Like everyone else I have been worrying over staying virus-free.  Better to take a gloved and masked trip into the market every 10 days or better to order—delivery or pick-up?  Is it safe to pick up the paper from the front porch each morning, or should I leave it there for a couple days?  I’ve been spraying the mail with 99.9 Clorox and leaving it in the vestibule to dry.  Is this mad?

Yes, it’s important to keep safe but it’s also important to think about those out there who cannot keep safe.  I’m talking about our homeless population, our folks with mental health and substance use issues whose illness sometimes keeps them from making wise decisions, and those who are currently in shelters or treatment facilities where the draconian precautions that seem necessary are very difficult to implement.   We have to remember that we are still losing about 130 people a day to overdose, about an equal number to suicide, and a large number to long-term conditions caused by these issues.

It is virtually impossible to isolate people with COVID-19 in a treatment facility or a shelter. If they are not sick enough to enter the hospital but need to be quarantined, separate facilities seem the best solution.  Can counties, with state and federal assistance, set up such places?  Can they be staffed with medical professionals who can keep serving people who are receiving mental health, substance use, and other medical treatment? Some places are attempting to do this by using hotels, portions of military bases, even dorms.

As the pandemic continues, I think we are realizing the value of prevention and early intervention.  Very costly mistakes were made in the United States during the first 4-6 weeks of the virus, yes, but we have also failed by not using evidence based practices and under-funding  mental health and substance use treatment,  and under-regulating standards of care and professional credentials.

If this pandemic is to have any silver lining, let it be that we emerge wiser, kinder, and with a greater commitment to the well-being of all, BEFORE catastrophe strikes.