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An outbreak of COVID-19 at San Francisco's Multi-Service Center South infected more than 100 people and shut the shelter's operations down. The potential for rapid spread of COVID-19 in homeless populations has prompted political and religious leaders to urge that empty hotels be used to shelter unhoused people. (Nicholas Wolfram Smith/Catholic San Francisco)
April 16, 2020
Nicholas Wolfram SmithAn outbreak of COVID-19 at San Francisco’s largest homeless shelter has put a spotlight on the danger of coronavirus spreading through the city’s unhoused population.
Multi-Service Center South on Fifth Street had 92 guests and 10 staffers test positive for COVID-19, according to city public health director Dr. Grant Colfax. About 170 people had been living at the 340-person capacity shelter before the city announced the outbreak on April 10. All remaining guests were moved out of the shelter and into hotels the following weekend.
“From the beginning of this pandemic, one of our biggest concerns has been spread in congregate living situations,” Mayor London Breed said in an April 10 tweet.
“We've seen this happen in countless other places throughout the country," she said. "It is now happening at MSC South.”
In response to the outbreak, the Board of Supervisors passed an emergency ordinance April 14 that would require the city to provide 7,000 hotel rooms for homeless people, including those residing in city shelters. Those over 60, who have health complications or who are pregnant would receive priority for temporary housing assistance.
The measure also called for 500 hotel rooms to be set aside for people who need to self-quarantine but do not have a safe place to do so, and 750 for front-line workers in the crisis, including health care and social service workers.
If the city cannot enter into agreements to supply the total 8,250 rooms, the supervisors asked the mayor to use her authority to commandeer units.
The same measure also required group housing arrangements like shelters, also known as congregate facilities, to abide by new guidelines. Staff and residents need to stay six feet apart as much as possible, and guests need to maintain the same distance while sleeping. The board also required city departments to issue plans on how to screen guests and employees for COVID-19.
As of press time, the measure had been sent to the mayor but her office had not yet acted on it.
More than 8,000 people in San Francisco are homeless, about a third of whom live in shelters, according to the 2019 point-in-time count, the most recent data available.
The housing requirements set by the supervisors sharply diverge from previous guidance coming from San Francisco’s administration, which had originally proposed renting a more modest 6,500 hotel rooms.In an email shared with the press, Trent Rhorer, executive director of the city’s Human Services Agency, said the city’s priority for hotel rooms is the population of unhoused people who cannot self-quarantine but have been discharged from the hospital, in order to free up hospital beds. Rhorer said rooms would also go to “front-line responders” and vulnerable unhoused people who are able to care for themselves.
Rhorer said the city would not be sheltering every homeless person. According to the city’s Department of Public Health, he said, “there is no medical need to isolate this population in hotel rooms.” Doing that could reduce the amount of rooms available for vulnerable homeless adults and for the hospital system, he said.
In addition, Rhorer said that with the city facing a budget gap of more than $1 billion, “it would not be fiscally prudent to spend City General Fund on renting thousands of hotel rooms for a population that does not require an urgent COVID health quarantine or isolation intervention.”
On April 15, Rhorer said the city had acquired 2,151 hotel rooms for use during the pandemic. Nearly 1,300 units have been set aside for vulnerable adults, and 874 people have been placed in them. The rest of the rooms are reserved for front-line staff engaging with the public.
Faith leaders in the city have been critical of the city administration’s approach to caring for the homeless for weeks. A March 25 letter signed by about 50 religious leaders called on Mayor Breed to house all unhoused people in the city, arguing that homelessness “exacerbates a dangerous public health crisis where group living facilities put people at extreme risk.”
The letter continued that while the city had asked some congregations to open their doors to shelter homeless people, it was “irresponsible to create new living facilities” that did not mitigate the risk of transmission.
Signers continued that with about 30,000 empty hotel rooms in the city, “It is madness to leave them empty while the epidemic rages -- and in fact is being fueled by the lack of safe spaces.”San Francisco’s nine United Methodist churches stepped up April 4 with a $100,000 donation to help nearly 20 residents at the Tenderloin’s Hospitality House move to a vacant hotel. The pastors partnered with Supervisor Matt Haney to arrange the move. The funds will cover residency costs as well as food and support services. St. Agnes Parish and St. James Episcopal Church in San Francisco have also contributed to the fund.
The Rev. Staci Current, Bay District superintendent of the California-Nevada Conference of the United Methodist Church, said the city’s UMC churches felt that with people’s lives on the line, “we weren’t willing to wait for a government process for these beloved people of God who were on the streets. We needed to act quickly.”
Christians everywhere feel the call to care for “the least of these,” Rev. Current said, and efforts to care for the unhoused so far “have been slow and shortsighted,” she said. “It’s time to get all of the folks into hotel rooms.”
“I think it’s an important moment for us to be the moral voice and moral compass for our society,” she said. “It’s our job at this moment to take up that mantle and pressure and motivate and encourage the powers that be to respond justly.”
The rapid spread of coronavirus through California’s vulnerable population could shock a hospital system that has been able to keep pace with the spread of COVID-19. Congregate facilities like shelters or nursing homes are particularly at risk for rapid outbreaks, as their residents are often older and have health complications.
At the beginning of April, California Gov. Gavin Newsom said cases of COVID-19 among homeless people had “heightened concern around the need to do more in our congregate facilities to isolate people ... and provide those basic essential services as we work through this crisis.”
The state earmarked $100 million in emergency funding for local authorities to counter an outbreak of COVID-19 among unhoused people, and is putting an additional $50 million toward leasing hotel rooms and purchasing trailers.
