The impact of COVID-19 is being felt across of the country, with nearly half of the population reporting negative effects on their mental health. But while the pandemic has introduced new anxieties for many, it has also exacerbated widespread, longstanding systemic issues that disproportionately harm people and communities of color, such as housing and food insecurity, economic instability, and disparities in health care and insurance coverage.
To tackle some of these challenges and ensure vulnerable individuals have access to the resources they need — now and after COVID-19 abates — students at the Perelman School of Medicine have been using their time away from the classroom and clinic to develop innovative solutions for community issues.
“From the moment our students were sent home due to the pandemic, they offered their services to our medical, university, and Philadelphia communities,” said Cindy Christian, MD, assistant dean for Community Engagement. “Their work — most of which has been done virtually — has ranged from developing technologies to address health needs to creating programs to help vulnerable community members. Our students have been spectacular, and I couldn’t be more proud of their efforts on behalf of those in need.”
One Extra Bag: Filling the Fridges of West Philadelphia
While many were able to prepare for the pandemic by stocking up on food, underserved Philadelphians, and especially those who lost jobs or were forced to close businesses, did not have that luxury. Students from low-income families lost access to free lunches as schools shut their doors, and even with social distancing restrictions still in place, many seniors and community members with compromised immune systems simply cannot risk popping into grocery stores or picking up food from assistance programs.
All of these factors intensified the city’s already troubling rate of food insecurity. Indeed, due to the fallout of the coronavirus, Feeding America projects that 21.2 percent of Philadelphia residents will struggle with food insecurity in 2020, up from 16.3 percent in 2018.
Eden Engel-Rebitzer was in her third year at PSOM and had started her sub-internship when COVID-19 hit the region. Eager to find “a concrete thing [she] could do to alleviate suffering,” she and a group of compassionate peers created One Extra Bag, a grocery delivery program that aims to address food insecurities caused or worsened by the pandemic. Though the program began as a way to assist Penn Medicine housestaff, it quickly grew to include home-bound geriatric patients and individuals who became home-bound due to positive COVID-19 diagnoses.
“There are many resources for food-insecure individuals who can physically access them, but home-bound people have been repeatedly left out of social safety net interventions,” Engel-Rebitzer said. “For example, an emergency SNAP benefit expansion was passed, but there was no infrastructure rolled out to make it usable for home delivery. People who are dependent on EBT benefits were somewhat food secure — until they became COVID-positive and home-bound. We felt compelled to direct our focus on a group that was being neglected.”
Using donations and grants provided by the Penn Medicine CAREs program and The Rally Fund, each medical or graduate student volunteer fills an additional bag with essentials while doing their own grocery shopping, then safely delivers it to their assigned patient’s home. The 1:1 ratio prevents unnecessary exposures, while also fostering relationships that last long after a patient’s last delivery. These friendships and the fulfillment that comes from playing an active role amidst the pandemic aren’t the only benefits for Engel-Rebitzer.
“Med students learn to take care of people’s physiology, and there’s a lot of additional training focused on holistic care, but one of the really powerful things that has resulted from COVID-19 is that we’re thinking about the whole person in a different, amplified way,” she said. “I hope to maintain that when I’m back in the hospital — that level of care that extends to knowing where my patient got their breakfast.”
More than 70 community members have used the program, with 30 families receiving weekly deliveries at its peak. But in addition to receiving food, these individuals were connected with long-term food security programs like MANNA and Meals on Wheels that can address their post-COVID needs. In this way, One Extra Bag has served as a vital bridge program.
“For many patients, acute food insecurity was a direct result of the pandemic, but there’s no question that there's a need for these services beyond COVID-19,” said Engel-Rebitzer. “We’re planning to wrap up our deliveries at the end of June, but we’re discussing what a long-term program could look like with institutional backing.”
Philly Connects: Overcoming Obstacles to Communication
The COVID-19 pandemic also illuminated inequities related to technology. As hospitals turned to telemedicine, schools moved to online learning, and families opted to connect via video calls, those without smartphones, tablets, or laptops have struggled to keep up. This is compounded by the fact that locations with free Wi-Fi or community libraries offering computer reservations have also closed.
Philadelphia’s digital divide disproportionately impacts Black and Hispanic neighborhoods and low-income households — populations that have also been most affected by COVID-19 and the resulting economic crisis. As the language surrounding the pandemic shifts to discussion of a “new normal,” reliable Internet and device access are critical in ensuring vulnerable groups can continue to engage in essential daily activities.
Second-year MD-PhD candidate Yentli Soto Albrecht noticed this divide as she finished her Internal Medicine rotation. As visitation policies became increasingly restrictive to prevent coronavirus exposures, she joined forces with Stephanie Javier-Fagbemi, a third-year medical student at Temple University, to start collecting video-enabled devices that isolated patients could use to stay in touch with their families, and, in the most severe cases, to say their final goodbyes. Through their new organization, Philly Connects, Soto Albrecht, Javier-Fagbemi, and a network of student volunteers have developed relationships with local health care sites and nursing homes, many of which serve predominantly Black communities, are not part of larger systems, and cannot readily meet the tech needs of their patients and residents on their own.
Using needs assessment tools, the volunteers determine the technology needs of each site, provide them with sanitized smartphones and tablets that have been donated or purchased, and can even create device stands using a 3D printer. Philly Connects recently hit its 100-donation mark across 25 sites, but this is only the beginning.
“Lack of access to devices doesn’t just impact health care; it creates issues at home and in education. It’s driven by economic and racial disparities, and it has become more pronounced as COVID-19 has been compounded by civic unrest,” Soto Albrecht said. “Getting tablets into these places isn’t going to help if patients’ families don’t have their own devices or Internet. Our team already developed a robust framework for donation drop-offs, pick-ups, and shipping, so why not meet as many needs as possible?”
With this expanded focus, Philly Connects is now also working to get laptops into the hands of children who attend predominantly Black schools and low-income, first-generation, minority college students so they aren’t left behind their classmates. Looking ahead, Soto Albrecht also aims to connect with unemployment centers to provide adults with devices so they can pursue virtual careers or job training — and to get devices wherever they are most needed, both during COVID-19 and afterward.
“I’ve always been driven to help people; it’s why I’m becoming a doctor. Whenever there’s a need, I just can’t turn away, especially when I know I have access to resources and networks,” Soto Albrecht said. “The digital divide in Philadelphia is a big problem that’s not going away anytime soon. But as long as we have the infrastructure and a volunteer workforce, Philly Connects is going to continue being present and helping those populations.”
Even in these challenging times, faculty, staff, and students across Penn Medicine continue to promote the health and well-being of our communities. Get to know the people, the places, and the reasons we serve through our new community impact report, Service in Action. Explore photos, animated graphics, videos, and more.