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How can SF protect the homeless from coronavirus?

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Itinerant populations of often older and already ill people are a potential nightmare scenario in a pandemic

A man rides a bicycle in front of tents on a sidewalk in San Francisco.
There are at least 14 confirmed cases of COVID 19 in San Francisco.
Photo by AP Photo/Jeff Chiu

The go-to plan for avoiding Covid-19 exposure in the Bay Area is to stay home as much as possible, and most of those who have already contracted the disease are similarly self-quarantined inside their residences. But what about the tens of thousands of people who have no homes and who may be among the most vulnerable?

As Alissa Walker of Curbed reports, many of the country’s half-million homeless residents suffer from pressing health problems, including immune system weakness, making shelterless populations a tremendous challenge for public health safeguards.

In San Francisco, the city’s 2019 homeless census found that 10 percent of homeless residents are 61 years old or older, and 25 percent were over the age of 51. Older people are more likely to suffer serious or fatal complications from the disease.

Seventy-four percent of those surveyed said they had health problems, and 31 percent characterized those problems as “chronic.” While some of these issues would not contribute to vulnerability to this particular disease, many others will, including most notably the seven percent of those surveyed who said they are living with HIV/AIDS.

The city’s unsheltered homeless population—more than 5,000 people—may be highly mobile and lack access to basic sanitation facilities where they can wash their hands to avoid potentially spreading of contracting the virus.

In response to these worries, the city will spend $5 million on programs to help the homeless become more secure and gain better access to basic resources. City shelters that are not open 24 hours will switch to a 24/7 schedule, and the city will increase meal delivery to single resident occupancy (SRO) hotels so that tenants have the option of staying inside longer.

The Department of Public Health has ordered SROs to establish required cleaning and contagion mitigation protocols, including “cleaning of high-touch surfaces and bathrooms appliances with soap and water followed by CDC-approved household cleaners” and multilingual signage warning residents to wash their hands.

For those who contract the disease and have nowhere to go, SF will rent recreational vehicles and loan them to patients for the duration of a quarantine. The city may also employ vacant homes or hotel rooms as a place for patients to hunker down.

“Our chief concern is for vulnerable populations who are most at risk of getting very sick, or dying, if they get COVID-19,” said Dr. Grant Colfax, San Francisco’s chief of public health.

“That is why we are recommending that people over 60, or with certain underlying health conditions, stay home as much as possible. For vulnerable people in SROs or shelters, this investment will help them limit their outings, by assuring that food and shelter is available, and that congregate settings are clean environments.”

Down in the South Bay, San Jose Mayor Sam Liccardo said that his city will stop rousting homeless camps for the time being, fearing that driving potentially sick people to relocate will facilitate the spread of the virus.

As of Tuesday, the SF Department of Public Health has 14 confirmed cases of Covid-19. “With confirmed cases that indicate community spread, the time is now” to take basic “social distancing” steps, such as vulnerable people avoiding spaces with 50 or more people if possible and employers granting time off without doctor’s notes, according to the latest guidelines.