

“If you can go inside, you can wash your hands any time you want to,” said Tom Kalaher, 54. “If you’re not allowed inside, it becomes a more difficult thing because public facilities are nonexistent now. Nobody wants to see a homeless person in their business.”

(Jeremy Harmon | The Salt Lake Tribune) Tom Kalaher, who is homeless, says he feels safer on the streets than in the shelters as concerns about a coronavirus outbreak deepen on Friday, March 13, 2020.

The city library announced later that day that it would be closing all branches starting Sunday through March 29 as a preventative measure.

Quinn Smith, a spokeswoman with the library system, told The Salt Lake Tribune on Friday that the city administration is working to place temporary restrooms and sanitation stations for those outside. A spokeswoman in the mayor’s office confirmed those efforts and said they would be in place at the library and in other areas of need as soon as possible.

Despite his fears, Kalaher said he felt safer camping near the library than seeking shelter at one of the Salt Lake City area’s three new homeless resource centers, since he says he picked up illnesses more frequently in the tight living quarters at The Road Home’s old emergency shelter.

“I think I’m safer out here in the open air,” he said. “But I’ve also resigned myself to if it hits, I’m probably dead. My health isn’t good anyway. I’ve got lung cancer and prostate cancer.”

Shelter the Homeless, the nonprofit organization that owns the homeless resource centers that replaced The Road Home’s old shelter in the Rio Grande neighborhood, said Wednesday that it was developing preventative measures and emergency plans to help protect its clients and the staff they rely on from the virus.

The nonprofit said in a statement that it was anticipating the coronavirus could lead to a possible increase in emergency shelter usage, as well as illness and absenteeism among homeless service provider staff.

Atkinson said the shelters have established strict guidelines to stop the spread of the virus, including “wiping down and disinfecting surfaces and not getting too close to clients and reminding clients to stay apart.”

But outside the Carl’s Jr. on 200 South in downtown Salt Lake City, a popular hangout spot for people experiencing homelessness, several people staying at the resource centers said they hadn’t heard from leaders there about the coronavirus and how to prevent it.

“They haven’t said nothing to me about it,” said Emil Miller, who’s staying at the men’s resource center in South Salt Lake, during an interview on Friday. “The only thing I’ve heard about it is something about a bat in China.”