Weeks ago it was clear that the coronavirus presented a unique threat to homeless people who often have underlying conditions that make them more vulnerable than the rest of the population. Cities up and down the west coast have rushed to take emergency measures to get as many people as possible inside, but that has its own risks as shelters are often overcrowded and put ill people a few feet apart from other vulnerable people as they sleep. Now we’re starting to see the first confirmed cases of the virus among the homeless population. In Seattle, four people have tested positive leading several shelters to lock down:

There are now four confirmed cases, in four separate shelters.

That news has some shelters in the area on lockdown, and others on edge…

“The big worry [is] that it could be transmitted pretty quickly through our clients before anybody really knows it’s happening,” said Dan Malone, the executive director of the Downtown Emergency Services Center, another of the largest shelter providers in the Seattle area.

Seattle has been struggling to open new spaces for the homeless to prevent overcrowding but the numbers are daunting:

Last week, a report by leading homelessness researchers estimated that King County would need to create 1,770 new units to decrease crowding in existing shelters, and create more than 9,000 new units for people currently living unsheltered during the COVID-19 pandemic.

In Los Angeles, Mayor Eric Garcetti announced the first case of coronavirus contracted by a homeless person last Friday. A report published by the UCLA Fielding School of Public Health last week estimated that as many as 400 homeless people could die from the virus just in LA County. To put that number in perspective, at present there are only 142 coronavirus related deaths in all of California.

San Francisco is making similar efforts and will be opening its largest convention center to the homeless this week. In the meantime, the city’s sidewalks have been filling up with tents as the city has put efforts to keep them at bay on hiatus:

If you want to see the challenges and limitations of enforcing San Francisco’s shelter-in-place order and observing social distancing, take a walk through the Tenderloin.

Since Mayor London Breed’s March 16 public health order, tents filled with homeless people have sprouted up along Hyde, Eddy, Turk and Jones streets — all with the quiet blessing of the city. Lines for the neighborhood’s free kitchens and methadone clinics stretch for blocks, overwhelming staff attempts to maintain a 6-foot distance between people…

“We got to sell stuff to get food, to get high — and everyday life,” said Diana Hardnett, as she sat with two friends, tending to boxes of razors, used clothing and other small items spread out on a blanket at the corner of Turk and Hyde streets on Wednesday morning.

A few feet away, a police officer handed out flyers to tent dwellers explaining the need for safe distancing, as a Public Works crew performed its daily sidewalk scrub-down.

If you’re thinking this sounds crazy, you’re right. But expecting people who live on the streets to take better care of themselves during a pandemic is really missing the point entirely. If they could take better care of themselves they wouldn’t be on the street in the first place. So issuing guidance by handing out fliers isn’t going to do much. The only way to prevent this population from becoming a hot spot for the spread of the virus is to take control of the situation and make sure people comply. Otherwise, a lot of these people are going to die and they are going to take up a lot of hospital beds, potentially putting others at risk.

When you think about it, the coronavirus is just the same old arguments we have had about the homeless for years, only on steroids. A lot of homeless people already die every year because we let them carry on as they wish even as they create a risk of spreading diseases like typhus and typhoid to people around them. I guess we’ll see if the threat of coronavirus changes the calculation or if we’ll still allow addicts and people with mental problems to carry on like normal.