Robin isn’t too worried about the coronavirus.
“I can’t really do much about it because of the situation I’m in,” said the 60-year-old woman who calls her car home. “If that’s how I die, that’s how I die.”
As COVID-19 takes hold in Delaware, spreading silently through communities as some patients fail to show symptoms or even know they have it, people like Robin – a member of Delaware’s most vulnerable population – are also most at risk, both of contracting and spreading coronavirus.
That’s been further complicated as shelters, drop-in centers and other public places close their doors to limit the number of people gathering together – ultimately removing the very locations many of these people have to spend their days.
That leaves them alone, on the streets, in the woods, not knowing if they are carrying COVID-19. Not knowing if they are spreading it.
In response, those leading Delaware’s efforts to address mental health, addiction and homelessness did what they always do, they took to the streets to help those who most people ignore – only this time, they got some help.
Offering emergency housing vouchers, cellphones, food, clothing, health screenings and the overdose-reversing medication naloxone, Dr. Sandra Gibney and her team donned surgical gowns, masks, face shields and gloves to reach those without a place to sleep Tuesday night in Dover. When all was said and done, they placed about 30 of the most high-risk people into Dover-area motel rooms and got food and naloxone to even more.
The effort comes as part of a state Division of Public Health initiative around the coronavirus pandemic, with Gibney leading the charge as the medical director of outreach initiatives and mobile health.
It’s not a new idea for Gibney, who also serves as the chairwoman of the Access and Treatment Committee for the Behavioral Health Consortium and regularly takes to the streets alongside Lt. Gov. Bethany Hall-Long to get naloxone into the hands of those who need it most.
Together, Gibney and Hall-Long, who chairs the consortium, as well as their team of outreach workers, have been addressing these issues across Delaware for more than two years.
“Honestly, I’m a hugger and I wanted to hug a lot of people and I couldn’t today and that was painful,” Gibney said after the outreach trip, “because I wanted people to know I got them. The state’s got them. The lieutenant governor’s got them.
“We’re not going to let them struggle without trying to help.”
Take Joe, a man Gibney met late last year when he was living in a homeless encampment behind Eden Hill Medical Center in Dover.
The camp has long been destroyed, he said, forcing him and his girlfriend, Courtney, to relocate to a new spot in town. But Joe immediately recognized the friendly doctor who cared enough to learn his story last year.
“I can’t believe it,” he said, as Gibney disinfected a wound on his hand and supplied him with antibiotic ointment, Band-Aids and her cellphone number.
Through this outreach initiative, he would have a place to stay and was on a list to receive a cellphone in order to re-up his medication for Type 1 diabetes.
“It only takes the apocalypse to get help,” Joe said, “but we’ll take it.”
For a man who has called tents and tarps his home for years, even he felt the effects of the coronavirus and subsequent closures in Dover. The shutdown of shelters and food services, done in an effort to prevent exposure, means he and his friends don’t eat.
Others readily accepted bagged lunches and additional food packaged and made by Division of Public Health cafeteria workers, who have been repurposed in this time of need. The state, under Gibney’s leadership, intends to do this outreach every day for the foreseeable future. The team was able to medically screen about 68 more Wednesday in Wilmington, and plan to hit more locations in the coming days.
The initiative is a reflection of how the state has been forced to act under these dire circumstances, pulling together emergency housing vouchers, repurposing cellphones, calling upon clothing banks and using naloxone funds to address and provide for those most in need. The challenge, according to the state health department, is funding these efforts.
State officials are hopeful federal funding will become available soon, enough to get everyone in need of housing sheltered for the duration of the outbreak. For now, officials are using triage efforts to identify those most at risk for COVID-19 and those with persistent mental illness.
While Gibney handed out lunches, Lt. Gov. Hall-Long – a longtime nurse and professor of public health at the University of Delaware – conducted basic medical screens of everyone gathered in the parking lot of Hopes & Dreams Peer Support & Resource Center.
She, along with registered nurse Kaitlin Rau, asked them: Do you feel feverish? Do you have a cough? Are you short of breath? All signs and symptoms of COVID-19.
Nearly everyone said no. One man pointed out he always has a cough. But almost everyone needed something.
A place to stay the night. A meal. A cellphone. A sweatshirt.
“I do think it shows that these populations, not only are they at risk, like all of us, with the COVID outbreak, but they are also at great risk at these times to be forced to suffer more immensely,” Hall-Long said.
Those living outside can’t wash their hands numerous times a day, as advised by health experts. They don’t have access to hand sanitizer, and getting a “good night’s sleep” is a whole other challenge.
One man, who was released from prison in the past few weeks, has been sleeping under a tree because he doesn’t have anywhere to go. He doesn’t have a phone, so he can’t call a health care provider if he begins to feel sick.
Steven Hall considers himself lucky to have a tent. But that didn’t stop Hall, who said he has been homeless for 3½ years, from signing up to get a room, especially as temperatures fluctuate this time of year.
He only wished it was this easy to find housing when there wasn’t a pandemic.
Ask him about the coronavirus and he says he’s not worried.
“God has me covered,” Hall said, but he’s still feeling its reach.
“It’s affecting us to the point that we have nowhere to go. … We’re human, too.”
Even for those who did have a roof over their heads at a nearby Dover motel, the resources and outreach were readily accepted.
Residents poked their heads out of dark motel rooms despite the blue gowns and masks covering Gibney’s otherwise-smiling face. They nodded their heads and smiled, grateful for the food and naloxone, especially in this Delaware hotspot for overdoses.
One woman said her job has shut down amid the coronavirus crisis. A bag of food would help her eat.
A man said that he was sleeping in a friend’s shed just big enough to fit a bed. He comes to the motel to shower because another friend is living there.
A young girl immediately ripped open a prepackaged bag of cookies, a small trickle of drool rolling down her chin. She followed the outreach workers as they walked around the motel, arms outstretched for more.
COVID-19 is scary for everyone, but for those who don’t know where their next paycheck is coming from, or if there even will be one, the stress grows.
“It’s been a lot lately,” said Karen Rowland, a case manager at the Dover Interfaith Mission for Housing. “We’re seeing a lot of scared, panicked people.”
She’s been spending her days teaching people about social distancing and why it’s important. Rowland said many are scared to say they aren’t feeling well for fear they’ll be quarantined away from the only people they know, the people they feel actually care about them.
Rowland came into work Tuesday to support the people relying on her despite Interfaith’s increased restrictions amid the outbreak.
“These are the times that really show who’s there for them,” she said.
Gibney and her team agreed. Despite the long day, and days ahead, the doctor wanted to be present in Delaware’s time of need. It’s where she feels most at home.
Time after time, as people thanked her for the food and sleeping mats, Gibney began to lean forward and then caught herself.
At one point, she admitted it, regret in her voice.
“I’d hug you if I could,” she told Joe, a man who’s story stuck with her since November.
“I understand,” he said, raising his hand in a half-wave.
This wasn’t the first time he had heard from Gibney. And even in these uncertain times, he was certain this wouldn’t be the last.
How to get help
Those with general questions about the coronavirus can call the Division of Public Health hotline at (866) 408-1899 or email the division at DPHCall@delaware.gov. Those with hearing impairment can call 711.
If you believe you have COVID-19, contact your primary care physician, as a referral is required to be tested. Symptoms include a cough or difficulty breathing. If you don’t have a primary care physician, call the DPH hotline.Contact investigative reporter Brittany Horn at (302) 324-2771 or firstname.lastname@example.org. Follow her on Twitter at @brittanyhorn