The next COVID-19 outbreak could already be happening

Advocates say COVID-positive SRO-dwellers are systematically denied quarantine hotel rooms and sent back to overcrowded residential hotels to sicken others

In the wake of 24 staffers and formerly homeless residents testing positive for COVID-19 at Casa Quezada in the Mission District last week, advocates say scores of SRO hotels could be experiencing similar outbreaks without our knowing. 

These hotels, approximately 400 that serve some 14,000 residents, have become blind spots, they say — lacking mass onsite testing, proper accessibility, and an efficient relocation process for those who test positive for the virus. 

“When I learned about Casa Quezada, it brought tears to my eyes,” said Diana Alonzo, a program manager at the Mission SRO Collaborative, explaining that similar outbreaks could be happening at residential hotels she works with. “But there’s been no investment from [the Department of Public Health] to test them, so tenants could be walking around COVID-positive without us knowing.”  

Alonzo noted the 58-unit Grand Southern Hotel on Mission Street near Civic Center, where at least four tenants have tested positive for COVID-19. The first Grand Southern resident who tested positive for the virus in early April was sent back home without being offered a quarantine hotel room, Alonzo said. Now, there have been four confirmed cases. “We suspect more cases,” she said. “But again, there’s no testing.” 

The story was the same at 16 Virginia, a 14-unit SRO hotel off Mission Street near 30th Street. So far, there has been one confirmed case, though testing is so limited that it’s difficult to know the real number. 

In that case, Alonzo said, the resident tested positive in mid-March, and the health department was alerted in early April. Nevertheless, the person remained at the SRO to isolate in his room with his wife, child, and another adult, Alonzo said. 

“Pretty soon everyone got sick in the room,” she said, adding that they had to leave the room for food and supplies. The city was so slow to act in that case, she said, the family had to quarantine in another room onsite. 

Residential hotels are congregate living quarters where dozens may share a single bathroom and kitchen — where rooms are small and the only places for children to play are narrow hallways. In other words, viruses spread quickly at SROs. So advocates say it’s especially troubling to hear of tenants being sent back to cramped quarters to isolate rather than being relocated offsite. 

“Our experience has been that people go do the right thing, test positive … and should be given a hotel room — and that just never happens,” said Matthias Mormino, policy director at the Chinatown Community Development Center. The nonprofit is a member of the SRO Families United Collaborative, which is in direct contact with some 700 families living in SROs around the city. 

Over the last month, his group has heard of seven such cases where residents were sent back to their room without being offered an opportunity to isolate from others. 

By contrast, Department of Public Health Director Dr. Grant Colfax said on Friday that the Health Department is in “constant contact with SROs.” The department is making sure “they’ve been applying cleaning to their hotels,” he said. “And that the people who need testing … have access to timely testing. And if they need isolation or quarantine rooms, that they are offered hotel rooms.” 

Mormino said, unequivocally, that was not the case. “I really wish that was the reality of things,” he said. “That sounds awesome.” 

It’s unclear where the system breaks down. Testing capacity is no longer an issue, Dr. Susan Philip, deputy health officer for the Department of Public Health, said at a press conference on April 23. The city can now test 4,300 people a day, she said, but most recently has been testing 500 to 700 people a day. The gap, she said on Thursday, was probably a result of having had fewer tests earlier in the pandemic. 

At that press conference last week, Philip said testing asymptomatic people in congregate settings would be part of the next phase in testing. But so far, that has not regularly happened.

Moreover, as of Tuesday, only 18 percent of the 936 hotel rooms for frontline workers were occupied, meaning 768 are vacant, according to city data. Currently, 46 percent of the 421 rooms for the “marginally housed” are occupied, with 175 vacant. (Sources tell Mission Local scores of rooms will need to be made available as the results of the Mission District testing campaign become known in the coming days.)  

The Department of Public Health did not respond to a request for comment on the specific cases at Grand Southern or 16 Virginia or why some residents had not been isolated in hotels. 

But Juan Garcia, the senior project coordinator for the SRO Families United Collaborative, said that Health Department officials recently told him that people “fall through the cracks,” as hospital personnel do not always ask about living conditions and may unwittingly send SRO tenants back to their crowded living arrangements. 

That happened this past Friday when staff at an Embarcadero test site did not ask a man whether he lived in a congregate setting, Garcia said. Luckily the man was in touch with Garcia, who helped the man obtain an isolation room.

But even the process for relocation can be byzantine and prohibitive, Garcia explained — demanding an extraordinary effort from SRO advocates. To secure the man his hotel room, Garcia had to navigate a 50-question online form with complex medical questions. He then got mixed signals from the city on room availability, and then he had to arrange a professional cleaning of the Columbus Street SRO himself. “The process itself was a pain in the butt,” he said, “but after the process everything was fine.” 

But he emphasized how infrequently the process is successful: “We’ve dealt with more cases of families not getting relocated than with folks who get moved out,” he said. 

Making matters more difficult is a longstanding problem with privately run residential hotels: Many are challenging to access, even for tenant advocates, and landlords are often difficult to coordinate with. 

San Francisco has roughly 400 privately run SROs, according to Department of Building Inspection records. Around 20 percent of those, Mormino estimated, are operated by landlords who are difficult to contact and coordinate with if a tenant tests positive for the virus. 

Oftentimes, he said, these SROs are owned by limited liability companies listing P.O. box addresses that operate in a “world outside of normal.” Alonzo estimated that 80 percent of the Mission District’s SROs operate this way.  

“In those cases, the communication completely falls through,” Mormino said. “The city is supposed to notify them of a positive case, and when all that’s available is a P.O. box, they’re unable to reach these owners. One of the things we have been trying to do is ensure that initial notification has come as quickly as possible.” 

Some landlords, advocates say, are not interested in taking proper sanitization measures — even though they can be provided by the city for free. “Cleaning is already a huge issue in hotels because it doesn’t get cleaned on a regular basis,” Alonzo said. “DPH put in an order to increase cleaning but there’s no implementation mechanism.” 

Alonzo charged that the owner of the Grand Southern has failed to properly clean the hotel after the COVID-19 cases there became known. Hotel management is “turning in logs for cleaning,” Alonzo said, “but reports from tenants [indicate] that no cleaning is happening.” 

“A landlord should have no option,” she continued. “The fact that you get one COVID case is enough, especially in cases with one bathroom and one kitchen.” 

Falah Salem, the property manager at the Grand Southern, said the hotel performs janitorial services twice a day, and that hand sanitizer stations have been set up everywhere. The hotel worked closely with the Health Department to sanitize the hotel following the positive virus cases, he said. And to the notion that cleaning is not being undertaken, Salem said: “Absolutely not. People are just worried, so they’ll complain about whatever they complain about.”  

With the news of positive coronavirus cases and allegations of inadequate cleaning happening at some private SROs, Alonzo said, tenants are afraid to leave their rooms. She’s heard stories of residents urinating in cups instead of going to the bathroom. 

“These rooms are 10-by-10, 8-by-8,” added Mormino. “So if you talk about sheltering in place in a place like that, you can’t go to the bathroom. It’s not something that’s going to work long-term, because you’re gonna go insane.”  

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