COVID-19: What happens when a homeless shelter resident tests positive?

Nestled among other street detritus on Florida Street sits a dry and seemingly abandoned handwashing station. Not far off sit three tents. Their inhabitants do not avail themselves of the nearby sanitation facility. No one does. 

“I don’t know if there’s soap or if the water is running,” says one tent-dweller. “I think they just left it here and forgot to pick it up.” 

The city’s thousands of unhoused residents are among its most vulnerable to the looming COVID-19 pandemic — especially when unable to adequately “shelter-in-place” or even wash their hands regularly. The rapid spread of the virus among mobile transients or shelter residents squeezed into communal living situations could undo the city’s best-laid plans and rapidly overwhelm its already-stretched healthcare system. 

Also, there seems to be a divergence on the street between policy and practice: While the city has not yet instituted any formal curfew, San Francisco Police officers “told us there’s a curfew from midnight to 8 a.m. We have to stay inside our tents,” said one of the Florida Street tent-dwellers. “Because that’s when it’s colder and we’ll get sick.” 

Homeless advocates worry that even a handful of positive COVID-19 tests among the unhoused population could be the spark that ignites a citywide conflagration. And the city’s response has, thus far, not assuaged worries. 

At Hospitality House, a homeless shelter on Turk Street, executive director Joe Wilson candidly admits that the city is “in uncharted territory, and nothing we’re doing is sufficient.” 

And, while the goal at this and every shelter is to “get people who are the most vulnerable out of harm’s way,” it warrants questioning at this time whether gathering large numbers of people into close proximity to one another meets that criteria. 

Wilson, for one, laments that he does not serve a “static population;” it’s a different crowd here every night. Of note, the city’s initial shelter-in-place rules forbade childcare centers with more than 12 kids, and mandated that those kids be the same every day. But that’s not the case with homeless shelters, which are far, far larger. Rather, it’s the opposite. 

At Hospitality House, Wilson is working to ensure that every person residing here is doing so on a long-term basis — “But we’re still getting one-night stays. We don’t have the authority to refuse people who are in an emergency seeking shelter. And that significantly increases the risk of exposure for everyone.” 

The city has announced efforts to instill “social distancing” even into its homeless shelters, reducing capacity; it pledges to pick up the slack by creating 1,500 beds in “pop-up shelters” around the city. This has not yet come to pass. 

One resident at Dolores Street Community Services told us that dinner tables are now spaced five to six feet apart. But: There are four diners per table. And, “they haven’t spaced any of the beds apart. It would be impossible to do so, because there’s not enough space.” 

Over at the Fifth and Bryant Navigation Center, a resident notes that there’s still soap in the dispensers — but toilet paper is hard to come by, a condition Mission Local is told is not unique to this Navigation Center. Residents here worry about cleanliness — of the facilities, and of the residents. “There’s a lot of things they can’t make people do,” says one. “Like shower.”

All of which serves as a preamble to the elephant in the room: What will the city do when someone tests positive for COVID-19 in a homeless shelter? This question was not directly answered by officials at both the Department of Public Health or Department of Homelessness and Supportive Housing.

City officials did assure us that protocols for this scenario do exist. Our requests to see them in writing resulted in us being sent these March 19 protocols applying to Single-Room Occupancy hotels and permanent supportive housing. That’s not the same thing, however, as a homeless shelter. 

And the link in the document to homeless shelter policy is broken. 

Wilson, at Hospitality House, explained the policy as it’s been disclosed to him. If a resident tests positive, it triggers “a series of backwards steps.” All of the people that person has come in contact with will be identified and must quarantine in some way; staffers could quarantine in their homes, but other accommodations would need to be lined up for homeless residents. Entire shelters could be shut down, in rapid succession.  

The non-static population Wilson lamented about makes this task exponentially more difficult — and, at the same time, renders such an eventuality both more likely and more dangerous. 

Chris Herring, a UC Berkeley doctoral student in sociology who often works with the Coalition on Homelessness, predicted that groups of sick or potentially exposed homeless shelter residents would soon be shunted, en masse, to the 4,000-odd hotel rooms the city is wrangling. 

He worried, however, that this would be a reactive move, which would doom and neglect the healthy, ultimately exacerbating a dismal situation. He and other homeless advocates are calling for putting the city’s homeless population into hotel rooms proactively, before they’re exposed to COVID-19 or develop symptoms — a call echoed by Supervisor Matt Haney. 

That would be a radical step, and a radical change of course. It was only last Monday that San Francisco officially reversed course on its policy of dismantling homeless encampments and bagging-and-tagging homeless people’s possessions — even during a pandemic. Now, such encampments will only be dismantled if they constitute a public safety issue. 

“Safety,” however, is a fairly nebulous term. And, separate and apart from humanitarian or morality issues, acting to disseminate and mobilize vulnerable homeless people during an infectious disease outbreak is highly questionable policy. 

Mary Howe, the executive director of the Homeless Youth Alliance, says police officers were still rousting homeless residents only days ago: “They’ve been driving around with bullhorns and telling people to move along,” she says, “which isn’t helpful when there isn’t anywhere to go.” 

This city’s homeless, Howe continues, are not “driven by the media” in their comprehension of the COVID-19 pandemic. “Their understanding of the situation is very limited.” 

And yet, very few homeless denizens haven’t figured out that something is up. Something big. Something not good at all. 

“The cops are scared to come near us now,” notes one of those Florida Street tent-dwellers. “They just drive by.” 

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