CovidX

The many aspects of vulnerability

During a global pandemic, the world is focused on health — but everything is health. The best medicines and technology are helpful, but social determinants define the true health of a population. The most vulnerable among us are even more vulnerable to the negative health, social, and economic impacts of our current crisis, and demand for support services is high. 

As the coronavirus spreads, our understanding of the impact on different communities has evolved. Two weeks ago, we expressed concern about those who can’t isolate at home because of housing insecurity, domestic violence, or other circumstances. Over time, more transparency and data has revealed the nuances of disparity; patterns vary by region, and every community’s needs are different. “Vulnerability” takes on new meaning every day; we already know race and ethnicity, age, employment, incarceration, and a number of other factors determine risk of exposure, access to care, and clinical outcomes. 

By its very nature, infectious disease affects everyone, but underresourced people often pay the highest cost. It’s in society’s best interest to swiftly address disparity and bring help to those at greatest risk. 

General resources

• The CDC published Interim Guidance for Administrators and Leaders of Community- and Faith-Based Organizations to Plan, Prepare, and Respond to Coronavirus Disease 2019 (COVID-19). The agency also published a telemedicine fact sheet for health and mental health providers.
• New York Cares, which is contracted with NYC Emergency Management to facilitate volunteer efforts, specified safety protocols for community organizations and volunteers.
• Many states and cities offer resources for people working across a range of social services; for example, the Michigan Department of Health and Human Services published a guide to supporting behavioral health workers.

Housing and homelessness

• The CDC published interim guidance to help service providers plan and respond to COVID-19, screen clients at entry to homeless shelters, and work with people experiencing unsheltered homelessness.
• The Disaster Housing Recovery Coalition — led by the National Low Income Housing Coalition and consisting of 850 organizations —  is also hosting national calls on coronavirus and homelessness every Monday at 2:30 p.m. ET. The coalition also published information on responding to coronavirus, eviction or foreclosure moratoriums, and the CARES Act.
• The National Healthcare for the Homeless Council is hosting weekly virtual town halls each Friday. The council also collated a range of resources, including a guide on responding to COVID-19 among people experiencing unsheltered homelessness.
• The Cloudburst Group prepared guides for Preventing & Managing the Spread of Infectious Disease Within Shelters and Preventing & Managing the Spread of Infectious Disease within Encampments.

Justice and incarceration

• The CDC published Interim Guidance on Management of COVID-19 in Correctional and Detention Facilities.
• The Vera Institute of Justice published a series of fact sheets for those working in the criminal and immigration legal systems, including police and law enforcement; prosecutors, defenders and courts; and jails, prisons, immigration detention, and youth facilities.
• Organizations are also hosting webinars for law enforcement and correctional staff: The National Commission on Correctional Healthcare has weekly virtual roundtables, and the American Jail Association shared a recording of their webinar COVID-19 in Jails: Talk to the Expert.
• The Marshall Project is tracking how justice systems are responding in each state, and the ACLU offers suggestions for how police, prosecutors, sheriffs, parole officers, and governors can help stop the spread of COVID-19.

Domestic violence

• There’s been an increase in domestic violence across the world, resulting in a surge in calls to helplines and visits to support websites.
• The National Network to End Domestic Violence consolidated a range of resources for support services, including guidance for program delivery, tips on operating remotely, and a toolkit for safely using digital services.
• State organizations are also sharing support materials: The Pennsylvania Coalition Against Domestic Violence collated resources for program providers; the California Partnership to End Domestic Violence is tracking new policies; and the Washington State Coalition Against Domestic Violence uploaded a webinar and slides for domestic violence and sexual assault advocates.

Mental health

• The American Psychiatric Association shared a range of resources for psychiatrists, including information on telepsychiatry and managing psychosocial responses to the pandemic. The association also offers a Practice Management HelpLine for members.
• JAMA Psychiatry published an article about Addressing the COVID-19 Pandemic in Populations With Serious Mental Illness.
• Several resources are also available to support practice management: The National Association of Social Workers shared a guide on how practices can prepare for the pandemic; the National Council on Behavioral Health collated resources for organizations; and Elous Health’s guide to transitioning to remote work includes tips around telemedicine and maintaining client privacy.
• Crisis Text Line is sharing notes on “everyday empathy” and its response to the pandemic, including texter demographics and the phrases that help texters feel more calm.

Drug and alcohol treatment

• Various policies have been amended to support social distancing: The Substance Abuse and Mental Health Services Administration (SAMHSA) issued revised guidance enabling access to 28-day, take-home supplies of methadone for all stable patients, and the Drug Enforcement Administration is permitting patients to be initiated on buprenorphine through telemedicine.
• Many services are also moving online: Alcoholics Anonymous and Narcotics Anonymous are hosting remote meetings, the Recovery Centers for America uploaded a list of virtual meetings and activities, and SAMSA shared a list of virtual resources.

Elder care and assisted living

• The CDC recorded a webinar for long-term care facilities. It has also shared a preparedness checklist for nursing homes and other long-term care settings.
• The American Journal of Managed Care published suggestions for preventing loneliness among the senior population during the COVID-19 crisis.

Family services

• The coronavirus is leaving many foster children with nowhere to go and advocates have expressed concerns over child welfare. The National Council for Adoption collated resources, including organizational resources for adoption professionals, and the Child Welfare League of America is sharing updates and links.
• The Association of Family and Conciliation Services shared resources for family law professionals, such as advice on parenting plans and remote dispute resolution.

Food insecurity

• Food banks are reporting unprecedented demand but have also needed to update practices to protect staff and clients. The California Association of Food Banks published Prevention Practices For Food Banks & Food Pantries and the Kansas Department of Health and Environment shared similar guidance.
• The Food and Nutrition Service published a list of actions to respond to COVID-19, including updates on SNAP benefits and the WIC Program.