There’s a hepatitis A outbreak in San Diego, and this article was the first one I read about it. It seems to tap-dance around directly stating what has caused the problem, but it’s not all that difficult to figure it out [emphasis mine]:
At least 481 people have been infected and 17 have died of the infection since November in San Diego. Eight-eight other cases have been identified in Santa Cruz and Los Angeles counties, where hepatitis A outbreaks have been declared.
Officials throughout the state are now rushing to vaccinate homeless populations, which are considered the most at risk…
Dr. Janet Haas, president-elect of the Association for Professionals in Infection Control and Epidemiology, said the outbreak is unusual for the U.S. because the spread of the liver infection has been blamed on a lack of basic hygiene and sanitation, not contaminated food…
“It’s not like there’s never been a hepatitis A outbreak before. ”¦ We know what’s worked in the past. Usually that contains it and the story ends,” Haas said. “But sometimes it doesn’t work, or circumstances are different and you have to ramp it up.”…
In San Diego, where nearly 85 percent of all confirmed cases are located, cleaning crews are hitting the streets, attacking them with high-pressure water mixed with bleach to sanitize any surfaces contaminated with feces, blood or other body fluids.
A private company was hired in September to deliver portable hand-washing stations in places where homeless residents tend to congregate.
Despite those efforts, the disease is spreading and many are asking what could have been done and what will effectively prevent future transmission…
County health officials have been hesitant to release any additional information about where the cases are specifically concentrated, citing state and federal health privacy laws.
In other words, it’s hard to escape the conclusion that this outbreak has been caused by homeless people defecating in the streets.
Is San Diego anything like the far more leftist Seattle, where cleaning human poop off the sidewalk with a power hose is considered insufficiently sensitive? And New York City has recently ended criminal prosecutions for public urinating (which is nowhere near the health hazard of public defecating).
HuffPo is quite direct about the San Diego problem and the fact that public human defecation has caused it. But it’s not as simple as blaming the homeless, because the volume of homeless people in San Diego (and certain other cities) has grown with the rise in housing costs and the lack of low-income housing. In addition, San Diego has remarkably few public restrooms:
In 2015, San Diego had just three city restroom facilities open round the clock, the San Diego County grand jury that investigates government operations reported. San Francisco had 25. San Diego had spent more than a decade trying to solve the problem, but funding difficulties, lack of support from businesses and concerns that additional facilities would attract more homeless people downtown have stood in the way, the grand jury noted.
Last week, as the crisis expanded, the city was making 14 public bathrooms accessible 24/7, and the mayor’s office said the city is hoping to install more. City officials plan to open three new temporary tented shelters with restroom facilities and other services, they announced Wednesday. At least 30 hand-washing stations have also been installed around the city, with the option to add more.
There are a lot of problems that come together here: the lack of affordable housing, the pleasant year-round climate that makes many areas of California a magnet for street people, the lack of public bathrooms, the refusal of many homeless people to go to shelters, the marginal mental status of no small number of homeless people (my guess is that this sub-population may be the one doing the bulk of the public defecating) either through chronic mental illness or drugs, and city governments that haven’t dealt with the problem adequately either because it’s not easy to solve or because they lack the political will (or both).
And why so few public bathrooms in San Diego? Lest you think it’s a simple problem with a simple solution—such as “build more of them”— please read this from 2015, before the current hepatitis outbreak:
…Portland Loo…[is] a prefabricated public restroom that’s been popping up from Seattle to Cincinnati to Montreal. The loos have real toilets and running water, and are better ventilated than port-a-potties.
But they’re controversial. The toilets turned out to be much pricier than expected, and some people complain that they could attract illicit activity ”“ prostitution or drug use…
Portland Loos are designed to ease the daunting task of keeping a public restroom safe and clean. They can be power-washed and have slits along the bottom to make it clear if there’s somebody inside. They cost about $100,000 each, but that doesn’t include the connection to sewer lines, which is where some cities stumble.
San Diego spent more than half a million dollars installing its two loos ”” double the initial price tag. Now, due to more costs and residents’ complaints, it’s planning to remove one and put it in storage. A nearby homeless shelter will open its bathrooms around the clock instead…
“The homeless population is up in this area since the Portland Loo was installed,” says Jon Wantz, who runs a restaurant a few blocks away from one. “The increased activity, whether it be criminal or drug-related, or just transient-related in general, it’s not good for business.”
“Affording individuals the ability to use a private and safe space to utilize the restroom is basic dignity,” counters Heather Pollock, executive director of Girls Think Tank, a San Diego homeless advocacy nonprofit. A restroom isn’t truly public, she says, unless everyone can use it ”” and many people aren’t allowed in the restrooms inside stores and restaurants.
“If I walked in and was holding all of my belongings, or I hadn’t showered in a few days, there’s a very high likelihood that I would not be able to utilize that,” she says.
What a mess. Literally.
[NOTE: It is estimated that about 12% of the world’s population defecates outdoors, mostly in rural areas (where it tends not to cause as many problems) but also in many urban areas in third-world countries such as India.]