Deaths of homeless people in San Francisco doubled during the first year of the pandemic

San Francisco suffered a surge of deaths among homeless people during the first year of the COVID-19 pandemic, a new study finds.

Researchers from the University of California, San Francisco, found that the number of deaths among people ‘experiencing homelessness’ doubled in the year-long span from March 17, 2020 to March 17, 2021, up to 311.

A surge in deaths caused by drug overdoses in particular accounted for nearly all of the increase. None of the deaths were attributed to the virus itself.

Ancillary deaths during the pandemic have been well reported on, but homeless people are generally left behind in many studies as gathering data regarding them is generally harder.

Researchers found that deaths of homeless people during the COVID-19 pandemic doubled, though the virus itself made up none of the deaths

Researchers say that while lockdown orders were successful at preventing transmission of the virus, they also closed resources homeless people could have used to deal with drug overdose. The lockdown order was the start of when homeless deaths began to surge

‘No deaths in our data set were due to COVID-19 itself, which may speak to the success of San Francisco’s efforts to mitigate the spread of the virus in vulnerable populations,’ researchers wrote.

‘However, the pandemic had far-reaching effects on outreach, health, and social services … that may have contributed to increased mortality from non–COVID-19 causes.’

Researchers, who published their findings Thursday in JAMA Network Open, gathered data from the San Francisco Office of the Chief Medical Examiner from 2016 through the pandemic year.

Deaths generally do not change year to year among any group, no matter the cause, barring some sort of massive event – like a global pandemic.

Homeless deaths slightly increased year-to-year from 2016 to 2019. from 128 in 2016 to 147 in 2019. 

San Francisco’s homeless population has had well documented growth in recent years. The number of homeless people increased 17% from 2017 to 2019 

These increases could just be normal fluctuation, or they could speak to the growing homeless population in the city.

From 2017 to 2019, it is reported that the city’s homeless population jumped a staggering 17 percent. 

Deaths more than doubled during the first year of pandemic-imposed measures in the city, eclipsing the 300 mark.

The deaths per 100,000 residents figure surged as well, up from just under 2,000 deaths per 100,000 homeless residents to over 4,000 during the pandemic.

Interestingly enough, the virus itself did not count for a single death included in the data.

Instead, drug overdoses made up almost the entire year over year differential.

In each of 2016 and 2017, under 40 drug overdose deaths were recorded among the city’s homeless population.

The figure jumped up to 66 in 2018, and jumped once again in 2019. This is consistent with the overall surge of opioid deaths that struck the nation in the late 2010s.

In 2020, drug overdose deaths among the homeless nearly double, with 178 recorded by city officials.

Opioids (black) make up nearly 80% of drug overdose deaths in the U.S., and synthetic opioids like fentanyl (brown) make up a large portion of overall opioid deaths

Drug overdoses surged in the overall U.S. population last year, with a record of more than 104,000 being logged from September 2020 to September 2021.

‘This disruption to services coincided with increasing unintended overdose deaths in San Francisco, driven by the growing presence of fentanyl,’ the researchers wrote, blaming the synthetic opioids for the surge in deaths.

Opioids account for around 80 percent of drug overdose deaths in America, with synthetic drugs like fentanyl making up around 70 percent in particular. 

‘COVID-19 mitigation policies may have affected how, when, and where people used drugs and the chances a passerby could intervene in case of an overdose,’ the research team added.

‘COVID-19–related effects on the health system may have led to decreased access to treatment. 

‘We found that a low proportion of decedents had recent contact with behavioral health services, including office-based substance use disorder treatment programs.’