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Surge in Virus Deaths Reinforces Need for Recovery Treatment

“The takeaway message to stay vigilant on booster shots and stay focused on our community’s recovery from the pandemic,” said Dr. Lisa Santora, the County’s Deputy Public Health Officer. “Many adults have been in isolation, which can be mentally and physically devastating. Check on your neighbors and relatives, help them see their doctor, catch up on deferred medical care, or find the treatment assistance they need. These factors can be hidden behind closed doors but can be a recipe for severe illness when co-mingled with Omicron or future variants.”

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Dr. Lisa Santora, Marin County’s Deputy Public Health Officer. Courtesy of Marin County.

Boosters, seeking primary and preventive care or treatment a must

A new analysis of recent local COVID-19 deaths reinforces the need for renewed attention to medical care and recovery treatment, and broader adoption of COVID booster shots.

On Feb. 25, Marin County Public Health’s weekly COVID-19 death report revealed 15 additional deaths, resulting in a total of 24 residents that have died from COVID-19 complications between January and Feb. 12 of this year. While the Omicron variant caused less severe disease than earlier variants, its higher rate of infectivity drove up hospitalization and death rates in Marin. Hospitalization rates were highest among unvaccinated and unboosted residents but were also high for older adults with underlying medical conditions and persons with lifestyle habits that put them at higher risk of adverse outcomes, including death.

“It’s not uncommon to see an increase in deaths linked to a surge,” said Dr. Lisa Santora, the County’s Deputy Public Health Officer. “We generally see a time lag in hospitalization and death rates after a spike in COVID-19 cases. What is different this time around is that the highly contagious nature of the Omicron variant raised the death toll higher than past waves. Fortunately, high vaccination and booster rates protected our community from greater losses.”

Of the deaths included in the report, the majority were adults, ages 75 or older, with severe comorbidities or “end of life” from a clinical perspective, meaning they had been on hospice or comfort care over the last three to five months. Deaths are to be expected among this group due to elderly adults having higher risk factors when at the end of their lives. On average, Marin County sees about five “end of life” deaths every day. However, in this situation, the Omicron variant has accelerated the death rate for these vulnerable adults.

Three of the newly reported deaths were among residents under the age of 70 years old who did not have full vaccine protection or had known risk factors. Research has shown that poor COVID outcomes, including hospitalizations and deaths, are linked to lifestyle diseases including obesity, diabetes, smoking, and substance use disorders. Prolonged exposure to modifiable lifestyle behaviors, including smoking, unhealthy diet, physical inactivity, and excessive alcohol use damages the immune system and weakens a body’s immune response to infection.

“The takeaway message to stay vigilant on booster shots and stay focused on our community’s recovery from the pandemic,” Santora said. “Many adults have been in isolation, which can be mentally and physically devastating. Check on your neighbors and relatives, help them see their doctor, catch up on deferred medical care, or find the treatment assistance they need. These factors can be hidden behind closed doors but can be a recipe for severe illness when co-mingled with Omicron or future variants.”

Vaccines are safe and effective in preventing severe illness due to COVID-19. Over the course of the Omicron surge, COVID-19 case rate among unvaccinated individuals was nearly 4.5 times higher than those who were up to date (boosted). Unvaccinated people were 17 times more likely to be hospitalized for COVID-19 and eight times more likely to die of a COVID-related illness. Notably, those who were boosted were nearly 50% less likely to be infected than those who were fully vaccinated.

As of Feb. 25, only 73% of booster-eligible Marin residents have received a booster. Boosters are a critical tool to blunt the force of potential future COVID-19 waves.

Marin County Public Health releases updated COVID-19 death data each Friday and has a two-week lag to account for processing time. Recent deaths and hospitalizations are reviewed by the Department of Health and Human Services (HHS) to identify deaths and hospitalizations due to COVID-19, with incidental cases removed. View Marin HHS’s COVID-19 Case Disposition dashboard on its COVID-19 surveillance and data webpage.

Activism

Oakland Post: Week of November 20 – 26, 2024

The printed Weekly Edition of the Oakland Post: Week of November 20 – 26, 2024

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An Inside Look into How San Francisco Analyzes Homeless Encampments

Dozens of unhoused people are camped at Sixth and Jesse streets in San Francisco’s South of Market neighborhood. Tents made of tarps and blankets, piles of debris, and people lounging alongside the allies and walls of businesses are seen from all angles. These are some of the city’s hotspots. City crews have cleared encampments there over 30 times in the past year, but unhoused people always return.

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Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.
Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.

By Magaly Muñoz

Dozens of unhoused people are camped at Sixth and Jesse streets in San Francisco’s South of Market neighborhood. Tents made of tarps and blankets, piles of debris, and people lounging alongside the allies and walls of businesses are seen from all angles.

These are some of the city’s hotspots. City crews have cleared encampments there over 30 times in the past year, but unhoused people always return.

But it’s normal to have tents set up again within less than 24 hours after an encampment sweep, David Nakanishi, Healthy Streets Operation Center Manager at the Department of Emergency Management, says. Sometimes there’s less people than before but often there is also no change.

“Most of the people that were in the encampments that want to go inside, we’ve gotten the majority of those [into shelter],” Nakanishi says. “Many of the people we encounter now, are those who have various reasons to not accept shelter, and some are already in shelter/housing”.

Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.

Where neighboring cities in the Bay Area are clearing encampments a few days a week, San Francisco is sweeping 10 times a week, two per weekday.

David Nakanishi, Healthy Streets Operation Center Manager at the San Francisco Department of Emergency Management, makes a 311 report on an encampment in the Mission District. These reports allow smaller city teams to tackle individual spots where unhoused people frequent. Photo by Magaly Muñoz.

David Nakanishi, Healthy Streets Operation Center Manager at the San Francisco Department of Emergency Management, makes a 311 report on an encampment in the Mission District. These reports allow smaller city teams to tackle individual spots where unhoused people frequent. Photo by Magaly Muñoz.

Considering the controversy that plagues the city around its harsh policies, the Post decided to tag along on a ride with Nakanishi to show us how he decides what encampments make it on the city’s sweep list.

Nakanishi, having over 20 years of experience in homelessness management, drives around the busiest parts of the city almost daily. He’s tasked with arranging a weekly sweeping operation schedule for city teams to engage with unhoused folks to help get them off the streets.

So what exactly is he looking out for when deciding what encampments get swept?

It depends, he says.

Locations like schools, recreational centers, senior centers, or businesses are places he tends to want to address quickly, especially schools. These are the places where the complaints are highest and access to facilities is important for residents.

He says he also takes into account 311 calls and reports made to him by city staff. On the date of publication, over 100 calls and reports were made about encampments around the city, according to San Francisco data.

Makeshift structures built from plywood and tarps are starting to pop up more throughout the city. Certain areas under freeways are not under direct authority from San Francisco, making it harder to sweep these encampments. Photo by Magaly Muñoz.

Makeshift structures built from plywood and tarps are starting to pop up more throughout the city. Certain areas under freeways are not under direct authority from San Francisco, making it harder to sweep these encampments. Photo by Magaly Muñoz.

Nakanishi made a few 311 reports himself on the ride along, pulling over to take photos and describe the encampments into his 311 app. He says it helps him remember where to possibly sweep next or allows smaller teams in the city to engage quicker with individuals on the streets.

Nakanishi also looks at the state of the encampments. Are there a lot of bulky items, such as furniture, or makeshift structures built out of tarps and plywood, blocking areas of traffic? Is trash beginning to pile up and spill into the streets or sidewalks? Sites that meet this criteria tend to be contenders for encampment sweeps, Nakanishi says.

Street by street, he points out individuals he’s interacted with, describing their conditions, habits, and reasons for denying assistance from the city.

One man on 2nd St and Mission, who rolls around a blue recycling bin and often yells at passing pedestrians, has refused shelter several times, Nakanishi says.

People deny shelter for all kinds of reasons, he says. There’s too many rules to follow, people feel unsafe in congregate or shared shelters, or their behavioral and mental health problems make it hard to get them into proper services.

Inside a tent left by an unhoused man on Stevenson and 14th Street in San Francisco. The area smelled of human waste and leftover alcohol. Photo by Magaly Muñoz.

Inside a tent left by an unhoused man on Stevenson and 14th Street in San Francisco. The area smelled of human waste and leftover alcohol. Photo by Magaly Muñoz.

Nakanishi references another man on South Van Ness under the freeway, who city outreach have attempted to get into shelter, but his screaming outbursts make it difficult to place him without disturbing other people in the same space. Nakanishi says it might be an issue of the man needing resources like medication to alleviate his distress that causes the screaming, but the city behavioral team is in the process of outreaching him to figure that out.

In October, city outreach teams engaged with 495 unhoused people. 377 of those engaged refused shelter and only 118 accepted placements, according to city data. That number of monthly referrals is consistent throughout the entirety of 2024 so far.

Nakanishi has long advocated for the well-being of unhoused people, he explains. In 2004, he was working with the Department of Public Health and told then-Mayor Gavin Newsom that there needed to be more housing for families. Nakinishi was told it was easier to deal with individuals first and the city “will get there eventually.” 20 years later, family housing is still not as extensive as it could be, and the waiting list to get placements for families is a mile long with over 500 names.

In 2020, he was a Senior Behavioral Health Clinician at a hotel in the city during the pandemic. He says in 2021 he collaborated with DPH to provide vaccines to those staying in the makeshift hotel shelters once those became available.

Nakanishi strips apart a solo tent on Stevenson and 14th Street in San Francisco. He discards items, like tarps and cardboard, so that people cannot reuse them to make another sleeping structure. Photo by Magaly Muñoz.

Nakanishi strips apart a solo tent on Stevenson and 14th Street in San Francisco. He discards items, like tarps and cardboard, so that people cannot reuse them to make another sleeping structure. Photo by Magaly Muñoz.

Despite the constant media attention that city outreach is inhumanely treating homeless people, so much so that it has led to lawsuits against San Francisco from advocates, Nakanishi says not a lot of people are seeing the true conditions of some encampments.

He describes soiled clothing and tents, drenched in urine, and oftentimes rodents or bug infestations in places where people are sleeping. He’s asked homeless advocates- often those who are the most critical about the city’s work- who have shown up to observe the sweeps if those are conditions the city should allow people to be subjected to, but not many have answers for him, Nakanishi says.

The city’s “bag and tag” policy allows city workers to throw away items that are “soiled by infectious materials” such as bodily fluids and waste.

Sweep operations are conducted at 8am and 1pm Monday through Friday. People at the encampments are given 72 hour notice to vacate, but some don’t leave the area until the day of the sweep.

City outreach workers come out the day before and day of to offer resources and shelter to those interested. The Department of Public Works discards any trash that is left over from the sweep and washes down the area.

Nakanishi told the Post that the only time the city takes tents or personal possessions from residents is when folks become physically violent towards workers and police take the items as evidence. Other items taken are bagged and tagged in accordance with city policy.

Stories from local newspapers such as the San Francisco Standard and the Chronicle show instances of SFPD handcuffing residents while their items are thrown in the trash or disposing of personal possessions without reason.

Advocates have long been pushing for a more competent and compassionate process if the city is going to choose to continue sweeping unhouse people.

No matter the lawsuits and constant criticisms from allies, the encampment sweeps are not slowing down, even with the cold weather quickly approaching the coastal city.

Nakanishi says there aren’t a lot of large encampments left in San Francisco so now they do runs of streets in order to stretch out the sweeps as much as possible.

It’s calculated strategies and years of first hand knowledge that make this job work, “It takes dedication to the work, caring for the people and the community, and persistence, patience and sometimes good luck to make the positive changes for the people on the street,” Nakanishi says.

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Oakland Post: Week of November 13 – 19, 2024

The printed Weekly Edition of the Oakland Post: Week of November 13 – 19, 2024

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