Federally Funded Clinics Say Low-Income Patients Are More At Risk For COVID-19

Apr 7, 2020

Doctors at local Federally Qualified Health Centers say their patients are at higher risk of contracting the novel coronavirus.

These clinics specialize in serving low-income patients, who are more likely to rely on public transportation and work outside the home, or have family members working outside the home.

“[They] work in FedEx, in the hospitals … some are still working in restaurants doing takeout,” said Dr. Andrea Fox, medical director at the Squirrel Hill Health Center. “They are all happy to have those jobs, but it does mean that the families are more at risk.”

Additionally, Fox said some of her patients live with elderly family members, who are more vulnerable to severe infection from COVID-19, in small houses or apartments. Close quarters can make quarantining someone from the rest of the household difficult.

“These families don’t have the option to close the door someplace to keep someone away,” said Fox.

Doctors at FQHCs say some other patients face immediate health challenges due to layoffs or furloughs. Not only are they now uninsured, some are unable to buy food, diapers and other household necessities.

“We’ve actually also been doing drop-offs for a lot of people at their homes of goods that we have in the office,” Dr. Sara Silvestri, medical director of the Sto-Rox Neighborhood Health Council, which has clinics in McKees Rocks and Mt. Washington.

Sto-Rox staff also deliver food and other supplies to elderly patients who cannot risk exposure to the virus by going to the store.

Silvestri said she’s been in communication with many area FQHCs, which are all in agreement that their main goal is to keep patients out of emergency rooms, not just for COVID illiness, but any emergent medical needs.  

But like FQHC patients, these clinics are feeling the pinch of the economic slowdown. Though clinics receive some federal funding and philanthropic support, they primarily survive on revenue generated through providing routine medical services, which are on hold in accordance with social isolation guidelines.

“Because we take care of people, regardless of their ability to pay, we’re not in a place where if we suddenly lose a lot of our revenue, we’ll be able to continue our operations,” said Dr. Matthew Yu, medical director North Side Christian Health Center.

Despite scaling back on billable services, staff at the North Side facility stay in frequent contact with patients who have COVID-like syptoms; they've also launched a hotline which people can call with concerns.  If FQHCs were to close or cut back services, Yu said that would leave gaps in the medical safety net.

“We had a patient who called in and said that he was outside the clinic and was ready to hurt sombody," said Yu. "We found out the he had been homeless for the last three years ... He was at the point of desperation. He hadn't eaten in the last three days."

Yu said the man told him that the libraries and restaurants where he usually used the restroom or got food were closed, and many of the shelters he frequented were full.

"We were able to help him," said Yu. But if his clinic and other FQHCs close, people in crisis will have a harder time getting the help they need, he said.