This story is part of Tipping Point, our new project focused on telling the stories of the Sacramento region’s evolution. Read more of our Tipping Point stories here.
A grocery sack containing what appeared to be human feces hung from a branch over the American River, a short boat ride upstream from one of Sacramento’s most popular summertime swimming areas.
Nearby, a makeshift toilet was perched over a hole in the sand, feet from the waterline and a short walk from a couple of tents and a man washing a shirt in the river.
“Depends on my mood, but if I have to go, I pop a squat,” said another nearby homeless man, before paddling away in a blue kayak.
The scenes on the American late last month illustrate an ongoing public health and environmental crisis in one of the two rivers that flow through California’s capital city. As Sacramento’s homeless population grows, the encampments and lack of public bathrooms for the people who live along the banks have created a risk of disease, public health data and interviews show.
A Sacramento Bee investigation found high levels of E. coli bacteria — a sign of fecal contamination — along the lower stretch of the American, where homeless camps line the banks, residents walk their dogs, and where thousands of swimmers dip into the water to escape Sacramento’s summer heat.
Water samples reviewed by The Bee showed dangerous E. coli spikes this summer when swimmers were present at Tiscornia Beach, a popular summertime gathering spot where the American and Sacramento rivers converge north of downtown. There, a swirling effect from the currents causes any bacteria washing from upstream to linger.
Thirteen out of 15 weekly water samples taken at the beach since June exceeded state and federal standards, records show. Those estimates determine when at least three out of every 100 swimmers would be expected to suffer ailments such as diarrhea from coming in contact with feces-fouled water.
Tiscornia’s E. coli readings were three times higher than the safety threshold on Aug. 27, and six times higher on Aug. 13, the height of the summer season. However, officials caution the high numbers wouldn’t necessarily translate into a three- to six-fold increase in swimmers falling ill those days.
Sacramento is one of the few U.S. cities with two easily-accessible rivers running through it. The county-managed American River Parkway attracts millions of bikers, swimmers, boaters, hikers and anglers annually. A 2006 county-commissioned study estimated that by 2025, more than 12.4 million people would use the park each year.
Despite this widespread popularity, few public bathrooms are available 24 hours because local officials have refused to provide them where homeless congregate, saying campers would just destroy them. Officials remain unwilling to point to the homeless, which number between 200 and 300 along the American River, as a source of the fecal bacteria.
Instead, they’ve embarked on a three- to four-year study that will test the DNA of the bacteria to determine its exact source. The cost to taxpayers: $600,000 to $800,000.
For their part, local officials say aside from the study, they’re already taking other steps to address the region’s homeless issue. The Sacramento City Council recently approved new shelters that will come online in the coming months, which will help reduce the numbers of parkway campers, officials said.
In the meantime, they post results of the state’s E. coli tests on the county’s website and have installed permanent signs along the parkway’s river access points to warn swimmers to avoid drinking the water and to wash their hands and shower after getting wet.
Those are good steps, said Alexandria Boehm, a Stanford University professor who studies water quality and contamination at public beaches. But Boehm said she wouldn’t swim or let a child get in the water at Tiscornia Beach after reviewing the state’s E. coli sampling data and learning that homeless camps were upstream.
She’s alarmed and baffled by officials’ decision not to set out toilets for the campers.
“You don’t need a Ph.D. to say, ‘There’s somebody pooping in the river. Let’s put a bathroom out,’” she said.
‘The real issue here’
In interviews with The Bee, Sacramento County’s public health officer, its parks director, the parkway’s chief ranger, and the city councilman and county supervisor whose districts include the Lower American River were either noncommittal or adamant that providing restrooms for homeless encampments wasn’t on the table.
When portable toilets are set out, the officials said, the homeless just destroy them. Officials told horror stories of the toilets getting clogged with sleeping bags, tipped over or set on fire. Officials do provide several portable bathrooms at Tiscornia, and for special events and when flooding closes permanent restrooms.
County park rangers also have to lock permanent parkway bathrooms during the night because the homeless use them to do drugs or for prostitution, they said.
BEHIND OUR REPORTING
About this story
Thousands of people swim, boat and fish in the American River near downtown Sacramento.
But a Sacramento Bee investigation found alarmingly high levels of E. coli bacteria — a sign of fecal contamination — along the lower stretch of the American, where homeless camps line the banks, residents walk their dogs, and where thousands of swimmers dip into the water to escape Sacramento’s oppressive summer heat.
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Officials said the only solutions are long-term ones, including more affordable housing and more shelter beds.
“If this is really a story about E. coli, let’s talk about what is contributing to the fact that you’ve got a population living on the parkway,” Sacramento County Supervisor Phil Serna said. “That’s the real issue here.”
Some relief on that front is on the way, but how much it will clear out campers along the river is unclear.
The Sacramento City Council voted last month to create hundreds of more shelter beds in the coming months. But most of the new shelters are focused primarily on getting homeless off the streets in individual neighborhoods, downtown in the Capitol Park Hotel and under the W-X freeway and in south Sacramento, miles from the parkway.
Sacramento County, which spent more than $50 million in homeless services last year, runs homes and apartments across the county as “scattered-site” shelters that house about 275 people a year. Another nearly 300 families are served by the county in shelters and temporary housing annually. But even as the county has prioritized finding permanent housing for homeless people, finding available affordable units to house the remaining thousands has proved challenging.
As the homeless population grows, a report released last year by the Sacramento Regional Coalition to End Homelessness pointed to a widespread lack of bathroom access that extends far beyond the parkway. The report said the city operates 205 parks, but most either have no bathrooms or have facilities with limited hours. In the central city, where many homeless people congregate, only five of 22 parks have restroom facilities.
Portable toilets are relatively cheap. The county says each one costs $155 per month to rent and maintain. But it’s far more expensive to operate bathrooms that are staffed by workers to make sure they’re kept clean and not vandalized.
In 2016, the city started a six-month pilot program that opened a “pit stop” restroom in the River District, an industrial area north of downtown, that was staffed during daytime hours. The program cost taxpayers around $174,000. Of that, the city paid $35,000 for a used, air-conditioned mobile restroom, featuring a dog-waste and needle-collection containers.
After the trial run, the city decided to shelve the program and is instead spending $575,000 on restroom and other homeless services at a county-owned facility in the River District.
The pit stop, meanwhile, is still available for rent from the city. The cost: $450 a day.
County spokeswoman Kimberly Nava said staffing a facility like that 24 hours a day would cost county taxpayers around $200,000 a year.
Meanwhile, parkway rangers can issue citations for open defecation, but tickets for human waste aren’t commonly given out. The campers have learned to hide their makeshift latrines or dispose of their feces, because if a ranger sees it, they can get cited, said Chief Ranger Michael Doane.
A recent federal appellate court ruling prohibits local governments from prosecuting homeless people for sleeping on public property if there are no available shelter beds. But rangers maintain they still have the authority to clear permanent illegal campsites from the parkway due to garbage, damage to levees and environmental degradation.
As of August, rangers have cleared 4,138 camps and removed 975 tons of trash in 2019.
The camps quickly pop back up.
Tommie McKinnie, who was camped last month upstream from Tiscornia, said when he has to go, he uses a plastic bag and carries his waste to the trash piles along the adjacent bike trail, where it’s picked up and disposed of by park workers. But many of his neighbors are far less courteous, he said.
“They throw bags (of feces) into the river. Sometimes they get into the river and just poop,” he said.
“Where they gonna go, you know what I mean? McDonald’s is way down there. They’re not going to walk all the way down to the restroom. They’re going to use the restroom right here. Every day, someone is using the restroom right here on this beach. Every day. I can tell you, right now, you can walk down, and you’ll see toilet paper right there. On the ground. With poop on it.”
Some swimmers are unaware of what’s going into the water upstream.
Over the busy Labor Day weekend when temperatures neared 100 degrees, Tawny Cooper was one of the dozens of people lounging at Tiscornia Beach. Cooper hadn’t seen the sign with small lettering warning swimmers about the risks on the drive into the parking lot. She said she had no idea that the water she was about to wade into was fouled with fecal bacteria.
“I was going to take a dip, but I might not now,” she said. “That’s really gross. Aren’t there bathrooms around here?”
Violating federal standards
So far, no cases of water-borne illness have been reported to county health officials, but experts say that’s no guarantee people aren’t getting sick.
The samples the state takes from the river are only looking for E. coli as an indicator of fecal contamination in the water, experts say. Not every strain of E. coli bacteria causes potentially lethal symptoms such as bloody diarrhea, which would trigger a notification to county health officials. Most E. coli strains found in human and animal intestines are harmless.
But feces can contain a host of other viruses and bacteria that can make people sick. Usually, the symptoms they would cause such as diarrhea clear up without a doctor’s visit, so the health department likely would never know if someone fell ill from swimming in the American, said Robert Metcalf, a retired Sacramento State microbiology professor who studies water contamination.
To determine the health risks of feces-contaminated water, the U.S. Environmental Protection Agency studied the rates at which swimmers were likely to suffer some sort of illness based on E. coli levels in the water.
Based on the research, the EPA set a public health warning threshold for when at least 32 people out of 1,000 would likely suffer from digestive problems from coming in contact with the water. In 75 tests since 2018, Tiscornia Beach exceeded that threshold in three out of every four samples, according to a Bee analysis of the state’s data.
Metcalf’s wife, Mary Beth, a physician, is on the Save the American River Association board of directors, which has been calling for more bathrooms along the parkway because of the risk to public health. SARA volunteers also have been performing their own bacterial sampling along the American River under Robert Metcalf’s guidance.
“Horrendous,” retired Sacramento State professor Alan Wade said in an email that included pictures showing ghastly gobs of bacterial growth on Petri dishes from recent samples he’d taken at Tiscornia. “This is what diluted sewage looks like.”
‘A long-term problem’
State officials at the Central Valley Regional Water Quality Control Board, which regulates water quality, are deferring to the county’s leadership on what to do with the results from their E. coli sampling data.
With no fecal disease outbreaks in Sacramento, officials are waiting for the results of the multi-year DNA testing study to be able to conclusively say where the contamination is coming from in the American River and whether it’s human-caused. The sampling started last month.
Officials will spend the next three to four years gathering samples at various points along the river and DNA testing the E. coli bacteria they collect. The hope is they’ll be able to track down exact sources of the contamination so the problems can be fixed.
“This is a long-term problem. We are not going to fix this problem tomorrow,” said Meredith Howard, a regional water board official whose agency is leading the $600,000 to $800,000 study, funded by the county and local stormwater and sewer districts.
Leaky sewage lines and other urban sources of feces could be contributing to the E. coli spikes, officials say. The DNA tests also could prove whether the E. coli stems from dogs and geese, whose feces also is found along the parkway.
On a recent morning, nearly 50 Canada geese were swimming at Tiscornia Beach. A single goose can produce up to three pounds of feces per day, by some estimates.
Several dog walkers were spotted letting their animals swim in the river near Sutter’s Landing, a popular dog park.
Last week, county-supplied dog waste bags weren’t anywhere to be seen on the walking path from the park to the American River. But several piles of dog feces were in the sand along the trash-strewn shoreline. Four young women in bikinis lounged waist-deep in the water, below a homeless campsite surrounded by trash. Toilet paper and human feces were strewn through the trees nearby.
Over Labor Day weekend, Edgar Munoz said he usually comes to the river about once a year, but after learning about the bacteria in the water, he’ll be thinking twice about taking a swim next time.
“I might not go in there now,” Munoz said. “I might just go home and rinse off.”
Profound disease risks
The health risks associated with open defecation aren’t limited to swimmers.
Last year, at least 14 cases of typhoid fever, a disease that can spread through fecal contamination, were reported in Los Angeles County, though it’s not clear how many of them, if any, were linked to the homeless encampments. Typhoid is rare in the U.S. with most cases associated with people who travel to foreign countries with substandard sanitation.
The trend continued this year. So far, there have been at least eight reported cases. One Los Angeles Police Department officer, and possibly a second, caught the disease, according to a May LAPD news release. The officers were based at a station near Skid Row where an estimated 2,000 homeless people live, but health officials and the LAPD haven’t disclosed how the officers came in contact with the bacteria.
Two years earlier, 20 people died in San Diego County from an outbreak of Hepatitis A, which was linked at least in part to poor sanitation among the homeless.
Both the bacteria that causes typhoid and the virus that causes Hepatitis A are found in stool, and they can easily spread when infected people don’t wash their hands after defecating. Typhoid also can be spread through water contamination. No outbreaks of either disease have been reported in Sacramento.
In San Diego during the Hepatitis A outbreak, officials declared a formal public health emergency, and began placing toilets and hand-washing stations out for the homeless, including along its rivers, said David Gibson, executive officer of the San Diego Regional Water Quality Control Board.
San Diego County officials in 2017 estimated around 300 people live along the San Diego River alone.
Yet officials almost immediately took many of the toilets away once the outbreak was contained, Gibson said.
The hepatitis outbreak may have been contained, but that hasn’t stopped homeless people from defecating where their feces washes downstream, contaminating local rivers and San Diego’s ocean beaches.
This summer, Gibson’s agency ordered local authorities to investigate and identify the sources of human fecal bacteria in the lower San Diego River. Gibson doesn’t have the authority to order them to put the toilets back out, but his agency can fine local authorities for allowing fecal waste from the camps to contaminate the waterway.
For Gibson, providing toilets would be a common-sense solution to a basic public health problem.
“Indeed, when you see outbreaks of hepatitis and typhoid,” Gibson said, “you begin to realize we’ve in a sense taken a step a century back in communicable diseases through lack of adequate sanitation.”
Sacramento Bee reporters Theresa Clift, Tony Bizjak, Michael Finch II and Alexandra Yoon-Hendricks contributed to this story.