Brief, continued.

Research shows that partner violence is associated with multiple adverse physical and mental health outcomes, including conditions that can increase vulnerability to severe COVID-19. Injuries, the use of risk-increasing coping behaviors (smoking, excessive drinking), and the effects of stress associated with daily life with an abusive partner are plausible reasons for these health effects. Coupled with fears around seeking medical attention or being directly prevented from obtaining care or medication, we can expect individuals living with physical, sexual, and emotional abuse to be at greater risk of morbidity and mortality related to direct and indirect effects of the pandemic.

Finally, the long-term consequences of social and financial upheaval are likely to impact survivors of partner violence hard, particularly women with children. Research suggests that violence negatively impacts women’s ability to maintain long-term employment, and in turn, precarious employment can create dependence on abusive partners. Fears linked to survival, including maintaining housing, health insurance, food, and childcare, are likely to be compounded for those living with abuse, increasing the difficulty of making decisions that could increase safety and well-being.

Certainly, our efforts to stem the lethal effects of this novel coronavirus must be community wide and inclusive of the best public health science to date, which includes widespread physical distancing and self-quarantining. But public health efforts also must focus on protecting those who are the most “vulnerable” among us, whether that vulnerability comes from weakened immune systems, age, or social and structural inequities, including partner violence. To do this effectively, community preparedness and response plans must include strategies to keep these segments of our population safe, while still implementing population-wide approaches to disaster mitigation. We understand that crowded shelters are places where COVID-19 can easily spread; alternative arrangements need to be identified long before the order to stay-at-home is announced. We recognize the importance of closing schools and day-cares to protect staff and students; alternative child-care facilities for parents who cannot leave children at home while seeking medical care or making a safety plan should be part of the response. We know that emergency departments and health clinics are likely to be flooded with sick patients and physicians overwhelmed; alternative medical care sites need to be established for the other causalities of the pandemic.