TFH’s patient families were particularly hard hit. Social distancing is not easily managed when four family members share a room and a bath. But, moreover, impoverished families suffer disproportionately from chronic conditions related to malnutrition—diabetes, hypertension and obesity. Routine primary care, suspended during COVID, was their lifeline to support. Self-monitoring devices such as glucometers and portable blood-pressure meters are not readily available for families living in shelters. Families were not able to receive the essential items such as diapers, formula, hygiene products, clothing and food that were routinely during shelter outreach visits. Most importantly, without their frontline support, many of whom were furloughed or working remotely, these families were left stranded, sequestered and struggling to find a safety net.
While much of America adopted phone or video telehealth for routine medical needs, the new healthcare model for homeless families without WiFi was postponement. These forgotten families rely on flip phones, if they have phones at all, and by-the-minute-purchase plans.
TFH staff members did what they’ve always has done—rolled up their sleeves and got to work. Drivers who used to transport patients, pivoted to contactless delivery of prescriptions, and transported essential staff so they could reduce exposure to infection on public transit. Existing patients were transported one family at a time to clinics for the most serious matters. Health educators ensured that each family who made it to a clinic left with essentials, and set up a distribution network among the shelters for donated and necessary goods. The new infectious disease doctor managed COVID-symptomatic as well as HIV-positive patients, and advised on testing protocols. The mental health team maintained contact with patients via telephone. Administrative staff adapted to home-based work, and worked tirelessly to secure every bit of COVID relief funding available.
As a “50-something” with parents in their 80s, I also had to adjust to a work-at-home world. My trips to the clinic, however, enabled me to see an amazing group of people as I did 16 years ago and marvel again at how they work through adversity with dignity and good spirits. It reminded me also of my original commitment to the hospital to preserve at least one place in healthcare where the concept of a safety net is preserved in its best form, and to aid those who dedicate their lives to make that happen.