On a cloudy morning in Northeast Bakersfield, Dr. Mathew Beare walks along a narrow trail of damp fallen leaves to a small homeless encampment. For over a year, Beare and his street medicine team have made the drive every Thursday from Clinica Sierra Vista in downtown Bakersfield to this barren site just off of Chester Avenue.
Beare tells his patient, Melissa, that she’s tested negative for the novel coronavirus. It’s her second negative test. In addition to administering Covid-19 tests, the team provides medical check-in’s, food, prescribed medication when needed, and syringe exchanges.
When the pandemic first hit, Beare says, the team paused their weekly visits to figure out how they could continue without exposing staff or patients to the virus.
“You're talking about a population with multiple chronic illnesses and a lot of chronic lung disease,” he says. “So when we started finding out the nature of Covid we thought for sure the unsheltered are going to get hit the worse.”
But he says, it was quite the opposite.
“Initially when we came out, people were really reluctant to even get tested for Covid. As one person got tested someone else was like ‘well can I get tested?’” Beare says. “And then it spread.”
The doctor says he hasn’t seen a single positive test which means the team can continue to focus on treating the roughly 30 people they see each week.
A woman named Shelly, who chose not to share her last name, receives her fourth negative test result. Shelly lives with her partner in a tent about 10 yards away from others in the encampment. She says it’s easy to social distance from the general population except when she goes to the store.
“When I go to the store I get concerned,” she says. “I put on my mask and everything, hand sanitizer and stuff, but there are a lot of other beliefs going on about that.”
There are also beliefs circulating about the Covid-19 vaccine. Shelly says she won’t take it based on the research she’s done online.
“It changes your DNA, some people could die from it,” she says. “If I had a PhD I could explain it better.”
But medical experts, including Beare, say it won’t change your DNA. Shelly remains skeptical but she says she might consider it if Beare recommended it to her.
“But I would want to see every tiny ingredient in that type of shot,” she says.
In a situation like this, Beare says he tries to educate about the safety of the vaccine and compare the risk versus the benefit. But he says he understands why the unsheltered population might be hesitant.
“There’s a lot of different reasons people might refuse the vaccine,” he says. “For someone in this situation there’s probably a huge distrust in the systems.”
And at this point, they can’t even offer the vaccine, Beare says. Until then, the team is working on pre-emptive measures, like treating on-going medical conditions, getting the most susceptible people housing and building trust.
Beare says it helps to have Scott Dopp, a formerly unhoused person, on the team. Dopp says he lived near Chester Avenue for almost four years. He credits Clinica Sierra Vista for helping turn his life around.
“They got me into a program and got me into transitional housing and I really liked what they did for me so I ended up volunteering,” he says.
Now he’s a paid employee doing outreach work and driving patients to and from their scheduled doctor’s appointments.
“A lot of people out here I know personally, so when word gets out who we are and how we’re trying to help them, it works out good,” Dopp says.
It’s worked out well for Terry, who’s lived at the encampment with his two dogs for nearly five years. He has several chronic illnesses and recently, the street medicine team helped him get into a transitional housing program for people who have Covid-19 or are at risk of contracting it.
“Dr. Beare and those guys they’ve really helped me out a lot,” he says.
It’s left Terry with a deep appreciation for the five member team. Even though he already has access to housing, Terry spent Wednesday night in his tent so he can say his final goodbyes to the team.
“I owe them everything,” he says. “They’re good people, all of them are.”
Due to the success of the street medicine effort, Dr. Beare says they’ve started a second team in Bakersfield, and the clinic hopes to start another one in Fresno.