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Coronavirus Magnifies Social Inequity In At-Risk Communities, Like The Unsheltered Population

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The coronavirus pandemic magnifies existing social issues. But, controlling the pandemic in at-risk communities, like the unsheltered, presents a unique set of challenges.

Speaker 1: 00:01 The coronavirus, pandemic magnifies existing social issues. KPB a science and technology reporter. Shalina chatline. He says controlling the pandemic and at risk communities like the homeless presents a unique set of challenges.

Speaker 2: 00:18 Jesse Angeles jr. Drives through San Diego's North park neighborhood to drop off food on a late may afternoon. It's for his clients who live on the street.

Speaker 3: 00:27 My workload has been almost doubled because of the needs. Angeles works with a homeless nonprofit group. Now clients they're saying like, well, we don't have any places to eat. We don't have places to use. The restroom. Angeles has been working with the homeless community for years, developing empathy, knowledge of mental health issues and trust, but he still has to approach some clients with caution, like a homeless man. He's building a new relationship with, so at this gentleman across the street, we're building rapport with him, just going to drop off a bag to him, just to let them know that we're still here for him. So, Brenda, Hey, I don't know if you remember me, would you like a bag of food?

Speaker 2: 01:06 Angela strikes up a simple conversation, but offers to leave. If the man

Speaker 3: 01:10 it feels uncomfortable, it actually went really well. Yeah.

Speaker 2: 01:14 Now that San Diego is opening up again, County officials have increased testing and started contact tracing to prevent coronavirus outbreaks. Officials hire people who can find infected residents in their contacts and ask them to quarantine, to avoid spreading the virus. Public health officials say contact tracing everywhere is key to controlling this pandemic. Angela says he doesn't know much about contact tracing, but asking for information. Isn't easy

Speaker 3: 01:40 because if you don't have that trust with them, like if someone just asked them to just like a blame question, like where you've been and stuff like that, it all has to, it has to develop the relationship. First,

Speaker 2: 01:48 San Diego County has distributed close to 8,000 hygiene kits and mass to the home plus and offer testing and shelter and hotels. And the convention center. The County says relatively few homeless people have tested positive for coronavirus, but while the County generally knows where positive cases are, there's currently no map of all the unsheltered communities that makes it difficult to create a regional approach for serving as well as testing and contact tracing unsheltered people, County supervisor, Nathan Fletcher says officials are doing as much as they can.

Speaker 1: 02:19 Certainly the, uh, our unsheltered community presents unique challenges, uh, both in terms of, uh, engaging them and, and, and building that trust.

Speaker 4: 02:27 But of course with people feeling like the government hasn't treated me well in the past, why would I feel like they will treat me in my community? Well, in terms of contact tracing,

Speaker 2: 02:35 Rebecca fielding Miller is an infectious disease professor at UC San Diego.

Speaker 4: 02:39 Just because there's an outbreak, doesn't mean the preexisting social issues go away. They actually come to the fore. Even more.

Speaker 2: 02:46 The County has already hired just over 400 and diverse contact tracers who plan to call or text people. But many homeless people don't have phones. And Miller says they may not trust those calls and texts from everyone. She suggest hiring people like Angeles who have the experts

Speaker 4: 03:03 we know in any community. There are people who are leaders formally or informally who are trusted by their community. And it's evident from watching the work of homeless workers, that building relationships is a key part of the job. Did you need help with that? Well, I go, I'll, I'll, I'll jump to that.

Speaker 2: 03:19 Back in his car. Angeles answers a phone call from one woman, Laurie buck they've stayed in constant communication since Angeles helped her get a phone. Okay. Now how these guys work to come over where we're at? Yes. We arrive at a motel in Loma portal. Angela's helped buck into this motel at the onset of the pandemic. She'd been homeless for eight years.

Speaker 5: 03:39 This is extremely frightening because you're supposed to be inside. And when you're outside it, but mean that's extremely difficult. I've never lived through a pandemic

Speaker 2: 03:49 buck, heard about the pandemic from a friend now that she lives in this motel. She tries to follow guidance, social distancing, wearing a mask and hand-washing, but she says, it's not that easy for people on the street as a single woman, when she was unsheltered, she didn't want to socially distance herself because their safety numbers,

Speaker 5: 04:07 it all depends on how you approach him. You know, you know, in some you're going to be able to get through and some that are mentally challenged, you might have a little bit of difficulty. There are people too

Speaker 2: 04:17 contact tracing is critical to controlling the spread of coronavirus. And while working with at risk communities has always been a challenge. The pandemic highlights the need to find longterm solutions.

Speaker 1: 04:29 Joining me now is KPBS science and technology reporter Shalina Chet Lonnie. Hi, Shalina

Speaker 2: 04:35 Hey Mark. Glad to be here.

Speaker 1: 04:37 So your feature notes that relatively few homeless people have tested positive for coronavirus, wherever they've been tested, mostly in shelters.

Speaker 2: 04:46 So I'd say the majority of testing has been happening at the San Diego convention center downtown. There've been around over 2000 tests that have been conducted there. Um, there are a few tests that are being conducted in shelters like father Joe's villages, but I'd say the majority in San Diego are happening at the convention center.

Speaker 1: 05:03 For those who have tested positive, it seems tracing who they've had contact with might be a tall order. There's mental health or substance abuse issues often, and few would seem to have much of a schedule or calendar to rely on what's the strategy for health officials to trace this population.

Speaker 2: 05:21 Sure. Yeah. That's a good question. I'd say what I've gathered from the city's contact tracing efforts in the County press conferences and on the job description for hiring contact tracers is that they're looking for people who have skills like empathy and cultural sensitivity, but this is alongside things like data entry and keeping spreadsheets. So I wasn't able to get access to data on who was hired, but I suppose we could conjecture on the types of people being hired, meaning that they have to have a certain background with data entry, right? So it sounds like the County is mostly going to be texting and calling people. This is an issue because a lot of homeless people don't have phones, tracers go through training, but it's unspecified. And what the training is. So the County says the strategy may change as state solutions are rolled out. But, um, they'll probably continue to use technology specifically

Speaker 1: 06:13 and you interview Jesse Angeles. He has trust and rapport with many homeless people, but as a Angelice or others working with a homeless, been able to do tracing with those who've tested positive as far as we know.

Speaker 2: 06:25 Yeah. So when I interviewed Angeles, he didn't really even know what contact tracing is. Um, obviously a lot of people don't know what contact tracing is and no, he hasn't been doing that. And what the infectious disease professor I interviewed proposes is that we should be hiring people who work in these sort of homeless outreach, specialty programs and nonprofit organizations to be doing this kind of work. And actually the County has a separate partnership with San Diego state university to hire community health workers, um, who come from different backgrounds like Spanish speaking backgrounds and from African American communities, for example, because they recognize that going into some underserved communities may be challenging because of language barriers, for example. So what is being proposed in this feature is that a similar approach could be taken with the homeless population,

Speaker 1: 07:17 San Diego County and city officials face criticism and struggle a couple of years ago during the hepatitis a outbreak among the homeless here, were there lessons learned from that crisis that can be applied now with the coronavirus pandemic?

Speaker 2: 07:31 Sure. So I posited that question directly to the County as spokesperson there said they wouldn't frame that they have had lessons learned, but are continuing practices that were effective in that response. So, um, some of the things they listed were partnering with organizations who do outreach and serve populations that are, um, at risk that need critical information, getting services, like testing to those populations and building strong partnerships through regional cities.

Speaker 1: 08:02 And do we know how other cities with large homeless populations, including those in California, are dealing with this tracing challenge, have San Diego health officials been looking to other cities for guidance?

Speaker 2: 08:14 So, yeah, again, I asked the County about this and they said that they couldn't speak to other cities, um, and their responses, but it does look like it's been kind of similar across the board for a number of other cities like New York, for example, that they are actually trying to address systemic problems within homelessness that have existed forever. Um, as the pandemic has been going on, the first of that obviously is lack of housing. So when the pandemic kicked off, a lot of, um, cities needed to find forms of shelter, hotel rooms, um, the convention center, like we have downtown in California, we've, uh, the latest data shows that we have, you know, around thousand people that have been put into hotel rooms. Um, and then there's also things like putting up, uh, you know, hygiene, hand washing stations and portable toilets so that, um, people can, uh, continue to maintain basic hygiene.

Speaker 2: 09:10 Uh, but I think, and what I try to get across in the feature here is that these are obviously all bandaids to the issue of homelessness. At large, for example, one woman I spoke to said that she wouldn't want to even go to the convention center because, you know, she's been given guidance to socially distance herself. So a lot of the messaging around some of the solutions is very confusing for people. Um, and so, you know, the point of the feature is to say that any one of these things has to be coupled with, uh, you know, social services, you know, mental health, for example, treating mental health issues, substance abuse issues, otherwise they're kind of short term solutions.

Speaker 1: 09:50 Well, it seems it's a novel Corona virus and it's got a novel challenge when it comes to homeless and the tracing, it would be clear.

Speaker 2: 09:56 It's definitely something that the County is freshly having to address.

Speaker 1: 10:02 I've been speaking with Shelina chatline and KPBS science and technology reporter. Thanks. Shelina thanks Mark.

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Maureen Cavanaugh and Jade Hindmon host KPBS Midday Edition, a daily radio news magazine keeping San Diego in the know on everything from politics to the arts.