Greater focus on under-resourced communities in the United States is urgently needed to ensure that all people can protect themselves and their families during the COVID-19 pandemic. Already vulnerable groups, such as people who are currently homeless or housing insecure, lack necessary resources to remain safe and healthy amidst a pandemic.

Many don’t have the option to shelter in place and lack access to basic hygiene facilities. The COVID-19 pandemic in the United States puts them at even greater peril.

“In most states, authorities are instructing people to protect themselves from COVID-19 by staying home, avoiding crowds and washing their hands often,” says Dr Carrie Teicher, director of programmes for Médecins Sans Frontières (MSF) in the United States. “This isn’t possible for the millions of people in the United States who are housing insecure.”

“Where are they supposed to shower or wash their hands when public restrooms and facilities have closed?” asks Teicher. “For people living in shelters or in communal housing, how are they supposed to self-isolate?”

Since the start of the outbreak, MSF has received hundreds of inquiries from civil society organisations, local governments and health care providers serving affected communities across the United States seeking guidance on keeping staff and clients safe.

“In the United States, state governments have taken the lead in the pandemic response, and there are vast disparities in access to services from one location to another,” said Jean Stowell, head of MSF’s COVID-19 team in the United States. “Based on our own experience responding to infectious disease outbreaks around the world, MSF is helping organisations and health care providers in the United States adapt and apply public health guidance according to the needs and resources available in their particular communities.”

In New York City, the current epicentre of the global pandemic, over 50,000 people sleep in homeless shelters each night. MSF is partnering with local organisations to improve infection prevention and control (IPC) measures in facilities serving people who are homeless or housing insecure.

We have donated over 80 handwashing stations to places like soup kitchens and supportive housing facilities and is distributing 1,000 mobile phones to vulnerable New Yorkers who lack the essential technology needed to contact emergency and support services, including telemedicine providers.

In addition, MSF has opened a temporary shower trailer in Manhattan, offering free showers to people who currently lack access to such facilities.

We have also sent teams to assess the local needs in several other locations where people lack equitable access to pandemic response services, including in Puerto Rico, Florida and Native American communities in the southwest of the country.