Outside St. James Cathedral, rain came down in gouts, spilling down the front steps and inside the vaulted sanctuary. Inside, the only warmth came from 221 candles arranged around the font, and the warm organ notes that filled the room, as around a hundred voices sang “O Holy City, seen of John”:

“O shame to us who rest content, while lust and greed for gain, in street and shop and tenement, wring gold from human pain,” the mourners sang.

Two hundred and twenty-one candles, one for each homeless person who died on the streets of Seattle over the previous year.

The Seattle Times’ Project Homeless is funded by BECU, The Bernier McCaw Foundation, Campion Foundation, the Paul G. Allen Family Foundation, Raikes Foundation, Seattle Foundation, Starbucks and the University of Washington. The Seattle Times maintains editorial control over Project Homeless content.

The congregation at St. James has gathered each year for more than a decade — no one can remember when it started, but it’s continued each year, not even interrupted by pandemic restrictions. They mark the names of those who’ve died without a home in Seattle and King County. It’s one of just a few such Catholic services in a country where homeless deaths are rarely counted and even more rarely remembered.

At the end of the service, laypeople from the congregation read the names of all 221 dead from last November to this one, and the six massive bells at the top of the cathedral’s 167-foot towers rang for each name. That’s more bells, and more candles, and more deaths, than the cathedral has ever marked.

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Ten months into the calendar year, the coronavirus pandemic, drug epidemic, record-breaking heat wave, and customary cold and wet snaps had killed at least 159 homeless people, which is higher than normal. The county medical examiner’s office, who investigate violent and sudden deaths, doesn’t expect 2021 homeless deaths to pass the previous high of 194 in 2018, but they’re likely to pass the two years since.

While the medical examiner’s is the most official count of homeless deaths in the county, Lee Thornhill, a public health data and evaluation manager for the public-private Healthcare for the Homeless Network, cautioned that many homeless people who die in places like hospitals are likely missed by this count, and extrapolating too much from a sample size of less than 200 can lead to faulty conclusions.

“One death outside is one too many,” Thornhill said, but “it’s hard from an analytical, statistical perspective to look at small numbers and make meaning from them.”

Still, there are smaller numbers within that total that tell their own stories: The number of dead outside or in vehicles or garages so far this year, 103, is already creeping dangerously close to 2018’s total of 107. It hints at the shelter beds the highly contagious coronavirus took from the system by making it impossible to shelter people in large rooms together. With shelters like the Union Gospel Mission cutting their capacity, people who might otherwise be in shelter were forced to find other places to sleep.

COVID-19 has claimed more homeless lives this year than it did last year — 28 so far as opposed to 18 last year — as public health and homeless providers have struggled to achieve a sufficient vaccination rate to slow the disease in shelters and housing programs.

Since late July, the county has seen a prolonged spike of between 22 and 68 cases a week in shelters, homeless camps and housing facilities, its most persistent spread since the pandemic began.

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Seventy-one deaths so far this year are from overdose, a number that Brad Finegood, a strategic adviser for the public health department, said is higher in the homeless population than ever before. Most of those involve multiple drugs in the form of opioids, especially fentanyl, and stimulants like methamphetamine.

There are a few causes for this rise, Finegood said. Pandemic restrictions shrank treatment programs for substance use disorder, especially for homeless people, at the same time negatively affecting many people’s mental health. Finegood said doctors are hearing people have less access to heroin and more access to cheap fentanyl.

“We need to be able to keep doors open and keep good quality services around for people,” Finegood said. 

Dr. Nancy Connolly, who lost her favorite patient to overdose earlier this year, said it’s horrible to watch her clients try to pull themselves off the street, only to find an uncaring system full of barriers to their recovery.

“It’s terrible to me — unconscionable, as they say — that people are discharged from mental health hospitals to the street, from jails to the street,” Connolly said.

More than the numbers, each name the congregants read out at the requiem Mass also told its own story.

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Betty Kautz, 66, who died of hypothermia and whose body was found by police next to a dumpster behind an AMPM last winter; she had no shoes on and she had one arm out of her shirt — possibly because she was in the middle of taking it off when she died, according to the police report.

Mohamed Hersi, a mid-30s man who was killed by a blunt force head injury in City Hall Park, according to the medical examiner.

Laten Arnold Jenkins Jr., who could often be seen walking outside the Nordstrom downtown with a blanket wrapped like a cloak around his tall frame, was found dead in that blanket the day after Thanksgiving last year, according to his brother, Lawrence. Lawrence wrote in the South Seattle Emerald that Laten — who had schizophrenia — was loved and missed by many more than the “many hundreds” of people who passed by his body at a downtown bus stop the day he died.

Others don’t have names: Unidentified Male. Unidentified Female.

Some were infants when they died: Baby Boy Rea-Garcia.

“We ourselves are not without blame when it comes to what happened to them,” said Father Michael Ryan in his address to the congregation, an address that doesn’t change greatly each year. “May they rest in peace, and may we not rest peacefully until we have made the scandal of homelessness our nation’s priority.”