20 Years Of Impact: Voice's Hepatitis A Coverage Spurred Dramatic Action

By Lisa Halverstadt, the Voice of San Diego

June 25, 2025

It was late summer 2017 and San Diego’s homelessness crisis had entered a deadly new chapter.

Months earlier, the county had declared a hepatitis A outbreak, warning that homeless people and illicit drug users were most at risk. The number of cases and deaths rose in the months that followed, and the city and county didn’t seem to be aggressively fighting back. Unsheltered residents with limited options to protect themselves were scared, and I was scared for them.

Urged on by a couple of sources and my Voice of San Diego editors, I dug in and reported on local governments’ sluggish response to the outbreak. On Aug. 30, 2017, I published a story revealing how local officials focused on bureaucratic hurdles rather than respond with urgency as the outbreak worsened. The story activated San Diego’s city and county governments and unleashed a response that likely saved lives.

County health officials quietly declared a hepatitis A outbreak in March 2017, a time when street homelessness was surging and increasingly unsettling San Diegans. Local governments were not acting swiftly or boldly to deal with it.

Hepatitis A, typically a food-borne illness, had become far less common and deadly since a vaccine became routine in the mid-2000s. The virus spreads when a person ingests trace amounts of fecal matter from a person who’s infected with it, meaning that people who lack places to wash their hands are more vulnerable.

Recognizing the risk for homeless San Diegans, then-county supervisor Ron Roberts and other county officials announced a plan in June 2017 to deploy temporary hand-washing stations in areas where homeless residents concentrated.

By August, the county had set up just two hand-washing stations – both were miles away from the downtown streets that were ground zero of the outbreak. I demanded to know why there were just two of them and why they were so far away from the outbreak. By then, 15 people had died and more than 330 had been hospitalized. The number of reported cases had more than doubled since the June announcement.

A group of unsheltered San Diegans I kept in regular touch with near Fault Line Park in East Village grew worried as people they knew – including two of their street family members – came down with the illness and ended up hospitalized. Debbie, a 60-year-old with irritable bowel syndrome who lived in the area, regularly called to let me know that the bathrooms at the park were locked, leaving her and others unable to easily access a restroom.

As I demanded answers about local governments’ outbreak response, the county and city organized a joint meeting of a half-dozen officials at the county’s Midway health complex to try to address my questions. They cited bureaucratic red tape plus coordination and vendor issues when I questioned the delays in deploying handwashing stations.

After the interview with officials including then-county Public Health Officer Wilma Wooten and the city’s then-Assistant Chief Operating Officer Stacey LoMedico, I put down my pen and rolled back my office chair. I’m typically quick to thank folks after an interview. I couldn’t do that this time.

“People are dying and you’re talking about permits,” I declared. “This is not a good story.”

Days later, on Wednesday, Aug. 30, I published a story on the “bureaucratic fumbling” that was taking place while deaths spiked.

Then came the scramble.

On Thursday, Aug. 31, Robbins-Meyer issued a directive to the city, demanding a plan to power-wash downtown streets and sidewalks, and that it allow the county to install dozens of hand-washing stations. They also called on the city to increase access to public restrooms.

And on Friday, Sept. 1, at then-San Diego mayor Kevin Faulconer’s urging, Robbins-Meyer declared a local health emergency and called a special Board of Supervisors meeting to ratify it the following week.

By the end of the weekend, county contractors had placed 40 hand-washing stations across the city in areas where homeless San Diegans congregate.

The following week, media outlets across the world reported on San Diego’s hepatitis A crisis. Long lines formed at mass vaccination events.

Faulconer – whose previous pledges to respond to the homelessness crisis had stalled – soon announced that the city would erect three large homeless shelter tents in Barrio Logan, Midway and East Village to accommodate hundreds. The city also moved unsheltered residents into a temporary campsite at city maintenance yard while it prepared to open the three large shelters.

Months later, as the city and county reflected on their respective responses to the outbreak, then-assemblymember and now-Mayor Todd Gloria requested a state audit.

A December 2018 audit found that local officials failed to adequately plan and quickly ramp up their response to the hepatitis A outbreak that ultimately led to 20 deaths and sickened nearly 600.

The audit showed the number of new cases dramatically declined in the weeks after the emergency declaration – and Voice’s Aug. 30 story. County data showed more than 70 percent of outbreak cases were confirmed before Sept. 1, 2017.

I teared up when I saw the epi curve chart highlighting the outbreak’s trajectory. What if Voice hadn’t published that story? I’ll be forever grateful that we did – and sad about the suffering that came before it.

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