As a pediatrician in Philadelphia, my heart breaks every time another one of my young patients loses someone they love to a firearm. This is why I was particularly distressed to learn that gun violence is on the rise during COVID-19.

The news reports read as if there is no “stay-at-home” order. Shootings over the last two months were the highest of any March and April over the past five years, and homicides are up 20%. The situation is similar in Cincinnati, Dallas, and Detroit. In addition to fearing COVID-19, the children I care for are scared, now more than ever, of gun violence in their neighborhoods.

Last year, our city launched an anti-violence initiative called the Philadelphia Roadmap to Safer Communities. Until then, it hadn’t seemed there was much we could do. Even the most tragic shootings hadn’t moved the needle on gun control laws. During the day, I would counsel children who had been shot, children who refused to leave homes for fear of being shot, and children whose fathers, brothers, and best friends had been shot. In the evening, I would read about another failed attempt at gun control. Universal background checks, red flag laws, statutes that could allow us to ban guns in parks and playgrounds. None of them would pass.

With the roadmap came a glimmer of hope. Philadelphia was mirroring the successful efforts of cities like Oakland, Calif., and Chicago by introducing a public health approach to gun violence, one that everyone could get behind. This approach is collaborative and data-driven. It aims to improve the “underlying factors that contribute to the violence” in the first place.

Unfortunately, the shutdown that has been necessary to curtail COVID-19 exacerbates just those underlying factors. Communities in our most vulnerable neighborhoods are being disproportionately affected by this crisis. They are being impacted in profound ways, ways that public health research links directly to an increased risk for gun violence.

Economic stability, for example, has been especially decimated in our most at-risk neighborhoods. Low-income jobs often cannot be done from home, and may not come with paid sick leave. One couple in my practice has owned their home for 21 years and never missed a mortgage payment. Now they have lost their jobs — she as a babysitter and he as a line cook. They are behind on payments and struggling with late fees. They can barely think about the cumulative sum that will come due in July.

Educational opportunity, also linked to a reduction in violent crime, has also taken an especially hard hit in underresourced areas. While schools in wealthier districts were already online and “barely missed a beat” as they moved to remote learning, underresourced schools faced enormous challenges with this transition. Many of my patients — especially those with learning differences, ADHD, and developmental disabilities — continue to struggle. And many who live in overcrowded homes or who face language barriers have given up entirely.

Usually, when my patients face chaos or instability at home or in school, they find solace in any number of our city’s youth organizations. But gone, for now, are their basketball teams, dance troupes, recreation centers, and church groups. Studies show that mentoring and social supports can be key to reducing violence among youth, but gone are the networks that buoy them up.

The Philadelphia Department of Health, and nonprofits like food banks and legal services, are working triple time to support families in crisis. Every day it seems I make a referral for help with diapers or homeschooling or landlord negotiations. These efforts are saving lives.

But firearm sales have surged across the country since COVID-19. Gun shops are inundated with first-time buyers, and efforts to curtail these sales have been impeded. We are left with neither legislative control nor the public health measures that can make a difference.

Our efforts at social distancing are working against COVID-19. They have been essential to minimize mortality and keep hospitals from being overrun. To be sure, as we reopen, resources will be scarce. Some of our city’s most treasured institutions are already facing budget cuts. But now, more than ever, is the time to continue investing in the Philadelphia Roadmap for Safer Communities. Now, more than ever, is the time for my young patients to emerge from their homes with hope, instead of fear.

Dorothy R. Novick is a pediatrician in Philadelphia.