More than twice as many people experiencing homelessness in San Francisco died during the first year of the COVID-19 pandemic compared to previous years, with the leading cause of death being drug overdose. No deaths were attributed to the virus itself.
The research, conducted by UC San Francisco in collaboration with the San Francisco Department of Public Health (SFDPH), demonstrates the urgent need to reach people who use drugs and are unhoused with substance use services. The research also shows that the City’s COVID-19 mitigation strategies to support this population, including placing people in Shelter in Place hotel rooms, were largely protective and may have prevented additional deaths from occurring.
The study, which appears in JAMA Network Open, examined deaths of people characterized as homeless between March 17, 2020, when San Francisco’s shelter-in-place order was issued, until March 16, 2021, compared to the deaths each year from 2016 until 2019. It then linked them to the City’s data showing demographic characteristics and the services people had used before they died. Autopsy results were provided by the Office of the Chief Medical Examiner.
“Our findings highlight the severe vulnerabilities faced by individuals who do not have housing,” said Maria Raven, MD, MPH, Chief of Emergency Medicine at UCSF and a Vice Chair in UCSF's Department of Emergency Medicine. Raven also co-leads the program on adults with complex needs at the Benioff Homelessness and Housing Initiative.