With Tuesday's shelter-in-place order, the City of San Francisco made it clear that social distancing and self-isolation are critical to slowing the spread of COVID-19. But for thousands of unhoused San Franciscans living en masse in the city's homeless shelters, distancing isn't an option.
"At this point, there's kind of a double standard," said Jennifer Friedenbach, executive director of the Coalition on Homelessness.
"For the housed population, the approach has been to advise people to practice social distancing and shelter in place. For the unhoused population, they're being asked to go into congregate settings, where they're unable to practice social distancing."
In most shelters, people sleep just a few feet from each other, with no partitions and inadequate sanitization of shared facilities and services, Friedenbach said. "If you have an outbreak, you have a situation where you basically have the entire shelter at risk."
At today's press conference with Mayor London Breed, Trent Rhorer, the executive director of the city's Human Services Agency, announced efforts to improve safety at San Francisco's large homeless shelters, which currently house about 2,000 people.
To start, the city plans to secure blocks of hotel rooms for use by unhoused people and SRO residents who test positive for COVID-19 and need to be isolated. By the end of the week, the city will have leased about 500 rooms, Rhorer said, with another 1,500 or more to come.
But for the moment, the only unhoused people who can use these rooms are those who've already tested positive for COVID-19. Older and immunocompromised homeless people, who face a greater risk of death if they catch the virus, remain exposed until it's too late.
Friedenbach believes this group "should be moved out immediately," and into solitary housing.
But it appears the unhoused will still have to share space, albeit in smaller clusters. At today's conference, Rhorer said the city plans to break up the big shelters, spreading them out across city-owned sites that will serve as "pop-up shelters" while the shelter-in-place restrictions are underway.
Rhorer said these shelters will be staffed with intake personnel, who will work to identify and isolate anyone exhibiting COVID-19 symptoms for care.
Last January, an official count found that more than 8,100 San Franciscans were living in shelters, vehicles or on the street. Were even half of that group to become infected with COVID-19, that's far more than the shelters or hotel rooms can currently house, especially since some of the hotel rooms will also be dedicated to SRO residents and medical professionals under quarantine.
Rhorer said the city would be increasing outreach teams to "find vulnerable people to move into shelters as well." But the rest are currently on their own — and already more vulnerable to disease, because they lack access to basic sanitation.
In the meantime, Friedenbach said, unhoused people can still access COVID-19 testing. Zuckerberg San Francisco General Hospital is offering testing, and patients can also visit their primary care doctor or urgent care center to be tested.