Last week San Francisco began acquiring hotel rooms for medical workers and COVID-19 patients. The plan is to lease up to 4,500 rooms so that medical workers who may be infected do not have to return home and risk exposing their families, and so that those residing on the streets, in shelters, and SRO’s with shared bathrooms have a place to self-quarantine. The city’s plan follows Governor Newsom’s goals of providing 50,000 hotel rooms for the state’s 108,000 homeless during the course of the pandemic.
There is a major problem, however. For those who have yet to test positive for COVID-19, Mayor London Breed and Gov. Gavin Newsom are abandoning the unhoused in congregate shelters and camping outdoors—settings that the CDC warns will catalyze transmission and could fuel an early surge on hospitals, ICU’s, and ventilators. To make matters worse, a recent study out of the University of Pennsylvania and UCLA project that the unhoused will require hospitalization and ICU’s for COVID-19 at more than twice the rate in certain age brackets compared to the general population due to underlying health conditions.
Rather than reactively housing the sick, we must get ahead of the curve and place all unhoused people as quickly as possible in hotels or comparable units. This may be more costly up front, but it will slow transmission, and will save lives and medical expenses down the line. Although there is a scarcity of hospital beds, ICU’s, and ventilators, the city has a surplus of vacant hotel rooms. The mayor’s current policy decision to leave those units vacant will stress our medical resources and personnel. The decision will also cost lives of the unhoused and housed alike.
While the mayor has not offered support of such a plan, five members of the Board of Supervisors have put forward a pro-active resolution that provides hotel rooms to all those without housing so they could “shelter-in-place” and practice the “social-distancing,” like the rest of us.
The hotel stock is there— 11,000 hotel rooms have been offered to the city already. There are at least 30,000 empty hotel rooms in the city. San Francisco has an estimated unhoused population of about 8,000. Many city hotels are already or plan to close and suspend services. Hotel workers are out of a job and healthcare. As the industry calls for a bailout, why not simply use the hotels and pay them?
The legal powers are there too. While the city has already begun a competitive bidding process to rent hotels, other options should be considered with the urgency of the crisis. Governor Newsom’s March 12 executive order, invoking CA. Gov code section 8571, allows the commandeering of hotel rooms. According to the City Attorney, Mayor Breed or the public health officer could invoke their emergency power to commandeer hotels immediately and work out “reasonable payment” afterwards.
Although it seems unlikely these bold moves will be made until hospitals are desperately looking to discharge and free up beds, we should heed the advice of health professionals. They tell us that moving those currently unhoused into hotel rooms now, prior to infection, will do far more to free up hospital beds in the coming weeks and months.
No doubt there will be complications. People will debate what “reasonable rates” look like. Hotels will not be appropriate for some of those currently in shelters or residing outside and the city will need to continue to make COVID-19 appropriate accommodations for these groups. However, the idea that most homeless people will not be able to survive well in hotels is unfounded. According to the city’s own surveys 35% of San Francisco’s unhoused became homeless in the past year, and the majority were housed and caring for themselves within their own homes in the past three years.
In implementation, cities will also need to figure out how to get case managers, medicine, and food into rooms to assist those with various disabilities. This will not be easy but providing the same services in dispersed encampments and the dangers of viral spread in congregate shelters, are even more challenging and dangerous. Just as doctors in San Francisco will likely be forced to decide who lives and dies due to limited ICU’s and Ventilators, the Mayor’s current plan leaves decisions of life and death to officials forced to decide who gets hotel rooms. Such choices are not necessary. With a surplus of vacancies and the political authority to open those spaces the Mayor should not delay.
Chris Herring is a PhD Candidate of Sociology at UC Berkeley who will be joining Harvard as a postdoctoral fellow and the UCLA sociology faculty. Neil Gong is a postdoctoral fellow at the University of Michigan and will be joining the sociology faculty at UC San Diego. Their research focuses on homeless services in San Francisco and Los Angeles.