A Window Onto an American Nightmare

Zach Hickson arrived in San Francisco to stay three years ago, at twenty-seven, because nowhere in America seemed more appealing at the time. The city was mild and fragrant. The streets on clear days had a liquid energy, and seemed to offer opportunities that he hadn’t had before. “It was a place where I could do what I wanted to do,” he told me recently. He began to call the city home.

Hickson was brilliant. He was brought up in a military family, on the gritty south side of Houston, with an I.Q. higher than both of his parents’. He struggled to fit in, got in some fights. When he was a teen-ager, he saw “Into the Wild,” the rugged adventure movie starring Emile Hirsch. “As long as I can remember, I just wanted to travel, and I was told it wasn’t possible,” he said. “I saw that movie and thought, There’s a way.” He left home at eighteen with his best friend, who had terminal cancer. They hit the road, staying no more than three days in any one place, because Hickson wanted him to see as much of America as possible. When his friend died, everything went dark for a while. Hickson kept travelling. He visited all forty-eight contiguous states, and, when he realized that he’d mostly seen just gas stations, he visited all forty-eight again, camping in national parks.

Hickson was enterprising. He made money by hunting exotic minerals and rocks. During the winters, if he wanted, he would get a job doing manual labor someplace warm. He would usually be hired as a stopgap worker, and, when employers saw his work, he was often asked to stay, and was sometimes put up in motels. Hickson is slender, not tall, with a dusty-brown farmer’s beard and distant blue eyes—a boy’s gaze added to the visage of an older man. In time, he got two words tattooed across his knuckles: “LIFE” on the left hand and “LOVE” on the right.

Hickson was interested in psychedelics. One day when he was twenty-five, he was taking L.S.D. under a tree in Cave Junction, Oregon, when a young woman approached and introduced herself. Her name was Elena Aytim, and she collected rocks, too. They spent the next several days together. “It got to be where we couldn’t get anything done, because we couldn’t stop looking at each other—everything disappeared,” Hickson said. “We would just lie in bed together and talk, and all of a sudden the sun would be going down.”

They travelled on together, and Hickson started calling her his wife. As they grew close, he learned that, as a teen, in Ohio, Aytim had got hooked on opioids after a car accident, and had moved on to fentanyl before kicking the habit. She confessed that she had recently relapsed with heroin, and she worried that Hickson would turn her away. Hickson said he wouldn’t; he himself had started drinking heavily after his friend’s death. “I was, like, ‘Hit me,’ ” he recalled saying. “ ‘If I don’t understand, I’ll figure it out.’ ”

He started using heroin with her. “I had control of it until she lost control,” Hickson said. “Then I’m, like, Fuck it, I’m getting high, because I can’t stand watching this.” The addiction quickly turned into a workaday grind. Every morning, he’d wake knowing that he’d have to earn enough money for a dose; otherwise, he would collapse into a days-long flulike illness.

That was when they decided to live for a while in San Francisco, which was known for its good public programs for getting people off drugs. They couldn’t find an apartment—the median monthly rent for a one-bedroom in the city is now, by one estimate, about thirty-five hundred dollars—but they were used to camping and decided to make do. It was only after settling in that Hickson realized he had fallen into a bigger rut. He was now one of thousands of homeless people in the city living on the streets.

Homelessness afflicts nearly one in five hundred Americans. As a crisis, it’s insidious, because its victims rarely plunge toward the abyss; they slide. Maybe you’ve been couch surfing in between jobs and you overstay your welcome. Maybe you’ve been in Airbnbs while apartment hunting and the search is harder than expected. Maybe, like Hickson, you lived on the momentum of a private dream until you had a reason to put down roots. Camping, couch surfing, “digital nomad”-ing—all these things are seen as normal middle-class activities, so the line between being without a home for now and being homeless is thin. Like a hiker crossing from France into Italy, you often don’t know where you are until you look around, hear locals talking, and realize that you’ve entered another country.

D., a punctilious woman with straightened hair, who had been living in San Francisco family shelters with her son for about ten months, told me recently, “We’re not some of those forever-homeless people—it happened, and it’s never going to happen again.” (She asked to be identified by her first initial because a lot of people she knows read this magazine.) D. had worked for years as a broadcast journalist, and was living in Las Vegas when her son’s father got colon cancer and died. Afterward, she went to San Francisco, where she’d gone to college. Finding a job, as a classroom aide for special-needs students, was easy. But she struggled to find an affordable apartment. When I met D., her days began at 6 A.M., on a mat on a shelter floor. She dropped her son off at fifth grade, then went to her classroom to teach.

D. is one of many homeless San Franciscans who can “pass” as housed as they go about their public lives. For others, the signs of the predicament are more pronounced. “You see some things that you really don’t want to see,” Kyriell Noon, the chief impact officer at the Glide Foundation, one of the city’s leading centers for homeless services, told me. One Wednesday morning, I walked from the downtown waterfront to Glide—a mile or so—and passed eleven people visibly in crisis. Two were on their feet, shouting at no one; another sat, bare-legged and smoking. A woman with a baby carrier clutched a sign that read “I HAVE NO JOB. I HAVE 3 KIDS,” and a trembling old man sat on a walker and ate seeds. Two young guys wandered, wrapped in blankets; another crouched on the ground; and a fourth, toothless, slumped on a newspaper box. A man on a corner could have been a commuter but for his sign: “I NEED MONEY AND MEDICINE. PLEASE GIVE IT.” This was all before I reached the sidewalk in front of Glide, which is crowded with people in need.

Such sights aren’t new to the Bay Area, whose homeless population spiked in the eighties, when the Reagan Administration cut the budget of the Department of Housing and Urban Development by seventy-eight per cent. But impatience and resentment have intensified. Between 2013 and 2017, calls to 311 about “homeless concerns” went up by nearly eight hundred per cent, and many residents have made a sport of swapping stories of incursions from the street: human feces on the sidewalk, tents blocking children’s paths to school. In January, a man reported being chased by a homeless person wielding a hypodermic needle who cried, “I am going to stab you!,” after being reproached for shooting up in public view.

These complaints, like many fears about a menace from the disadvantaged quarters of society, have reached the President. On the day after Christmas, Donald Trump tweeted, “Nancy Pelosi’s District in California has rapidly become one of the worst anywhere in the U.S. when it come to the homeless & crime. . . . Along with her equally incompetent governor, Gavin Newsom, it is a very sad sight!” Newsom announced several new homeless-assistance efforts in his State of the State address this year, including a nearly seven-hundred-million-dollar call to fund medical treatment and housing. “You have all lost patience, and so have I,” he said.

In truth, the California crisis isn’t an extreme. New York City has a worse per-capita homelessness problem than San Francisco, and is home to fourteen per cent of the United States’ homeless population. Three-quarters of low-income people across the country who needed housing help last year did not get it, and California’s proportion of homeless residents trails that of New York; Washington, D.C.; and Hawaii.

The problem in California is simply more visible. New York City has shelter beds for nearly every homeless person. San Francisco has beds for approximately forty per cent. Homelessness figures are notoriously squishy, but San Francisco officially reported 8,640 homeless residents in 2002—a peak—and almost as many in 2019, suggesting that, even as these numbers have fluctuated over the years, the high-water marks have been consistent. Yet a new wave of development in the city has brought the unhoused into public view. “The Dogpatch and Mission Bay area used to be fields and warehouses,” Kenneth Kim, a senior director at Glide, said. “For a long time, no one really saw the people in tents there—they’d be in meadows or squatting in unused commercial buildings.” Now such areas are filled with offices and condos, and the people who once lived there have no place to go.

San Francisco spends more per capita on homelessness solutions than nearly any other U.S. city—three hundred and thirty million dollars a year. That sum reflects an eighty-five-per-cent increase from 2005 to 2015, when homelessness rose by thirteen per cent. It’s puzzling that so much funding did so little. But the puzzle also makes San Francisco, a city that has tried some obvious things, a great place to think through more focussed solutions.

With COVID-19 shutdowns imperilling the middle class, the need for answers has grown desperate. San Francisco’s homeless population is now an epidemiological tinderbox. “It’s already a crisis, and when you layer on top of that coronavirus, coupled with the vulnerability of the homeless population, it is a potential catastrophe,” Glide’s president and C.E.O., Karen Hanrahan, told me. Homelessness is where the most acute American nightmares of this era meet, and San Francisco has a way of making what is hidden elsewhere visible. Ever since the recent tech boom turned life in the city upside down, all the paraphernalia of American society—the wads of cash, the access keys, the drugs, the nubs of ideology—has been spilling out of San Francisco’s pockets, into an enormous pile on the street.

One morning before COVID-19 overtook the city, I walked to the St. Anthony Foundation, another center for the city’s homeless, in the Tenderloin, a wedge-shaped section of downtown that has a reputation for being haunted by the living. Unhoused people gather in the district partly because it’s a place where they know that their presence won’t turn heads. When I arrived, the kitchens and the stockrooms at St. Anthony’s were bustling. Preparations for the nearly three thousand meals served at the center every day begin at 6:30 A.M. Three lead chefs command six industrial kettles, a phalanx of assistants, and ovens that together can hold thirty-nine sheet pans at once. St. Anthony’s also offers a computer lab, a free “shop” for toiletries and donated clothing, and medical and substance-use-disorder clinics. Guests with disruptive mental illnesses or what’s known as “extreme hygiene” are often offered food to go. “It is very difficult for us to serve someone who has three-, four-, or five-day-old feces on them,” Lydia Bransten, the dining-room manager, observed. Yet dishevelment is not always a sign of negligence. “People don’t approach you if you’re smelling really bad,” she explained. “There are protective mechanisms happening there, especially with women.”

During lunch, I manned the watercooler while diners wandered past with trays. One young guy I met gave me an elegant précis of Niels Bohr’s work in quantum mechanics, and then told me that, while meditating, he once left his body to commune with angels. “I know it sounds crazy!” he said. I thought it seemed normal-ish for Northern California, as did most of the other things I encountered. The unhoused population in the dining room included loudly dressed middle-aged men, young people with dangling earbuds, and elderly Asian women wearing polyester slacks. One of the longest-serving volunteers at St. Anthony’s, a retired woman named Monica Incerti, told me that her work sometimes had an eerie, edge-of-the-cliff feeling. “I couldn’t have worked here in my twenties or thirties or even forties,” she said. “I would have felt as if I could have been here myself.”

In San Francisco today, people who earn less than eighty-two thousand dollars a year—or a hundred and seventeen thousand for a family of four—are considered low-income. (The figures for individuals in New York and Seattle are, respectively, sixty-four thousand dollars and sixty-seven thousand dollars.) The city’s minimum wage is $15.59 an hour, which means that a minimum-wage earner working forty-hour weeks with no vacations will gross $32,427.20 a year—far less than the median rent for a one-bedroom. Working a job in town while living in a distant suburb adds transit costs.

Concerned parties often talk about helping homeless people find jobs, but many homeless people whom I spoke to had them. “It’s not unusual for people in the shelter system to be working during the day,” T. J. Johnston, who helps run Street Sheet, a long-standing newspaper sold by the homeless to support the homeless, said. Johnston was going to the office to report and edit, and to a shelter to sleep. It’s not the life that he expected. He had earned a B.A. at the University of Massachusetts and worked at the Census Bureau and elsewhere before becoming unemployed and falling behind on his rent. D., the special-needs instructor, also college-educated and fully employed, told me, “Someone housed today, unless they’re making eighty thousand dollars a year, could be homeless tomorrow. That’s the bottom line.”

Since 1970, “real income” in the United States—income adjusted for inflation—has been nearly flat. But the costs of major purchases (houses, cars, education) have increased ahead of inflation. Why? Zoom in and you find that during the same period one demographic did experience an increase in real income: Americans above the ninetieth percentile of income distribution.

In San Francisco, big money is made not in wages but in equity—for example, as stakes in highly valued companies—and this wealth notches up the costs of major purchases. Regular homeowners, feeling the cost-of-living pinch, realize that they can get money, as loans or rent, from the suddenly enormous value of their homes. That extra cash allows the cost of living to keep climbing. Some homeowners liquidate and bail, replaced by people better suited to such rarefied financial air. Everybody else, the paycheck people, might leave if they can, headed for somewhere—Detroit? Atlanta?—that’s a few years behind in the cycle. Otherwise, they, too, stay, and slowly feel the bolts of their once steady lives come loose.

For those whose finances were precarious to begin with, the risk is worst. There are disproportionately high rates of homelessness in places with multigenerational poverty cycles, and in historically marginalized populations. (Six per cent of San Francisco’s general population is black; thirty-seven per cent of its homeless population is.) Listening to people’s cries of pity for “the homeless,” though, one often feels that these laments do more to protect the privileged identity of middle earners nearing the edge than they do to express compassion. A 2018 study by the University of New Hampshire and Zillow found that homelessness numbers started climbing when median rent exceeded twenty-two per cent of median income, and shot up when it reached thirty-two per cent. In San Francisco, despite its high salaries, the median rent-to-income figure rose above thirty-nine per cent. A professional can earn what even a decade ago would have appeared a princely wage and still feel a cold updraft from the gap below.

That’s alarming, because San Francisco, Seattle, Boston, and New York are not outliers when it comes to economic trends; they’re leading indicators. “It’s one thing to have high employment,” Jose Ramirez, the executive director of St. Anthony’s, who was homeless in his youth, told me. “But, if you can’t hold one job that provides you with enough financial stability to have your own place or put food on the table, what good is that?” For people constrained in this way, one well-placed crisis, personal or national, causes everything to come apart.

What distinguishes the United States from other countries is, in part, the force of a certain romantic dream. We purport to honor those who make their own ways on untrodden paths; we build room for risk because we value the rewards. If we’re able, we strike out on a path at eighteen. If we fail—with time to spare—we try to start again.

True to their hopes, Zach Hickson and his wife kicked heroin in San Francisco through treatment with methadone. Hickson immediately decided to return to school. Since 2017, community college in San Francisco has been free, and Hickson enrolled at City College, in a two-year associate’s program in community health work. He had already trained to be an H.I.V.- and hepatitis-test counsellor, a credential that he noted to me with some pride. “I wanted to go to school so I could do that better,” he said.

Hickson and Aytim had moved out of a tent and into a “navigation center”—essentially, an upgraded shelter. The centers, which began operating in San Francisco in 2015, partly to house a conspicuous homeless population in advance of the Super Bowl, are meant to serve not as landing pads but as runways. In theory, people get a case manager and are put on a path to housing. But there aren’t enough housing options, so many wind up parting with pets and belongings to meet shelter requirements, spending a few weeks at a center, and then returning to where they were. In eighty-four per cent of visits to navigation centers, guests left without having been placed in housing.

The city currently has 3,462 shelter beds available. The mayor, London Breed, who grew up in public housing, was elected in 2018, after her predecessor’s death. Around that time, she promised a thousand more beds by the end of 2020. But, by the most conservative figures, there are still about four thousand more people than beds on any given night. When I first spoke with T. J. Johnston, the Street Sheet editor, he was commuting to work from a shelter where he had a ninety-day reservation. The citywide waiting list for shelters was nine hundred people long.

A number of unhoused people told me that they prefer living on the streets to staying in shelters. “I find it safer,” Richard Day, a sixty-two-year-old who has been homeless for seventeen years, said. He ran a contracting company until he got addicted to cocaine and his life unravelled. Now sober, he lives by himself in a spacious tent with a battery-operated TV, and his grandkids visit once a month. In a shelter, he would face theft and be forced to sleep among addled strangers. “It’s safer to hide my tent away,” he said. “You have to have that for your own peace of mind.” Safety concerns are particularly acute for women, L.G.B.T.Q. people, and families.

At the navigation center, Hickson’s days followed a strict schedule. Early each morning, he and Aytim rode a bus to a methadone clinic, then took another to City College for a 9 A.M. class. In the afternoon, he worked as a volunteer at Glide, and headed to a different campus for night classes.

Small irregularities derailed the routine. If the methadone counsellor was late, Hickson would miss his morning class. If there was trouble at the navigation center, the bottom fell out. One day, he and Aytim quarrelled. They were expelled for disruption, and had to return to their tent, which they dismantled every morning. On a rainy dawn, he watched Aytim struggling, and felt a wave of shame. “Seeing her getting rained on, even if she didn’t complain, hurt me,” he said. “And I can’t do anything about it, and that makes me angry. We ended up fighting about stupid stuff.”

Hickson left City College, and spiralled fast: “It was, like, What do I do? Being off opioids is most important, so I’ll drop out of school and figure out my housing situation. But then I was depressed about dropping out of school and living in the rain, and I ended up back on opioids again. That was all in a month.”

Homelessness in San Francisco is what’s known as a systems problem: cause and effect seem woven together in a complex wreath. Hickson’s ability to stay in school depended on his methadone treatment, which was hard to balance with the logistics of both school and life in a tent. If it hadn’t also been a rainy El Niño year, the whole arrangement might have worked.

A wreath-shaped problem cannot be unbraided, but it can be simplified, and that is what St. Anthony’s tried a few years ago, by focussing on its own city block. The foundation’s buildings, on Golden Gate Avenue, are near Larkin Street Youth Services, for homeless youths; the De Marillac Academy, a Catholic school; St. Boniface church; and a preschool called Wu Yee. For years, the mix of daily foot traffic—young and old, churchy and kite-high—was disastrous.

Yet the block is now pristine. Change came when everyone agreed to treat the individuals who slept on the sidewalk not as interlopers but as residents. At 6 A.M., the people in tents gather up their possessions. The sidewalks are hosed down. For several hours, St. Boniface opens its pews to homeless people, and by 8 A.M., when school begins, the sidewalks are clear. From 10 A.M. to 1:30 P.M., a line forms at the St. Anthony’s dining room. Then the kids leave school, the light fades, and the tent dwellers return. They clear away their things again each morning because the needs of the kids were explained to them, and they made sense.

In “The Death and Life of Great American Cities” (1961), Jane Jacobs described successful neighborhoods as ecosystems held together by human difference; they depended on coördination among individuals, not on aesthetic ideals or notions of “proper” use. The Bay Area could learn from the St. Anthony’s block in this respect. People, housed or unhoused, need space to live without feeling under siege. You can’t subtract one functional space, like a sidewalk, without adding useful space elsewhere, especially space where people can set down their belongings and rest.

Nothing on the St. Anthony’s block is a remedy for homelessness, but the harmony shows that it is possible to create shared space and resources on a small scale—also known as a community. In San Francisco, somehow, things seem to fall apart as the system begins to grow. What does that look like, and why is it happening?

“There were two hundred and sixty tents in my district when I started—I know, because we counted,” Hillary Ronen, who was elected to the city’s Board of Supervisors in 2016, told me in her office one afternoon. Ronen used to be a lawyer for immigrant workers; now she represents a district that includes the Mission. Under pressure from constituents, some of whom had been finding pots filled with feces and urine on their steps, she has led many of the city’s nonpunitive attempts to get tents off the streets. “I was getting complaints from people who felt horrible complaining,” she told me. “People who said, ‘I volunteer in homeless shelters, but I’m at my wit’s end.’ ”

Ronen got a developer to loan the city a vacant building, on South Van Ness Avenue, and turned it into a navigation center. She sent a team to talk to the homeless: “Word spread. ‘They’re serious. This navigation center is a safe place. You can come and go like an adult. You aren’t treated like a child. You truly can bring your partners, pets, and belongings.’ ” People were allowed to stay as long as they needed to secure a path out of homelessness, provided that they seemed to be trying. Within two months of the center’s opening, in 2017, the number of tents in the district dropped to thirty. The shelter closed after its yearlong lease was up, but it became the template for a new generation of navigation centers across the city, like the one where Zach Hickson stayed. The expansion, Ronen said, was disastrous.

“The city took what we did in the Mission, dumbed it down times ten, and spread it all over the city,” she told me. The new centers, assembled by three different agencies, did little outreach to either neighbors or people in tents, and put limits on how long people could stay. Ronen saw the number of tents in her district climb again.

It is easy to think the lesson here is that all problem-solving should be local, but that idea presents problems of its own. Ronen’s navigation center, like the St. Anthony’s block, depended on specific, highly motivated people. What happens if she leaves office? What if St. Anthony’s moves away? Policy, by contrast, can outlast its best actors.

Yet warring theories have emerged on what that policy should look like. The founding director of the city’s four-year-old Department of Homelessness and Supportive Housing, Jeff Kositsky, is a data-and-systems guy. He hoped to create a single integrated system of care for homeless people. “We had a bunch of nonprofit fiefdoms and a bunch of departmental fiefdoms,” he told me. He started a program called Coordinated Entry. Instead of going to whichever aid organizations they happened to hear about, homeless people were interviewed, prioritized, and pointed toward services and housing options that seemed suited to their needs. Kositsky’s approach could be called democratic-egalitarian—making sure that everyone gets equal access to the front door.

The other strong view in town is what could be called the communitarian idea: we ought to draw on existing relationships and shared identities to serve people as individuals. “Solutions need to be rooted in the specifics of our smaller communities,” Laura Valdéz, the executive director of Dolores Street Community Services, a nonprofit that provides housing and immigration help, often to Latinx residents, told me. “It cannot be a one-size-fits-all model.” She doesn’t like Coordinated Entry; she has watched people enter Kositsky’s system and get sent off for services in unfamiliar neighborhoods, their fate unknown to those who care.

Both democratic-egalitarian and communitarian ideas have a rich lineage in left-of-center thought. We want a society in which everyone gets equal public support; we also want a society in which those same people are at liberty to build their own communities and conduct their lives in private ways, whether that means sending kids to Black Panther community schools, living under Hasidic law, or, as with Hickson, hitting the road. In San Francisco, the collision of these ideologies has caused aid structures to fall apart before they’re fully built, and the casualties are the people most in need.

The block of St. Anthony’s leads to one of the city’s grimmest corners. On its south side, Golden Gate Avenue, chatty drinkers huddle with carts of their belongings. On its east side, Jones Street, substance-using people sit or lie down, wrapped in soiled clothes and dirty blankets. Traditionally, the most jagged period on the streets is between the seventh and the tenth of each month, the end of one benefits pay cycle and the beginning of another, when withdrawal symptoms start to set in. I came by on the eighth.

People often speak of “the homeless” as a monolith, but the population is subject to its own hierarchies. Living in a vehicle can seem a step up from a tent. Older people often lament the ways of today’s homeless youths. “On that corner, they do meth all night long,” Rachel Elizabeth Haynes, a sixty-three-year-old who lives in a tent, told me. “When we were using drugs, in the seventies and eighties, you could not go out on the street and have a needle sticking out of your arm! ”

I wanted to meet some residents of the corner, because the voices of such people—those not visibly striving to escape their lot—are often ignored in articles written for readers seeking heroic stories of the downtrodden reaching for middle-class success. A gray-haired, wispily bearded man there, Martin, has lived in the Bay Area for twenty-eight years, five on the street. He gets a disability check for mental illness and has occasional appointments with a doctor, whom he trusts. But he looked exhausted. “It’s hard to get sleep,” he said. “The police officers are always moving you along in the morning.”

“Kumbaya,” Hugo, to Martin’s right, offered. He grew up in San Francisco and came to the streets six years ago. Sometimes, because of his mental illness, he has episodes and stalks up and down the sidewalk, yelling and beating his chest.

The high number of mentally ill people on the streets—about half the homeless population, by some estimates—is often blamed on “deinstitutionalization”: a process that began in the fifties and intensified in 1980, when President Jimmy Carter, worried about conditions in mental institutions, funded community care centers instead. The next year, President Reagan cut that funding, permanently stranding patients between the old and the new models of care. But the streets themselves are bad for mental health, too. “If you’ve ever been on a trip where you got bumped off your flight and you’re stuck in an airport, with no hotels—well, two days of that and we’re broken, right? We get home and are, like, I can’t even think! I need a glass of wine!,” Lydia Bransten, of St. Anthony’s, told me. “This is people’s life day to day to day out here. They don’t know when the plane is coming.”

After Hillary Ronen’s navigation center closed, she became convinced that poor mental-health care was at the heart of her district’s problems. With another supervisor, Matt Haney, she put forward a program, supported at the last minute by Mayor Breed, called Mental Health S.F. The program, which is still being rolled out, will create a mental-health center where any homeless, uninsured, or mentally disabled San Franciscan can get free care.

On the corner, Martin opened up a black plastic bag that contained his essential belongings: toothbrush, toothpaste, vape, comb. Hair was hard to deal with on the street, he explained. He worried about scaring the passersby, so he had got his hands on some pomade to make himself presentable.

“Hugo and Martin, these are people others will actively take pictures of, put up on the Internet, and say, ‘This guy needs to be taken down by the police,’ ” Bransten said. But the unhoused on Jones Street aren’t, in general, comparably resentful. A few yards up the block sits a mosque, AlSabeel Masjid Noor Al-Islam. A year ago, following mass shootings at mosques in New Zealand, some homeless people from the neighborhood kept watch outside AlSabeel during services, taking shifts guarding those inside.

In 2018, to address complaints about tents, the city formed a coalition called the Healthy Streets Operations Center, which is now frequently accused of trying to chase away the city’s homeless problem with police. Jeff Kositsky began leading the center in late winter, after leaving his department. “I don’t think law enforcement is the right approach,” he told me before taking the job. “And I can tell you the chief of police agrees with me.”

“It’s not a crime to be homeless,” the chief, William Scott, told me, describing the center as an effort still finding its way after a neighborhood-based precursor. “For the first two years, we really made a lot of progress in cleaning up the areas that we were focussed on. Then we expanded, to go citywide, and started to learn that there were some issues.”

The history of the law and homelessness is vexed. In 2010, Newsom, who was then the city’s mayor, proposed a “sit-lie” law, allowing police to ticket people lounging on the sidewalks between 7 A.M. and 11 P.M. Voters approved it, but enforcement dropped amid controversy. In 2016, another ballot measure made it legal for officers to remove tents, with twenty-four hours’ notice, and to put their inhabitants in shelters. Breed has supported the effort. “If people don’t pack up and move, or agree to services, we have a responsibility,” she told me. “To let them set up shop and use drugs in these tents—and to continue to impact public health in the way they are—is not something we’re going to tolerate.”

Breed visited people living in tents on the Embarcadero, San Francisco’s downtown waterfront, in an effort to move them into a shelter. “I went out with a team twice to have conversations with people, and to get an understanding of what they’re dealing with,” she said. “It was absolutely insane—most of the people did not take us up on the offer.”

People on the streets described a different dynamic with officials. One afternoon, I had a late lunch with Couper Orona, a former firefighter who retired young, after a major back injury. When her relationship fell apart, some years later, she started living in a tent by the junction of Interstate 80 and Highway 101. She put her E.M.T. skills to use in the encampments, cleaning wounds and reviving overdose victims. She has often found herself at odds with the police. “We’re not used to being treated nice,” she said.

We were sitting at a restaurant not far from Orona’s R.V. (an upgrade, thanks to a benefactor, from her tent). Orona, who describes herself as butch, sported a fauxhawk and a flannel shirt, and in her right ear she wore an earpiece connected to a police scanner, which she uses to track “sweeps” of tents. (“We don’t do sweeps,” Breed told me.) When police officers move homeless people off the streets, they’re supposed to “bag and tag” their belongings for safekeeping in a warehouse. But Orona alleged that some officers chase people away with threats of arrest and classify their property as “abandoned,” allowing it to be discarded. (“It’s a system that is not a perfect system,” Scott said. “I’m sure there are people who have had bad experiences. But that is never the intent.”) Homeless people have complained of losing identity documents, H.I.V. medications, and the ashes of a relative. Hickson lost family photographs that he had carried during his travels.

“I want London Breed to come with me for twenty-four hours, no cameras, no nothing,” Orona told me. “I’ll dress her down, put her in a baseball cap. I want to take her to the Bayview, have her watch the sweeps, and show her the way her officers treat these people. If she does that, I will wear a dress for twenty-four hours. I’m not fucking kidding.” She added, “My mom would freak out.”

One view of homelessness is that wages haven’t kept up with the cost of living; another is that housing has failed to keep up with growth. In California, many blame stunted housing development and Proposition 13, under which property taxes are based on the value of a house when it was purchased, as opposed to its current value. The fixed tax encourages people to hold onto their houses, and, as employees in newly created jobs arrive, they have to seek other places to live, leading to high prices and growth by sprawl rather than by density. California’s stringent zoning and construction regulations are further impediments to matching supply with demand.

By some estimates, seven hundred thousand units, more than two-thirds at affordable levels, would be needed to balance the market. Fans of zoning deregulation and Manhattan-style density often call themselves YIMBYs (for “Yes, in my back yard”). As the Times journalist Conor Dougherty notes in his crisp and sane new book, “Golden Gates: Fighting for Housing in America,” San Franciscans mostly agree on basic points—“More housing generally, more subsidies for those who needed them”—but disagree on what should come first.

Breed has invested heavily in affordable housing but has been a critic of regulation and bureaucracy that hinder development. In the fall, she declined to support a proposal, passed unanimously by the Board of Supervisors, to increase the fee that office developers pay to help fund affordable housing. She argues that the city’s subsidy coffers are already overwhelmed by needy outsiders, such as Hickson. “We are a magnet for people who are looking for help,” she told me. “There are a lot of other cities that are not doing their part, and I find that larger cities end up with more than our fair share.” Whether this seems like a plausible explanation depends on how one reads the data: seventy-one per cent of homeless people in San Francisco previously had homes in San Francisco, so most of the city’s homelessness is homegrown.

Like many who oppose YIMBY-style growth, Jennifer Friedenbach, the executive director of the Coalition on Homelessness, an activist group, worries that loosening the rules will benefit the affluent first. “All of those homes they want to build with no local control and no community process? That is never going to be housing for homeless people,” she told me. She conceded that the city’s review process for new construction is annoying and friction-prone, but she said that it’s the only lever advocates have for getting big, lucrative projects to accept more affordable units.

In recent years, many in the city’s tech industry have funnelled cash toward their own solutions. People who work with the homeless are grateful, but some told me that, aside from a few highly strategic efforts—such as a thirty-million-dollar initiative launched by Marc Benioff, the co-founder and C.E.O. of Salesforce—the industry’s gestures can be naïvely misdirected. For that reason, many advocates think that money raised through taxes is more valuable. In 2017, the Coalition on Homelessness proposed taxing companies with gross receipts of more than fifty million dollars and channelling the funds to homeless services. The mayor opposed the idea, but it gained support from local powers such as Benioff and Pelosi, and passed as Proposition C. The tax has raised three hundred million dollars annually. But, for now, that money remains unavailable, ensnared in legal challenges from the business world.

One afternoon, I stopped by the Delancey Street Restaurant, whose dining room has a fancy, old-fashioned style: wood panelling, thick white tablecloths, small arrangements of flowers in the center of each table. A waiter in a crisp white shirt and a black bow tie led me through a hallway to a private dining space, where I met Mimi Silbert, who has run the Delancey Street Foundation, the restaurant’s parent organization, since the nineteen-seventies.

“People call us the Harvard of the underclass!,” Silbert, who exclaims most things, exclaimed to me. If many San Franciscans think that the remedy for homelessness rests with exterior forces, Delancey Street believes that it starts with the individual. “Communities happen when other people all help each other, not when some wonderful people are helping with the problems,” she said. Homeless people, gang members, neo-Nazis, and other untouchables arrive at Delancey, have their hair cut short, and aren’t allowed to use the phone for three months. They are given housing and jobs—as cooks or maître d’s in the restaurant, perhaps—to help them build skills for aboveboard life. In time, they receive vocational training, and can pursue a high-school-equivalency degree. There is no staff; senior residents preside over the greener ones. Anyone who uses substances or threatens violence is expelled. “We kind of make an outside version of you—we don’t go in and do therapy before we have an outside that’s successful,” Silbert said. After a stay of at least two years, residents are sent back into the world.

Silbert, who has feathered copper-colored hair and a taste for well-built blazers, has been a mentor figure both to Kamala Harris and to Gavin Newsom, who visited Delancey Street for nightly therapy in 2007, during a rough patch in his personal life. In recent years, however, the Delancey tenets—tough love and a pressure to assimilate—have fallen out of fashion. “That’s a very old-school therapeutic model, where they shame people all the time,” Paul Harkin, a former head of Glide’s harm-reduction program, told me. (Harm reduction is about merely containing the worst effects of substance use.) It’s a model that can also cast homelessness as a personal failing, further cordoning off unhoused people’s lives. Last year, Silbert attended local meetings to challenge the city’s plan to put a navigation center near the restaurant. She told me, “I’m not opposed to it—I wanted, right here, in this particular area, not to have people who are allowed to use drugs.”

Others at that meeting were more resolute, launching a nonprofit, Safe Embarcadero for All, to oppose the shelter, and a GoFundMe campaign for the war chest. The public response in San Francisco was abhorrence.

“The idea that we don’t like poor people or homeless people living next to us is preposterous, because the Delancey Street Foundation is right there,” Wallace Lee, a member of the Safe Embarcadero board, told me. In his view, homelessness stems primarily from drug abuse, and he worries about needles and strung-out people in the neighborhood where he is raising children. “Housing wouldn’t solve the issues that led people to homelessness,” he said.

The mayor, most harm-reduction advocates, and even Lee support the use of supervised-injection sites, where patients dose themselves, with clinicians overseeing the process and disposing of needles. The obstacle to their creation has been federal. In 2018, when San Francisco and Philadelphia revealed plans for such sites, Rod Rosenstein, then the Deputy Attorney General, announced that the Justice Department was prepared to arrest clinicians and clients alike. Meanwhile, injecting on the street would remain just a ticketable offense. For people with addictions and no home, the choice of where to shoot up was clear.

Stigmatizing drug dependence, as in the Delancey Street model, seems to help some people break free of the vortex of homelessness. But destigmatizing it, as at the supervised-injection sites, appears to help others. Contradictions like this one are a reminder that every structural problem is a problem of human structures. In terms of survival, there is nothing mortifying about camping on a sunny street corner, just as there’s nothing mortifying about camping in Big Sur. Within the architecture of a culture, though, one represents a lack of access and provision. When society speaks of people “on the streets,” then, it’s trying to locate its borders of belonging: whom as a community, small or large, we carry as our own, and who remains beyond the boundaries of our care.

The novel coronavirus came early to San Francisco, freezing the city in place and bringing a new sense of urgency to those without homes. Couper Orona decided to occupy a vacant house one afternoon in May. Working with a group called Reclaim S.F., she and an unhoused friend entered an empty investment property. Before the police arrived to chase them out, Orona opened the bay windows and paused there for a long time, looking at the city from inside.

Ordinarily, in small facilities with stable, hygienic residents, infection is controllable. Maria, a busy young mother of two whom I spent some time with, had recently been barred from a family shelter while her fourteen-month-old daughter was contagious with the measles. “It makes sense because of the kids,” she told me. But add mental illness, drugs, and extreme hygiene into the mix and a shelter can become to sickness what a field of dry brush is to fire. Last year, Newsom decried the spread of what he called “medieval” diseases, such as typhus, among the homeless population. COVID-19 looked worse. “Many homeless people are at heightened risk because of their age or underlying health conditions,” Karen Hanrahan, of Glide, said.

On March 17th, Breed joined other local officials in implementing the first shelter-in-place restrictions in the country. The shelter where T. J. Johnston was staying stopped accepting new residents, took temperatures, and began practicing social distancing. Capacity was reduced by seventy-six per cent at shelters citywide. St. Anthony’s dismissed its volunteers and turned its block into a battle station, with meals to go, mobile hand-washing stations, and a medical triage tent on the sidewalk. (These measures increased the foundation’s monthly operations bill by two hundred and forty thousand dollars.) When the city’s hotel-occupancy rate fell by about ninety per cent, the Board of Supervisors saw an opportunity.

“The city was procuring hotel rooms for people who were COVID-positive or needed to be quarantined,” Hillary Ronen explained. Why couldn’t the homeless, infected or uninfected, use those rooms, too? Hotels agreed to make at least eighty-two hundred rooms available. The city leased two thousand hotel rooms, equipped with special staff and services, for high-risk residents, but the mayor resisted broadening the effort to the general unhoused population. “Let’s be honest,” she told me. “There’s no way we’re going to be able to keep anyone who’s addicted to drugs in a room against their will.”

On April 2nd, the first San Francisco shelter resident tested positive for the coronavirus. That same day, the city opened a large “distancing shelter” in the Moscone Center, a convention building. Rectangles for each resident were marked with masking tape on the floor. Entrants were given a floor mat, a pillow, and a metal folding chair. They were not allowed to bring belongings with them. On the day the shelter opened, Street Sheet reported, no hand-washing stations could be found. Two weeks later, the Board of Supervisors unanimously passed an ordinance requiring the mayor to house seven thousand homeless people in hotel rooms. When nothing had happened by May 12th, a group of activists calling themselves Housing Is the Cure projected “Breed, Obey the Law” across the façade of City Hall.

On May 19th, the supervisors unanimously passed another ordinance, this one requiring eviction protections, medical-response protocols, and other special supports in S.R.O.s, where there had been a fifteen-hundred-per-cent increase in COVID-19 cases since March. The numbers for the unhoused were alarming, too—as of last week, there were a hundred and fifty-nine confirmed COVID-19 cases and one death among the city’s homeless population, and many unhoused people had begun avoiding shelters in favor of the street. On May 4th, U.C. Hastings College of the Law, in the Tenderloin, joined locals in filing a federal suit against the city for “deplorable” sidewalk conditions. The number of tents had more than doubled since the shelter-in-place order went into effect, to nearly four hundred. “What has long been suffered in the Tenderloin has become insufferable,” the filing read. The law school’s chancellor and dean, David Faigman, had read about a judge ordering Los Angeles’s mayor to move some tent occupants into shelters or other safe sites (bypassing normal political processes) and hoped to get similar action from Breed.

Starting on May 11th, the city moved fifty tents to what it called a “safe-sleeping village”—an approved encampment—in a small plaza in front of the main library, and the city began planning a second in a parking lot at the foot of Haight Street. The safe-sleeping villages offer safely distanced tents and meals, and are surrounded by a fence. Some observers have called the sight “dystopian”—especially in the middle of a prospering city with thousands of vacant hotel rooms—but others, such as Faigman, hope that the model will spread. “We need to insist that those who are in tents be told that they have to move to encampments,” he told me. “There will be more-than-adequate provisions for their safety and health—but they don’t have a choice.”

People with a long view tend to think that the way past homelessness is what is known as permanent supportive housing: a home that comes with social services. One afternoon, I met a woman named Tina Singletary in Fremont, southeast of San Francisco. She has lived in an apartment there for two years, after spending a quarter century in a tent, mostly with her partner, Billy Hunting. Singletary had told me on the phone about her time on the streets—a past that included struggles with her health, drinking, and losing custody of her kids—but she greeted me with a warm host’s smile. Upstairs, I met Hunting, who has blond hair and extensive scarring from two severe burn accidents, and who wore a yellow T-shirt that read “I’M JUST ONE BIG FREAKIN’ RAY OF SUNSHINE.”

“Living here has changed everything for us,” Singletary said. “When we moved in, I didn’t know what to do with my damn self. You could put something down, leave, and it would still be there—no one would steal it! You could go to the supermarket and get anything you wanted.” She smiled wryly. “We didn’t do the freshman fifteen—we did the freshman fifty.”

The kitchen opened onto a well-furnished living room with a breezy balcony. There was an aquarium with a slider turtle named Bob, and a shelf holding a snow-globe collection that Singletary started after moving in. There were racks of DVDs, which they had watched in their tent, on a battery-powered device. Singletary told me about the loneliness of that time. “We had lost a lot of friends,” she said. “Billy wasn’t home a lot, and I was afraid I was going to die alone out there—” Her voice caught, and her eyes welled up.

Singletary got her apartment through a supportive-housing nonprofit called Abode Services. It works across the East, South, and North Bay, financed by a mix of private philanthropy—contributions largely from Silicon Valley—and affordable-housing funds, and it’s the biggest housing-services provider in the Bay Area. Abode’s C.E.O., Louis Chicoine, started working there twenty-six years ago, when the organization ran an emergency shelter, and soon realized that he wanted to take another approach. His father was an early engineer at Sprint, and the tech industry gave him an idea.

“We looked to Cisco and Intel, which were struggling with having enough hotel rooms for venders,” he told me. “They started master-leasing apartments.” Abode decided to master-lease apartments, too, and put homeless people in them.

“What we found is, sure enough, if you give people a home and basic services to go along with it, they’ll thrive, at very high rates,” Chicoine said. “We were shocked.” Ninety per cent of people maintained their housing for a year. When Abode transferred the leases to the tenants, steering them into the rental market, retention rates were even higher. “It’s astonishing how many people, even in a real-estate market like the Bay Area’s, actually can pick up the rent,” he said.

Today, Abode starts with getting people an apartment—no hoop-jumping required—then helps them hold onto it by building up their incomes. Maybe that means dealing with addiction, addressing old warrants, or earning a degree. The organization is lavish with aid, with this goal in mind. By a year in, seventy-five per cent of the clients are paying their rent. Abode passes their subsidy on to someone else, creating a forward-moving machine, not a growing pool of aid. (It keeps paying for the permanently disabled.) Should residents lose a job, Abode floats them with a loan, so that they can stay housed until they find work. If they are expelled by landlords for disruptive behavior, Abode finds them another apartment.

“This can go on for three or four moves,” Chicoine told me. “But we find that, at some point, the vast majority of people will start doing a cost-benefit analysis and get at the threshold of behavior they need to make it work.”

This year, Abode will expand into San Francisco. Chicoine is apprehensive. “I have no illusions,” he told me. Yet the approach might have better odds than anything else. It is democratic-egalitarian (open to anyone) and communitarian (balanced on personal connections). It is based on the simple idea that, if you do everything you can to keep people in homes they can be proud of, they will be not just housed on paper but integrated into middle-class life. Abode is working on nine hundred million dollars’ worth of affordable-housing projects similar to buildings such as Singletary’s, and Chicoine says that the model could work at twenty times its current size.

Singletary and Hunting gave me a tour of their building: the computer lab, the child-care center, the community patio shaded by redwoods. For the first few months after they moved in, Singletary said, she was depressed. “I thought, Why am I not happy?” Abode connected her with a therapist, who helped her realize that the shift from survival mode to secure mode was hard. When Hunting started drinking again, Abode helped him get sober.

As we were saying goodbye, on the sidewalk, a police S.U.V. swerved onto the curb, in front of a passing cyclist, and a cop sprang from the door.

“Billy!” Singletary screamed, and, in the space of a second, she grabbed her partner by the shoulder, yanking him behind her.

The officer wasn’t there for them, though. He leaped and tackled the cyclist—a known drug dealer. When Singletary recovered, she and Hunting smoked for a while and watched as the man was cuffed. Then they put out their cigarettes, got their keys, and, just in time for dinner, went inside.

By late last year, Zach Hickson and his wife were back in a navigation center, this time on Division Circle. One day, he went to the pharmacy to pick up a prescription, and it came with a mysterious letter saying that they had been granted an S.R.O. “I don’t know what happened,” he told me. “But suddenly they decided we were worthy of housing.”

Hickson now has his first locking door in San Francisco, on Sixth Street and Mission, just east of the city’s main drag. By volunteering for twelve hours a month at Glide, he earns his rent, food stamps, and two hundred and seventy dollars in walking-around money. He hasn’t had a drink in three years, and got off heroin after moving in. Life without the daily hustle felt almost too easy, he said, and he wasn’t quite sure what to do with himself; he ended up working a bunch of extra hours. One afternoon, I met him at Glide, and we walked to his place. It was on one of those ecstatic San Francisco days when you can see Mount Diablo to the east and the Farallon Islands to the west, but the hallways of his building were fluorescent-lit. As he opened his door, roaches scurried across the floor. “I never had bugs when I was homeless,” he told me.

The place was about as big as a college dorm room, and dominated by a bed with brown sheets and no pillowcases. There was a half-size refrigerator and dishes in the sink. “I still feel like I’m sleeping in an alley,” Hickson said.

With resignation, he had requested that he and Aytim get separate S.R.O.s. “All through our relationship, she’d bounce for a while, go do her own thing, and then come back,” he said. “I didn’t want her to decide she was going to go and be homeless.” The move proved prescient; not long after they were installed in housing, Aytim left their relationship—but stayed in her place. “I’m really not sure what to do without her,” Hickson told me. “I went through a pretty hardcore state of depression the past couple of months, and I think that has a lot to do with why she left. She was also depressed.”

They’d almost had a home together; now each had merely a home. A relationship is the smallest system, the tightest unit of community, and the two of them, like many in the city, had struggled with growth and ambition and collapsed under the strain. When Hickson spoke about Aytim now, it was with flickering duality—as someone just like him, then as someone in a different world. “She’s a good person,” he told me, with an air of heartbreak reimagined into pity. “But she was in a bad place.” ♦