The Convention Center Coronavirus Outbreak Was Inevitable

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The Convention Center Coronavirus Outbreak Was Inevitable

Mayor Todd Gloria said Wednesday that he remains committed to the operation despite the recent surge in cases and the large sticker price to keep it going. The spike in cases has ratcheted up calls to move homeless San Diegans into hotel rooms, which health experts have deemed safer.

The city of San Diego is temporarily housing homeless residents at the Convention Center in an effort to stop the spread of the coronavirus. / Photo by Adriana Heldiz

The city appears poised to continue housing homeless San Diegans at the Convention Center for at least weeks more despite a spike in coronavirus cases at the shelter.

Since April, hundreds of homeless people have slept there each night and until recently, there had been just over two dozen confirmed positive cases. That changed this month. More than 160 residents and staff have received positive test results since early December, leading dozens to temporarily isolate in county-funded hotel rooms and fueling more uncertainty for those who remain there about how long the shelter might remain open. The positive cases have also inspired advocates to ratchet up longstanding calls to instead move homeless San Diegans into hotel rooms that health experts have also deemed safer options.

The outbreak and questions about the future of the shelter came amid a mayoral transition that added to the chaos. Mayor Todd Gloria took the reins at City Hall last Thursday having already vowed to find funding to keep the shelter open into the new year. He was forced to clarify his plans after confusion over whether the shelter might be forced to close at the end of the year since the City Council had yet to approve plans – and leaders including Gloria hadn’t said how they’d pay for it. The operation is already expected to cost just over $40 million to operate through Dec. 31.

Gloria said Wednesday that he remains committed to the operation despite the recent surge in cases and the large sticker price to keep it going. He believes he can extend the operation through January with mayoral authority but said he is still finalizing funding sources and will need the City Council’s sign-off to keep the shelter open beyond next month.

“The Convention Center is certainly an expensive option, but when we look at what’s available to us, and where we can do the most amount of good for the most number of people, I believe that that’s it,” Gloria said. “Obviously, we have to control for the current outbreak that’s there, and clearly I’m not happy with those numbers. I don’t think anybody is, but we are not gonna be in a position where we’re putting hundreds of people back out on the street at the same time we’re telling people to stay home to protect their health.”

The Convention Center has for months been the focal point of the region’s response to protect homeless San Diegans, a population considered particularly vulnerable to coronavirus and other health crises.

In late March, officials announced they would quickly transform the Convention Center into a shelter for up to 1,500 people as they faced the prospect – and in some cases, the reality – of staffing shortages and closures at existing shelters and packed facilities ill-suited to incorporate social distancing. They initially pooled $7.1 million in state emergency funds to support the operation. The city has since tapped several other state and federal funding streams.

Current and former city officials who helped ramp up the operation say they recognized early on that cases at the Convention Center could eventually surge despite protocols they instituted including six-foot spacing between beds, additional staff meant to help encourage social distancing and mask-wearing and regular coronavirus testing.

“Essentially, we’ve been planning for this since the inception of the operation and put every safety measure in place that we could think of or that we could devise with the county public health partners,” said Keely Halsey, the city’s chief of homelessness strategies.

Joel Day, who served as the point person coordinating the city’s coronavirus response under former Mayor Kevin Faulconer, said officials realized that a large-scale shelter wasn’t ideal but believed leaving homeless San Diegans in the city’s packed existing shelters would be far worse.

Once the Convention Center opened, Day said, the city planned for and even modeled out how it might handle large-scale outbreaks.

“It was in the back of the incident command’s heads the entire time that nothing should be taken for granted,” Day said during last week’s VOSD Podcast.

For months, despite coronavirus outbreaks in shelters elsewhere in the country, San Diego’s Convention Center shelter avoided those outcomes. Activists often argued that the shelter was an unsafe environment for homeless San Diegans, yet city officials cheered the fact that there had been just 27 positive coronavirus cases at the shelter through November and that hundreds who stayed there had been connected with housing.

Then, as the San Diego region saw an increase in coronavirus cases after Thanksgiving, the Convention Center shelter got hit too.

Rip Rippetoe, CEO of the San Diego Convention Center, speaks at a press conference for Operation Shelter to Home. / Photo by Brittany Cruz-Fejeran

Over a seven-day testing cycle earlier this month, 136 people staying or working at the shelter tested positive for coronavirus – a positivity rate of 9.3 percent for more than 1,460 tests that were part of a regular testing round of residents and staff. Another 27 positive tests were reported Wednesday and Thursday.

County data shows a positivity rate of 7.8 percent for coronavirus tests given countywide during the same testing period, from Dec. 3 to Dec. 9.

Even before the spike in positive tests at the Convention Center, Halsey said the city consulted with the county daily to assess whether it should adjust protocols at the shelter and those discussions have continued.

Dr. Lou Gilleran, the county medical official overseeing the Convention Center operation, wrote in a statement to VOSD that the county is closely monitoring the situation and expects to learn more from additional testing.

“Ongoing testing is occurring this week, which will provide further insight into the mitigation efforts to contain spread of the virus,” Gilleran wrote.

Ed Bidwell, 61, has been staying at the Convention Center since April. He said this week that he and others there have been uneasy about what might come next. He said residents have been unsettled as some staff have been temporarily replaced and beds have been removed after those who used them tested positive. He and others crave more clarity about what will happen.

“Everybody’s on edge,” Bidwell said.

Two doctors whose research focuses on the homeless population told VOSD that the Convention Center’s previous low incidence of coronavirus likely amounted to good luck – and that the recent spike in cases there was to be expected.

“It was inevitable,” said Dr. Margot Kushel, director of the UC San Francisco’s Center for Vulnerable Populations.

Kushel, who provided input as the state crafted its guidelines for protecting the homeless population during the pandemic, noted that a simulation study she and several other researchers released this fall showed that even shelters with intensive strategies to control the spread of coronavirus were unlikely to prevent outbreaks when there is even moderate community spread.

Kushel said that the the realities and risks associated with a large-scale shelter amounted to a ticking time bomb, even with commendable efforts to protect Convention Center residents.

Dr. Kelly Doran, an emergency physician and a researcher at New York University’s School of Medicine, agreed.

Ideally, Doran said, the city and county could move homeless San Diegans out of the Convention Center and into their own homes or temporary hotel rooms.

“Putting hundreds of people to a room has never been a particularly humane solution to homelessness and during a pandemic of an infectious disease, it is not a particularly humane solution to homelessness,” Doran said.

Doran and Kushel are among a chorus of experts who have for months urged cities and counties to move as many vulnerable homeless people as possible into hotel rooms, if only temporarily, to protect them during the pandemic.

Disability Rights California senior attorney Parisa Ijadi-Maghsoodi has also argued in court filings and most recently, in a Friday letter to City Attorney Mara Elliott, that homeless San Diegans with underlying health conditions should be moved into county-funded hotel rooms.

“Given COVID-19’s high propensity for rapid community spread and the inherent danger of the Convention Center, confirm immediately that all unsheltered individuals in the Convention Center will be immediately transferred to hotel rooms,” Ijadi-Maghsoodi wrote in a Friday demand letter.

Lisa Jones, executive vice president of strategic initiatives at San Diego Housing Commission, said the city has offered homeless people with certain health conditions who enter the Convention Center the option to instead stay in shelters at Father Joe’s Villages and PATH that allow for more distancing. She said this week that the city expected to check in with particularly vulnerable Convention Center residents as some at Father Joe’s and PATH moved into permanent housing, opening up beds at those shelters.

Hotel rooms haven’t been an option for the vast majority of San Diego’s homeless population during the pandemic.

Days before the city announced it would turn the Convention Center into a shelter, county officials revealed they were amassing hundreds of hotel rooms they could offer to people who tested positive or had been exposed to coronavirus and to homeless people considered particularly vulnerable. Those categories – which match the qualification requirements for Federal Emergency Management Agency reimbursements – limit access for many of the more than 3,500 people who have stayed at the Convention Center since it first opened, and many more who have remained on the streets during the pandemic.

Since March, the county reports that it has put up nearly 3,700 people in hotel rooms, including more than 1,700 homeless San Diegans who tested positive or were exposed to coronavirus. Those numbers include dozens of people who at least temporarily left the Convention Center the past couple weeks. The county now says it has over 800 hotel rooms available for those in need, though it only pays for those that are occupied. As of Tuesday, it reported that 237 of the 385 people staying in its so-called public health rooms were homeless.

The city reported that 665 people were staying at the Convention Center shelter on Thursday.

Just a fraction of homeless San Diegans the county has put up during the pandemic have been proactively placed in hotel rooms because they were considered particularly vulnerable to coronavirus.

Through October, the county reports that dozens of rooms overseen by the Regional Task Force on the Homeless temporarily housed 483 homeless San Diegans, most of whom who were over 65 or who had health conditions that made them high-risk. The county’s contract with the Task Force ended Oct. 31. The county has said it has continued to serve some at-risk homeless San Diegans and has put 81 people up in hotels during the pandemic, far fewer than many advocates would prefer.

“We have been prioritizing, in this really high demand, the isolation-quarantine for the general population protection,” county Chief Nursing Officer Denise Foster told VOSD last week.

Unlike many other counties across the state, San Diego County decided not to seek federal emergency funds through the Project Roomkey initiative that Gov. Gavin Newsom launched to help counties temporarily house thousands of homeless Californians. Project Roomkey links counties with federal funds that can reimburse them for 75 percent of hotels and some related costs.

Instead, county spokesman Craig Sturak said the county estimates it has spent about $20 million in federal CARES Act funds on its hotel initiative. It did recently receive about $727,000 from the state to bolster its efforts to support and permanently house homeless San Diegans in its care during the pandemic.

Sturak said the county did not seek Project Roomkey funding for its hotel rooms because it had started its own initiative by the time the state one rolled out – and that its program hasn’t suffered as a result of that decision.

“CARES Act was a stable funding source that offered flexibility for use,” Sturak wrote in an email to VOSD. “We did not decide to leave money on the table. It didn’t exist when we launched the program.”

Sturak said the county may seek federal emergency funds in the future.

The county ostensibly could have already sought reimbursements via Project Roomkey to cover a portion of its costs and continued to use CARES Act funds to cover the remaining share, or to use a combination of both streams to expand its program.

At a Wednesday press conference, County Supervisor Nathan Fletcher said the county is looking at how it might make more hotel rooms available for people at risk, particularly as cases increase at the Convention Center and across the county.

“We are taking seriously what’s happening at the Convention Center and working to make sure we do everything to address that, and we are simultaneously working to see what avenues or paths may be available to open up rooms for individuals who may be at higher risk,” Fletcher said.

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