photo: Stuart Malcolm, a doctor with the Haight Ashbury Free Clinic, speaks with homeless people about the coronavirus in San Francisco.
Stuart Malcolm, a doctor with the Haight Ashbury Free Clinic, speaks with homeless people about the coronavirus in San Francisco. Josh Edelson / AFP/ via Getty Images

Cities like San Francisco and New York City are moving shelter residents to hotels as coronavirus spreads. But federal authorities have a different solution.

Updated: April 20, 2020

On Good Friday, Tyree Leslie traded a bunk bed in Multi-Service Center South, San Francisco’s largest homeless shelter, for a bed in a room lined with pale yellow wallpaper in the city’s historic Hotel Whitcomb. He gets three meals a day, his own bathroom, and the chance to truly shelter in place — away from the coronavirus that tore through the shelter he’s been staying in since the winter. “It makes a difference,” he says. “I’m just glad to be indoors.”

So far, more than 750 people experiencing homelessness in San Francisco have been transferred into private hotel rooms in an effort to slow the spread of disease. That’s a small fraction of the homeless population in the city, which is estimated at around 9,000. Homelessness activists, health advocates, and city supervisors have been calling on the city to dramatically reduce density in crowded homeless shelters, navigation centers, and SROs by tapping San Francisco’s 30,000-plus empty hotel rooms as isolation housing since the city’s shelter-in-place was ordered on March 17. But what was first pitched as a preventive measure became more urgent on April 10, when more than 70 residents and staff in MSC South tested positive for the disease. By Tuesday, the number had climbed to over 100.

“It’s impossible for people to isolate when they’re living in a large group sharing a bathroom and sharing eating spaces with large groups of people,” says Jenny Friedenbach, the director of the Coalition on Homelessness, a San Francisco advocacy group. She’s calling for the city to dedicate 9,000 hotel rooms for the city’s entire homeless population, and expand testing to everyone in the shelters and the streets. “The have-nots are basically put into large congregate settings and locked down there until they’re able to pull out the dead bodies.”

She shared a fear echoed in cities nationwide, and around the world: If the populations crowding homeless shelters aren’t quickly and substantially thinned, there will be more coronavirus outbreaks, and more fatalities. On Tuesday, San Francisco’s Board of Supervisors took steps to meet the Coalition on Homelessness’ demands, unanimously passing an emergency ordinance to lease 7,000 hotel rooms for people experiencing homelessness, regardless of whether they had been exposed to the disease. Another 750 rooms will be made available to front-line health care workers, and 500 more for medical quarantine.

California has been a leader in the effort to tap unused hotel and motel space to ease crowding in shelters. On April 4, Governor Gavin Newsom announced an initiative dubbed Project Roomkey, a first-of-its-kind effort to relocate shelter residents to the more than 6,000 rooms under state possession.

Similar efforts are getting underway elsewhere. On April 11, New York City Mayor Bill de Blasio announced that in addition to the 3,500 homeless individuals already in private hotel rooms, he’d transfer about 2,500 more — a fraction of the 60,000 in shelters, and the other 3,000 on the streets. Los Angeles Mayor Eric Garcetti has secured 1,700 hotel rooms so far for the 36,000 homeless people in the city; In Washington, King County opened 400 for its 12,500-strong homeless population. In Connecticut, Governor Ned Lamont ordered shelters to move residents to the more than 1,000 hotel rooms available, if social distancing wasn’t possible on-site.

The movement to reduce shelter populations comes as alarm grows about how coronavirus is spreading undetected in large congregate facilities for people experiencing homelessness. In Boston, for example, researchers from Massachusetts General Hospital and the Boston Health Care for the Homeless Program conducted coronavirus tests at one large shelter for the homeless. Of the 408 individuals tested, 147 people tested positive for Covid-19 (or 38% of the shelter population). But only a handful of individuals showed any symptoms of illness. “Our findings illustrate the rapidity with which Covid-19 can be widely transmitted in a homeless shelter setting,” the researchers’ April 15 pre-publication paper reads. In MSC South, as the San Francisco Chronicle reports, none of the 93 residents who tested positive showed severe symptoms of the disease.  

Many cities, including San Francisco, have started by providing rooms only to homeless people who have been exposed to the virus, tested positive, or are in a high-risk category for Covid-19. Advocates want to go further, pushing for preemptive isolation and expanded testing, because these undetected cases pose just as large a risk. “We are very concerned that the lack of screening and the lack of testing at this point is allowing the virus to hide out,” said Chris Herring, a Ph.D. candidate in sociology at the University of California, Berkeley who has done research on Bay Area homelessness. “While we don’t know exactly how widespread the virus is within shelters, we are concerned that once it shows up, viral spread will be rapid.”

Charles Pitts, an unhoused man who attended a drive-through rally to advocate for opening hotel rooms in San Francisco on April 13, says he feels safer on the streets than in a shelter. “In the navigation centers, you have strangers six inches from each other,” he said. “I just understand for the most part whatever platform San Francisco is going to put or force me in is probably going to be more toxic than me staying outside.”

Nationally, projections by University of Pennsylvania Researchers suggest that about 40% of the estimated 550,000 people experiencing homelessness in the U.S. could be infected at the population’s viral peak, with more than 21,000 needing hospitalization. Such numbers mean elevated risk those who live on or off the streets. “The city could do everything right in terms of sheltering in place, and people being careful, and businesses closing, but if we didn’t address congregate living facilities we would see a surge of new cases,” said San Francisco Supervisor Dean Preston, who co-sponsored the city’s new legislation. “If you don’t address congregate living facilities, that impacts everyone, not just the folks at those facilities.”

From the White House: a very different approach

Closing big shelters, however, is not the direction that federal authorities are pushing. The Federal Covid-19 Homelessness Workgroup, a White House task force assigned to coordinate the specific coronavirus response on homelessness, has given guidance to a network of faith-based shelters on how to resist evacuation orders — a memo that faith-based shelters are interpreting as assurance that they don’t have to comply with local orders to evacuate homeless people to hotel rooms.

Robert Marbut Jr., who is the newly appointed White House czar on homelessness, heads up this group. As the director of the U.S. Interagency Council on Homelessness, he oversees initiatives for crisis housing across 19 different federal agencies. For the task force on coronavirus and homelessness, he has assembled a panel that includes the Citygate Network, a Christian ministry that links some 300 shelters across 45 states and the District of Columbia. Also on board the coronavirus task force: the Salvation Army and the American Red Cross.

Missing from the task force are policy and advocacy organizations such as the National Alliance to End Homelessness and the National Coalition for the Homeless. Marbut has long been at odds with these groups over the “Housing First” approach to solving homelessness, which puts immediate housing needs before substance abuse treatment or other behavioral prerequisites. Instead, Marbut has pursued policies that make sobriety a pre-condition for shelter stays. In Texas and Florida cities that have hired Marbut to consult on homeless services, his approach often emphasized consolidating services for the homeless in large facilities, often located far from urban centers.

In a letter dated April 9, Marbut wrote to John Ashman, president of the faith-based Citygate Network. Marbut assured Citygate that its missions are indeed deemed essential as part of the pandemic response, pointing to a late March advisory issued by the U.S. Department of Homeland Security’s Cybersecurity & Infrastructure Security Agency. “The CISA guidance is that workers performing ‘food, shelter and social services’ are identified as ‘critical infrastructure workers,’” the letter reads. “Keeping homelessness shelters, centers and campuses medically healthy is a critical strategy in order to help protect the overall medical system.”

In San Diego, the city’s convention center has been opened as an emergency shelter. (Bing Guan/Bloomberg )

While Marbut’s letter acknowledges the autonomy of tribal, territory, state and local authorities, it also says that local governments should defer to federal guidance. The Citygate Network has since updated its website to include Marbut’s letter as part of a coronavirus toolkit available for member missions to download. “If you need an official letter for state or local authorities to confirm that the rescue mission or ministry you run is an ‘essential’ provider, and that removing guests to motels or other facilities could actually remove them from critical care and oversight, this letter might be helpful,” the website reads. (Update: The Citygate Network has since removed information about the letter from its website. It can still be seen on web archives.)

“Marbut seems to be discouraging efforts to move people experiencing homelessness from congregate shelters, where they remain at high risk of contagion and illness, to hotels,” says Diane Yentel, the president and CEO of the National Low Income Housing Coalition, which is not involved with the White House task force. “His guidance is dangerous.”

The Citygate Network did not respond to requests for comment; Marbut replied to an email with links to coronavirus policies recommended by the CDC.

Failing to move people out of crowded shelters before they’re infected could have deadly consequences, experts say. Shelters often have one or two bathrooms for dozens of people to share, and beds are placed snugly — in San Francisco, the minimum distance between them is only 22 inches. In addition, people in shelters tend to skew older, according to data from L.A., Boston, and New York, making them more susceptible to severe cases of Covid-19; co-morbidities like respiratory problems and pulmonary disease are elevated among homeless people, too.

But some shelters aren’t necessarily eagerly welcoming state or local government interventions to reduce crowding. On its website, the Citygate Network has posted step-by-step guidance for missions to apply for emergency funding from FEMA instead. The site also suggests that overwhelmed shelters partner up with the Christian Camp and Conference Association to relocate “regulars” by moving them to faith-based campgrounds, freeing up space for people with health concerns and “new guests.” The site even promises its member missions personal contact information for a direct liaison to the White House task force. (This contact info was also deleted after CityLab asked for comment from the Citygate Network and federal authorities.)

Such specific federal guidance for non-Christian shelter systems facing a potential Covid-19 crisis has been less forthcoming.

The struggle over sheltering in hotels

The prospect of that federal authorities could interfere in local efforts to ease shelter crowding looms over the lagging efforts by cities and states to mobilize the resources to relocate homeless people. In San Francisco, the political give-and-take over using hotels as shelters reflects how challenging these efforts have been.

Under the terms of the San Francisco supervisors’ emergency ordinance, the city has until April 26 to obtain the thousands of hotel rooms and fill them. But to meet these goals, the supervisors need the cooperation of San Francisco Mayor London Breed.

The mayor has been widely praised in the national media for her early and aggressive stay-at-home orders, which were issued the same day as five other neighboring counties and appear to have helped slow the curve of infection rates in San Francisco, America’s second-densest major city. But some homelessness advocates and critics like Joe Eskenazi of the local news site Mission Local have highlighted the public health dangers posed by her resistance to moving people experiencing homeless out of congregate settings.

The mayor deflected early calls to rehouse people in hotel rooms, citing prohibitive cost, staffing limitations, and concerns about drug use and behavioral issues playing out in a less-monitored space. She initially planned to use a wing of a convention center as an emergency shelter for 450 people, filling the space with thin plastic mattresses spaced little more than six feet apart. Only after a photo of the bare-bones set-up was published by the Coalition on Homelessness’ newspaper, Street Sheet, and news broke that 19 people in the emergency shelter had come into contact with someone who had the virus, was this plan scrapped.

She then promised to dedicate 3,500 vacant hotel rooms to homeless people in shelters and on the streets, starting with those like Leslie who may have been exposed to the virus, are over 60, or have underlying conditions.

Tyree Leslie’s hotel room, where he moved after residents of MSC South started testing positive for coronavirus. (Courtesy Tyree Leslie)

On Wednesday, Breed’s office told CityLab that the mayor was still reviewing the supervisors’ emergency ordinance to expand these targets, and cited the “incredible logistical challenge” of opening thousands of rooms by the end of the month. The city will “need to maintain flexibility in how we respond to this crisis as it continues to evolve,” her deputy communications director, Andy Lynch, wrote. When asked by the San Francisco Chronicle’s Trisha Thadani if the supervisors’ plan was realistic, Breed said no. “The mayor can choose to veto the legislation,” the newspaper reported. “But with a two-thirds vote — which likely will be easy to gather — the board can override her veto.”

In other cities where officials have made similar edicts, attempts to move homeless residents into hotels have been met with resistance from nearby businesses and residents, as well as hotel owners. (Preston says that Breed has the power as mayor to commandeer hotels that don’t voluntarily cooperate.) It’s also a notably expensive solution: San Francisco’s measure could cost an estimated $58.6 million per month, the San Francisco Examiner reported, with $10 million to $40 million eligible to be covered by state or federal funding.

Other cities have set up different kinds of emergency shelters. In San Diego, for example, dozens of homeless men and women began moving into the city’s convention center, where preemptive coronavirus testing is also beginning. But the alternatives can be grim, as illustrated recently by a now-notorious scheme from Las Vegas. Though the collapse of tourism has left the city with about 150,000 unused hotel rooms, city officials have yet to explore using them to shelter its estimated 5,500 homeless residents. Instead, the city painted small 10-by-10 boxes on a empty parking lot for homeless people to huddle within, on the pavement. After a public outcry, the city erected tents on the same parking lot for people experiencing symptoms who had nowhere else to go.

Those sheltering in motel and hotels may be far better off, but being safer from infection can also mean having their mobility severely restricted. Oakland’s hotel for people who have coronavirus or are presumed to, dubbed Operation Comfort, has a long list of rules for its residents, according to a picture posted on Twitter by Oakland-based independent journalist Jaime Omar Yassin. They get three scheduled 20-minute outside breaks a day, and do not have a key to their room, but can lock it from the inside. (The Alameda County office that runs the hotel did not respond to a request for comment.)

Leslie doesn’t have his own room key, either, but he says he feels free to move in and out whenever he needs — he just signs in and out, and takes an elevator ride downstairs (only one person is allowed in the lift at a time).

Security fears have fueled some of the resistance to hotel shelters. Mayor Breed and Grant Colfax, the director of the San Francisco department of public health, have warned that homeless individuals with severe mental health or substance abuse problems will find it hard to transition to private rooms. That’s a concern some shelter operators echo. “You can’t just throw somebody in a hotel and think it will all be good,” says Ivan Klassen, director of community partnerships for L.A. Mission. “That person may have mental health issues, or may be diabetic. There are also wraparound services that need to be taken into consideration. That is incredibly important, I think, as the city navigates this.”

Supervisor Preston says that though some people will need more round-the-clock care, the range of experiences of San Francisco’s unhoused is vast. “It’s been very disturbing to see the least-functional among the homeless population held up as the reason that there can’t be action for the thousands of more-functional people who can easily be placed in hotels and staffed by the same organizations that are staffing [the shelters],” he said.

After this phase of the crisis passes, what next?

When the first U.S. coronavirus cases emerged in suburban Seattle, the region’s homeless shelter officials knew how vulnerable they were. “It felt like we were sitting ducks,” said Daniel Malone, the executive director of Seattle’s Downtown Emergency Service Center, which supports 3,000 to 3,500 people across six homeless shelters, a few supportive housing locations, and a behavioral health program. “If illness gets into one of these places it has the potential to spread very quickly.”

Public health officials in King County are now cautiously optimistic that the region as a whole may have passed its peak of new infections and deaths. But Malone isn’t sure the worst is over for the people he works with. “I do not believe that anybody thinks that that describes the course of this spread within the homeless population,” said Malone of the state’s flattening curve. The first case detected among DESC’s residents was on April 2. Since then, Malone says the organization has averaged more than one case a day — as of April 13, 13 had tested positive, and one person living in supportive housing had died.

One theory for why the trajectory of infection among homeless populations has looked different than that of the general population may be because they have smaller and less diverse social networks. “It could be that folks experiencing homelessness are naturally isolated from a lot of mainstream society,” Malone said.

John Brooks, the chief development officer of Columbus House, a network of shelters in Connecticut, says that he was more worried that staff would infect clients than the other way around for that same reason. Columbus House discontinued all outside volunteer services, and asked that all clients stay in the shelter instead of leaving each day. They started screening people for signs of sickness and fever at the door, installing hand-washing stations, and feeding people dinner in multiple shifts. Finally, with the city of New Haven and the state’s support, Columbus House has moved everyone into hotels, starting with the most vulnerable. Along with three meals a day, the services they would have enjoyed at the shelter are brought to them. While three staff have tested positive, Brooks says no clients have.

Malone, too, has been able to get people more personal space. Of the 400 rooms King County offered, one 100-room hotel — a Red Lion in Renton, Washington — was given to DESC, whose shelter staff now runs the building. About 50 residents are living at a different motel, in rooms leased by DESC itself. The shelters that continue operating are running at a reduced density.

Another Red Lion was given to Sophia’s Way, a women-only shelter on the east side of King County. The shelter moved 20 women who had experience living alone into hotel rooms, and opened up the hotel’s ballroom for the approximately 40 women a night staying in the emergency shelter. Every day, 40 to 60 more women come in looking for a safe place to nap or eat.

The transition hasn’t been seamless. “There’s a hundred different issues that we have to deal with moving into the hotels,” said Alisa Chatinsky, the executive director of Sophia Way. Still, the current conditions are much safer: The women are farther apart when they sleep, and during the day. At their old location, “it was not a matter of if, it was a matter of when someone gets Covid,” Chatinsky said. “I’m not saying it’s perfect, but it’s better.”

The need is far greater than the capacity, she says: When word got out that Sophia Way had a hotel, an influx of women came seeking respite. Domestic violence organizations fear that pandemic lockdowns will trigger a surge in abuse in the coming weeks. “Everybody deserves a safe place,” she said. “I just don’t know how to go about giving them all that.”

Like Malone, she also worries that infection rates among unhoused people may be on a different timeline than the general population’s. “While this affects everyone, of course the poor and the underserved and people of color are being hardest hit because they lack the resources,” said Chatinsky. ”That’s why I think it’s going to come around again, and it’s going to come around harder.”

The future holds many other unknown threats. As unemployment rates reach historic proportions, and rent and mortgage payments loom, the ranks of the homeless in America could swell enormously. But just as the disease has ruthlessly exposed the vulnerabilities and inequities of the U.S. economy, it’s also shown what’s possible with extraordinary mobilization.

This mobilization requires buy-in from the shelters themselves. At the end of March, L.A.’s Skid Row reported its first case of Covid-19, when an employee at Union Rescue Mission tested positive for coronavirus. The mission — an affiliate in the Citygate Network, the faith-based system that has sought relief from local orders to evacuate — took its own steps to triage, isolating certain areas in the five-story building where it provides shelter for some 770 people. Since then, the employee has died and infections have spread, leading mission staff to scramble to relocate residents. (CityLab reached out to Union Rescue, Citygate, and federal authorities with questions about their shelter operations, but hasn't received a response.)

Last month, Columbus House staff were able to get more than 40 residents into permanent housing, Malone said — an unprecedented number in such a short period. San Francisco, whose mix of tech-boom affluence and desperate poverty made it a national symbol of urban inequality in the pre-pandemic era, has suddenly managed to drum up support for an emergency housing-first policy.

“For years they told us there’s nothing that can be done about the homeless situation, that it costs too much money,” says Harry Louis Williams, a minister at San Francisco’s Glide Church, which serves homeless residents in the Tenderloin. “One of the questions is, once coronavirus peaks, will these rooms still be available to the people who need them, or will they come and say everything’s back the way it was and you’ll have to go to the streets again?”

Coalition on Homelessness’ Friedenbach hopes that won’t happen. “I’m hoping this will shift the way the general population thinks about homelessness — that they don’t see them as so other but that they’ll see how very intimately linked we all are to our fates,” she said. “This pandemic shows that.”

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