Research shows homeless deaths skyrocketed during the pandemic’s first year

‘Our findings highlight the severe vulnerabilities faced by individuals who do not have housing’

Data from the San Francisco Department of Public Health found the number of homeless residents who died in The City during the first year of the COVID-19 pandemic doubled compared to previous years, with most deaths being linked to overdoses from fentanyl.

The research, released Thursday and conducted jointly by the health department and UCSF, showed that between March 2020 and March 2021, 331 homeless people died in San Francisco.

That is about twice the number of years prior, with 128 homeless deaths in 2016, 128 in 2017, 135 in 2018 and 147 in 2019.

Overdose deaths linked to the synthetic opioid drug fentanyl accounted for the majority of deaths, or 82% of the 331, according to the data.

Of those who died, 268 or 81%, were males.

The numbers also show African Americans accounted for a disproportionate amount of the deaths, representing 27% despite African Americans making up 5.6% of The City’s population.

None of the deaths were attributed to the COVID-19 virus, and according to city officials, efforts to house homeless people in hotels and shelters during the stay-home order may have contributed to this.

“Our findings highlight the severe vulnerabilities faced by individuals who do not have housing,” UCSF Chief of Emergency Medicine Dr. Maria Raven said in a statement Friday.

“Death from the COVID-19 pandemic may have been avoided, but deaths from other factors known to impact this population disproportionately — drug use and violence — have increased,” she said. “Mitigating death among people experiencing homelessness will require a multifaceted approach and a willingness to invest significant resources.”

Because 90% of those who died within the pandemic’s first year had previously used city health and social services, researchers were able to track their use of services. The researchers found substance use services declined to 13% between 2020 and 2021 from 20% between 2019 to 2020.

“The pandemic has significantly impacted our delivery of care and services to people experiencing homelessness,” San Francisco’s Medical Director of Street Medicine and Shelter Health Dr. Barry Zevin said. “We have been able to provide care and treatment to large numbers of people who were previously hidden. The key is meeting people where they are at.”

The findings can be found at

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