Homeless, living with HIV, and lacking antiretroviral medication, Bella Casebolt is fighting to survive.

By Martin do Nascimento

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Bella Casebolt recalls the dread she felt when she first heard about the shelter-in-place orders announced by authorities across the San Francisco Bay Area, the first place in the country to do so.

Stores across the region began selling out of toilet paper and shelf-stable food, while city streets and sidewalks fell empty overnight. At the 20-person homeless camp where Bella was living near the Oakland Coliseum, her neighbors were becoming anxious as well. 

“Everyone would stay in their tents until late at night,” she says, and then one day “people started coming to the recycling center, and they were protesting early in the morning because that’s how they were making their money.” 

The sudden closure of the adjacent Lakeside Recycling facility completely cut off any revenue from sales of cans and bottles collected from recycling containers. The drastic drop in traffic circulating in the city meant no more ‘flying signs’ asking for money at busy intersections. The meager incomes so many of Oakland’s homeless had been scraping together had quickly disappeared.

“After that is when all the restaurants started closing,” says Bella. “I couldn’t go to Burger King. I couldn’t go to Taco Bell, and I couldn’t go to Jack In The Box because all of the lobbies are now closed and people can’t walk through the drive-thrus. It’s against regulations.”

Still, Bella felt fortunate at the time that she didn’t have to resort to ‘flying.’ 

Since she came to California from Texas to meet her husband David earlier this year, the couple had been running an ad hoc store out of their tent with Bella’s sister and her sister’s girlfriend, selling Twinkies, chips, cigarettes, soft drinks, and water to fellow residents of the camp. When they first opened the store, the group had dreams of providing for their peers out of the surplus from their sales — buying a weekly meal for all comers at the camp or materials to shore up neighbors’ dwellings.

But with each passing day since the shelter-in-place order, maintaining the store grew more difficult and less profitable as supplies became harder to come by and people in the camp ran out of money. A dispute between Bella and her sister became the final straw.

“Things got to the point to where my husband woke up at 3:00 o’clock in the morning, said we have to leave. So that morning we packed up the entire tent and left,” says Casebolt.

The decision to leave the camp and set out on their own would have been difficult enough under normal circumstances, but on top of all the other challenges, Bella is living with HIV.

Bella Casebolt plays with her dogs Milo and Marley days before to the shelter-in-place orders were enacted in the San Francisco Bay Area.

For the past seven years, Bella has been prescribed antiretroviral medication that suppresses build up of the virus, which would otherwise deplete her immune system and leave her susceptible to countless ailments, particularly COVID-19.

But when Bella ran out of antiretrovirals the same week she moved out of the camp, the combination of homelessness and HIV positive left her struggling to navigate an already convoluted health system amidst the chaos of the pandemic.

“I’ve called doctors. I’ve called my doctor back in Texas. I’ve called people,” says Bella from her new camp site, a few miles from the last. “I can’t get in to see a doctor here because there’s no doctors here to see me. They told me I should go to the emergency room to get seen.”

But she doesn’t think anyone at an emergency room can prescribe the medication she needs, and she fears walking in the building for risk of contracting COVID-19. “If I go to the emergency room right now and there’s anybody with the coronavirus, I am more susceptible than anybody in that room at that very moment to get that.” 

When they set up their new camp, Bella and her partner deliberately chose a secluded location to avoid other homeless people who could potentially transmit the virus. But that choice came at the cost of losing access to services, like portable toilets and handwashing stations, in the city’s more established camps. 

“We’re completely isolated. We’re technically at our own little island,” says Bella of their new camp. “So, that’s cool. But I still need the basic necessities, like not having power for my phone — it’s not having outside communication to know about the Coronavirus.”

For now, Bella has resigned herself to the fact that she won’t likely find access to her antiretroviral medication until the COVID-19 pandemic has subsided. In the meantime, she and David have resorted to ‘flying’ as a way to make ends meet.

“I don’t want to be out there flying,” says Casebolt. “I mean, it’s degrading, it’s embarrassing. I come in contact with a lot of people. If they give me money, that’s cross-contamination,” she says. “I might be isolated most of the time throughout the day and not around people, but that still puts me at high risk and I have to do it because I have no other way to make money right now.”