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SAN FRANCISCO (AP) – When the coronavirus first emerged in the United States this year, public health officials and homeless advocates feared the virus would tear shelters and tent camps apart, devastating vulnerable people who have often chronic health problems.
They rushed to move people to hotel rooms, cleared crowded shelters, and moved tents to designated locations in licensed open-air camps.
While shelters have seen large outbreaks of COVID-19, the virus so far does not appear to have caused devastation to the homeless population as many feared. However, researchers and advocates say a lot is unknown about how the pandemic is affecting about half a million homeless people in the United States.
In a country that has passed 5 million identified cases and 169,000 deaths, researchers are unsure why there appear to be so few epidemics among the homeless.
“I’m shocked, I guess I can tell, because it’s a very vulnerable population. I don’t know what we’ll see next, ”said Dr. Deborah Borne, who oversees health policy for the COVID-19 homeless response at the San Francisco Department of Public Health. “That’s why it’s called a new virus, because we don’t know.”
More than 200 of the estimated 8,000 homeless people in San Francisco have tested positive for the virus, and half came from an outbreak at a homeless shelter in April. A homeless man is among the 69 deaths in the city.
In other places with large homeless populations, the numbers are also low. In King County, which includes Seattle, more than 400 of 12,000 homeless residents have been diagnosed. In Los Angeles County, more than 1,200 of 66,000 homeless people have been diagnosed.
It is slightly higher in Maricopa County, which includes Phoenix, where nearly 500 of an estimated 7,400 homeless people have tested positive, nine of whom have died.
Health experts say the numbers do not indicate the extent of the disease or its long-term course. It is not known how many people have died from diseases indirectly linked to the virus. While the coronavirus can dissipate more easily outdoors than indoors, living outdoors comes with its own risks.
With public libraries and other places closed, the homeless say they lack food and water, toilets and money. In San Francisco, 50 homeless people died in eight weeks in April and May – twice the usual rate, said Dr Barry Zevin, medical director of the Department of Public Health’s street medicine program.
Official cases are pending, but Zevin notes that fentanyl overdoses are on the rise and stay-at-home orders may prevent people from getting help quickly. He knew that isolation could lead to more overdoses.
“I think it happened, and whether it’s more or less than I expected, I don’t know,” he said. “It’s frustrating to be able to predict something as a problem, to do whatever you can to prevent it from being a problem, but it’s absolutely a case of competing priorities.”
Getting good data on the homeless population is difficult because hospitals and death certificates do not track housing status, says Dr Margot Kushel, director of the Center for Vulnerable Populations at the University of California to San Francisco.
She was hesitant to draw any conclusions about how the pandemic has affected homeless people in general, but said: “This may be an example where being outside and homeless, just in terms of COVID, maybe let people be at less risk. But then again, part of this is we just don’t really know.
New York City has reported more than 1,400 infections and 104 deaths among homeless residents out of more than 226,000 positive cases and 19,000 deaths. About 60,000 people live in shelters, unlike towns on the west coast where many more are not.
But because shelters in New York City have more children than the general population, when deaths are adjusted for age, the homeless death rate is 67% higher than that of the general population. , said Giselle Routhier, policy director of the Coalition for the Homeless.
“It’s extraordinarily high, in our opinion,” she said.
As advocates push for private hotel rooms for the homeless, a massive 1,200-person shelter at the San Diego Convention Center shows that it is possible to reduce the number of cases by strictly adhering to a spacing of 2 meters, frequent cleaning and a mask. -wearing.
“We have a team of firefighters going up and down the floors to put the beds back where they’re supposed to be,” said Deputy Fire Chief Chris Heiser, who is the shelter’s operations commander.
He estimates that around 3,000 people have passed. And of more than 6,000 COVID-19 tests administered, 18 to date have been positive. San Diego County has reported more than 200 positive cases and no deaths among its nearly 8,000 homeless.
Richard Scott, who is in his 50s, moved to the convention center about three months ago after his roommate, who is medically fragile, told him he could stay home and not work or leave. Scott has since slept on a cot alongside about 500 men in a cavernous room with high ceilings and a large floor.
Sometimes there’s a theft or a disruptive person, but overall Scott calls it a safe place to stay.
“We wash our hands 20 times a day – well some of us – and we check our temperatures every day, and they’ve been very strict about that as well,” Scott said. “I am so happy to be here; it is a blessing.
Virginia McShane, 63, sleeps in a separate part of the center. She arrived in April after she could no longer afford a $ 25-a-night hostel.
“We have a back entrance and a front entrance, and that allows the air to circulate quite well, so I think that’s why we haven’t all got the coronavirus,” she said.
The rates at which homeless people have tested positive for COVID-19 are everywhere, says Barbara DiPietro, senior policy director of the National Health Care for the Homeless Council, which is working with the Centers for Disease Control and Prevention to study the problem.
Surveillance tests of more than 10,000 people in shelters and settlements across the country yielded a rate of just over 8%. But DiPietro says more than 200 tests of homeless residents in five cities have shown rates ranging from 0 to 66 percent.
“So it’s an extravagant variant, a moving target depending on who, how and when you test,” she says.
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Associated Press editor Anita Snow has contributed to this story from Phoenix.
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