Delta Force

Facing the challenge of the newest variant and other infectious diseases

The very particular work of keeping up with the unique needs of New Yorkers experiencing homelessness is no small task. It takes kindness, care and a big heart. But it also takes patience, intuition and tenacity. And as of late, such a calling requires people who can remain indefatigable in the face of a continually morphing global health pandemic.

With the growing spread of the new Delta variant of Covid 19, administering vaccines is ever-more important to The Floating Hospital’s patients. Estimates this summer from the Department of Homeless Services put vaccination rates for homeless adults at around 20%, in comparison to the city as a whole, with a reported near 60% fully vaccinated rate.

But patient needs don’t end at slowing the spread of the latest riff of the coronavirus. The conditions under which adults and children experiencing homelessness live—high-density shelters, lack of hygienic accommodations—make them particularly susceptible to other infectious diseases. Compounded with isolation and lack of reliable information, such families often are at peril.

“The population the clinic serves has many infectious-disease issues—chronic hepatitis B and C, HIV, tuberculosis, and other recurrent infections that occur in more complex medical backgrounds, all of which inevitably interweaves with socio-economic situations,” says Dr. Seung Kang, the Floating Hospital’s new infectious disease physician.

Dr. Kang says she’s also seen a significant rise in sexually transmitted diseases over the course of the pandemic, adding yet another level of complication in the pathway to good health. “A lot of infections are treatable. A lot are preventable,” she says. “My job is to let people know there is great treatment out there and it’s available here.”

Keeping up with these serious but treatable health issues and encouraging people to get inoculated has been a significant challenge. Part of the solution was expanding the role of a dedicated infectious-disease specialist from only once a month to Dr. Kang’s schedule of twice-weekly full office days at the new Long Island City clinic. The Floating Hospital is in the planning stages of building a new dedicated vaccine center in the clinic adjacent to the community center, following its integrated “one stop shopping” model of offering multiple services under one roof.

But, it’s been a challenge during Covid getting the word out about the enhanced services.

“My understanding is [we] used to see more HIV and hepatitis B and C patients and right now, not many because people in the community know we have expanded our infectious-disease services,” she said.

Through health education and shelter and community outreach, she anticipates the word will get out.

“There are many barriers related to where patients live, how they live, and the circumstances they’re under,” says Dr. Kang. “Many times, they don’t have cell phones, so we reach out through the shelters. We try to call them, to educate them on how significant a condition is.”

She cited the experience of long-time social workers at the clinic who understand the many social and insurance issues shelter residents face, and who are experienced in connecting them to resources.

Dr. Kang’s greatest challenge, however, isn’t treating disease or helping her patients establish a path to good health: It’s education. Patients, she said, often don’t understanding the seriousness of a condition or the importance of treatment. Or, in current times, they may have misinformation about the Covid 19 vaccine. And all of this can be impeded by language barrier issues or deep-seated cultural beliefs leading to vaccine hesitancy.

“People are swayed by misinformation very easily. A physician has to have a rapport with her patient and find out a good starting point to begin the conversation,” she says. “It takes time. All the providers here work really hard to educate patients about vaccination, and be encouraging in a gentle manner.”

The Floating Hospital is currently raising funds to build out a new, dedicated vaccination center. For information on how you can help, please contact executive director Ellen Barker, ebarker@thefloatinghospital.org