If Eric Smith wants to wash his hands with hot, soapy water, he has two options.

The first is to walk about four blocks from his small encampment in North Beacon Hill to the Lazarus Center on Rainier Avenue, but that closes for most people at 6 p.m.

The second is to boil water collected from willing neighbors over a camp grill.

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

Going to the bathroom would be equally, if not more, difficult without Smith’s friend Mark Lloyd, a tech worker who has been bringing toilet kits to his homeless neighbors since 2016.

Across Seattle, thousands of people in small encampments or RVs have even less access to the basic hygiene and sanitation the U.S. has been relying on to prevent the spread of infectious disease over the last century. During a public health crisis like COVID-19 – which the World Health Organization declared a pandemic Wednesday – those gaps leave people like Smith with less protection against a viral infection.

Being in Seattle makes him, in some ways, even more vulnerable.

Where cities like Los Angeles, Berkeley and San Diego in California have deployed dozens of hand-washing stations for homeless people to use within the last week in order to prevent the spread of COVID-19, Seattle lacks those mobile tools. City of Seattle officials have said they would give out hygiene kits including soap, water, paper towels and informational pamphlets when they are available, but as of Thursday, they did not have information on how many hygiene kits had already been distributed.

Instead, during the crisis, the city’s focus is “to create new shelters that have access to bathrooms and showers or both,” city spokesperson Kamaria Hightower said in a statement. “That will require significant investment from our state and federal government.”

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Seattle Mayor Jenny Durkan has asked Vice President Mike Pence that the federal government deploy emergency resources to help set up new shelter, quarantine and isolation space during the crisis, in part to provide better access to hygiene facilities.

However, adding shelter does not address recommendations from the U.S. Department of Housing and Urban Development for local homelessness agencies to enforce sanitation guidelines in both sanctioned and unsanctioned encampments. Seattle has long resisted providing such widespread hygiene and sanitation services for people living outside, partly out of concern that to do so would imply the camps are permanent.

The result is an unsheltered homeless population that lacks regular access to some of the basic and few ways people are able to protect themselves from COVID-19, the infection caused by SARS-CoV-2. When Seattle libraries close for a month starting on Friday, homeless people will have even fewer places to go.

Smith, who wears gloves to protect the cuts on his hands from infection while he places trash into garbage bags (also provided by Lloyd), said he first heard about coronavirus on the news at the Lazarus Center. It made him more vigilant. The work he does on his own to keep his encampment clean could put him at risk.

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“I’m doing things where, trying to help other people, I don’t pay attention to helping myself keep safe, so I’ve got to watch out for that sometimes,” Smith said.

“Fits and starts”

As public health officials tallied a mounting death toll from COVID-19 in the Seattle area, city and county elected officials declared civil emergencies. Some of their first actions targeted the vulnerability of people living outside and in crowded shelters.

Last week, King County Executive Dow Constantine announced the purchase of a motel and the deployment of modular housing for people, and particularly those without home addresses, to quarantine and isolate if necessary. Durkan used her emergency authority to expand tiny house village units and enhanced shelter for an additional 100 people, and opened the Exhibition Hall at Seattle Center to decrease crowding at a downtown shelter.

The recently added shelter space only makes a dent in temporarily housing the number of people living outdoors, and it doesn’t address the sanitation needs of those who will continue living outside. During the 2019 one-night count of homelessness, an estimated 3,558 people were unsheltered.

The city says that there are “well over 100 publicly accessible facilities offering toilets, showers, or both” in Seattle, but few are regularly accessible, a February 2019 city auditor’s report showed. Only six city-funded restrooms were available 24/7.

Public restrooms aren’t enough to ensure someone can maintain high levels of hygiene, said Josh Castle, advocacy and community engagement director for the Low Income Housing Institute. “These are just not very clean and they aren’t very accessible. It’s just not an ideal situation at all.”

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Of the six 24/7 public toilets available in Seattle, only three have sinks.

“One of the most basic public health imperatives in the developed world is making sure people have access to clean water and sanitation facilities, ways to dispose of human waste,” said Bobby Watts, CEO of the National Health Care for the Homeless Council. “We are in the richest country in the world, and in some of the richest and most expensive cities in the world, and our neighbors are without these most basic conditions.”

Asked about the risk of not having regular access to hygiene services or a roof over their heads during an outbreak, the county’s Healthcare for the Homeless Network said this could increase the likelihood of contracting the virus.

Elected officials in Seattle have debated adding better access to public bathrooms in an “unsuccessful effort of fits and starts for the last couple of decades,” said Seattle City Councilmember Lisa Herbold.

In 2016, when the city cleared the “Jungle” encampment in the East Duwamish Greenbelt after a fatal shooting, it set up portable toilets and dumpsters at a temporary camp at Royal Brougham Way. But those toilets were short-lived, said Lloyd, who volunteered to come in and pick up garbage at the time.

“The toilets would not stay clean,” he said. “The trash would get into the dumpsters and then hauled out of the dumpsters by people who would want to go through the garbage.”

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Besides cost, part of the reason Seattle has struggled with hygiene services is that city officials “did not want living rough to become our default policy,” said George Scarola, former homelessness director under Mayor Ed Murray. There was a concern putting those sites in camps would encourage them to grow. Rather than making camping outside more livable, the city decided to put its resources toward expanding outreach and shelter, Scarola said.

Former Seattle City Councilmember Mike O’Brien said proposals about hygiene and sanitation would always be met with an argument about making it easier for people to live outside.

“The narrative that kept getting spun up was ‘Seattle Freattle,’ and ‘You’re just enabling people’ and it was really hard to just have a conversation on the council about that,” O’Brien said.

But during a crisis like COVID-19, “public health interests have to be paramount,” said National Health Care for the Homeless Council’s senior director of policy Barbara DiPietro.

“To have political concerns like we might give the appearance of sanctioning an encampment, that cannot be a principle that governs decision-making,” DiPietro said.

Mobile pit stops 

Homeless advocates are now asking that the city prioritize putting in place hand-washing stations and mobile toilets at encampments during the COVID-19 outbreak.

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That should have already started, they say. In November, the city dedicated $1.3 million to buy and deploy five mobile restrooms for unsheltered people. But by March, those mobile pit stops have yet to be purchased.

“If we had put hygiene services as a priority over the last decade, we might not be in this situation where we wouldn’t have these resources to deploy in different neighborhoods,” said Tiffani McCoy, lead organizer at Real Change.

Councilmember Herbold also thinks Mayor Durkan should expedite the deployment of the mobile pit stops during the outbreak.

“We get stuck in the Seattle process,” Herbold said. “It’s really important to recognize that we are actually still under the homeless state of emergency that we enacted four years ago.”

Advocates also say Seattle should follow the lead of cities like San Jose, which announced this week it would suspend encampment removals during the outbreak while people are at risk of contracting COVID-19. But Seattle officials said that, while no large-scale encampment removals are planned, the Navigation Team will continue its work of clearing sidewalks and public rights of way — which Seattle/King County Coalition on Homelessness Executive Director Alison Eisinger called the “opposite” of what they should be doing.

“When it’s cold and wet outside, sleeping outside after your tent has been swept is not a good recipe for maintaining health,” Eisinger said.

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Some people living in encampments have received city pamphlets on coronavirus and work with the city to help dispose of their trash. Since the beginning of the outbreak, the Navigation Team has conducted outreach at 127 sites, according to the city, and distributed 370 public health flyers.

Sheryl Stepetin, who sometimes lives in an encampment under a Sodo bridge, heard about the disease from a city outreach worker earlier in the week who distributed hand sanitizer and told her how to prepare. She’s been washing her hands more frequently with water she’s boiled over the fire since.

The site where she was staying is one of 12 where city-funded outreach workers regularly distribute garbage bags for encampment residents to organize trash that the city later picks up.  Outside of its encampment removal work, the Navigation Team has also greatly scaled up its litter picks in recent years, from 28 in 2018 to 369 in 2019.

“I think everybody is at risk,” Stepetin said. “It’s just that simple to get.”

But in more isolated encampments across the city, people are struggling even more to maintain order while dealing with the uncertainty of what would happen if COVID-19 got into their camps.

Anthony Clark, who lives in a tent in Sodo next to a friend’s RV, said on Tuesday that he spent the afternoon cleaning up the sidewalk, but still struggles to find ways to wash his hands when the options for doing so are so far away.

“If [COVID-19] gets down into these places, it’s hard to get rid of,” he said, citing the lack of running water and laundry available nearby. “If it gets in with all the people down here, it’s going to get bad, I think.”

Project Homeless Engagement Editor Anna Patrick and Project Homeless reporter Scott Greenstone contributed to this story. 

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