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Mayor Faulconer Addresses Hepatitis Response

September 22, 2017 1:15 p.m.

San Diego Mayor Kevin Faulconer Addresses Hepatitis Outbreak


Kevin Faulconer, mayor, City of San Diego

Dr. Nick Yphantides, chief medical officer, San Diego County

Related Story: Mayor Seeks Solutions To Hepatitis A Outbreak, Dismisses Blame


This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

I am Maureen Cavanaugh. It is Friday, September 22 . The top story, as the number of hepatitis A cases continues to increase in Antigo, Kevin Faulkner says he is canceling a planned trip to Washington DC to lobby for NAFTA and other issues. He will instead stay here to oversee the response to the outbreak. The mayor, along with County officials have been criticized for allowing the outbreak to escalate to one of the largest outbreaks in recent U.S. history with more than 440 diagnosed cases and at least texting deaths. I spoke with Mayor Faulkner today about the city's effort against hepatitis A. He was joined by the County medical officer. Welcome.

Doctor, welcome.

I appreciate the opportunity.

This week you announced a new vaccination, sanitation, and education program targeting that hepatitis A outbreak. What else can the city do ?

It is a partnership. It is about getting the word out and you hit the nail on the head. Vaccination is first and foremost primarily -- particularly it has been clear on that at risk population which is primarily the homeless and illicit drug users. The more that we are vaccinating that group, which is the at risk population, that has been our sole focus not only the outreach that we had yesterday at City Hall but the work that we are doing, the city and the county with the public health therapist -- nurses, going out to the street and going out to the canyons to get those people that need the vaccinations the most and get them vaccinated. That is incredibly important. At the same time, getting the word out. If you are a healthy adult, wash your hands. Wash over and over. Take additional steps. Some of are at risk areas, sanitation Street washing enhance annotations, we left a SANDAG meeting. This outbreak which started in El Cajon is in virtually every city in the county. It is most acute in San Diego. It is a collective effort on education but most of portly, stress and it the vaccination to the at risk group, the homeless and illicit drug users.

Doctor new, city staff said yesterday that more handwashing stations are said to go up today. There are plans for eight more public bathrooms in the city on Monday. What are your estimates for how many need to be installed ?

This is an unprecedented situation. We do not have a reference point of anybody else who has gone through this of being able to say here is that a specific XYZ number. What we are doing is a comprehensive scientific approach of mapping where are the individuals and as the basis of where those individuals are, making sure that they have access to the handwashing and toiletry that they need. I cannot give you a specific number but I can give you a commitment that that evaluation is ongoing at the city and the county level. To echo Mayor Faulkner's comments, the attention is in downtown San Diego, we are dealing with the issues throughout the region.

Mayor Faulkner, you're setting up three large shelters in the near future. This was an idea that was pushed by business leaders for months. They are donating one point $5 million for the project. What is the role of the business community.

It is a great partnership. I am glad you mentioned them. Working closely with them, we are looking for an indoor facility. When we announced this, you will never find the perfect location. There is pushback on the sites we did announce. We have to do this. We have to get people off the streets come into a secure and sanitary environment where they can get the services that they need, mental health and substance abuse. Yes. We are moving forward on a significant presence with three different locations. One is in St. Vincent and one out in the midway district focused on the veterans population. You know, we are looking at close to 700 and probably more. And to see -- back to your question, to see that commitment saying the government can do there part but to see local business leaders saying we are going to help also. I hope that will grow because the challenge is so big. I cannot say enough for Peter, that is the leadership we want and that I am fostering that says we are all in this together. This is our city. These are our neighbors and let's take the right action.

What about the critique from David Alvarez that three months until December, that is when the first tent will open is too long to get the tents up. Some other shelter options should be found.

I am not spending my time listening to critiques for people like that who have not been helpful when it comes to the homeless issues. We are looking forward. What do we need to do now to get people off the street now ?

Right. Not December but now. What are you looking at what

We are looking at safe zones. We encourage people to get off the street. In addition to the shelters but it is important to note saying Paul, we are driving people into those because they have capacity. Part of the message is we have some spots that we want to use but we also need -- we are moving forward, the need is greater. As you will hear more, we are going to move forward with safer zones that will be a big help. The determination, the commitment, I should say, we need to get people off the street and bigger numbers.

Do you think this outbreak was preventable or foreseeable? Four grand jury reports warned leaders that more public restrooms were needed downtown. One report warned that an outbreak of illness caused by such unscented -- unsanitary conditions could result in a liability to the city.

I will tell you this. Any time we are doing homeless services, you are going to get pushback. The fact that we have said no, we are acting immediately on a hand washing stations and opening restrooms. It is all about, we have a situation. We have a crisis. We need to solve this and come together as a community and that is the message that we are talking about. I will leave it to Doctor Nick.

You know, based on the long incubation period, there is an unprecedented challenge that we are facing. There are biological reasons that it took several months for us to track with this darted and so on and sore fourth. We were on, -- we had confidence that we were on top of it. Hepatitis A constantly occurs but most of the cases were from people coming from outside of the country. Whether or not this could have been prevented in hindsight, there are so many factors that go into this and so many places in our country that are facing similar challenges that we have had. To be honest, some context that I've had, I am frankly surprised that we did not happen -- this did not happen sooner. This is part of the reflection of the complexity of the factors that are in play.

Mr. Mayor, I know you have a concern to stop the outbreak but I am wonder if conversations are going down in silly -- City Hall about liability and the families who have died.

I can say our conversations are about how we can get people the help they need right now and not looking backward. We are bringing everybody together in an unprecedented fashion, the city and the county and the medical professions. From our standpoint, we had AMR and fire rescue out there on vaccinations. The whole team was doing sanitation. This is a all hands on deck effort and rightfully so. This is our community. This is our county. These are our people and we need to take care of each other and we do get people to support and the services they need. And that is my soul focus right now.

I know that you do not want to look back and you are in the middle of the crisis but humor me for a moment. Homeless advocates say that San Diego's decision to close emergency tent shelters were -- would not work because the were not permanent beds for the homeless. When those were permanently closed, we began to see a dramatic increase in the people living on the streets. Homeless advocates were screaming about this. Do you see that as a reason for the hepatitis A outbreak?

We are not looking back. We went to the permanent indoor shelter, was that better than a winter shelter? Absolutely. Let's get more people the beds and the services, not just a couple of months during the winter but your round. What we have clearly seen as as the need grows, we need to do more. Absolutely. When you look at long-term, we need permanent and supportive housing. That cuts across all of this. On the back end of that, we can talk a lot on the things we are trying to do to get that but that is incredibly important. The shelters we will move forward because we need to. That is incredibly going to be helpful but ultimately, we need permanent supportive housing to get people not just off the street but you transition. Talking with good people like Bob McElroy who has done this -- once you get people into the shelter environment you can transition them. That is what we want. We want you to be safe and healthy. We want you to get back into the work environment and give you the support you need. That is what San Diego is about. That is why this is all hands on deck to not just tackle this for the next foreseeable months but longer-term. One reason -- I felt so strongly as you know we have talked before. The measure to not only expand the convention center but to raise the dollars for a permanent supportive homeless funds that we do not have. We do not have a dedicated fund. They chose to put that off. I think that was the wrong decision. We will get help because we need dedicated funding and I feel very passionately about.

I have been speaking with Mayor Kevin Faulkner and with chief medical officer, thank you.

Thank you.