Jim O'Connell; Center for Primary Care at Harvard Medical School
July 2020
The COVID-19 pandemic has cast health inequities into stark relief, though this hasn’t surprised those of us already immersed in the care of homeless persons.
In healthcare, being intentional about the built environment is sort of a new idea,” said Dr. Neel Shah, a director at Ariadne Labs, in a May 12 virtual roundtable discussion hosted by MASS. “Within three days, we were doing the project, which involved letting the architects peer into Mount Sinai using a GoPro camera and Zoom conferencing,” added Bucuvalas. This was MASS’s second COVID-19-related undertaking, after it advised on the construction of two emergency tent structures for Boston Health Care for the Homeless Program back in March.
“I’ve learned from her that in medicine in particular, we kind of conceptualize drug use and pathologize it in a really profound way that isn’t necessarily valid,” Gaeta said.
Quarantining is complicated if you don’t have a home. “Homeless folks don’t have a place to isolate,” said David Munson, medical director of respite programs at the Boston Health Care for the Homeless Program (BHCHP). “They’re not able to physically distance in the way we have been advised to, the way that prevents the spread of this very infectious virus.”
The Boston Health Care for the Homeless Program found a “stunning” rate of COVID-19 transmissions while tracing asymptomatic carriers stemming from an outbreak at Boston’s Pine Street Inn.
As a data manager at Boston Health Care for the Homeless Program, Leah Shaw, A16, MG17 (MPH), typically uses her background in epidemiology and biostatistics to support HIV and Hepatitis C initiatives. But when the pandemic hit Boston in early March, it was all hands on deck. At Boston Hope, the field hospital set up in part to shelter homeless people who had tested positive for COVID-19, Shaw donned layers of personal protective equipment (PPE) to work with patients, doing everything from making beds to serving meals.
“We are still seeing a lot of overdoses,” said Dr. Jessie M. Gaeta, chief medical officer for the Boston Health Care for the Homeless Program. “We’re also worried that the percentage of them that are fatal are higher, just from our anecdotal experience. . . . Right now, we’re hearing about more of our patients dying than we’re used to seeing.”
When I worked at Boston Health Care for the Homeless Program, part of my role involved outreach at Common Cathedral, a homeless street ministry that gathered weekly on the Boston Commons.
The homeless are among the most vulnerable populations and a community that is among the most susceptible to contracting COVID-19. Harrison Keyes is making sure they are receiving the same care as the rest of Boston’s population.
