http://www.digitaljournal.com/life/health/op-ed-san-diego-hepatitis-a-outbreak-tied-to-homeless-population/article/502759

Op-Ed: San Diego Hepatitis A outbreak tied to homeless population

Posted Sep 18, 2017 by Karen Graham
Not only does San Diego, California have a homelessness problem, but the city now is battling a Hepatitis A outbreak that has sickened 421 people and killed 16 between November 2016 and September this year. At least 279 people have been hospitalized.
A woman pushes her walker past tents housing the homeless in Los Angeles  California on February 9  ...
A woman pushes her walker past tents housing the homeless in Los Angeles, California on February 9, 2016
Frederic J. Brown, AFP
San Diego County has the unwanted distinction of being fourth behind Seattle, Los Angeles, and New York City in the number of homeless people, with a total of 9,116 homeless people in San Diego City and San Diego County as of September 4, 2017.
Like many cities on the Top 10 list, a lack of affordable housing is a key component of the homelessness crisis in San Diego. Even people who get housing vouchers are often unable to use them because of low vacancy rates and high rents. Additionally, redevelopment in the downtown area has caused cheap, single-room units to vanish, pushing people onto the street. San Diego also has the second-largest population of homeless veterans in the country, at 1,156 people.
Now the city is dealing with a Hepatitis A outbreak that has been going on since November of last year. Usually, the city records on average, about 26 cases of Hepatitis A annually. The situation has been exacerbated by the lack of adequate restroom or shower facilities in the downtown area, something homeless advocates have been asking the city to remedy for months.
Homeless veteran Kendrick Bailey steps out of his tent on a streetcorner near Skid Row in downtown L...
Homeless veteran Kendrick Bailey steps out of his tent on a streetcorner near Skid Row in downtown Los Angeles
FREDERIC J. BROWN, AFP
As it turns out, the number of Hepatitis A infections grew so large the city’s sidewalks became contaminated, so officials started power-washing them with a bleach solution every other week. And it wasn't until earlier this month that the San Diego Board of Supervisors declared a state of emergency.
Hepatitis A is a highly contagious virus and can be spread through contaminated foods, water, and objects, as well as person-to-person contact, fecal matter, bodily fluids, and sex. The virus infects the liver, and while some people can be ill for a number of weeks, it can result in a lengthy hospitalization or even death.
Much to the relief of homeless advocates, the city has started installing hand-washing stations and portable restrooms in the downtown area, and officials say the facilities will be cleaned at least two times per day and will be watched over by full-time security.
A pedestrian walks past a homeless man living on the street in Los Angeles on December 2  2015
A pedestrian walks past a homeless man living on the street in Los Angeles on December 2, 2015
Frederic J Brown, AFP
“The installation of more public restrooms is important to stop the spread of hepatitis A,” Jonathan Herrera, the City’s Senior Advisor on Homelessness Coordination, said in a statement. “This is one of the many steps the City is taking to assist the County of San Diego in addressing this public health emergency.”
We need to address the root of the problem
The big problem is the number of homeless people in our country. On one night this year, there were an estimated 549,928 homeless people counted in the U.S. One in five homeless people live in California. At any given time, 50 percent of the homeless are living in the streets, vehicles or parks, or in places not fit for humans to stay. By comparison, Only 5.0 percent of New York City's 62,000 homeless men, women, and children end up sleeping on the streets each night.
A homeless man shelters from snow in New York's Central Park on January 23  2016
A homeless man shelters from snow in New York's Central Park on January 23, 2016
Kena Betancur, AFP
And it all comes back to a lack of affordable housing and job training. It is a shameful situation, made worse by a lack of good municipal planning or any real concern for the least of those in our society. When perusing the different news sites reporting on the Hepatitis A outbreak in San Diego, there were a number of comments that questioned who was going to pay the cost of treatment for people who were sickened by the virus.
Hospital care for those infected, as well as treatment of outpatients, has run into the hundreds of thousands of dollars. And that is not even looking at the cost of the vaccinations already given to over 19,000 people or the power-washing of city streets. And these costs are absorbed by the city, and ultimately, tax-payers.
Homelessness is a result of both poor policy decisions and economic conditions that have caused a decades-long increase in the widening gap between rents and incomes for the lowest-income households. This has resulted in keeping large numbers of people in a state of constant instability.