Homeless people are among the most likely to die when infected by COVID-19, medical professionals across the nation have said. An infection in The City’s notoriously pervasive homeless population would be a nightmare.
San Francisco woke to that nightmare Friday.
Mayor London Breed revealed an “outbreak” of COVID-19 at San Francisco’s largest homeless shelter, Friday, which infected 68 unhoused people and two staffers.
Homeless advocates called it an “explosive catastrophe.” They also used another word for the terrible contamination: predictable. Advocates have been agitating for The City’s homeless population to be moved into hotels for weeks.
City officials have pushed back, saying hotels are logistically difficult to staff with enough workers to safely shelter homeless people. So San Francisco leaders are racing to find different solutions. But one of their newest tools to save homeless people from COVID-19 is something NIMBY San Franciscans have long fought against.
Tent encampments. Yes, you read that right — tent encampments.
For years, San Francisco front-line workers have tossed tents into garbage trucks, police officers ripped them apart with knives, and encampment-fearing neighbors have tapped the numbers 3-1-1 on their phones with enough furious speed to crack the iPhone’s much-vaunted Gorrila Glass.
Now they’re The City’s newest hope for stemming the spread of COVID-19.
Tents for all
While Jennifer Friedenbach, the head of the Coalition on Homelessness, would rather The City move thousands of homeless folks into hotels — and medical professionals agree with her heartily — Friedenbach said sanctioned encampments with accompanying services would be helpful, in a pinch.
“If the city falls short, obviously that’s better than having people sleep on the concrete and not having access to a shower,” Friedenbach told me Friday.
Abigail Stewart-Kahn, a spokesperson for the Department of Homelessness and Supportive Housing, confirmed San Francisco officials are looking for open-air sites when asked by a reporter at a Friday press conference.
Jeff Kositsky, the new manager of the Healthy Streets Operations Center, a multi-department effort to ease homelessness on city streets, expanded on Stewart-Kahn’s comments to me on Friday.
These safe sleeping sites, as they’re called, will differ from traditional tent encampments, Kositsky said.
No more than 60 people would be allowed at any identified site, which may be an enclosed outdoor space, like a parking lot. People would be allowed, and encouraged, to bring tents, and there would be a “social distancing” buffer zone of roughly 200 square feet around each tent on lots roughly 10,000 square feet total. Two staff would be at the site 24/7, at least.
“At a minimum,” Kositsky said, the sites would provide bathrooms, drinking water, handwashing stations and three meals a day. “Things we’d like to have,” he said, include showers, a trailer for staff to store supplies, storage space for people camped out, charging stations for phones and Wifi, and potentially fencing.
Kositsky declined to identify specific sites The City is exploring, but said, “we need to keep a lot of space between people. Space for people to walk by each other, but not too close.”
Neighborhoods hardest hit by homelessness are on the top of the list to see these sites, he said, including the Tenderloin, Golden Gate Park/Haight Ashbury area, South of Market, the Bayview, the Mission and Castro area, and near Showplace Square.
Some aspects of the plan are still being developed. Kositsky said the Department of Public Health is “working with me on ‘Who goes?’ How do we decide who goes into these sites?”
They’re also working on a transition plan for once the pandemic has calmed, which most likely will involve seeing people moved into the many now-empty homeless shelters.
Christin Evans, owner of The Booksmith store on Haight Street and who has become a prominent citizen-advocate for the homeless, said she distributed 800 tents to homeless people in San Francisco, with the help of some Coalition on Homelessness volunteers and staffers, to help ensure health and safety amid COVID-19.
The City has had few options for unhoused people as of yet. Evans and other volunteers delivered hand sanitizer and other supplies to homeless people when they were needed most.
“If you’d been at my house the last three weeks you’d see the piles of tents,” she said, “masks being made. The piles of hand sanitizer.”
Evans hopes nearby Kezar Stadium, the historic home of the 49ers, becomes a site for homeless people to safely stay in tents. Friedenbach, from the Coalition on Homelessness, agrees, noting the stadium’s showers and other facilities.
Kositsky said, “in each one of those neighborhoods we have multiple spots we’re looking for, or looking at. If you said is Kezar one of them, I’d say everything is on the table.”
Phil Ginsburg, the general manager of the Recreation and Parks Department, who has continued to see Park Rangers shoo homeless people out of parks at night, and who years ago instituted a curfew at parks to ostensibly combat “graffiti,” did not respond to my request for comment on the possibility of Kezar as a shelter site.
Big ol’ surprise.
In the meantime, the progressive Democrats of the San Francisco Board of Supervisors, homeless advocates and medical professionals are all clamoring for unhoused people to be sheltered in hotels.
While some in The City critiqued that stance, it may seem a lot less extreme considering 70 people tested positive for COVID-19 at MSC South, San Francisco’s largest homeless shelter, Friday. It was open-air, and infections simply spread. Now those people will be housed in hotels.
“The quote-unquote progressive wing of the board of supervisors may have looked hysterical at the beginning, but we were making the right medical call weeks ago,” Supervisor Aaron Peskin told me Friday.
The need is great, the Coalition on Homelessness noted, and medical professionals agree.
Researchers at the University of California Los Angeles Fielding School of Public Health, Boston University, and the University of Pennsylvania warned in a statement on March 25 that more than 21,000 homeless people across the United States are expected to be hospitalized as a result of the pandemic, with as many as 1,200 deaths of homeless people in California alone from COVID-19.
“It’s important to know this actually isn’t rocket science,” Dr. Colette Auerswald said in a joint press conference with the Coalition on Homelessness. Auerswald, an associate professor of community health science at the University of California Berkeley, said unhoused people are “a higher risk of being ill and at higher risk of dying” because they are generally older and have underlying conditions that make them more vulnerable to COVID-19.
Dr. Juliana Morris, a physician at the University of California San Francisco, told reporters, “We knew it before, but it is now clearer than ever, that it is medically necessary to shelter people in hotel rooms immediately.”
That isn’t so easy, city officials said on background.
Just over 1,000 hotel rooms have been secured for unhoused people who have tested positive for COVID-19, and people living in single-room-occupancy hotels who tested positive. To staff those hotel rooms with “site monitors,” The City drafts workers from all walks of city life — the Department of Elections, the Ethics Commission, the War Memorial Opera House, the Recreation and Parks Department.
These “disaster service workers” are the front lines of many efforts at The City. But they can only be trained so quickly, city officials said. About 30 city workers were trained Friday to be site monitors at hotel rooms for COVID-19 positive homeless people, and roughly 150 will be trained next week.
Far more are needed, Mayor Breed has said publicly, and staffing shortages are a real barrier to care.
Supervisor Matt Haney, among those pushing for San Francisco’s homeless to be housed in hotel rooms — regardless of testing positive for COVID-19 or not — pushed back on Breed’s stance, citing the infections at MSC South.
“Last week it was because it was too expensive. The week before it was because the negotiations with hotels were taking time. Meanwhile, hundreds of people were being put in clear danger and being infected,” he said.
He added, “It’s unacceptable by any measure.”
Whatever comes next may decide whether a sizable chunk of San Francisco’s homeless population lives, or dies.
On Guard prints the news and raises hell each week. Email Fitz at firstname.lastname@example.org, follow him on Twitter and Instagram @FitztheReporter, and Facebook at Facebook.com/FitztheReporter.