Modern medicine can cure a hepatitis C infection with three doctor’s appointments and two prescription refills. For most, it is not a big ask to rid oneself of a deadly disease.
But for those without homes, keeping up with the required 12-week treatment regimen can be an overwhelming commitment.
Sitting on a metal folding chair at the edge of an empty parking lot in Balboa Park on a recent morning, Holly, a resident of San Diego’s nearby O Lot safe sleeping site, explained that visiting a doctor’s office miles away comes with significant risk.
A tent can never be fully secured, so leaving one’s possessions inside to go to the doctor’s office all but guarantees returning to find possessions missing.
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“There is nobody that holds themselves accountable for your stuff, so it’s just hard for me to leave, knowing that,” she said. “Everything I have left in the world is in that campsite, and it’s easy for people to just walk right in.”
And yet Holly just completed her full hepatitis C treatment, not missing a dose over three straight months after a screening test detected her infection. Her friend, Chris, just started his second week. Like his companion, he said that because his infection had not yet progressed far enough in damaging his liver to start causing symptoms, there is pretty much no way he would have traveled to the clinic for treatment.
“You know, you just sort of put it on the back burner if it’s not causing any signs,” he said.
Finding and keeping housing trumps following up on test results. And that is the particular problem with hepatitis C, which may take decades to cause its first symptom. Often, by the time signs and signals such as easy bruising, fatigue, yellowing of the skin and weight loss appear, a person’s liver is significantly damaged, making life-altering consequences such as liver cancer much more likely.
In recognition of the disease’s slow and deadly burn, the county health department, several local medical providers and the Liver Coalition of San Diego County launched a hepatitis C elimination plan in 2021 with the goal of preventing new cases while simultaneously working to discover and treat so-called “chronic” cases that have gone undetected.
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Though recent results are skewed slightly due to a change in how hepatitis C cases are counted, the overall case trend has been downward since 2019 when 4,249 chronic cases were confirmed or suspected compared with 2,298 in 2023.
A big part of driving that number down, said Dr. Christian Ramers, medical director for research and special populations at Family Health Centers of San Diego, has been more aggressive outreach to those at increased risk of hepatitis C infection. Because the virus transmits in human blood, injection drug users are at an increased risk as are those with HIV.
The crusade to eliminate hepatitis C started with increasing screening to detect chronic cases and with the region’s first needle exchange programs, helping drug users avoid re-using and sharing needles. Many have recently begun to realize that those techniques, while effective, are not enough.
Chris and Holly’s recent experience in a Balboa Park parking lot involved a physician assistant with Family Health Centers whose job is to take many services, including the checkups and medication delivery necessary to cure the disease, out of doctor’s offices and into the places where people with reduced mobility live.
“Really, the only way is to bring the care to this population,” Ramers said. “They’re not going to come in and meet us at the clinic, so we have to find a way to go to them.”
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And, simply showing up in tent encampments for checkups and to fill prescriptions is not enough. Family Health Centers workers have learned that the usual practice of delivering one month’s worth of medication at a time does not work. Such a large supply is likely to be stolen before it can be consumed.
Instead, workers deliver seven pills at a time, making weekly visits and using those encounters to discuss other health matters that a person might also be experiencing.
But eliminating the disease will not be accomplished only by embracing street medicine for those experiencing homelessness. Scott Suckow, executive director of the Liver Coalition of San Diego County, said recent modeling by researchers at UC San Diego found that reaching intravenous drug users in many different types of venues will be key to winning this fight.
More work could be done, he said, in organizations that treat substance use disorder, often combined with mental health care, to screen for hepatitis C and to make sure that those who test positive are referred to medical providers for treatment.
The state, through the ongoing reform of its Medi-Cal health insurance system for needy residents, has recently approved paying substance use treatment and behavioral health providers for “enhanced care management” when treating patients with substance use disorder. This additional benefit allows for a more holistic set of services that can go beyond drug and alcohol treatment.
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Driving hepatitis C infections lower, getting more people screened and treated, Suckow said, is likely to see a significant benefit from the enhanced care management benefit if the disease is included in the host of additional health problems that doctors look for when care management is engaged.
“The position we’re taking is that it’s the behavioral health and substance use disorder treatment community’s responsibility if they’re providing whole-person care, to make these linkages, especially if they know that a client has hepatitis C or they’re at risk for it,” Suckow said.
Why couldn’t this simply be a mandate of the county health department, which spends millions per year contracting with substance use treatment programs serving patients whose care is covered by Medi-Cal? Why couldn’t a mandate to test all substance use treatment patients for hepatitis C infection just be written into county contracts?
Dr. Nicole Esposito, chief population health officer for the county’s behavioral health department, said that contracting is not seen as the right solution for promoting better coordination between different types of medical providers serving Medi-Cal beneficiaries.
Better coordination of care is not, she noted, about only one disease.
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“The goal of care coordination is to really assess all of the needs of the whole person, rather than programmatically calling out specific diseases in contracts,” Esposito said. “Then it becomes like a patchwork where we have the hepatitis C expectations and the HIV expectations and we have some that get missed.
“I think the goal is to put the person at the center and work across all of the various factors, whether it’s all of the illnesses they might have or housing needs or social needs or school needs, rather than trying to do it with line item contract language.”
Medi-Cal changes, she added, will make it easier for different types of providers to securely share patient information electronically, making it easier for referrals to be made across organizations that are engaged in different missions.
“I think the big hope for significant progress lies in the fact that, in the future, we’re going to have a lot more data sharing so that there will be more visibility of whether tests were done, what were the results, was treatment started, was treatment completed,” Esposito said.
Padres roster review: Sung-Mun song – San Diego Union-Tribune
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SUNG-MUN SONG
Position(s): Third base, second base
Bats / Throws: Left / Right
2026 opening day age: 29
Height / Weight: 6-foot / 194 pounds
How acquired: Signed as a free agent in December 2025
Contract status: A four-year, $15 million deal will see Song make $2.5 million in 2026, $3 million in 2027, $3.5 million in 2028 and $4 million in 2029 if he does not opt out of last year; Half of his $1 million signing bonus is due in January 2026 and the other half in 2027; There is a $7 million mutual option for 2030.
.214 — Song’s isolated power in 2025, a career high as he prepared for a jump to the majors. Isolated power measures a player’s raw power (extra bases per at-bat) and Song had a .190 OPS in 2018, in his third year as a pro in Korea, before it dropped to .101 in 2019 and then a career-low .095 in 2023. Hitting 19 homers pushed Song’s isolated power to .178 in 2024 and then a career-high 26 homers push it even higher in 2025.
TRENDING
Idle — Drafted by the Heroes in 2014, Song debuted in the KBO the following year but didn’t become a regular until 2019. A drop-off in production — he had an .884 OPS in 78 games in 2018 and a .597 OPS in 103 games in 2019 — was followed by losing the 2020 season and a chunk of the 2021 season to military service obligations. Then three straight sub-.700 OPS seasons forced Song to rethink his approach to professional baseball, especially in the face of the likes of Ha-Seong Kim,Jung Hoo Lee and Hyeseong Kim generating big-league buzz. Song started with weight training and nutrition. A hitting coach also helped him with balance, pull-side power and the ability to catch up with the sort of fastballs that seem to dog Korean players when they arrive in the States. It all added up to a breakthrough year in which Song paired 19 homers, 104 RBIs and 21 steals with a .340/.409/.518 batting line. To prove it was no fluke, Song followed up his 2024 season with another strong effort that solidified his wish to try his hand in the majors. The ensuing, four-year, $15 million deal that Song signed with the Padres in December cost his new employer a $3 million posting fee to be paid to the Kiwoom Heroes.
2026 OUTLOOK
Like Kim before him, Song appears to be joining the Padres as a utility player with the hope that he blossoms into more as he gets comfortable in a new country and league. Song had experience in Korea at third base (500 starts), second base (149 starts) and first base (38 starts). Padres president of baseball operations A.J. Preller even mentioned outfield reps in passing as he assessed how Song could help the Padres in 2026.
Former KBO player Sung-Mun Song shakes hands with Padres vice president of amateur and international scouting Pete DeYoung after signing a contract with the San Diego Padres at Petco Park on Saturday. (Photo by Armond Feffer/San Diego Padres)
Drivers traveling through the city of Poway may have noticed a dramatic change to the landscape. Since September, more than 1,400 trees — many of them eucalyptus — have been removed as part of the city’s hazardous mitigation grant project aimed at reducing wildfire risk and improving public safety.
Poway is spending roughly $3 million on the effort, which focuses on removing trees that are dead, dying or considered dangerous. Much of the cost is being reimbursed by FEMA. Officials say the project is designed to make emergency evacuation routes safer while improving the overall health of trees along major roadways, rights-of-way and open spaces.
“I was relieved that there were some efforts being put into improving our resiliency to wildfire in our community,” said Poway Fire Chief Brian Mitchell.
Mitchell said spacing out trees can slow the spread of a wildfire and prevent roads from becoming blocked during an emergency.
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“That certainly has the potential to block our first responders from accessing somebody’s house in the middle of an emergency,” Mitchell said.
City leaders also point to storm safety as a key reason for removing hazardous trees under controlled conditions rather than risking falling limbs or entire trees during severe weather.
“I don’t want to be driving down that street and just a random limb just happened to collapse, you know, just hit me,” said Poway resident Dawn Davis.
Davis said she also worries about the threat the trees pose to nearby homes.
“I don’t want anybody’s homes here to be damaged, either by them or fire,” Davis said.
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A Poway spokeswoman said a certified arborist evaluated nearly 6,800 trees in Poway. About 2,800 invasive trees were recommended for removal.
This story was originally reported for broadcast by NBC San Diego. AI tools helped convert the story to a digital article, and an NBC San Diego journalist edited the article for publication.
The front of the Fowler Athletic Center at San Diego State includes a pair of double doors that open from the inside out. Replacing them with revolving doors would seem appropriate, given all the comings and goings nowadays.
SDSU had two dozen football players — including five starters on the defense — enter the NCAA transfer portal, which opened Friday. The first wave of candidates to replace them visited over the weekend.
And by Sunday afternoon, SDSU announced its first two signings. It was a package deal.
Sophomore offensive linemen Charlton and Mercer Luniewski are Michigan State transfers from Cincinnati. And twins.
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Charlton Luniewski’s social media says that he goes by “Big Chuck,” although Mercer is listed as an inch taller and 13 pounds heavier at 6-foot-6, 320. Mercer is also, by the way, 45 minutes older.
Charlton profiles at guard and Mercer at tackle, though SDSU typically works players in multiple spots to find the ideal fit. The twins are expected to challenge for spots on the two-deep if not the starting O-line, which lost three starters to graduation.
The twins were highly recruited two years ago out of Cincinnati Hills Christian Academy, where they also competed in track and basketball. They have three years of eligibility remaining.
The Luniewskis were among a dozen transfer recruits who visited SDSU over the weekend. Commitments have come from half of them. More recruits are scheduled for the coming this week as the Aztecs look to replenish the roster.
SDSU also received a commitment Sunday from Nate Henrich, a 6-6 edge from Division II Gannon University in Pennsylvania. Henrich had six tackles at Gannon, but he is viewed as having high upside with good size and length. He could provide needed depth at a position where the Aztecs lost four players to the portal.
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SDSU also expects commitments from Oregon State edge Kai Wallin, Portland State safety Isaiah Green and College of the Sequoias wide receiver Marshel Sanders.
Wallin is a 6-5 senior from Sacramento who played in nine games this season (seven starts) for the Beavers, making 17 tackles with one sack and four quarterback hurries. Green, a 6-1 junior from Oxnard, had a team-high 101 tackles at Portland State. Sanders is a 5-11 junior from Fresno who had 70 receptions for 929 yards and four touchdowns.
Bostick back
SDSU wide receiver Jacob Bostick announced on his social media Sunday that he is returning for the 2026 season.
His post read, in part: “Excited to get back to work with my coaches and teammates.”
Bostick had 11 catches for 157 yards and three touchdowns over six games before suffering a season-ending knee injury during practice six games into the season. He anticipates being ready to return by fall camp.
