Where do unhoused people wash their hands? There’s no punch line. As Philadelphia closes down in response to the COVID-19 pandemic, public bathrooms, restaurants, and even gyms have shut their doors. If you don’t have soap and running water, you can’t prevent coronavirus. That puts 5,700 people’s lives on the chopping block. Their crime is simply not having a place to live.
In Philadelphia, the COVID-19 pandemic has forced 13 percent of people out of their jobs and is poised to ignite a massive eviction crisis. People are coping with homelessness any way they can. With fewer than 50 homeless shelters in the metro area, there are not many options, causing people to take matters into their own hands. It is clear that the government isn’t interested in helping people, so mutual aid groups are stepping up to save lives. The leaders in this fight to keep people housed and healthy are applying the lifesaving principles of harm reduction to prevent overdoses and coronavirus in encampments and temporary shelters. And guess what? It’s working.
Harm reduction is the idea that providing someone with their basic needs—food, shelter, medical care, and dignity—helps prevent disease. Harm reduction saved lives during the AIDS crisis with sex education, syringe exchanges, and free condoms. Harm reduction also includes safety measures like face masks to prevent COVID-19 transmission; seat belts to prevent driving fatalities; and fentanyl testing to prevent addiction related fatalities. However, those are single-use tools that don’t cause systemic change. Harm reduction can also include housing, universally accessible healthcare, and employment programs. For people who use drugs and people seeking recovery from substance use, those basic human needs are vital to keeping people off the streets and working on their wellness instead.
Philadelphia’s community took harm reduction into its own hands when COVID-19 hit the city. Most of the CDC guidelines and city’s health standards for the pandemic focus on people who have a safe, stable place to live: washing hands, staying away from other people, self-isolating if someone feels sick, and maintaining a clean environment. People who aren’t housed are not able to do those things. Many of them don’t have access to masks, hand sanitizer, showers, running water, disposable gloves, or any of the other PPE that housed people do. In response to this need, houseless people have set up a safe, clean encampment at 22nd Street and Benjamin Franklin Parkway.
The settlement is healthy and self-sustaining, offering free food, water, clothing, and medical care to anyone who wants it. Neighbors and mutual aid groups come to the settlement to support the residents. The group is self-governing, with lower rates of violence than even high-income suburbs. There is mutual support when an overdose or mental health crisis happens—and the ability to transport someone to medical care immediately. As the encampment has grown, it has become more than a safe place to live, get cleaned up, and wait out coronavirus. It’s become a symbol of what’s possible for underprivileged people when they’re given the resources they need. Philadelphia Housing Action, a coalition of groups that organized the encampment, said the encampment was conceived as a form of political protest over city policies toward the homeless and the lack of low-income housing in the city. Now, about 100 people call it home.
Those people are healthy, safe, and following the city’s pandemic guidelines; without housing, their lives will be at risk. When people can shelter in place, their odds of surviving COVID-19 increase dramatically. Without access to basic needs, they will need to search for resources in crowded shelters, clinics that are overflowing with coronavirus patients, and food bank lines. If they have a mental health disorder like addiction, they are doubly at risk because they may use a substance that is laced with deadly fentanyl or accidentally overdose without access to naloxone, an opioid-reversing medication. Just because people don’t have insurance doesn’t mean they stop needing medical care. It is less expensive to house someone than to jail them for “vagrancy.” Housing is less expensive than paying police officers to round them up and destroy all their belongings. And it’s less expensive than supporting someone through a lengthy, invasive treatment for COVID. It’s estimated that every $1 spent on harm reduction, such as housing and food stamps, saves $7 in social service funding. In a pandemic, it’s in Philadelphia’s best interest to fund solutions that protect fragile populations and keep the maximum number of people healthy, safe, and inside.
Saving lives isn’t just about putting a roof over someone’s head and calling it good. It’s about offering the resources that make life worth living. When unhoused people have homes, and everyone can access the tools they need to stay healthy and safe, we’ll slow the death rates in Philadelphia. Harm reduction can help anyone. It’s time for Philadelphia to use it—and there isn’t a moment to lose.