In May, the University of Washington Medicine announced that it would furlough 4,000 more workers due to a $500 million shortfall in its budget stemming from coronavirus-related costs and reductions in revenue-generating services.
Neighborcare, the nonprofit that provides health care to low-income people, shared a similar fate.
Just as low-income households need medical care the most, Neighborcare has been forced to reduce its staffing due to loss of funds. At the same time, it’s deploying a nursing team that has predominately served permanent supportive housing buildings to do coronavirus testing in unhoused communities.
“We’re pushing to make sure our patients know that we are available for care, because we don’t want them to go without care,” said Mary Schilder, spokesperson for Neighborcare.
However, it is hard or impossible to do much of the work they once did since Gov. Jay Inslee put orders in place that restricted some services in order to prevent the spread of the coronavirus.
Dental appointments have dropped by 90 percent, and medical visits are down by 30 percent, Schilder said.
In-person health visits are still possible, but they are more rare. The organization is making up some of the difference with telemedicine, allowing people to call in for appointments like mental health care or medical care. When they see a patient in person, they limit the amount of time people are in the waiting room and do additional sanitization work to ensure safety.
Out of office visits, particularly for COVID-19, the disease caused by the coronavirus, are ramping up.
Joanna de Haan is Neighborcare’s homeless and housing programs manager. She runs the Homeless Outreach Team (HOT) and the COVID assessment team (CAT), a mobile unit that tests people experiencing homelessness for the virus.
“We’re trying to do it all right now,” de Haan said.
Neighborcare is in partnership with other health care providers such as Swedish, Harborview and the Seattle Flu Study to ensure that people without stable housing are being tested for coronavirus to avoid community spread among people experiencing homelessness.
They’ve found symptomatic and pre-symptomatic people in congregate settings, like shelters, de Haan said. So far, there hasn’t been a known outbreak among people experiencing homelessness that are living in unauthorized encampments.
That doesn’t mean it hasn’t happened, de Haan said.
“I think we’ve seen fewer cases in encampments than in congregate shelters,” de Haan said. “That being said, people move between and use the same services, so it’s very hard to track. I think there is some of that cross pollination that happens.”
Still, said Richard Waters, the site medical director for the homeless and housing program, there has yet to be a confirmed case in a homeless encampment.
“The push to get people into shelter no longer has the same kind of risk-benefit that it used to, the harms being much greater,” Waters said.
As of early June, only one person on the outreach team had contracted coronavirus, and it happened through community transmission, before mobile testing began and before Inslee instituted the statewide lockdown.
Things could get worse.
As Washington counties have opened up, coronavirus cases have jumped. Inslee called out Benton, Yakima and Franklin counties. More populous counties, like King County, have not been cleared for a reopening because even relaxed standards for the coronavirus — 25 cases per 100,000 residents versus the previous standard of 10 — have not been met.
People need to continue to be cautious, Waters said. They should not go to work if they are sick, and congregate shelters, unlike single-occupancy hotels, are not necessarily safe.
The killing of George Floyd, a Black man, by Derek Chauvin, a now-former member of the Minneapolis Police Department, ignited protests that have now gone on for weeks with thousands of Seattleites thronging to public spaces. These congregate places could be a ripe place for coronavirus to spread, but Waters said that, so far, the health care system has it under control.
No member of the public health system in King County has encouraged people to stay home rather than protest, despite potential risks. So far, the predicted spike in coronavirus cases has not occurred. Most protesters wear masks, which a recent study showed to be far more protective against spreading coronavirus than previously thought.
It’s still important to be careful, Waters said.
“We need to be making sure we don’t lose sight of what we’ve clawed back in terms of stopping transmission,” Waters said, at the beginning of June.
As cases in Washington escalate, weeks after, Neighborcare will still be there.
Ashley Archibald is a Staff Reporter covering local government, policy and equity. Have a story idea? She can be can reached at ashleya (at) realchangenews (dot) org. Follow Ashley on Twitter @AshleyA_RC.
Read more in the June 17-23, 2020 issue.