As millions of people across the U.S. struggle under stay-at-home orders due to the novel coronavirus pandemic, there are thousands in the homeless population who are facing the threat of COVID-19 without a safe place to stay.
To help this uniquely vulnerable population, Penn State alum Brett Feldman is working on the streets of Los Angeles during the novel coronavirus pandemic. He said that while times are difficult for everyone, the unsheltered homeless face different challenges than those in shelters.
“While we are all being told to stay safe and stay home, they don't have anywhere to go,” said Feldman, who is now a physician assistant and the street medicine director for the Keck School of Medicine at the University of Southern California. “And if they live in crowded areas like Skid Row, social distancing is difficult, conditions are often unsanitary, and basic recommendations like washing hands is impossible.”
Feldman graduated from Penn State in 2003 with a degree in kinesiology, his interest in medicine sparked by Lori Gravish, an assistant teaching professor in kinesiology at Penn State. In 2018, he received the Alumni Service Award, which recognizes Penn State Health and Human Development alumni who have positively impacted people's lives through service to others above and beyond their call of duty.
According to Feldman, his interest in street medicine — care designed to address the needs of the unsheltered homeless and to be delivered in their own environment — was inspired after his wife and fellow Penn State alum started a clinic at the Allentown Rescue Mission with DeSales University.
“We realized that in that setting, our care was tied to the patients staying in the shelter,” Feldman said. “If they left the shelter, we lost them. We would start potentially lifesaving treatment during their shelter stay and knew they wouldn't do well without it after they left. At that point, we decided to take the care to the street.”
After the coronavirus reached the U.S., Feldman realized that the homeless population would need special care and attention.
Now, two months later, Feldman starts his days by suiting up early in the morning with gloves and a mask. With about 45,000 people sleeping on the streets of LA in a given night, he said it’s impossible to reach them all, but he tries to prioritize those who are high risk.
“In street medicine, we don't work out of an office or RV,” Feldman said. “All care is delivered during walking rounds with a pick-up truck and backpacks. The motto is to ‘go to the people,’ which we do in a radical way. We want to see them where they feel comfortable, not where we feel most comfortable. This ends up being in some strange places — sometimes under a bridge, behind a dumpster, or anywhere they are staying.”
Of course, Feldman faces the same challenges that all healthcare providers are currently facing with COVID-19: there is no proven treatment or medication for the disease and criteria for getting tested is strict. But, he’s still able to take temperatures, distribute hand sanitizer, and provide education about how they can protect themselves.
Feldman said encouraging social distancing, in particular, has been difficult. Without a home to go to or the resources to stock up on groceries and supplies, people instead need to travel the streets searching for supplies and shelter. And, while he said many are taking the threat of coronavirus seriously, it is not the only danger they are up against.
“These people are used to many daily threats to their health and safety,” Feldman said. “Their threshold for reacting to these threats is much higher than ours, so COVID-19 is just another daily threat they face. In this way, they are much more resilient than we are, for better or worse. The feeling of knowing you're exposed to danger but without the ability to protect yourself is a feeling no one should face.”
Feldman said the job comes with many logistical difficulties, such as trying to stay in contact with patients and keep their eyes on the streets when they can’t take care of everyone. But while it can also be emotionally and mentally draining, it’s a career he chose for a specific purpose.
“In street medicine, we choose to stand in solidarity with those we serve and accompany them on their journey,” Feldman said. “By doing so we share in their suffering and become witnesses to that suffering. By doing so, we have the duty to come back and report what we see. COVID-19 is our next chance to share in their suffering with joy.”
'We Are' stories
The “We Are” spirit is perhaps more important than ever before, and Penn Staters everywhere are coming together in new and amazing ways. During these challenging times, our community is continuing to realize Penn State’s commitment to excellence through acts of collaboration, thoughtfulness and kindness. As President Eric Barron has written on Digging Deeper, this truly is a “We Are” moment — and we want to hear your “We Are” stories.
Visit news.psu.edu/WeAre to share how you or other Penn Staters are supporting each other to overcome the collective challenges presented by the novel coronavirus. We are!