Q&A with George Nashak from Care for the Homeless on the COVID-19 crisis

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For 35+ years, Care for the Homeless (CFH) has brought essential medical, mental, and behavioral health care to people experiencing homelessness in New York City. We chatted with Executive Director George Nashak to learn how CFH is helping vulnerable communities in New York City during this difficult time.

How has the homeless population in NYC been impacted by COVID-19?

People experiencing homelessness in NYC live on the streets, in drop-in centers, or in congregate shelters configured as dormitories. Obviously people in these circumstances are at very high risk of transmission of a highly infectious respiratory virus. In addition, many of our clients are living with multiple chronic medical conditions, including co-occurring mental health or substance use disorders, making them more vulnerable to significant health consequences if they are infected. To address this risk, the NYC Department of Homeless Services and the homeless provider community have established a network of hotel-based isolation programs where people who are symptomatic or COVID-positive can be isolated for their own recovery and to reduce the risk of transmission to other residents or staff.

Care For the Homeless, as a health care provider to homeless and unstably housed people, has committed to remaining available to all of our patients. This has been challenging for multiple reasons, not the least of which is that some members of our medical team have been impacted by the virus themselves. But we have been able to remain open at most of our sites and we have expanded our use of tele-medicine significantly.

What have we learned about the pre-COVID-19 health care system from how the pandemic has played out?

While the COVID-19 pandemic did not cause health and economic disparities, it has very efficiently exposed these disparities. It has been disturbing to see how many homeless and vulnerable people were not connected to high-quality health care coming into this crisis. It is frankly shocking to learn how few Americans have just a month or less of savings to tide themselves over in a crisis. Those of us in this field have long advocated for making the social safety net more robust. Sadly, the COVID-19 pandemic has demonstrated the validity of the concerns we’ve expressed for years. It’s not okay that there are so many low-income people living with multiple chronic health conditions, particularly when those conditions are preventable or treatable.

What strengths of the CFH organization has the pandemic exposed?

Before COVID-19, we knew our staff were extraordinary. But I have been moved on a daily basis by how heroic our team has been in the face of a real crisis. Our medical and shelter staff leave their families each work day and put themselves at risk by serving our patients. Their selflessness has been a real inspiration to all of us.

Post-pandemic, how do you think the healthcare landscape will be forever changed?

I can describe how I would like it to be changed. The lessons of COVID-19 for those of us who serve low-income and vulnerable people are that everyone should have low-barrier access to high quality health care. People with chronic health conditions have turned out to be at much greater risk of serious health consequences and even death from COVID-19 infection. We should be ashamed by how many of these tragic consequences could have been avoided by providing everyone – not just wealthy people – with high quality health care. Universal access to health care needs to become a priority and perhaps one of the positive outcomes of this pandemic will be to provide a strong argument for doing so.

How can people help your organization as you continue to work on the frontlines of this crisis?

Care For the Homeless is committed to remaining available to our highly vulnerable patients.  The COVID-19 crisis has created multiple challenges to our ability to accomplish this important goal.  We are facing staff who are themselves ill, lowered revenue because patients are seeking less routine health care in the crisis, and the loss of revenue associated with a slower roll-out of new health centers that were scheduled to open in recent weeks.  We’ve also needed to increase our spending dramatically to ensure our staff have appropriate protective equipment and medical supplies. Our key need at this point is funding to sustain our operations to ensure that we can survive this crisis.  We welcome donations to help us continue our life-saving work. Anyone interested in helping us can donate at www.careforthehomeless.org.

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