LOS ANGELES – On a grimy sidewalk, a clot of homeless people watch cars whiz by, surrounded by their tents, piles of bicycle parts and clothing and a half-consumed can of nacho cheese spread.

What’s missing, say those living outdoors on Flower Avenue in the city’s trendy Venice district: the basics needed to ward off coronavirus – hand sanitizer, a dependable source of clean water and easy access to showers, for starters.

That’s one reason the homeless, along with the elderly, are considered high risk during the crisis.

“People experiencing homelessness not only have a set of challenges that make it really hard to do what we ask – stay home when you are sick, wash your hands frequently, talk to your medical provider if you are feeling ill – but they are in worse health than many other people,”  Barbara Ferrer, Los Angeles County’s director of public health, told reporters.

The same issues are playing out across the country in cities with large numbers of people sleeping on the streets. Officials are starting to take action.

• In the Seattle area, the county government bought an old motel to isolate coronavirus victims and let those who don’t need hospitalization recuperate.

• San Francisco plans to lease motor homes that could be parked in the city’s scenic Presidio park surrounding the Golden Gate Bridge as housing for the homeless under quarantine.

• Los Angeles is considering whether to provide more “sanitation stations” to homeless encampments.

The destitute often live in crowded encampments where the bathroom is an alley. Trash in the vicinity can attract rats and fleas.

Disease in the encampments can spread quickly and easily. In Los Angeles alone, the homeless and those who care for them have had to deal with outbreaks of hepatitis A and typhus, even before coronavirus arrived.

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Los Angeles County had 44,214 people classified as unsheltered in last year’s official homeless count, up 12% from the previous year. They may be living in a tent, a car or simply sleeping out in the open.

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In the encampment in Venice, clean water comes from knocking on doors of nearby homes and asking residents if they can fill a jug. “If we’re lucky, you can fill a gallon bottle,” said Laurence Miller, 61. For showers, he said, people can try to get one at a community center across the street, “but it’s limited.” Some homeless people use the outdoor showers at the beach several blocks away.

Also lacking: education about the virus, officially designated COVID-19.

“I am not aware of it because I don’t get the info,” said Kevin Scott, also 61. Instead, he said, homeless people are “surviving the best way they can.”

Scott said he thinks officials should be distributing kits containing sanitation items.

“They should make (sure) everyone out here gets a care package every day,” he said. In recent days, he said, no one has come by to distribute sanitizer or other products.

The county health department says it is trying to develop a strategy with street teams to try to reduce the chances of an outbreak among the homeless. The biggest fear isn’t that homeless persons will spread coronavirus to the general population, but rather among themselves, said Ferrer, the director.

The department is trying to extend the opening of temporary shelters for winter. “It’s easier for us to work with homeless people who have a shelter … than it is to work with people who are completely unhoused,” Ferrer said.

Not only is serving basic needs of homeless by night an issue during the crisis, but by day as well. More public libraries are temporarily shutting due to the coronavirus. Some of them are in cities that have numbers of people on the street, including Los Angeles and San Francisco in California; Seattle; and New York City.

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For those remain outside, a big need is more hand-washing stations. Los Angeles City Council members Mitch O’Farrell and Monica Rodriguez have proposed the installation of sanitation stations at more of the homeless encampments around the city.

“While the coronavirus is mainly affecting travel and tourism, it is imperative that we have a lens focused on the potential to imperil those experiencing homelessness,” said O’Farrell in a statement.

One of the city’s largest homeless shelters, the 1,000-bed Union Rescue Mission, is installing stand-alone outdoor sinks at the front and rear entrances to its complex on Skid Row, home to the city’s largest population of homeless, said its CEO, the Rev. Andy Bales.

The facility is also creating quarantine areas in case it has to care for any homeless coronavirus patients who aren’t deemed serious enough for hospitalization.

“If they come in with a fever and a cough, we’re going to ask them to go into quarantine,” Bales said.

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In the Seattle area, which has been the most hard-hit by coronavirus, King County bought a former 85-bed Econo Lodge specifically to house patients. The motel was selected because its guest room doors open to the outside and each room has its own heating and air-conditioning unit. Officials in the town of Kent are fighting the county’s plans in court.

Having seen past viruses that have swept through homeless communities, Bales said he hopes the coronavirus can be contained.

“I am praying it doesn’t cause a rise in the number of people dying on the street,” he said.

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