With Coronavirus Present, It Seems That Poverty Is Three Times As Deadly
The number of homeless people in San Francisco who have died over an eight-week time frame has dramatically tripled compared to the same period last year. While coronavirus is the suggested reason by officials, interestingly, the virus isn’t the direct cause for many of these deaths.
Instead, there’s been an influx of drug overdoses and worsening health issues. This is a result of the disruption that coronavirus has caused for homeless people both physically and mentally.
Let’s learn more about the statistics and the background of these increased deaths in the city of San Francisco.
From March 30 to May 24, 2020, 48 homeless people in San Francisco died. This is more than three times the 14 deaths recorded during the same time frame last year. This is an average of six homeless people dying per week.
Some of these people tested positive for coronavirus close to their time of death.
However, the causes of death are still under review and have not been recorded as COVID-related deaths. The data is preliminary, and the exact reasons of fatality are pending until the medical examiner’s officer files a report.
But, according to Dr. Barry Zevin, medical director of the San Francisco Department of Public Health’s Street Medicine Team, most of these deaths aren’t a direct result of COVID-19.
As of June 12, 2020, there have been 44 COVID-related fatalities since the first case was reported in San Francisco on March 5, 2020.
Instead of being COVID-19 related, Zevin suggested most of the deaths are likely related to substance overdoses. These usually take place in the overcrowded homeless community of San Francisco’s infamous Tenderloin neighborhood.
The health department states that “overdose deaths, especially those linked to fentanyl, have been increasing significantly over the last year.” The worries that homeless advocates and service providers have is that these deaths are written off as overdoses, rather than linked to COVID-19.
If this is the case, the public may dismiss them as drug-related deaths, fueling the belief that homelessness is a drug-related issue. This, in turn, can affect both the emotional and financial aid the public offers to homeless people as well as supporting charities and organizations.
One person who died recently was diagnosed positive for coronavirus in a postmortem test. But, that person was understood to have died from catastrophic peritonitis. This is a life-threatening infection.
Another person that died had previously recovered from coronavirus, contracting the virus when an outbreak occurred at MSC South, San Francisco’s biggest homeless shelter.
The Indirect Effects of Coronavirus on Homeless Communities
The recent deaths of homeless people don’t seem to be directly related to coronavirus. But, the sudden annual spike suggests that the pandemic is still to blame.
Disruptions and stress to services and limited shelter space caused by COVID-19 may well be a contributing factor.
San Francisco was forced to reduce its shelter capacity to allow for social distancing and to prevent the spread of coronavirus. Likewise, other services that homeless people often use, such as drop-in centers and community clinics, have closed or have reduced capacity and/or reduced times.
As a result, many homeless people haven’t been receiving the treatment and services they usually require. Without such vital facilities, both mental and physical stress can aggravate those suffering from chronic or mental health disorders.
“Congregate settings are a huge danger in terms of COVID spread, and that’s why we made these changes. I think it was the right decision, but it comes with consequences,” Zevin said. “And it is very painful.”
San Francisco was already suffering from a growing homelessness issue.
But the COVID-19 pandemic has pushed it to its limits. Forced to leave shelters and move back to the streets, homeless people’s mental and physical health has suffered. In extreme circumstances, these distressing conditions can contribute to death.
At risk on the street, some homeless people feel obliged to stay up awake all night. If they don’t, they may experience assault or robbery. To keep themselves awake, many homeless people turn to drugs and end up becoming addicted.
Other homeless people suffer from underlying health conditions and mental health disorders. Back on the streets and without access to proper support and services, they manage the trauma with dangerous and addictive substances.
The majority of the 48 deaths took place outdoors.
More were located in the famously low-income neighborhood of the Tenderloin than any area in the city.
In this area, the number of makeshift homes on the streets using tents exploded by 258 percent since the spread of COVID-19. Throughout the rest of San Francisco, the number rose by 71 percent.
In a statement, San Francisco’s department of public health recognized that “measures San Franciscans have taken to protect our community from the virus and reduce its spread have been necessarily disruptive, and have saved lives, but they could also be having indirect impacts on other aspects of life for people experiencing homelessness.”
“These excess deaths I see as COVID deaths, whether or not they were from the virus or from the complete failure of the COVID response from the city,” noted Dr. Rupa Marya, co-founder of the Do No Harm Coalition. “They were deaths that would not have happened otherwise.”
With coronavirus present, it seems that poverty is three times as deadly. While the death rate of homeless people was already high in San Francisco, fatalities have spiked because homeless people are more unsettled, disconnected, and vulnerable than usual.
Keeping Homeless People Safe in San Francisco
Yet there have been efforts from San Francisco officials to protect homeless people during COVID-19.
Since the virus spread, more than 1,200 homeless people have been moved to hotel and motel rooms to social distance. Here they receive food and access to behavioral health services. This may be enough to replace the usual services that homeless people need, for the time being at least.
The most vulnerable homeless people were typically moved to hotel rooms and motels. These include the elderly and people suffering from health issues that make contracting coronavirus riskier for them.
Likewise, Zevin noted that since mid-March, the DPH Street Medicine Team has tripled the number of people starting buprenorphine. This drug helps relieve opioids’ withdrawal symptoms, and it’s effective for homeless people suffering from addiction.
Zevin also announced that outreach teams such as the Street Medicine Team, the Homeless Outreach Team, and the Harm Reduction Therapy Center, are conducting outreach activities on the streets daily.
But while these combined efforts have likely saved many homeless people’s lives during the pandemic, there are still thousands of homeless people living on San Francisco’s streets experiencing drug addiction, poor hygiene, and declining health.
It seems that San Francisco requires a dedicated health policy that addresses the conditions of homeless people and helps them when a global emergency like COVID-19 comes up. After all, such a virus has occurred once. Something similar could rear again.
If it does, vulnerable homeless people should not be the last people we think of. They should be the first.
Photo by Franco Folini, Flickr