Besides San Francisco’s homeless population, single-room-occupancy hotel dwellers are among the highest risk to catch and spread COVID-19: Dozens of tenants living in single rooms in SROs often share kitchens and bathrooms, making healthy isolation nearly impossible.
Nonprofits running SROs are experiencing what they call frustrating miscommunications with the San Francisco Department of Public Health that may put those hotel-dwellers at risk.
Emails this columnist obtained between doctors, public health officials, city leaders, nonprofit SRO staff and others show a scramble behind-the-scenes to figure out just how to stem the spread of COVID-19 in SROs.
City officials want the Department of Public Health to notify them of buildings containing COVID-19 positive patients, so that quarantine measures can be enacted, but public health officials have refused, citing medical privacy laws.
Sources also tell this columnist the Department of Public Health has in some instances ordered SRO residents to shelter-in-place at home, despite The City’s stated practice of moving COVID-19 positive SRO residents into roughly 2,000 hotel rooms that have been obtained specifically for SRO residents and homeless people to be quarantined.
Interviews reveal at least one case of mistaken identity in an attempt to quarantine family members of a COVID-19 positive patient, and a lack of Cantonese-language speakers has hampered doctors’ ability to timely help SRO-living COVID-19 positive patients and their family.
Sheltering-in-place is nearly impossible in an SRO, where shared surfaces — like bathrooms, faucets and kitchen tables — mix the lives and fates of as many as 200 households in a single building.
City leaders fear that without proper protocols, SRO’s may just be a powder keg.
That’s the fear of Mrs. Chen, a self-chosen pseudonym for one Nob Hill SRO tenant who spoke on the condition of anonymity.
No quarantine possible
Mrs. Chen’s father and mother-in-law both tested positive for COVID-19, and her father-in-law even now is on a ventilator in Chinese Hospital.
But here’s the rub: Mrs. Chen, her husband, and two sons, aged 16 and 10, live in the same SRO as her in-laws, just downstairs. The chance that they, and her mother-in-law, were exposed to COVID-19 was strong. They were terrified.
“Living in an SRO we weren’t able to quarantine ourselves,” Mrs. Chen told me Thursday in Cantonese, as translated by a nonprofit SRO staff member.
The family eventually contacted the Chinatown Community Development Center, which oversees other SROs in Chinatown and the Tenderloin. But Chinatown CDC, as they are called, contacted the Department of Public Health on the Chen family’s behalf.
Matthias Mormino, director of policy and government relations at Chinatown CDC, described the communication with the Department of Public Health as fraught.
Five days after Mrs. Chen’s father-in-law tested positive for COVID-19, the mother-in-law also tested positive — which the family insists should have been caught sooner. She was then admitted to Chinese Hosptial, emails show.
But after her symptoms stabilized she was told she could quarantine herself in the SRO.
When the family, with the help of a translator, told the Department of Public Health that the mother-in-law lives in an SRO, with shared bathrooms and a shared kitchen, and could not possibly quarantine without effecting others, the solution officials gave them was a portable toilet.
At around the same time, Mrs. Chen’s family had not yet been quarantined. Public health officials mistook Mrs. Chen’s family for her brother-in-law’s family, who was already in contact with the Department of Public Health.
“They’re different unit numbers, different names, we’re telling you, you haven’t talked to them,” Mornimo recalled telling the Department of Public Health.
By April 3, Mrs. Chen’s family was quarantined and tested — negative.
“This is when we have a handful of cases,” he said, that required extensive email exchanges between roughly a dozen staffers from multiple city agencies and nonprofits to properly figure out. “If we get to an MSC South-level outbreak, they want us to email them about 70 cases? That’s not possible.”
Supervisor Aaron Peskin, who represents the neighborhood Mrs. Chen lives in, among others, is pushing for change at the request of nonprofits.
Health care clash
Department of Public Health Director Grant Colfax and Supervisor Peskin exchanged lengthy emails between April 10 and April 14, clashing on solutions to the pernicious problem posed by COVID-19 in SRO hotels.
While the list of tweaks to the process sought by Peskin and the SRO Collaborative, a partnership of SRO organizations, is lengthy, perhaps chief among them is more robust disclosure.
In situations like Mrs. Chen’s, SROs hope the Department of Public Health can inform them of a COVID-19 positive case so other SRO tenants can take precautions to avoid shared surfaces, like kitchens or bathrooms, and more effectively “contact trace” where the COVID-19 resident had been — what they touched, and who they talked to.
In one case, the Tenderloin Neighborhood Development Corporation, which operates 43 buildings with more than 5,800 San Franciscans living in them, told the Department of Public Health that notification was lacking.
“We were notified of a confirmed case at one of our SRO properties,” a TNDC staffer wrote to public health officials. But, TNDC was not informed of who the tenant was, whether they were at home or not, nor whether or not they had been assessed by The City’s Isolation & Quarantine Team.
Peskin asked that Colfax reveal buildings with confirmed patients to his office and the Department of Building Inspection to provide oversight of the Department of Public Health’s efforts to quarantine SRO residents.
In an April 10 email to Supervisor Peskin, director Colfax said “building address and confirmation of the status of the tenants’ quarantine could not be provided because, “by law, we do not provide patients protected health information including addresses.”
When Peskin pressed Colfax to provide specific information to the owners and operators of SRO buildings of the specific residence of a COVID-19 infected person, Colfax replied, “Knowing that an individual is COVID positive does not protect residents or the public because SARS-CoV-2 is circulating in the community.”
As for Mrs. Chen she just wishes the Department of Public Health would fulfill San Francisco’s promises to residents: A hotel room for those infected, in a prompt and timely manner.
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.