
San Diego Declares Health Emergency Amid Hepatitis A Outbreak - Mz
http://www.npr.org/sections/thetwo-way/2017/09/03/548299633/san-diego-declares-health-emergency-amid-hepatitis-a-outbreak
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curun1r
It's way past time that we start dealing with homelessness as the national
problem it is rather than leaving it to cities who are ill-equipped to deal
with it. Cities like San Diego only have homelessness problems because they
have weather that's amenable to living outdoors. The vast majority of their
homeless population was born elsewhere. It's unconscionable that we leave the
job of providing services for these people to these cities. When people are
made homeless by hurricanes and flooding, we don't question the need to help
and we give FEMA free license to spend what's necessary to provide support.
And yet when it comes to the long-term homeless population, we act like
there's no moral obligation to help. These kinds of outbreaks are just a
natural and expected outcome when we take such a localized approach to
homelessness.

~~~
bluejekyll
Basic income, basic housing, basic food, basic education, basic healthcare?

Seems like we need to address all of these issues. Literally the only
institutions that provide all of these things are jails, which many homeless
attempt to get into.

~~~
ams6110
Not true at all. These things are all provided. Welfare, public housing, food
stamps, public education, Medicaid. That we still have a homeless problem
indicates that the reason for long-term homelessness is something else.

~~~
Mz
There is a really huge shortage of genuinely affordable housing in the US.
Public housing is generally pretty crappy and in short supply to boot.

Having studied the problem in an actual college class and also spent the last
5.5 years on the street: It's complicated. But we need more solutions for
_people_ and fewer aimed at _poor people_ specifically. Programs to _help the
poor_ are routinely craptastic.

Affordable housing and single payer medical coverage would go a long way
towards reducing the problem.

~~~
hueving
>There is a really huge shortage of genuinely affordable housing in the US.
Public housing is generally pretty crappy and in short supply to boot.

This is disingenuous, the housing shortages are all in the highly desirable
locations like the SFO, LAX, NYC, etc. There is no housing shortage in the
vast majority of the country (look at Detroit).

It's completely unsustainable to try to support a model where anyone should be
able to live in whatever city they choose for an extremely low cost.

~~~
thebooktocome
Follow this line of thought long enough, and you get to a hukou system.

[https://en.wikipedia.org/wiki/Hukou_system](https://en.wikipedia.org/wiki/Hukou_system)

~~~
EGreg
Is that good or bad?

Listen, I support single payer systems, but how do they figure out how much to
pay in each region? Same question for UBI.

I have come to believe that UBI and all other safety nets have to come with
immigration requirements. Not just everyone is going to be accepted to live
among rich billionaires without concern for running out of money. And so on in
every neighborhood.

Thus, UBI needs for each area needs to be tied in with community membership,
and be based on the Consumer Price Index in that area.

Communities can open themselves up to more people from time to time.

~~~
thebooktocome
It doesn't work so well for the Chinese. You end up with second class citizens
illegally immigrating within your own borders.

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latchkey
This makes me really sad. I'm originally from San Diego and left when I was
18. At one point my mother was even homeless there (alcohol abuse). A lot of
homeless people travel up and down the coast (meaning, this could spread).
Many of them refuse treatment or can't abide by the rules of the house, so
they get kicked out.

I'm living in Saigon now. While millions of people here are painfully poor and
have almost nothing, they almost all have somewhere to live. There is drug
use, but it is really looked down upon. I see signs everywhere warning people
able the dangers. People seem to take care of each other more as a clan, as a
family, as humans.

I recently went back to San Francisco to sell everything and move to SE Asia
full time. I'm never going back. The homeless in SF was awful. MUNI and Bart
have people openly defecating, shooting up and sleeping in the stations.
Nobody does anything about it.

It is a really sad situation.

~~~
gedy
> Many of them refuse treatment or can't abide by the rules of the house, so
> they get kicked out.

> While millions of people here are painfully poor and have almost nothing,
> they almost all have somewhere to live.

I think these are the two key points. Many countries allow and tolerate slums
and cheap, DIY housing that people own or 'own'. The US has not tolerated
slums in 100 years, and the past 50 years has really tightened the regulations
on the quality, safety and 'DIY-ness' of housing.

The poor get funneled into 'free' housing, but as gov't programs these are not
owned and do not tolerate breaking the rules. Especially by the tax payers who
fund them.

Not sure I see a quick solution as each of these are reasonable on their own.
I do think cheap, 'ugly' housing owned and maintained by the low income ends
up better than most gov't housing projects in the US.

~~~
mschuster91
> Many countries allow and tolerate slums and cheap, DIY housing that people
> own or 'own'. The US has not tolerated slums in 100 years, and the past 50
> years has really tightened the regulations on the quality, safety and 'DIY-
> ness' of housing.

And with perfect reason: "slums" always end up being a hazardous environment.
Fires, pests (due to trash and excrements being everywhere), streets too
narrow for ambulances, susceptibility to wind or rainfall...

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hilyen
I work in East Village, have for a few years. I'd say part of the problem is
the local gov decided upkeep of the public restrooms they had was too
expensive, so they removed them. They kind of shot themselves in the foot it
seems. [http://www.sandiegouniontribune.com/news/politics/sdut-
portl...](http://www.sandiegouniontribune.com/news/politics/sdut-portland-loo-
remove-crime-cost-restroom-2016feb05-story.html)

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rabboRubble
This is why I fought my doctor and my insurance plan for the HepA/HepB
vaccines. Doctor did not think it was needed as I was not a medical
professional. Insurance company was being cheap. I had to point out that they
were both on the CDC recommended vaccination list for all adults.

The moment there is a safe enough HepC vaccine out, I will be getting it. I'd
rather have AIDS over HC. Nasty disease with nasty drugs.

~~~
tbarbugli
FYI there is a cure for HepC nowadays that actually works, if it did not cost
>10k we could probably get rid of HepC for good.

~~~
tyingq
What I can find says $80k+ for the existing Hep C treatments. Wow.

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mnm1
There's a Hepatitis A vaccine and it's readily available, yet trying to get a
doctor to give you one requires a lot of conning and manipulation. Why is
this? They say this is a disease only found in other countries, so if you tell
your doctor you travel a lot, they'll finally give in and give it to you. How
about giving the vaccine as a default? Clearly, San Diego is not in another
country. This should be a standard vaccine encouraged and administered to
anyone and everyone who wants it. This is certainly not a healthcare system
that works well or at all.

~~~
Gustomaximus
Wow. In Australia, Norway and England theyll give you A/B vaccines easily on
request. I find it hard to believe they wouldnt do tbis everywhere bar a few
exceptional circumstances.

~~~
mnm1
Jus† got the Hep A. S†ill working to convince them about Hep B. Yup, we're
really backward here in the states with our healthcare, even for people who
have insurance / can pay. There are many, many other ways we're backward here.
Let's just say outside of emergency care, healthcare here is just horrific.
And that's putting it nicely. Insurance or no†.

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downrightmike
> The California State Legislature is reviewing whether the amount of health
> resources in the county are adequate. Its findings are expected within the
> next several months.

The closing lines tell that there's not enough being done if this has been
going on for 10 months. Almost like the start of a zombie movie. "Nothing
going on here, we're assessing the situation" Then boom, national guard and
CDC checkpoints.

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ChrisNoPratt
Ugly truth in any western country is the mental health issue. Here in Poland
(i'm certain in USA is the same) many homeless people are mentally ill and
refuses help in many cases. Also they get aggressive with people. Without
those problems it would be much easier to help them.

~~~
onion2k
_Without those problems it would be much easier to help them._

The solution to the problem is to eliminate the stigma of mental health
issues, to subsidise mental health therapies, and educate people about the
signs of deteriorating mental health so they can seek help earlier. If people
can be helped before they're homeless then they'd never become a homeless
person. That's better for everyone.

I strongly suspect this would be _incredibly_ hard to implement in any country
that doesn't have a national health service though, and even if a country does
it'd still be difficult.

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EdSharkey
Make living on the street a crime, take away people's freedom. Get them on a
path back into society by placing them in work camps and reform them. Or, if
they're mentally ill, properly hospitalize and care for them.

If you do this, the looming public health crisis can be averted. Otherwise,
plague.

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Animats
There's a good vaccine for Hepatitis A. And another one for Hepatitis B. Get
inoculated.

~~~
Gustomaximus
And remember Hep B is 2 shots several months apart.

~~~
tallanvor
4 shots. The first 3 given in one month intervals, and the 4th a year later.

~~~
Animats
Then you're done for maybe 25 years.

At one time, the US did mass inoculations in schools, using air injectors.
Just lined everybody up and zapped them.

