Children’s Dental Health Month – Practice Taking Precautions during Pandemic: Don’t Postpone Your Child’s Dental Care
by guest contributor Rosie Kickish, DMD, Inspiration Dental in Riverview, FL Everyday life looks different…
Self-isolation. Social distancing. “Shelter-in-place.” Or in the words of some (not-safe-for-work) Italian mayors who have gone viral – “I don’t want excuses, you have to go home!”
Whatever term you use, reducing crowds in public places and through private gatherings is an essential piece of the state and national strategy to reduce the spread of COVID-19 and preserve essential medical resources. But what happens when you don’t have a home to shelter in, or when your regular shelter is itself crowded and doesn’t allow for isolation?
Nationally, roughly 568,000 people are homeless on a single night in America (based on 2019) data, according to the Department of Housing and Urban Development, looking at those who are “unsheltered,” in places not meant for habitation (cars, campsites), and within homeless shelters. However, about 172,2000 people across 54,000 families with children fall under this umbrella. Families with children are more likely to make alternate arrangements such as motels or living “doubled up” with family or friends. This definition, which is used by the Department of Education for its programming includes at least 1.5 million students, three-quarters of whom live “doubled up.”
Different populations experiencing homelessness have different needs. A key concern among housing agencies is the continued spread of the virus should an individual in the shelter system become sick; most shelters use dorm or communal living situations, which makes true isolation impossible. As the Urban Institute notes, “communities should consider ways they could temporarily expand shelter capacity to allow for isolation or form a plan with their public health agency for isolation strategies once people are identified.” There has been significant media coverage of California’s efforts to house homeless families and individuals in hotels which are facing significant vacancies, though advocates report there is stalled movement on obtaining this necessary level of privacy for self-isolation with success ranging by county.
The U.S. Interagency Council on Homelessness has a resource document to help schools and other providers consider the specific needs of housing unstable families during this crisis, including the following (additional considerations for each question are provided in the full document):
The New York Times shared a vivid portrait of one New Jersey family whose doubled up arrangement was quickly upended, leading the family to sharing one room in a motel during quarantine. The family is eligible to continue receiving free meals from their school, but cannot obtain transportation to do so, and so make use of the small in-room kitchenette. Another Times piece highlighted that family shelters in New York City often do not have available wireless internet – so despite the fact that devices have been made available for students to continue virtual learning, children in shelter cannot “log on” with their peers. These challenges add to the stress families are experiencing as they try to stay safe and healthy, and will deepen the “learning gap” that divides families by income.
There is also a need to ensure that more families do not become homeless as a result of this crisis and the ensuing economic impact. The Urban Institute highlights eviction moratoria – passed by a growing number of state and local governments, as well as extended to certain federally funded housing – as a key policy lever which can make sure vulnerable families do not lose housing, risking their health and well-being. They also identify opportunities to utilize surplus government property as shelters (allowing more individuals to move off the street, or to reduce the concentration of people).
The issue of homelessness and housing instability has always
required collaboration across multiple sectors – housing, health, education,
human services, and non-profit organizations – and that need has never been
greater than with the urgency brought by the pandemic.
 This post focuses on the situation for families particularly with young children. The US Interagency Council on Homelessness (USICH) maintains a COVID-19 specific database on resources and examples from communities across the country related to individuals, families, and unaccompanied youth. Increased outreach for those experience “street homelessness” is essential, as are safety procedures for both staff members and the population with whom they work. For those interested in learning more about the situation for individuals, who may be chronically homeless or facing co-existing health issues, we suggest recent media coverage from The Texas Observer and Vox media.