The Hidden Health Risk Behind Bay Area Homeless Encampment Sweeps

Sycamore Street in West Oakland sat eerily quiet under a scorching August sun.

Here, tents once spilled across sidewalks and RVs butted into intersections, but now a few scattered plastic bags and scraps of trash remain after the city cleared an encampment.

Crews demolished wooden structures, fed heaps of garbage into compactors, and hauled away vehicles with forklifts.

Donald Sims used to sleep in an SUV and stored his belongings in a tent on the sidewalk. He said he lost everything he owned in about ten minutes. “One officer told me that he wasn’t gonna tow my car because I was living in it,” Sims said, gray-streaked dreadlocks framing his weathered face. “Next thing you know, [the city] came the next day and towed a bunch of cars.”

Gone were his clothes and toiletries, along with paperwork for disability benefits and the Narcan he kept for emergencies. Sims said he uses fentanyl to cope with PTSD and depression stemming from three gunshot wounds. “I’ve been kind of self-medicating, and I know that’s not the way to go.” Last night, he said he crashed behind a dumpster out of sight.

Bay Area leaders have accelerated encampment sweeps following the U.S. Supreme Court’s decision last summer granting cities permission to cite or arrest people for sleeping in public, even when shelters are full. Afterward, Gov. Gavin Newsom swiftly issued an executive order directing state agencies to “move urgently to address dangerous encampments.” Oakland’s count jumped from 19 last July to 132 this July — a nearly seven-fold increase.

“We are compassionate, we are supportive, we continue to help people,” former San Francisco Mayor London Breed said at the time. “But this is not the way. It is not humane to let people live on our streets in tents, use drugs … We have found dead bodies. We have seen people in really awful conditions, and we are not standing for it anymore.”

The local surge mirrors what’s happening nationally. Over the summer, President Donald Trump deployed over 2,000 National Guard troops to police the streets of Washington, D.C., which included clearing encampments. Officials forced people to leave who were sleeping near the Kennedy Center and fenced off blocks near the New York Avenue Presbyterian Church, a longtime hub of services for unhoused residents.

“We will rebuild our once great cities,” President Trump said during a political rally. “Including our capital in Washington, D.C., making them safe, clean, and beautiful again.”

The hidden cost behind newly cleaned streets is an increase in health risks. People lose vital medical devices—wheelchairs, canes, and oxygen tanks. Many end up farther from the clinics and treatment programs they rely on. That can mean missed appointments, lapsed prescriptions, or untreated wounds — crises that drive people to the emergency room. For people using illicit drugs, it can mean losing contact with street medicine teams—or using alone, which is especially dangerous when trusted friends aren’t nearby to administer Narcan. A national study projected that sweeps could fuel hundreds, maybe thousands, of extra overdose deaths in the next decade. On the ground, research in California and Colorado found that encampment closures led to spikes in overdoses, hospitalizations, and worsening health.

“Feeling like at any moment that someone might come in and take your belongings and ask you to move, creates a deep sense of instability, which has mental health implications,” said Kelly Knight, a medical anthropologist at UCSF. “People feel a sense of futility being moved from place to place.”

Encampment closures can sever the tethers people rely on. Oakland’s policy requires officials to provide 72 hours’ notice in advance of a sweep, but in practice, residents said they’re still caught off guard, forced to make hasty decisions under police supervision about what to carry and what to leave behind. The result is often the loss of both essential items and the social ties that once provided stability. Greg Adams, a Sacramento resident, said he lost his seizure medication during a sweep, and then days later, he suffered an episode and injured his head.

“As a health care provider, it’s incredibly distressing and upsetting,” said Dr. Aislinn Bird, director of integrated care for Alameda County Health Care for the Homeless. City leaders notify the county’s street response teams before an encampment closure, but Bird said her team can still easily lose contact with patients afterwards.

“Before we would pull up to a large encampment and people would come to us; they knew that we were going to be there and provide care,” Bird said. “Now that folks are so dispersed, we often lose track of them, so the level of complexities we’re seeing has really increased.”

She worries about one of her patients, who she has not seen since he lost his shelter. The man had lived in the same encampment near downtown Oakland for two decades, long enough that he had gone to kindergarten with many of his neighbors.

Bird could reliably find him to treat several mental health conditions. But when city workers cleared the area six months ago, he refused an indoor shelter because crowded spaces set off his PTSD. Since then, Bird has checked soup kitchens and jails without any luck.

“I’m sure he’s not on his psych meds,” she said. “Or his hypertension medication. We’re in a heat wave right now. Does he have enough water? Does he have access to food?”

“There used to be dozens and dozens of people along here,” said Tony Carroll, a community health worker for Alameda County, as he pointed to rows of concrete bins strategically placed on several streets in the West Oakland neighborhood. “I don’t know where they’re at. It’s almost like people are being disappeared.”

Bay Area cities have said they conduct sweeps humanely — by storing belongings and offering services. Yet advocates are critical of “bag and tag” policies.

A 2022 lawsuit filed by the Coalition on Homelessness claimed San Francisco cleared camps without offering people a place to stay and seizing personal items.

The case settled this summer for $2.8 million, and recently the Board of Supervisors unanimously approved an agreement to give people a chance to reclaim their belongings before they are destroyed.

One of the plaintiffs in the suit, Toro Castaño, 51, told KQED that the encampment sweeps would happen at “four in the morning, five in the morning. “It was very traumatic because it’s very cold outside and a lot of things they’re taking are warm clothes, warm jackets, blankets, things that you need just to survive,” he said.

San Francisco police have increased monthly arrests connected to encampments tenfold from just a few dozen in the spring of 2024 to nearly 300 by April 2025.

In the last year, officers issued more than 2,200 citations and arrests, more than half for illegal lodging. The rest were tied to outstanding warrants, narcotics possession, resisting officers or violating stay-away orders.

“Residents, visitors and businesses deserve to have clean and healthy streets in San Francisco,” Evan Sernoffsky, spokesperson for the San Francisco Police Department, wrote in an email. “Our goal is always to connect individuals with services and get people into shelter. If individuals do not accept services and are in violation of the law, they may be cited or arrested.”

Officials often justify closing encampments to support public health, pointing to the lack of bathrooms, running water, and trash. But the National Health Care for the Homeless Council argues that sweeps waste millions of dollars that could go to housing and health care instead.

“We don’t have a homeless problem — we have a problem where we can see homeless people,” said Paul Boden, who was unhoused in San Francisco for six years and now leads the Western Regional Advocacy Project. “If we can make it so we don’t see so many of these people, we’ve solved the problem. People get hurt.”