Stuck between a virus and a cold place: A choice for homeless Americans [PODCAST]

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“What form the incoming winter will take depends on the location and status of the COVID-19 pandemic. Each city must find a method that will provide the most relief and assistance for their homeless population. Analyzing the results of the measures already taken by shelters in the country will prove vital to developing individualized intentional plans for others. Finances will have to be the deciding factor on whether a shelter will install an HVAC system, engage in strict lockdowns, tap into the community, or develop a hybrid solution. Whatever the choice, shelters and the cities best act fast, because after all – winter is coming.”

Miracle Diala is a medical student.

He shares his story and discusses the KevinMD article he co-wrote, “Stuck between a virus and a cold place: A choice for homeless Americans awaits.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Miracle Diala. He is a medical student, and he co-wrote the KevinMD article “Stuck between a virus and a cold place: A choice for homeless Americans awaits.” Miracle, welcome to the show.

Miracle Diala: Thanks for having me on, Dr. Pho.

Kevin Pho: So we’ll get into that article in a little bit, but first off, can you share your story and your journey to where you are today?

Miracle Diala: Yes. So I suppose my story would start about 10 years ago. I come from a Nigerian family, and as Nigerian families go, they tend to push you into fields such as medicine, engineering, and the like. But I wanted to make a decision for myself, and so that decision came after I had a posterior spinal fusion. So I went through that, spent eight hours being operated on, and rested for about a week at a hospital and two months afterwards. After that, I started to think about what I wanted to do. I connected with my surgeon and all the medical staff so well that I figured that I’d want to go into medicine and be able to do for others what the staff were able to do for me.

Kevin Pho: Excellent. And from that procedure, talk about the perspective that it’s given you going through your medical school journey.

Miracle Diala: Having gone through that procedure, it’s definitely given me an eye for being able to understand the healing process and how difficult it can be from a medical, personal, and social aspect. And I think what it’s going to do for me is give me a certain level of perspective, because the specialty I’m actually aiming for, as of right now, one of my choices is physical medicine and rehabilitation. So I think having gone through what I have will give me a better perspective once I eventually treat my own patients.

Kevin Pho: Fantastic, and best wishes going forward.

Miracle Diala: Thanks.

Kevin Pho: So let’s get into that KevinMD article that you co-wrote, “Stuck between a virus and a cold place: A choice for homeless Americans awaits.” Now, for those who haven’t read the article, can you just walk my audience through it and share the story of why you decided to share it?

Miracle Diala: There was a group project that was assigned to a number of us in our global medicine program, and so we were given a variety of topics. One of the topics was how the COVID pandemic would affect the homeless population, and after I saw that, I was immediately drawn to it. And so I, along with my co-authors, Christopher Llerena and Marina Lentskevich, decided to tackle this project. We looked at various aspects of how different homeless shelters across the States have been tackling the issue and the potential problems that they’d be coming across. And so we just wanted to take all that information and summarize it, that way anyone else who happened to be interested in the topic or wanted to contribute in some way would have at least a baseline amount of information to go off of in order to enact their own plans.

Kevin Pho: Excellent. So let’s go into the article. So tell me, how has the pandemic affected the homeless population?

Miracle Diala: It’s difficult to put yourself in a situation in which you’ve lost your job and you’re facing homelessness, and this is something that a great amount of people have been facing due to the mass amount of job loss that has happened since the start of the pandemic. And so my immediate thoughts upon seeing this would be: How would the systems be able to hold up in order to help these people who were disadvantaged, especially as time has gone on and more and more jobs have been lost? I believe the last month’s jobs report was fairly poor, and quite a few people are facing evictions. This is a problem that’s only going to be increasing.

So upon realizing that, I was drawn to being able to at least write about this issue, that way as many people knew about it as possible. And I think it’s going to become more of an issue coming into 2021 as the lockdowns continue. We have a new strain coming out, and that’s going to impact quite a bit of things, both on the economic side and the health side.

Kevin Pho: So tell me about the intersection between the economic side and health side. Through your research, did you come across any stories or examples of people being affected by this, the homeless population, and how that affected their health?

Miracle Diala: So a friend of mine that I know personally, actually his family business, his father’s family business, was actually being greatly impacted. It had to do with construction, maintenance of buildings. Well, since quite a few buildings had been closed due to the pandemic, his family wasn’t receiving as much business, and so he had told me that come the holiday time, around this time, his company would probably end up running out of money and he would be in dire straits.

And so it was after he told me that story that I started to gain an interest in the intersection between health and economics, because his family has been doing everything they can to be safe. They have quite a few people who are vulnerable in his family, and so he understands the importance of staying safe during these times, but at the same time, there’s another threat on the horizon for him. And so that started getting me into it. It’s actually one of the things I plan on reading about after boards are over: both the impact of COVID on the health system and the economy, as well as, going forth, looking for different systems that could possibly address this intersection a little bit better and help prevent people from falling into this precarious situation in the first place, or if they do, being able to help them out of it as much as possible.

Kevin Pho: So going forward, what are some of the proposed solutions to solve some of the issues that you’re talking about?

Miracle Diala: So as far as the article that was written, there were a few solutions that were presented. The most economic one that was presented, because different homeless shelters are going to have different budgets, obviously, would be to try to see if there was a way that they could expand space, expand bed space for individuals that happen to come in, and then have a very strict policy: If you leave, then you’re not allowed to come back without being properly tested. That’s what a few homeless shelter systems had done. A few others had attempted to install an HVAC. HVACs are obviously more expensive, depending on the building size and whatnot, and so that’s also a proposed solution.

I think the best solution and the most economic solution, having a very strict policy as to who can and cannot leave, would be smartest to have for now. But especially now that our mild winter is probably going to start getting, our relatively mild winter in the Midwest, it’s probably going to get a little bit more intense in the coming months, that is something that may or may not be sustainable long term.

Kevin Pho: We’re talking with Miracle Diala. He is a medical student, and he co-wrote the KevinMD article “Stuck between a virus and a cold place: A choice for homeless Americans awaits.” Miracle, you mentioned some solutions from a governmental standpoint in terms of funding and whatnot, but from an individual standpoint, medical students, clinicians, physicians, what are some things that we can do to help address this issue?

Miracle Diala: So I definitely think in our community, as clinicians, medical students, and the like, we can do our best to reach out. I’ve heard of a few homeless shelters wanting to work with vaccine implementation, and so I know a few students from my school, they were already first in line to get the vaccine and offered to distribute the vaccine. So I think that’s what we can do on a personal level.

I think from the clinician view, being able to understand that an increasing amount of people are going to be put in a precarious economic situation, which may want to impact the route you go about in prescribing treatments: definitely stressing preventative medicine methods, such as increasing exercise, bettering your diet, especially given that one of the vulnerable populations for COVID is obese people.

Kevin Pho: And if you wanted to learn more about this issue, what are some of the resources that you found in your research, and some resources that you could suggest online?

Miracle Diala: I looked at a number of databases online to learn more about the intersection between homelessness and health, for one. And for another, being able to do more sociological research, look at more sociology research about food deserts, for example, because many individuals who are being put out on the streets, they’re not able to access quite a bit of food themselves. So being able to look at food scarcity and how that affects different populations, looking into research articles on that, would be helpful, I believe.

Kevin Pho: Sure. And my final question, what’s your take-home message that you want to leave with the KevinMD audience?

Miracle Diala: My take-home message is just to definitely be more mindful. I think that as a medical student, I for one, I’m receiving some money through scholarship, some money through student loans. I’m in a more privileged situation economically than others. And I think other physicians, given that the health care industry is known for having better job security, I think being mindful of our privilege financially in this particular pandemic would be very helpful, and definitely carry that as you treat different patients of different financial backgrounds.

Kevin Pho: Miracle, thank you so much for sharing your time and insight. Thanks again for being on the show.

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