New York City faces an unprecedented health crisis with the spread of COVID-19. This crisis calls for rapid and innovative interventions to ensure that the virus is contained to the largest possible extent, and that those who are infected are able to take care of themselves so that they can heal not spread the virus to others. In crises like these we must take into account the heightened risks face by those who face structural marginalization to ensure they are given adequate support. Accordingly, we implore you to make immediate changes to support those bedding down on the street – who are disproportionately people of color - to stay as healthy as possible.

Currently, municipal outreach teams engage people who are street homeless primarily by offering beds in municipal shelters, which are most often rejected by those on the street for understandable reasons: they have typically experienced them before and found that for reasons of safety the streets are safer. Accordingly, we implore the city to follow federal public health guidance, which falls in-line with a general harm reduction approach. This guidance calls for the city to provide bottles of hand sanitizer, socks, blankets and other items to those on the street.

As it stands, DHS is currently cherry-picking public health guidance as regards those living on the street. In particular, municipal outreach workers are now administering surveys, providing a mask to those who report they are symptomatic, and then compelling a hospitalization if a clinical determination is made that the person may be infected. This is the most bare-bones and half-hearted approach the city could take, and in no way meets the needs of those on the street. Rather than administering surveys and moving on when someone does not express being symptomatic, DHS must provide these individuals with preventive mechanisms to help support their health at this time of extreme vulnerability. Those living on the streets with soap and hand sanitizer to keep their hands clean, and socks and warming supplies to help ensure the health of their immune systems.

Homeless New Yorkers living on the streets are especially vulnerable to COVID-19, given that they often suffer from disproportionate levels of disabling conditions. With some community organizations that provide food, showers, laundry and other services beginning to limit what they can offer (in order to prevent social crowding and viral spread), New Yorkers living on the streets and subways – disproportionately people of color - are finding it increasingly difficult to access basic items that would help prevent from catching and/or spreading coronavirus and other illnesses. Moreover, given that they often have no or extremely low income, they are often unable to purchase items like hand sanitizer or hand soap on their own. At the same time, they are often not allowed to use restrooms in private establishments to wash, and the city has chosen not provide any portable public restrooms, which it does maintain a supply of.

Outreach teams are most successful when they can build trust and rapport with individuals who have faced significant traumas – as most on the street have – by supporting their safety in the present. Currently, DHS strongly discourages providers from distributing basic needs items that would reduce the harm of living on the street. In a particularly cruel unstated long-time policy, DHS takes the position that providing basic needs supplies which can reduce harm, such as socks, may cause someone to stay on the street longer and, correspondingly, that it is better not to provide these items and persistently ask the person to come into municipal shelter. This perspective is not based on evidence, defies common sense, and contributes to distrust and discord by those on the street toward outreach workers. It is certainly not a perspective informed by or in line with public health recommendations. It also assumes, wrongly, that providing basic aid and offering shelter are mutually exclusive. In fact, they are not at all mutually exclusive – DHS can and should empower and resource its outreach teams to do both of these simultaneously.

Given the circumstances, now more than ever, DHS must challenge age-old conservative notions about poor people that have continually plagued the agency, and take a leap in a progressive and compassionate direction. In this case, compassion falls directly in line with guidance given by HUD. Outreach teams must be encouraged and resourced to provide people with hand sanitizer, socks and other basic needs. It is of note that companies have already begun offering significant supplies to begin this process with, and we implore DHS to start there. However, the reality of this crisis is that the city must dedicate some emergency resources to ensure ongoing harm reduction interventions for the health of those on the street, and the health of all of us.