Hepatitis A Spreads Among Ballard Homeless Population, As Hygiene Stations and Restrooms Remain in Short Supply

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A new outbreak of new Hepatitis A cases among people experiencing homelessness in Ballard could get worse if people are unable to access sinks and showers, both of which remain in short supply in the neighborhood and across the city.

King County Public Health confirmed 11 new Hep A cases among people who self-identified as living homeless in Ballard this week, of 25 new confirmed cases in March. In January, when it became clear that the city was experiencing an outbreak but before COVID-19 shut down libraries and businesses open to the public where homeless people typically access restrooms, public health spokesman James Apa noted that “People who are living homeless or who are using drugs are more likely to have underlying health conditions that can be worsened by hepatitis A.”

Dr. Richard Waters, the medical director of homeless and housing programs for the Neighborcare Health clinic network, says that hepatitis A cases during the last two outbreaks, in 2018 and 2019, “were predominantly among people experiencing homelessness, in large part because of the lack fo sanitation facilities.” Now that there are even fewer places for people to wash their hands because of restroom closures, he worries that the virus will spread. “People use the bathroom who don’t, or are unable to, perform adequate hand hygiene, touch things that other people may touch … and it spreads. Hand hygiene is key,” Waters says.

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Today, Apa said that the health department’s environmental health team is “connecting with Seattle Parks & Recreation to confirm best practice sanitation procedures of the Portland Loo at the Seattle Commons as a precaution.” The Portland Loo—a $550,000 public restroom designed to deter illicit behavior that was set up at the park last year—could be a vector for disease if people use the toilet and do not, or are unable to, use the handwashing station on the outside of the unit.

The Loo remained locked this afternoon, and several Honey Bucket port-a-potties——which the city refers to as “comfort stations”— had been set up nearby. Will Lemke, a spokesman for the city’s Human Services Department, says the restroom was closed “to ensure that staff were prepared and equipped to do the appropriate deep cleaning of the facility. The loo will reopen in the near future.”

Neither of the sinks at a temporary handwashing station adjacent to the portable toilets were working this afternoon, although the station was stocked with soap and paper towels.

Lemke also said that the Navigation Team was out in Ballard this morning handing out hygiene kits and information, and providing information about vaccinations. King County Public Health and Neighborcare provide hepatitis vaccinations to people experiencing homelessness. The area outside the Ballard library and the perimeter around the Ballard Commons, which is ordinarily cleared by the Navigation Team or Seattle police, has been crowded with tents ever since the library closed its doors on March 13. Much of the park was fenced off.

Earlier this week, the city released a map of the six new handwashing stations it is providing in response to the COVID-19 epidemic. An HSD blog post on hygiene services that was updated yesterday says that “at least four” mobile hygiene trailers, with showers, sinks, and toilets, will be coming online “soon” and are “under procurement.” As I reported yesterday, the city budget passed last year included $1.3 million to buy these units, but the city did not start looking for them in earnest until after the COVID-19 epidemic was underway. By that point, the trailers were in high demand, and the city has been unable to procure them.

Currently, the city’s plan is to rent two trailers from out of state, with the contract going through Seattle Public Utilities (SPU recently took charge of finding the trailers, which was previously the responsibility of HSD.) A spokesman for the city’s Emergency Operations Center said Thursday that the trailers “are being delivered this week,” but that “we are still working through logistical and operational approaches including staffing. SPU needs to consider all public health guidelines to ensure the health and safety of employees and clients.”

2 thoughts on “Hepatitis A Spreads Among Ballard Homeless Population, As Hygiene Stations and Restrooms Remain in Short Supply”

  1. Handing out “hygiene kits”. Sounds good doesn’t it until you look deeper and discover they do not include hand sanitizer. What a joke. With the supplies provided someone may be able to wash their hands once but what about after that?

    1. There’s more going on here than just the library being closed. That portland loo should be being cleaned regularly – daily during this pandemic – why isn’t that happening? And isn’t the handwashing station on the outside of it? For everyone to use? It should be useable even when somebody is inside the loo? Perhaps drug users aren’t using the handwash station for other reasons – or there are other ways the disease is spreading.

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