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Kelly Doran MD MHS Profile picture
@KellyMDoran
Aug 26, 2020 • 12 tweets • 4 min read • Read on X
That a small group of #UWS residents prefers to risk the health of hundreds of homeless New Yorkers than to see them in their neighborhood is disheartening to say the least. Here’s a thread with some facts amidst this noise. (1/)
1st: framing this as a move "so they can get services in shelters" is a bold-faced lie. The hotels are operated *by the identical nonprofits* that operate the shelters from which these individuals came. Services are available in the hotels, as they are in the shelters. (2/)
This and other lies that have been used to fire community opposition (including those regarding sex offenders) have been debunked in a well-written petition at uwsstrong.org (3/)
As I described thoroughly in another thread, many of the visible homeless people on the UWS sparking community concerns are likely to be unsheltered rather than hotel residents. (4/)
There have been several studies during the pandemic showing SARS-CoV-2 can spread very quickly (to both shelter residents and staff) in congregate homeless shelters. Here's just one study, by the CDC (5/) cdc.gov/mmwr/volumes/6…
As I tweeted earlier today, when it comes to SARS-CoV-2 we are all in this together. We need to protect the most vulnerable among us to protect all of us. (6/)
While we don't have much research on it yet, so far signs point to hotels as benefiting the lives and health of people experiencing homelessness in multiple ways. To argue shelters are "better" for them is disingenuous to say the least. (7/)
You can hear that in some of the stories collected here by @HowardCenterASU. I also recommend listening to these stories to understand more deeply how hard the #COVID19 pandemic has made life for people experiencing homelessness. (8/) cronkitenews.azpbs.org/howardcenter/c…
Other arguments about why dehumanization of people experiencing homelessness must stop are presented eloquently by @Giselle_Ashley here (9/) nydailynews.com/opinion/ny-ope…
People *will* eventually be moved from hotels back to shelters (absent 1000s of units of affordable housing where else where they go?). But the decision about when to do so should be driven by science and public health considerations, not by hate or NIMBYism. (10/)
If the Mayor capitulates to a vocal minority rather than to science, health, and welfare for the city's most vulnerable residents it will set a dangerous precedent. (end)
👆ugh, typo. 2nd “where” should be “will.” This stuff really gets my blood pressure up and I just binge ate way too much Nutella.

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More from @KellyMDoran

Kelly Doran MD MHS Profile picture
Jul 25, 2023
Long awaited results of the Accountable Health Communities project are out and... well... somewhat confusing / underwhelming. A brief 🧵. (1/)
What were Accountable Health Communities (AHCs)? This was a big Centers for Medicare and Medicaid Services pilot starting 2017 that (to simplify a lot!) funded 32 agencies to screen for & address patient social needs (things like food insecurity, housing insecurity, etc.) 2/
In one "track" of the project, patients who screened positive for a social need AND had 2+ ED visits in the past year were randomized to get either a written list of community resources (control) or that PLUS "navigation" (intervention) -- referrals, follow-up, etc. 3/
Read 10 tweets
Kelly Doran MD MHS Profile picture
Dec 7, 2022
NYC paramedic @AnthonyAlmojera (who also has lived experience of NYC homelessness) describes here why the Mayor’s plan related to involuntary hospital transport of people experiencing homelessness is “not the answer”. (1/)
nytimes.com/2022/12/07/opi…
First, he notes that this isn’t even particularly new (though “makes splashy headlines”) — already EMS responds to calls for hundreds of “emotionally disturbed patients” daily, already they bring in people experiencing homelessness who are in mental health crisis. (2/)
But w/this push, “the mayor is shifting more responsibility for a systemic crisis to an overworked medical corps burned out from years of low pay & the strain of the pandemic.” 🙏 to EMS workers who really are on the front lines. This exposes them to more stress & violence too 3/
Read 10 tweets
Kelly Doran MD MHS Profile picture
Feb 18, 2022
I've now read the full "Subway Safety Plan" and have...some thoughts. There are some glimpses of good here amidst the bad but I'll start by saying that the idea of "subway safety" being the framing for the city's plan to address unsheltered homelessness makes my heart heavy... 1/
Good: the plan starts by saying that we shouldn't conflate homelessness & crime, & notes that people experiencing homelessness are more likely to be victims of crime than to commit crime...

...Yet the actual provisions move us in a direction of criminalizing homelessness. 2/
Specifically, outreach teams "will work with NYPD officers to canvas platforms, stairwells, mezzanines, and entrances." The plan notes that already “More than 1,000 additional officers have already been deployed across the system.” 3/
Read 14 tweets
Kelly Doran MD MHS Profile picture
Feb 18, 2022
I agree with @JoshDeanNYC. I work in an ED and see a lot of folks, most of them homeless, brought in by police. Presence of police does not foster a therapeutic relationship, and does not imbue people with the trust they need to freely “accept offers of services.” (1/)
The police agree:
“A law-enforcement source didn’t hold out high hopes for success.
‘I don’t have any reason to believe that it will be any more successful than any other homelessness effort…There’s people on the subways because they’re afraid to stay in the shelter system.’” 2/
I’m beyond confused about why school nurses specifically are being recruited for these teams. Nurses have specific training and expertise garnered from experience. 3/
Read 4 tweets
Kelly Doran MD MHS Profile picture
Feb 17, 2022
Excellent report comparing medical respite to other levels of health care services and describing barriers that people experiencing homelessness face to receiving the level of health-related care they may need, from @NatlInstMRCare (1/) nimrc.org/wp-content/upl…
I’ll put it more bluntly than they do: medical respite programs cannot just be the “easy discharge option” for hospitals to send people to who may need a much higher level of care than respite can generally provide (some might call this “patient dumping”). (2/)
I’m a big supporter of medical respite programs. But they have a specific niche role. Especially as the homeless population nationally is aging we will need to have more and more conversations about care options for people with longer term, more significant health needs. (3/)
Read 4 tweets
Kelly Doran MD MHS Profile picture
Apr 23, 2021
🚨NY Dept of Health (@nycHealthy) put out an alert today about increased cases of Hepatitis A seen among people who are homeless, use drugs, or were recently incarcerated. EDs and other locations serving these populations urged to vaccinate. (1/)
The alert did not have specifics on numbers but said the increase in cases had been observed since Dec 2020. We have seen similar outbreaks nationwide in the past several years. (2/)
In these past outbreaks among people who are homeless, use drugs, or were recently incarcerated *61%* were hospitalized and 1% died. (3/)
Read 11 tweets

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