First thing Monday morning, March 16, the staff of Palmetto AIDS Life Support Services in Columbia, South Carolina, held a meeting figuring out how to handle the coronavirus crisis. When they got out, Carmen Julious, their CEO, got on the phone with TheBody to say that the agency had decided to stay open, for the time being—but only Mondays, Wednesdays, and Fridays, from late morning to early afternoon—to help clients in emergency situations.
“That way, we won’t have a lot of people in and out of the office, but we’ll have our medical staff taking folks who need prescriptions, and we’ll be here for people who need help with things like getting rent and utilities paid,” she said. “We’ll be delivering food and medications to folks who need it. A lot of our own staff and volunteers have compromised immune systems,” she said, so the meeting was about finding the balance between “taking care of clients but making sure we’re not making anyone sick.”
She added: “This is new territory, so we’re just trying to figure it all out.”
Establishing a New Normal—for Now
Welcome to HIV care and services in the midst of perhaps the biggest national public health crisis since, well, AIDS. Nationwide, as schools, bars, restaurants, and all sorts of public and private venues shut down in state after state, HIV agencies are scrambling to ascertain exactly how to make sure that vulnerable clients don’t fall through the cracks, while minimizing human contact to the greatest extent possible.
And to hear agency staffers tell it to TheBody today, they’re finding some ingenious ways of splitting the difference. In Harlem, African Services Committee has decided to have just one person per department be in the office in case of client visits, said Amanda Lugg, director of advocacy and LGBTQ programming. “Staff overall have been asked to try to do client sessions over the phone,” she said. “We’re not even sure if we’ll be open at all next week—we’ll reassess on Friday. Basically, we’re staying open for the food pantry and for people who come in freaked out, in need of ‘comfort conversations.’”
Even the past few weeks, she said, the protocol for anyone who came in visibly ill or coughing was for the receptionist to ask them to go to the counseling room to have their temperature taken and to be medically assessed. And, she added, her own LGBTQ support group, made up mostly of recent arrivals from Africa and the Caribbean, were all staying in touch with one another, and with her, via a WhatsApp thread. “We’ve been pretty active on there,” she said.
In Montgomery County, Maryland, the Dennis Avenue Health Center is taking the temperature of everyone who enters for medical or supportive services, then making sure that anyone with a temp over 100.4 degrees Fahrenheit wears a mask and is assessed by medical staff. That’s according to social worker and program manager Melvin Cauthen, who added: “We’re also considering measures to assure that clients can continue to get their meds or have their health needs addressed in the event that there is a building closure” ordered by the state.
In Miami, Stephen Fallon, executive director of Latinos Salud, says, “We’ve received notice that we can perform Ryan White services remotely, but if public libraries close, this would obviously present a challenge for clients looking to get on board with services who might need to scan or send documents, especially if they don’t have a smartphone. We therefore expect to stay open as long as possible.”
Additionally, he added, the agency had canceled all group meetings, was wiping and disinfecting all surfaces twice daily, and was screening clients at the door for fevers or cough.
Coronavirus May Impact Finances and Fundraising
Plus, he continued, the agency was taking precautionary fiscal steps. “I’ve written to all of our funders, requesting that if there is a dip in clients served, we get paid the regular monthly [amount] per grant, and make it up by end of grant year,” he said. “If the COVID-19 outbreak gets severe or extends for months, then I have written that I would expect our health agency–funded grants to forgive any missed deliverables, as either we are forced to close, or clients quarantine and do not come for services.”
The crisis is also affecting agencies’ long-term events and plans. In Cincinnati, the agency Caracole, Inc. is going to make its March 29 AIDS Walk and 5K/10K Run a virtual event. “This is a departure for us,” said the agency’s Tricia Bath, “but we believe it’ll allow us to raise awareness of our mission while not putting any of us—especially those living with HIV—at risk or in harm’s way.” She also added that the agency had sent out a blast to supporters asking them to go to the agency’s “wish list” on Amazon to have essential items for clients—mainly toiletries—delivered to the site for future distribution.
Meanwhile, some agencies have taken their cue from Seattle, which has instituted drive-up coronavirus testing. “We’re open by appointment only, and we ask clients to stay in their cars until their case manager calls or texts them to come into the office,” said Donna Fuchs, who heads Northeast Florida AIDS Network in Jacksonville. “There’s no hanging out in the reception area. I don’t see us reducing staff, but we never know what’s going to happen. Our pantry will remain open as long as we have supplies.”
And at the 550 Clinic, the main HIV treatment center in Louisville, Kentucky, a staffer said, “Clients can come in and get their meds, but unless they have an appointment, we’re limiting our face-to-face interactions. Staffing-wise, we’re all here as of now, but we’re still waiting for a response from the state, so that could change by tomorrow. We may get shut down completely for the time being. Maybe we can move to the university hospital and still deliver meds to our clients, because our homeless clients don’t have anywhere else to go for their meds.”
They’re not the only agency that’s waiting for clearer instructions from on high. “We’ve got no clear state directive about what to do, so it’s been left up to us, and we’re trying to be as proactive as possible working with an immune-compromised population,” said Derek Landes at Spectrum Health Care, which serves largely rural, spread-out central Missouri. “As of today, most of our staff is remote, doing Zoom meetings, and the primary care clinic has been closed to walk-ins and new clients for the time being. But we’re trying to do as much telehealth as possible. And our case managers are reaching out to all their clients to see if they’re OK.”
Somewhat remarkably, Desert AIDS Project in Palm Springs, California, which has its own dedicated campus of services, is starting an actual COVID-19 clinic, in a dedicated building so as to adhere to social distancing, to treat and test clients struggling with severe symptoms of coronavirus. Clients must be screened by phone first, and asymptomatic clients will not be tested. The agency believes the cost of the clinic may be $575,000 over the next several months, and has only just started fundraising on the project.
“This pandemic is as real as it gets,” David Brinkman, CEO of Desert AIDS Project, said. “If we are going to change history, we need to take our roles very seriously. How we act in the next two to three weeks are critical to flatten out the curve of this pandemic.”
One thing is clear—it’s not the first time that staffers at HIV agencies have gone the extra mile for their clients in times of disrupted routines, such as 9/11 or the financial crash of 2008. “We’re social workers and activists, after all,” said African Services’ Lugg. “This is what we do.”
And that mantra looks like it applies coast to coast. “We’re doing phone therapy at the moment, and every client has been incredibly understanding,” said Linda Ryan, a social worker at Sunburst Projects in Sacramento, California. “We have a vulnerable population, so we want to be accessible to them. I don’t usually do this, but I brought my work cell home with me all weekend. We want them to know that we’re always available.”