The Elephant In The Room

As coronavirus continues to spread, with the total number of reported cases now exceeding 77,000 people worldwide, stock markets plummeting because of the impact of the virus on the global economy, and the World Health Organization saying that the world should be prepared for a pandemic, scientists are trying to figure out exactly how the virus spreads.

According to the Chinese Center for Disease Control and Prevention, one of the apparent pathways for the disease is through the fecal matter of infected people.  The Chinese CDC “recommends strengthening sanitation and hygiene measures to prevent fecal-oral transmission” in areas where the coronavirus is present, with the hygiene measures to include “drinking boiled water, avoiding eating raw food, implementing separate meal systems, frequent hand-washing, disinfecting toilets, and preventing water and food contamination from patients’ stool.”  The concern is that infected persons’ “stool samples may contaminate hands, food, water” and cause infection when the microbes enter the mouth or eyes, or are inhaled.

gettyimages-693551624What does the apparent transmission route through fecal matter tell us about who is at risk in the event of a serious outbreak in the United States — something that hasn’t happened yet?  It seems that one logical course should be to target specific populations where sanitation and disposal of human waste aren’t well controlled.  If I were a public health official in America, I’d therefore be considering what can be done to anticipate and prevent a nightmare scenario in which coronavirus reaches one of the colossal homeless encampments found in some U.S. cities, like Los Angeles.  Public health officials have already identified poor health conditions and contact with fecal matter in “homeless zone” as the source for transmission of diseases like typhus, typhoid fever, and tuberculosis in Los Angeles.  What would happen if a rapidly spreading disease like coronavirus were to reach one of the densely populated, squalid encampments?

America hasn’t shown much of an appetite for tackling the issue of homelessness, which has become the unspoken of elephant in the room in many American cities.  When it comes to public health and disease prevention, however, we’re all in this together, and potential avenues for rapid disease transmission can’t simply be ignored away.

I’m hoping that the potentially disastrous implications of coronavirus reaching homeless populations will cause local, state, and federal officials to finally work out a solution that helps the homeless find places that are safe, secure, and healthy, with adequate sanitation facilities and running water.  If we’re going to get a grip on the spread of coronavirus, or the next disease coming down the pike, it’s time to be proactive and to act to protect the vulnerable and the rest of us as well.