Signs at the Forest Hollow Mobile Home Community in Beaumont, Texas, advise residents to wash their hands. That simple act is the first line of defence against the infection that sickens victims of the coronavirus.

But when Amy Yancy, unemployed, left the hospital this month after suffering a miscarriage, she was unable to follow the instructions.

The water at the trailer park had been shut off.

“I was terrified we would get sick,” Yancy said. Already, eight people have tested positive for the novel virus in the southeastern Texas city, where nearly 20 per cent of residents are in poverty – above the national average.

Yancy’s predicament is shared by Americans throughout the country, as the escalating outbreak exposes how uneven access is to resources like water – resources allowing private individuals unable to protect themselves as public institutions stumble. As many as 15 million Americans experience a water shutoff each year, according to one 2016 estimate. That leaves them unable to clean themselves and flush the toilet, all because of nonpayment, compounded by spiralling late fees.

Scores of cities have tried to prevent water deprivation from exacerbating the public-health emergency by pausing shutoffs during the pandemic. Some states have even stepped in. But getting the water turned back on can prove an arduous process, leaving the most vulnerable without basic protection against the coronavirus.

In numerous cases where service has been restored, access has depended on legal intervention or philanthropic goodwill, underscoring the precariousness of public works, even during a pandemic.

“You can’t wash your hands, you can’t flush your toilet, you can’t clean your house or take care of your family,” said Mary Grant, a campaign director at Food and Water Watch. “And during a global pandemic, we shouldn’t need to depend on court action or some other extraordinary step for people to have basic water service.”

In Beaumont, the problem was not that Yancy had failed to pay her bills. She was up to date, she said, on her $1,050 monthly rent, which covers water, sewage and trash for the two-bedroom trailer she shares with her husband.

Theirs is one of 65 units, whose residents include both very young children and elderly adults; some live as many as eight to a trailer. One resident, Tonya Lanham, is caring for her fiancé, who is sick with cancer, at the trailer park.

It was the facility’s operator, Southern Choice LLC, that was behind on water payments following significant cost spikes. In dispute was $50,000, according to court records.

The city turned off the water on 19 March, the same day the state’s public health commissioner declared a public-health disaster – and the same day Yancy returned from the hospital.

Without proper running water, US residents are asking how they can hope to wash their hands properly in the fight against Covid-19 (Getty) (Getty Images/iStockphoto)

She needed water not only to stay hydrated for her recovery but to keep herself clean. Her husband found two gallons discarded on a random aisle of a nearby store – everyone was panic-buying by that point – and her sister drove an hour-and-a-half to retrieve another two gallons, she said. They used what they had to bathe and flush the toilet.

Jeff, who asked to be identified only by his first name because he works for the state, moved his family to a hotel room for a day so they could wash.

“We were in a situation where we couldn’t follow the health advice being put out by our own government because they had cut off our water,” he said.

Meanwhile, complaints piled up on a Facebook page for the trailer park. Lanham, 48, used social media to contact a judge in Jefferson County. His wife replied, saying her complaint was the second they had received about water shutoffs in the area.

An attorney for the property manager sought to negotiate with the city, proposing the operator pay what it could. But the city demanded $30,000 to restore service, according to court records. The city manager, Kyle Hayes, did not respond to multiple requests for comment.

A representative for the property, Bill Rodwell, said the city had been overbilling the trailer park. “We want to do everything in our power to provide a safe, nice, quiet place to live,” he added

The owners of a Missouri insurance agency contributed $5,000 to cover bills after the city said it would cut off water to residents who had not paid (iStock)

Residents at Forest Hollow said the conditions have been anything but.

“I don’t care if you have an ongoing dispute with the landlord – you don’t do that during a crisis,” said Lanham, who recently lost her job as an assistant manager at a Luby’s restaurant.

On 21 March, Southern Choice sued the city in district court in Jefferson County. At 6pm that Saturday, a judge granted a temporary restraining order requiring the city to turn on the water.

“Specifically, the lack of running water could result in loss of life and prohibits hand washing and proper hygiene during the Covid-19 health disaster,” found the judge, Baylor Wortham.

The water came on that night. But the judge’s order expires next month.

“I don’t know how long the water will stay on,” Yancy said.

In some places, it is still being shut off.

In Billings, Montana, identified by Food and Water Watch as among the 30 cities with the highest shut-off rates, terminations continue, an employee with the public works department confirmed this week. Mount Vernon, Illinois, conducted shutoffs throughout March but will pause new ones in April, according to the city manager.

Shutoffs are most frequent in the South, as well as in low-income cities burdened by poverty and unemployment. But the problem is increasingly pervasive. Nearly 36 per cent of households could be unable to afford water in five years if rates rise at projected levels, a scholar at Michigan State University recently found.

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While draft legislation in the House responding to the coronavirus outbreak included $1.5bn to defray water costs, coupled with a mandate that recipient states halt utility shutoffs, the $2.2tn package advanced in the Senate – and approved Friday by the House – does not include a similar allocation.

That leaves “tens of thousands of water systems across the country to make these decisions,” said Grant, the campaign director at Food and Water Watch. “It’s a patchwork of regulatory agencies.”

Legal action was required in Beaumont, after a three-day scramble to get the city to reverse course.

In Troy, Missouri, a private act of philanthropy filled the gap. This month, as the novel virus bore down on the state, the owners of an insurance agency contributed $5,000 to cover delinquent bills after the city said it would cut off water to residents who had not paid.

“We rely on members of the community to give us their money to sustain our livelihoods, so we needed to be able to reverse engineer that and help our neighbours,” said Ramiz Hakim, a co-owner of North Star Insurance Advisors in Wentzville, Missouri.

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Jodi Schneider, Troy’s city clerk, said the city was “following its regular policy for having to do monthly disconnections.” She said the board of aldermen would consider changes to the policy at its next meeting, scheduled for Monday night.

Among cities that have halted shutoffs, many are also vowing to restore utilities discontinued before the onset of the public-health emergency. But not proactively enough, warn advocates.

In Detroit, where taps were shut off in about 23,000 homes last year, the city said its crews were canvassing the 2,800 homes where water was known to be discontinued, and that nearly 1,500 homes had already taken advantage of the promised restoration. But Monica Lewis-Patrick, a Detroit activist, said there were “tens of thousands of homes” overlooked in the city’s data.

In Buffalo, New York, the water department has agreed to restore service but is asking residents to call a customer service line to set up an appointment. Local attorneys said the arrangement presumes the city’s most vulnerable residents have access to a telephone, as well as to television or other media where the number has been circulated.

But Oluwole McFoy, chairman of the board for Buffalo Water, said the city cannot instantaneously switch back on the water for fear that plumbing problems might lead to flooding. “We need a contact, and we need someone present when our crews arrive,” McFoy said.

The city’s message, he added, was, “Please call, please call.”

Steven Halpern, an attorney at the Western New York Law Centre, called the expectation “grossly unfair.” He helped one of his clients, a 67-year-old Vietnam veteran who had been collecting rainwater to flush his toilet, request service, but he said there were “doubtlessly hundreds of others in the city who don’t have lawyers, who haven’t been in contact with anyone about this issue.”

His client, who asked not to be identified, said, “The shower felt so good.”

Andrea Ó Súilleabháin, executive director of the Buffalo-based Partnership for the Public Good, estimated as many as 4,000 households a year have their water shut off for lack of payment. The city should have a list, she said, and could “proactively communicate with these households.”

McFoy said 128 households had been without water in the last month, and 64 had seen the resource restored since the onset of the pandemic. Now, the water department is accepting from advocates a list of their clients most in need of water.

In turn, advocates are asking the city to consider why a resource as fundamental as water is ever switched off.

“Equitable access to affordable water was a national issue even before this crisis,” Halpern said