Jason Albertson has been working in the communities of poverty, substance use, HIV, and mental illness with people experiencing homelessness in San Francisco since 1991. Currently, he is assigned to the Department of Public Health’s Outbreak Management Branch, Shelter and Encampment Division as the team’s Behavioral Health Specialist.
Submitted November 16, 2020
In March of 2020, I was activated as a Department of Public Health Disaster Services Worker and stopped working at my regular job as a health program coordinator providing services to people experiencing homelessness and HIV. I began to build a program to help people who had been diagnosed with COVID-19 or were suspected of being positive remain in an isolation and quarantine hotel.
The memory of watching groups of individuals follow a deteriorating trajectory, and feeling that we as caretakers had abandoned the folks when we closed the shelter for the good of the community will stay with me. It was a necessary decision but the concomitant needs and implications were not explored well.
How It Is
Written June 19, 2020
I’ve been working the alleys, helping out with the DPH outbreak management branch work and helping folks get tested. Folks on the alleys, in the streets, have been in place a long time, in the heat, in the dust. They are cooked. There is no available shelter. Access to hotels is based upon COVID-19 vulnerability. If you don’t have vulnerability, no room for you.
Many ask me how to get help, how to get into a Shelter In Place hotel, how to get a California ID in a time of viral uncertainty. I don’t have many answers.
“I’m working outbreak”, I say, “Would you like a mask, a squirt of hand cleaner, a bottle of water? How are you doing? Any fever, cough headache? Do you know you can have this illness and not have symptoms and give it to people? Can we help you stay safe? I can give you a mask.”
I recognize people I know from positions I’ve held on the Encampment Resolution Team outreach, from the Homeless Outreach Team, from LINCS HIV case management navigation team, and even from the mental health clinic I worked at 20 years ago. With the people I know, there is almost always a smile, a rueful, knowing smile that they find me here, on this street, at this time, with them. I think the smile is talking.
“You too, huh? We should have expected to see you out here, even though last I heard you were management.”
Nowhere I’d rather be than on that street, smiling. Smiles can be seen above the mask. The eye-flesh crinkles up. I see someone, I smile, and hold it. We need the smiles more than ever because of COVID-19, because I might get the illness.
I think we are all in this together. All at risk. There is an Arabic saying, “When danger comes, sing to it.” I’m singing more these days. The fam is a bit irritated by that.
There are a lot of folks out here with compound challenges but more than the impacts of mental health problems or substance use problems, they are worn. Each day takes a bit more reserves from them. Help is not in sight, maybe not on the way, the cavalry bearing health and a place to stay isn’t showing.
The fundamental injustice is clearly defined. Holding up, bearing up, bearing down, taking joy with people around them, but knowing, beyond knowledge, that in the ways that really count they have been abandoned, judged negatively on the status dimension, relegated to the ranks of misbegotten children. If they hadn’t been abandoned they’d be inside, safer, and we’d be working to develop support and services.
Sometimes I think the folks on the street are waiting, waiting for COVID-19. I’m working outbreak management. I’m waiting for COVID-19. Units are being developed, processes being established and I have full respect for the Human Services Agency and Homeless and Supportive Housing partners driving this process. But it is not enough, not fast enough and people are cooked.
When I go to work, each day, I ride Mission Street. Each day I see people crashed out on the sidewalk. Each day I see them get a little dirtier, more bearded, more tanned. Then I see they have lost their shoes. The next time I see them they are shouting to beings I don’t see, shoeless in the street. They are on the tracks, the train is coming and they can’t see that headlight.
Meth eats people. That road to recovery is a long one, and it’s hard to walk that trail.
I keep hope going. It’s a conscious process. I don’t do anybody any good at all if I lose hope. “How do you do that?”, someone asks. The answer is that I spend a few minutes each day, usually on the way home, thinking about what I am grateful for and what I have in my life that I love. This inspires hope. It is my hope that I can inspire hope, and the opportunity to do so is never far off.
In a time of unforeseen calamity, unexpected impacts, hope might be what we have to give to each other, for each other, and for our community.