Times-Herald, March 28, 2020
By Marisa Kendall
The Bay Area will need thousands of new beds at a potential cost of hundreds of millions of dollars to get homeless residents off the streets, out of crowded shelters and into relative safety from coronavirus, according to a recent study. Santa Clara County would need 11,635 new beds at a cost of $327 million per year — with similarly high figures for San Francisco and Alameda counties, according to the research by professors from UCLA, the University of Pennsylvania and Boston University, which was published online by the National Alliance to End Homelessness. Otherwise, the researchers estimate 40% of homeless residents will be infected, potentially leading to 526 hospitalizations in Santa Clara County alone, and 85 deaths. As Bay Area officials struggle to build new shelters, set up travel trailers and open hotel rooms for the homeless, the new numbers underscore just how daunting it will be to adequately protect unhoused residents from the virus. “This is a highly vulnerable population,” said Randall Kuhn, a public health professor at UCLA, and one of the researchers who wrote the nation-wide study. “Homeless people present with risk factors typical of someone 15 years older than they are, and given that half of them are age 50 and older, that means they are much more vulnerable to the effects of COVID than the general population.”
Alameda County could see 433 homeless residents hospitalized and 70 killed by COVID-19, he said. San Francisco could see 409 hospitalizations and 66 deaths. To prevent that, Alameda County would need 9,429 new beds at a cost of $266 million per year, and San Francisco would need 8,368 beds at a cost of $238 million per year, according to the study. The numbers the researchers came up with are sobering, but they seem plausible and accurate, said Andrea Urton, CEO of HomeFirst, which operates several homeless shelters in Santa Clara County. Nearly a third of the people in her shelters are 55 or older, and 38% have a disabling medical condition. “It’s disheartening,” she said. “You’ve got this space where you almost feel helpless, and yet you’re doing everything you can to prevent a mortality. And yet you know the likelihood that there will be more than one is great.” The researchers calculated how many beds are needed using each jurisdiction’s biennial point-in-time count of unsheltered homeless residents, and then increasing it by 40% — making up for the undercounting experts agree is rampant when trying to document off-the-grid populations. The researchers assumed each new bed would cost $25,000 per year to maintain, based on documented national shelter expenditures. And they assumed 40% of the new units should be private accommodations for residents infected by or exposed to COVID-19 — which would cost an extra $7,500 per unit per year. A regular bed for someone not exposed to the virus would typically cost $68.50 per night to maintain.
The researchers also took into account the need to reduce density at existing shelters by 50% to allow space for social distancing. Cities and counties across the Bay Area have ramped up efforts to get homeless residents housed safely, including renting hundreds of hotel rooms. But as officials struggle to staff the rooms and set up food delivery and other services, just a fraction have been filled.
At the same time, the rush to provide resources has raised key questions, including what type of housing should be provided, and who should get it? When Alameda County gets its first hotel up and running, it will prioritize people who are infected or have been exposed to COVID-19. In San Francisco, which similarly prioritized the sick, Supervisor Dean Preston accused city officials of failing to protect the rest of the homeless. He took it upon himself to rent 20 rooms for vulnerable homeless individuals and families who hadn’t been exposed to the virus. The city also plans to open Moscone Center West as an overflow shelter while officials try to reduce capacity at existing shelters.
In the study, the researchers laud private accommodations, such as hotels, as the best and safest option for the homeless during the pandemic. And vulnerable people — not just the infected — should get rooms, Kuhn said. For Urton, the biggest issue right now is one of speed. “We just need to continue to act as quickly as we possibly can,” Urton said. “If you see a homeless person, put them in that hotel room. Don’t wait.”