Coronavirus Brings New Challenges To Doctors For NYC's Homeless

NEW YORK, NY — When the coronavirus pandemic hit New York City, doctors at Project Renewal knew their mission of providing medical care to homeless New Yorkers would become all the more important.

But it would also bring new challenges — the first being connecting with those who need their help.

"They were refusing services, they were staying in their rooms — they were scared to come out," Chief Medical Officer Dr. Allison Grolnick said.

"We've worked really hard to...help people understand this is a really hard time for everyone, and we can provide support."

Slowly but surely, Grolnick said, residents at the 11 shelters Project Renewal runs or has clinics in began to respond, and the need for their medical services rebounded.

The expanded outreach, both in their shelters and with their mobile medical van, has been just part of how Project Renewal, based on Varick Street, has had to adapt during the coronavirus pandemic, to which homeless New Yorkers are particularly vulnerable, Grolnick said.

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One of the biggest changes has been switching to virtual appointments, particularly for the much-needed psychiatric care of their patients.

Before the pandemic, Project Renewal had three psychiatrists who did virtual appointments. Now, they have 17.

The Telehealth approach ensures residents can not only talk with someone about their mental health challenges, but continue to get medication refills, all while maintaining social-distancing, Grolnick said.

"The space that normally would have been for seeing [a psychiatrist] face-to-face has a mounted screen that a staff member turns on and off," she explained. "The client doesn't have to touch anything other than sitting in the chair."

That social distancing has become increasingly important as Project Renewal deals with its own staffing shortages because of the coronavirus.

So far, 25 of its 850 staff members have been diagnosed with the coronavirus and another 45 are suspected to have it.

Grolnick said they also have anywhere from 10 to 15 percent of their staff staying at home because their own pre-existing conditions or age makes them vulnerable to the virus. Many of those staff members are also jumping on video chats to still care for their clients from home, she added.

Those appointments have become all the more important given that their clients are particularly vulnerable to the coronavirus.

Homeless New Yorkers are more likely to have underlying medical conditions like diabetes, heart problems, asthma or hypertension that make them more at risk both for getting COVID-19 and having it be a more serious case if they do, Grolnick said.

"Often they have all of the above, and serious mental health and co-occurring substance use issues," she said. "It's more common than not we’re treating all of those things."

Project Renewal has compiled a list of patients who either have these underlying conditions or are at higher risk because of their age so that they can monitor them, Grolnick said.

Those who are suspected of having the virus are transferred to isolation beds set up through the Department of Homeless Services. So far, 45 Project Renewal patients have tested positive for the coronavirus.

Keeping their patients healthy even has another level of importance during the pandemic — preventing unnecessary trips to the city's overwhelmed hospital system, Grolnick said.

"These are people that normally flood emergency rooms," Grolnick said. "Right now its even more critical to keep people out."

Project Renewal is among the many New York City organizations and shelters shifting its services during the coronavirus pandemic. Struggles with social-distancing at some shelters led the city to open 6,000 hotel rooms for homeless New Yorkers to help stop the spread of the virus, though some have said the efforts should go much further.

As of last week, 51 people in the care of the city’s Department of Homeless Services died of complications related to the coronavirus, which has now spread to more than a third of the city’s 450 shelters, according to the New York Times.

Through the challenges, though, Grolnick said a source of hope at Project Renewal has been her staff's unwavering commitment to those they care for, even as they or those they know get sick.

"It is a definite tremendous burden and weight that’s overlaying everything, but despite that people have returned," she said. "They’ve taken time to grieve, and they’ve come back. They’ve taken time to heal themselves, and they’ve come back."

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