As the dates for the All-star baseball game approached in 2016, the San Diego city administration responded by pushing her homeless into congested living spaces east of downtown. Around the same time, public toilets and bathrooms were clamped down citing Reasons like prevention of the spread of herpes and aids and to curb prostitution and drug peddling. Inadvertently, the city administration created the perfect environment for the spread of a highly contagious disease. Hepatitis A - a disease that thrives in congested unsanitary conditions found the perfect spot to breed and spread.

As a result, the city witnessed an Outbreak of hepatitis A among the homeless. LA Times calls it the worst outbreak the US has seen in decades.

What has changed now?

Those crowded encampments are now gone according to a report from PBS. Portable toilets and hand washing stations have replaced them. The city’s first homeless camp will open soon near Balboa Park. These steps and more are being taken to contain an outbreak that killed at least 17 and infected nearly 500. The reason cited for it being so difficult to contain the outbreak is that San Diego has over 5600 homeless people, many of who routinely turn away offers of getting vaccinated. That’s one of the reasons why it’s so challenging.

Another challenge is that the virus has a particularly long incubation period of 50 weeks. A person carrying the virus can spread it to hundreds of others before showing any symptoms and seeking treatment.

Challenges before the city administration

Jonathan Fielding, previously the Departmental Head at LA County Department of Public Health feels that the problem will take a long time to solve.

He said, “I don’t expect this is going to be solved overnight. It could take a year or more.” The number of people who have been vaccinated in the county stands at 54000. Hepatitis A hasn’t received much attention from the medical community in the US. The reason is that unlike hepatitis B and C which are widespread, hepatitis A is much more uncommon.

Mostly gay men and tourists coming to the US carry the virus for the disease. A lot of the resistance against getting shots is changing now. With their peers sent away to hospitals, some sense is dawning on the thousands of homeless in and around the city. They are now more open to getting those dreary shots if it means that they stay protected.

The disease has spread to other areas around the nation

What’s disconcerting is that the outbreak has spread to other cities starting from San Diego. The CDC has issued a public health alert since it was found that the same strain of virus-infected people in areas like Santa Cruz and California. That said, the elephant in the room shouldn’t be ignored.

Homelessness is the root of the present health crisis that threatens to spread and infect the whole nation. If homelessness isn’t solved then it can evolve into a much bigger societal and health crisis than it is now.