Nearly 10 years ago, San Diego was subject to one of the worst public health crises this region has seen.
Within the span of a year, 576 people contracted hepatitis A, a condition which spreads rapidly when people are living in unsanitary conditions, such as a lack of restroom access or a place to wash one’s hands. As this epidemic rolled on, 17 people lost their lives.
Our elected officials had failed to act swiftly, transforming what could have been a containable situation into an epidemic. Many of those disproportionately impacted were some of our most vulnerable community members: those experiencing homelessness and extreme poverty.
It took months for homeless service providers, public health and elected officials to bring the hepatitis A outbreak under control by making key investments in public health infrastructure: handwashing stations in areas where people experiencing homelessness congregated; portable toilets; providing vaccines; and testing and referring those who had been infected with Hepatitis A to treatment.
Over the years that followed, this epidemic was brought back under control. Rates stabilized and decreased. There were only 17 reported cases of Hepatitis A in 2024.
Today, our city’s response to hepatitis A remains one of the greatest success stories San Diego has been able to tell: living proof that our region was able to bring a serious public health crisis under control.
But as public health budgets shrink, we risk a repeat of 2017.
These very investments that our city officials once made to keep hepatitis at bay have been scaled back or even cut. Though the city ultimately scaled back its plans to close 13 public restrooms in Mission Bay, public restrooms have dramatically declined over these past three years. There is now only one public restroom downtown, which is located at the Neil Good Day Center.
Federal funding cuts may also jeopardize other key tools that helped keep the hepatitis A, B and C strains under control, including vaccines and research.
We have seen what happens when federal, state and local agencies disinvest in public health: simply look at what’s happening across the country as Cyclospora spreads. Thousands of people have fallen ill and it took weeks for health officials to respond with the urgency this moment demanded. Imagine how many hundreds of people could have avoided becoming infected had officials intervened sooner.
Early intervention is how we prevent a few cases from snowballing into an epidemic. And it is especially critical in treating Hepatitis.
Whether type A, B or C, hepatitis that is left untreated and undetected for years can have especially deadly consequences. Over time, nearly all forms of hepatitis can drastically raise a person’s risk of developing liver cancer, cirrhosis or even liver failure.
Many of the most common risk factors for hepatitis infection are ones that people experiencing homelessness may be especially prone to, including inadequate hygiene, sharing needles and lacking consistent medical care.
Hepatitis is treatable and, in the vast majority of cases, curable. A person’s odds of recovery are far greater if their infection is caught early. Vaccines, proper hygiene, routine check-ins and substance use disorder services can go farther still by preventing someone from becoming infected at all.
We have long known the value of intervening early. It is why, for years, Father Joe’s Villages has gone to great lengths to provide the care, services and infrastructure that help our neighbors avoid Hepatitis infection and receive treatment if they are infected. This includes providing health education, screenings, vaccines, medication, 24/7 restroom access and basic hygiene supplies.
Proactive measures are how our region has been able to prevent repeating 2017’s hepatitis crisis. We already know what works. And we know what doesn’t: cutting budgets, closing bathrooms and scaling back street medicine funding.
Continuing to invest in facilities and services that will help people avoid infection is how we will keep our community’s rates of Hepatitis under control. It is as simple as that. Our state, county and city officials must not allow themselves to become complacent, not when our region has managed to successfully avoid a major outbreak for as long as it has.
Our officials must denounce any attempt to cut funding to current programs that are on the frontlines of monitoring and treating hepatitis. And when our officials fall short, we and our fellow service providers are left holding the bag.
Hepatitis is preventable, treatable and curable. But these outcomes are only possible if San Diego has the willpower to wisely invest in public health.
Deacon Jim Vargas is president and CEO of Father Joe’s Villages.
