Susana de Sant’Anna hasn’t been able to take a full breath of air since about June 2015.
That was when she was hospitalized in San Francisco with severe sepsis, complicated by Lemierre’s syndrome – a rare infectious disease - and an abscess of the left lung. She underwent two lung surgeries, and in the two years it took her to recover, she burned through all her savings and became homeless. Sant’Anna has spent the last five years bouncing between shelters, transitional housing and friends’ couches.
Now, with wildfire smoke choking the city, fog for weeks on end and the lingering threat of a virus that affects the lungs, she spends her days hiding in a hotel room paid for by donations that she stretches by cutting back on food, knowing that just one breath of the smoky air outside could set her recovery back.
“They’re saying people like me with vulnerabilities need to be in a safe place, but I don’t have a home,” Sant’Anna said. “Now I have two hazards to face.”
Tens of thousands of Californians across the state have found themselves in circumstances similar to Sant’Anna: unhoused or housing-insecure amid a pandemic, struggling to breathe in a region cloaked in smoke. North of Los Angeles, the Lake fire has been burning in Angeles national forest since 12 August, tearing through 31,089 acres. Mid-August lightning storms ignited more than 900 wildfires in the north of the state that together have burnt through more than 1.5m acres (2,344 sq miles) and killed eight.
Though their encampment sits 50 miles south of the Lake fire, the ash that rained down upon 48-year-old Brooke Carillo and her community was so heavy that it weighed down their tents.
“It looked like little flakes of snow,” she said. “Living on the street, we get a lot of dust and dirt and soot already. It wasn’t the smoke that bothered us so much as it was the ash. It weighs down your tent. It makes things warmer in your cooler.”
The local fire department passed out masks to protect against the smoke and coronavirus, Carillo said. Farther north, however, other homeless communities were left to fend for themselves.
Even before the wildfires, houseless Californians were hampered by cuts to services in some jurisdictions, diminished operations at some shelters because of social distancing practices, and a dwindling of resources with businesses closed. At Carillo’s encampment in Chatsworth, a neighborhood in Los Angeles’ sprawling suburban San Fernando Valley, the unhoused residents have been forced to relieve themselves in bags and cups and toss them into garbage cans because there are so few restrooms open, Carillo said.
And in Sonoma county, unhoused residents found little relief when the wildfires hit. Smoke has clung to the region each fire season since the Tubbs fire tore through in 2017, displacing hundreds and killing 22. “Yet to this date, we don’t have a program in which the county administers PPE to folks on the streets,” said Marcos Ramirez, co-founder of Mask Sonoma, an organization that passes masks out to unhoused residents for protection from both the smoke and coronavirus.
With the LNU Lightning Complex fire – now the third-largest wildfire in California history – burning through parts of the county, prompting widespread evacuations, many homeless people were left behind, Ramirez said. As the Russian River community of Guerneville vacated, advocates like Ramirez got reports of unsheltered individuals wandering the empty streets, wondering where everyone had gone. “There was no concerted effort to get those folks off the street, let alone effort to get PPE to them,” Ramirez said.
“The long story short is, folks were exposed and they were exposed for a long period of time,” he said. “Unless they received masks from us that were both Covid-safe and had a good enough filtration for the smoke, it was not provided by the county. Folks suffered, and who knows what that will mean in terms of the long-term effects for their health.” Sonoma county officials did not immediately respond to requests for comment.
This week, Ramirez watched with other community advocates as police cleared a homeless encampment of about 100 individuals near downtown Santa Rosa. The Centers for Disease Control and Prevention have repeatedly stated throughout the pandemic that if “individual housing options are not available, allow people who are living unsheltered or in encampments to remain where they are” – it is safer for everyone and mitigates the risk of spread.
“You weigh the guidance of the Centers for Disease Control, which is that you don’t cause encampments to break up, and you weigh the conditions in the encampments themselves,” David Gouin, Santa Rosa’s director of housing and community services, told the Guardian.
Given the number of people living in the encampment, city fire marshals grew concerned of fire risks, Gouin said. Beyond the cooking fires and barbecues typical of an encampment, “someone had figured out a way to wire into the lamp post for electricity and folks were running electrical cords from it”, he said. By his count, he said, there were 41 residents in that encampment, 21 of whom accepted city services to eventually transition out of homelessness.
City providers have been handing out masks to protect from coronavirus, but not specifically to filter smoke, Gouin said. They will continue to hand out coronavirus masks, but not smoke masks, Gouin said, including to the homeless residents inhabiting the 68 two-person tents of the city’s outdoor sanctioned encampment. “We don’t differentiate between a mask for keeping people safe from a forest fire several miles away that is challenging for us or a mask for keeping people safe from a pandemic,” he said. “To us, it’s all about wearing a mask.”
In any case, Gouin said: “Masks were provided. They primarily weren’t used.”
Ramirez, who estimated that Mask Sonoma had passed out tens of thousands of masks since he co-founded the organization during the Tubbs fire in 2017, disagrees with Gouin, saying homeless people do wear masks, and that regardless, “everyone should have access to the same tools”. Plenty of housed individuals choose to walk their children outside in the smoke and not wear masks, even in jurisdictions where masks are mandated. But they have the option to return indoors and to protect themselves if their health requires it. Without even smoke-filtering masks, unhoused residents do not.
In San Francisco, Sant’Anna should have qualified for a hotel room provided by the city. With a pre-existing medical condition, she was at risk for Covid-19 and needed to shelter in place. But when her friend told her she could no longer stay with her at the end of June, and she found the city and its homeless services unresponsive.
Even before her friend asked her to move out, Sant’Anna had been calling every agency and reaching out to housing advocates. Her doctor wrote the city in August. A friend and an organization helped her pay for two weeks at a hotel, but since then, she’s been living off of funds raised through her GoFundMe page.
City officials said they could not comment on individual cases but said that referrals to shelter-in-place hotel rooms “are made through referring entities including first responders and street outreach teams as well as through other vetted entities working within the public health system”. On days that the air quality reaches a certain level, homeless outreach teams provide N95 masks for “sensitive groups who are unsheltered and have respiratory conditions”, said Deborah Bouck, a spokeswoman for San Francisco’s department of homelessness and supportive housing.
Sant’Anna moved to San Francisco in 2013 after getting her master’s degree in digital media, hoping to get a job in tech like so many others. But now she gets exhausted talking for too long. She doesn’t know which days will be too smoky for her to go outside, so she stays indoors.
“My lungs are suffering, but my heart is suffering too,” Sant’Anna said. “I don’t know what to do. The stress – the stress will kill you.”