Porta potties near Plaza de Panama at Balboa Park
Porta potties near Plaza de Panama at Balboa Park on Nov. 1, 2021. / Photo by Adriana Heldiz

The city of San Diego is pledging to identify possible locations for additional portable restrooms and handwashing stations following a directive from the county to respond to a small spike in hepatitis A cases and prevent further spread.

The county’s deputy public health officer sent a letter last week to the city’s chief operating officer ordering the city to deploy more restrooms and handwashing stations, step up sanitation procedures where unsheltered residents gather and analyze locations of homeless camps and “work to provide housing or provide frequent cleaning.”

Dr. Ankita Kadakia noted in her Feb. 15 letter to the city’s Chief Operating Officer Eric Dargan that the county’s 2017 outbreak was spread person-to-person and via trace amounts of fecal matter. She wrote that the local response to an uptick in cases in recent weeks should go beyond vaccinations and education efforts that have already begun.

“We know that adequate sanitation and access to restrooms and handwashing stations, in combination with homeless outreach efforts, is vitally important,” Kadakia wrote. “Enhanced sanitation and education will minimize transmission and reduce the chance for an outbreak.”

The 2017-2018 outbreak led to nearly 600 cases and 20 deaths, including of more than a dozen unhoused people. Thus far, the county has tallied four hepatitis A cases and one death – not enough to declare an outbreak. One of those cases was at a city shelter. A county spokesman said officials have not identified where two other homeless residents who contracted the illness stayed.

In 2017, the city and county deployed dozens of additional handwashing stations and more portable restrooms to quell the outbreak.

In a Wednesday letter to County Public Health Officer Wilma Wooten, Dargan wrote that the city’s Performance and Analytics Department is examining a heat map of the city’s homeless camps to determine where restrooms and handwashing stations could be placed.

The city has long struggled over restroom access. In late 2021, Mayor Todd Gloria set a goal to have public restrooms within a five-minute walk of all areas downtown. That goal hasn’t been met – and Gloria acknowledged last year that even maintaining restrooms is a continuing challenge.

Gloria spokeswoman Rachel Laing said Wednesday that the city’s timeline to place additional restrooms and handwashing stations was “not yet known.”

In his response to the county, Dargan wrote that the city now services its portable restrooms at least three times a day and will continue that practice. He also noted that the city regularly sanitizes sidewalks, something it began doing during the 2017 outbreak, and that it has worked with the county to schedule vaccinations at both city-funded shelters and other service centers.

Dargan also wrote that the city is “working with homeless outreach staff and partners to maximize available resources to those willing to accept placement and services.”

“The city values its partnership with the county and will continue to be dedicated to minimizing transmission and bringing awareness and education with the goal of reducing the number of cases of hepatitis A,” Dargan wrote.

Lisa is a senior investigative reporter who digs into some of San Diego's biggest challenges including homelessness, city real estate debacles, the region's...

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  1. 1) Counterproductive to eliminate weekend hours and reduce other hours for the only day center for homeless residents in Downtown San Diego, serving 1000s, while saying you’re working with the County to administer HepA vaccinations at “service centers”.
    2) With 1784 City-funded shelter beds and at least 4800 houseless City residents, it’s extremely disingenuous to continue to suggest that houseless residents’ unwillingness “to accept placement and services” is a constraint. Add to this that almost half of these shelter beds are top bunks and unusable by Seniors and others with limited mobility and only 60 aren’t in congregate shelters which are themselves proven health and safety hazards. Focus on finding HOUSING that keeps people housed, rather than blaming these people for the decades-long failure to so do.

  2. Another risk to your family, and another expense paid for by your family to support unstable drug addicts who should be in prison.

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