By Ricky Rodas | In Dialogue, Street Spirit
Here’s how homeless people can stay safe during the pandemic—and how housed people can assist their unsheltered neighbors.
Dr. Jason Reinking—endearingly known by his patients as Dr. Jay—is a busy man. The novel COVID-19 outbreak has swept through the U.S at an astonishing pace and has thrust a daunting challenge upon physicians like Dr. Jay—making sure the most vulnerable members of society have access to health care even when they don’t have a roof over their heads.
A graduate of the Loyola Stritch School of Medicine in Chicago, Dr. Jay has spent the last several years of his medical career in the Bay Area practicing street medicine and treating underserved communities.
He is currently a physician and medical director of LifeLong Trust Health Center. Previously, he was a street medicine doctor for Oakland Roots Clinic, providing urgent and primary care services to roughly 1,500 chronic street sleepers in Oakland.
Despite his busy schedule, Dr. Jay made the time to speak with Street Spirit about ways unsheltered people can protect themselves during these tough times—and what their housed neighbors can do to provide support. “There’s a lot of articles in the San Francisco Chronicle about all this stuff, but folks that we care about read this publication,” he said. Our interview has been lightly edited.
Dr. Jason Reinking AKA Dr. Jay. (Courtesy of LifeLong Medical Care)
Street Spirit: Overall, what can unsheltered people do to protect themselves right now with limited resources?
Dr. Jay: I’m going to say a few things.
Social distancing practices—why we stand “six feet apart”
This illness spreads by droplets in the air that come through when people cough, sneeze, and even when people are talking especially loudly, the virus can come out of the mouth and into the air. It typically falls to the ground within six feet. So, the reason that the ordinances from the state and the [Alameda] county are in place to maintain six feet distance because droplets in the air fall to the ground, usually before six feet.
So, social distancing is a really important concept to prevent the spread. One of the metaphors that is being used for this infection—for preventing this infection— is being in a bubble. If you’re sleeping in a tent on the street and you’re sleeping with one person in the tent, that tent is your bubble. You and that person want to keep your bubble intact, meaning that if that person goes away from you and starts interacting with a bunch of people and then comes back into the tent, the bubble is broken.
The best possible situation is to keep your bubble intact with whoever you are staying with in your immediate proximity.
Best hygiene practices
We also know the virus spreads by getting on people’s hands and then getting into their nose or mouth through touching food, touching your mouth, or touching your nose. So, you want to do a few things. You want to make sure to keep your hands as clean as possible either through washing hands or using hygiene gels. Always be thinking about trying not to touch your face.
Most outreach organizations have been equipped with hand hygiene gels. So, if you see folks out, please ask for [hand sanitizer]. If the hand washing station that you’re around is not functioning or it needs to be refilled, if you don’t have a hand washing station in whatever encampment you’re in, if you see outreach workers who are out there, please advocate for them to get you a hand washing station wherever you’re staying.
Hygiene practices—food preparation
[The CDC is not advising] to wash your food before you eat it. There’s this idea you need to wash everything you’re eating with soap and water, but what’s more important is that you actually need to wash your hands before you eat if possible.
Alameda County does have facilities for folks who are sick. That means if you feel like you’re getting sick, then you need to reach out to the outreach folks who are coming around your area. Or, you can reach out to local homeless service providers, such as shelters and meal centers. Let them know that you’re not feeling well. That way, [you can get a spot in an] isolation hotel. [Hotels allow] people [to avoid] passing the virus by being in their own room with their own bathroom.
I think that’s an important thing that I want people to know about—to reach out if they’re feeling sick.
The biggest ones are fever, cough, shortness of breath, sore throat, runny nose, and to a lesser extent, diarrhea. The other major symptom is just overwhelming fatigue or muscle aches. So, if somebody is feeling the onset of those things and it hasn’t been going on for months and months and months, but really just, you know—I feel like I’m getting sick and this is how I’m feeling—please reach out to those homeless service providers so that you can get the help you need.
Street Spirit: How can housed people help their unsheltered neighbors during this time? What are some resources that unsheltered people may need, and how can these supplies be given in a way that protects both groups and minimizes exposure?
Dr. Jay: I think that is a really important question. I think the major things are to, number one, donate to the local food banks. I have heard that the local food banks are running a little low on supplies. There are a variety of organizations that are using the food banks to bring food out to encampments all over our county.
If people want to help people who are sleeping on the street right now, if they can donate things like hand hygiene gels and masks. The other thing that I’ve heard is helpful is tents so people can stay more socially distanced within the encampments.
[Donate to] organizations that are working with homeless and doing outreach. Some of the big ones are LifeLong Medical Care, the Suitcase Clinic [currently closed for rest of Spring Semester], Roots Community Health Center, Alameda County Healthcare for the Homeless, and the Berkeley Free Clinic. There are many, many more shelters and meal centers that are directly directing helping the homeless during this [pandemic]. (See the chart at the end of this article for additional places to donate.)
Street Spirit: Would you suggest for the person who’s donating the material to take the initiative to disinfect it, or should they leave that to the organization they’re donating to?
Dr. Jay: I think that’s a great idea. I think the most relevant point is it appears the virus is staying on surfaces for up to three days. If you’re grabbing a tent that’s been rolled out in your garage for example—if it’s been in a stable place for more than three days, you don’t need to get it all out and disinfect the tent itself. But, upon handing it to somebody, if you’re using your hands then obviously it could be something on the outside of the tent. So what I recommend doing is putting things in anything you want to donate to in bags. When you donate it, you empty the bag and take the bag with you. That way, whatever is inside the bag stays relatively clean.
Anybody who receives anything from anywhere at any time, whether you’re receiving it as an organization or you’re actually a person who is receiving something for your own use, obviously the best thing to do is to disinfect it. That might be hard to do on the streets so we definitely recommend [anyone] who is giving things to people on the street disinfect themselves before giving them out to people.
Street Spirit: If an unsheltered person starts to feel sick, how can they practice self-isolation while staying safe and getting the stuff they need?
Dr. Jay:If somebody is starting to feel ill, like all the symptoms that I was describing before, it’s really important to reach out to whatever service medical service provider is in your area. So for example, there are some street teams that are doing consistent outreach during this that have nurses and doctors on them.
Please reach out to those street teams. If you don’t have a street team in your area, please consider going to either a clinic like LifeLong, or even the emergency room if absolutely necessary to take a test and get evaluated.
In those situations, if you are feeling the signs and symptoms of COVID, the best thing to do is to use the county’s offering of a hotel room so that you can be separated from other people to prevent the spread of the illness. If somebody doesn’t want to go to the hotel and has to stay in the camp, then you absolutely need to wear a surgical mask. Try to stay away from people by six feet and please don’t be handling things back and forth to people. That’s the most you can do.