Three steps to help homeless amid virus

COVID-19 has evoked fear in all of us. Fear can motivate us to take appropriate precautions in worrisome situations, but may also lead to decisions that negatively impact others and ourselves. We are in the midst of the outbreak and our federal and local health care systems are enacting measures that could assist us.

But as we all hasten to impose social distancing in our lives, and to shut down gathering sites and large events, it’s important to note that for some members of our community these changes pose an extraordinary threat.

In addition to closing down citywide gatherings such as the rodeo, Houston has also seen the closure of prominent homeless shelters and other support systems. This poses big challenges for the men and women and families who currently rely on services for the homeless. These groups have unique dilemmas, including a lack of homes to isolate themselves in, which limit the effectiveness of common practices such as social distancing.

Without support for their immune systems — such as food and shelter or access to health care providers — the homeless remain particularly vulnerable to COVID-19, the disease caused by the novel coronavirus.

Social connection with physical distancing can work if there are ways for everyone to assert some distance from each other while still getting basic needs met. A plan that doesn’t consider the broader social context will produce failures, due to its inability to account for all individuals that would require intensive care. The key strategy is to slow the spread of the infection in all populations enough to prevent overwhelming the medical infrastructure. An overwhelmed infrastructure with a lack of intensive care beds will hurt all of us, including those without COVID-19 with serious illnesses requiring that level of care.

Fortunately, there are three things that we as a community can do to assist the homeless and ultimately, ourselves:

Habitat: Adapt night-only shelters to 24 hours, include testing guidelines for symptoms and establish isolation locations for those possibly affected and for those who test positive for COVID-19.

Food: Develop feeding efforts that encourage isolation/distancing. For example, churches/temples/nonprofits could provide lunch deliveries to help people isolated in tents from seeking access to crowded public areas for food.

Help: Communicate to homeless persons what to do if they show positive or severe symptoms, as well as where to go if they are symptomatic and offer areas that provide testing and isolation for affected individuals. We do not want those mildly affected to go to the ER, nor do we want them to go to large populated shelters or remain isolated.

The dangers of health care workers exposing themselves when caring for others must also be a consideration. However, recommendations and lessons learned from previous outbreaks can be applied now.

Now is the time for city leaders to better understand the nuances and implications of health inequities when implementing preventive outbreak measures for vulnerable populations. The health and safety of our entire community is at stake.

Buck is the associate dean for community health and a professor of clinical studies at the University of Houston. Murray is the J. Ralph Meadows Professor of Medicine, director of the Division of Infectious Diseases at UT McGovern Medical School and a professor of microbiology and molecular genetics. Patnaik is a fourth-year medical student at McGovern Medical School.