While everyone is freaking out about hand sanitizer, scrubbing their hands to two full rounds of “Happy Birthday” and canceling everything even if the event doesn’t involve a crowd (all the while, crowding the aisles of Costco to buy supplies), the reality is that we’ve been living with the danger of serious outbreaks for years.

Or maybe “living with” isn’t the right term. Maybe it’s more like “doing our best to ignore” the situation.

The sanitation issues that arise when homeless people live in squalor, urinate and defecate in public places and forage in trash cans are a threat not only to their sector of the population, but to everyone. It’s been that way for years.

Just one example: Last month, a reader sent photos to the newspaper that showed a homeless woman using the bathroom at the city kiss-and-ride bus stop in Hawaii Kai. The woman was right out in the open, in broad daylight in front of everyone waiting there with her pants pulled all the way down while she squatted into a cement planter (which also serves as a bench) in the area where people stand to board the bus. The pictures were too graphic for the newspaper, but a story ran describing the situation.

A few weeks later, more photos were sent to the newspaper: same lady, same place, same activity, but even more graphic. Nothing had changed.

That’s just one example of one person at one bus stop, but it’s happening all over. If you walk around downtown, you know this sort of thing happens at many bus stops and alleys and stairwells and alcoves. People poop and pee on the sidewalk, in the bushes along buildings, in the grass at Iolani Palace, wherever. There are those who take it upon themselves to hose it all down or pick it up on a regular basis, but how much of the threat of pathogens remains?

Most people are careful about where they sit, where they step, what they touch, but the folks who are doing their business in public places are doing so without benefit of toilet paper, soap or Purell. It’s one thing to push elevator buttons with your knuckle. It’s another to reduce the threat of these shockingly unsanitary conditions in our lives.

In 2017, San Diego’s homeless population experienced an outbreak of hepatitis A related to unsanitary living conditions. There were 592 cases reported and 20 deaths, a fatality rate similar to that of COVID-19. That is only one possible pathogen spread by human waste.

Perhaps the upside of this crisis in which we find ourselves is that we will be more aware of public health and sanitation after this, and that it will lead to measures beyond hand sanitizer and pressure-washing sidewalks. Being cautious is a good thing. It shouldn’t end when this outbreak has passed. It should fuel the most serious commitment to get people out of the streets and bushes and into decent shelters, not slowly over time, but immediately and urgently.