San Francisco Chronicle, May 2, 2020
By Dr. Juliana E. Morris
I knock on the hotel room door to greet my first patient of the day. I hear a rustling inside the room and a loud cough. My heart accelerates. Does he need to be tested? I adjust my mask and take a step back as I wait for the door to open. I’m a doctor working in the hotels where people experiencing homelessness have moved to shelter in place during the COVID-19 pandemic. It has been extremely rewarding to work with these neighbors who finally have access to a clean room where they can physically distance and protect themselves from infection. And although I want to reassure them, “You’re safe now,” each day I’m filled with anxiety that, actually, they’re not. For one, I’m afraid that people will get infected with coronavirus within the hotels. Some people infected by the coronavirus can be asymptomatic, so without testing it is impossible to know who is contagious and who requires medical monitoring. While we strive to maintain physical distancing practices within the hotels, we are not equipped with the gear and protocols to fully protect hotel guests from infection. Those of us who work in the hotels are also at risk. Protective gear is limited, and shelter workers have already fallen ill. Without access to testing and adequate protections, staff members will continue to get sick and also contribute to asymptomatic spread.
In addition to risk of infection, I worry about the instability of my patients’ housing. Currently, the city has sheltered around 1,000 of our houseless neighbors in hotel rooms. However, we know that thousands more are still staying in the streets, shelters and other congregate settings. Unless more opportunities for safe shelter come online ASAP, I fear that my patients could lose their rooms, and I know that many more people will be left out in the cold. San Francisco must do more to ensure that our neighbors experiencing homelessness can safely shelter in place. We need universal coronavirus testing for all unhoused people and the workers who serve them. We need robust protections for staff, including protective gear, health care and financial support. We need contracts to be expedited with more service agencies to ensure people can access the support they need inside of the hotels. We urgently need more hotel rooms so they can be offered to all of our unsheltered neighbors. And policies must be put in place so people can transition to permanent housing following the pandemic. To be sure, San Francisco’s leaders have been dealing with many competing priorities during this crisis. However, I believe that the strength of a city lies in how well we protect the most vulnerable. Not only do our homeless neighbors experience the intersecting challenges of housing instability and poverty, people of color are disproportionately represented among the unhoused because of decades of institutional racism in the city. Ensuring comprehensive support for people experiencing homelessness must be a top priority to counteract the heartbreaking inequities we are seeing play out during the pandemic. We are racing against time, but San Francisco still has an opportunity to push forward innovative solutions to protect our neighbors experiencing homelessness from COVID-19. We have enough tests, vacant hotel rooms and service providers. What we need now is bold leadership. Only then, with a proactive and equitable response in place, will I truly be able to reassure my patients that they are “safe now.” Juliana E. Morris is a family doctor at San Francisco General Hospital and UCSF. The views expressed are the author’s own and do not necessarily represent those of her employers.