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Homeless advocates warn hepatitis A spike could turn to outbreak if services aren't expedited

The county continues to monitor the hepatitis A spike among the unhoused population. KPBS reporter Kitty Alvarado went to downtown San Diego and spoke with a homeless advocate and several unhoused people to discuss the issue.

On any given day, you’ll find Tyrone Bivens walking the streets of downtown San Diego.

Bivens said Wednesday he had no idea there was a spike in hepatitis A cases among individuals without a home until KPBS informed him about it. He said he’s been homeless since 2017.

"It’s ridiculous what they’re doing to us. They want us off the streets so they come out and they sweep us off the street only to allow us to be somewhere else for two or three days, and then they come sweep you from there, so that’s why people are sitting there catching these diseases because we’re all encamped close together," Bivens said through tears.


According to the San Diego County Health and Human Services Agency, there is not an outbreak of hepatitis A because they typically see two to three cases a month. So far, one person has died of the disease and five recent confirmed cases, three among the homeless population.

"So most people don’t know about it yet," said Michael McConnell. He's been a homeless advocate for 15 years. He said he was surprised to find out that many people living on the street did not know about the spike.

"It’s shocking," he said. "Because that’s how it spreads. It spreads because our public health officials don't take immediate action to get the word out."

"It’s wrong for them not to tell these people out here in these streets, OK. Because there’s no other way they can protect themselves unless they know what to do," said C. Shine, who said he's been homeless for 30 years. He said some blame belongs to individuals for their lack of respect for basic cleanliness, but also the city for their lack of clean-up efforts. He also thinks they need to put more trash cans and portable bathrooms.

McConnell said he's trying to get the word out, but the county also needs to reach out to the community, as well as provide preventative services. Hepatitis A is spread through fecal contamination, and McConnell said San Diego County needs to do more to alert unhoused individuals that good hygiene is important to stop the spread.


"To get sanitary stations out, whether hand washing stations, port-a-potties — get hand sanitizer out to the folks," he said. "Most importantly, we need a massive vaccination campaign because that’s what really slowed it down last time."

McConnell knows all too well that if they don't act fast, hepatitis A can spread "like wildfire" among the homeless population due to their close proximity. In 2017, an outbreak hit the homeless population hard. Nearly 600 people were infected and 20 died.

"Somebody’s already died, that seems like an emergency to me, but unfortunately, about 600 people died unsheltered last year," he said, noting there have been reduced hours in some public restrooms. "We don't need to see more failings of our government not to act. We need to keep restrooms open, obviously, don't shut down these restrooms on the weekend, that's criminal and we need to start adding more restrooms."

McConnell said that, most of all, these individuals need to be housed. He sees the problem growing despite the money being spent on it. He sees the same people on the street for years who don't get the help they need. A recent report released by the Regional Task Force on Homelessness showed the homeless population is growing.

Bivens said he has tried to find help, but somehow, he can't get the services he needs.

"The programs are collecting the money and we're not getting the real help that we need … they don't want to use the money that the government gives them, not for us homeless," he said, adding that until people start seeing those who are experiencing homelessness as human beings, who have hopes and dreams like everyone, else nothing will change.

San Diego County has started vaccinations and the city of San Diego says they are working with the county to make sure what happened in 2017 does not happen again.