More than 60 homeless people died in Portland in 2020, a dramatic increase from previous years, according Preble Street, a nonprofit social services agency that organizes a vigil for unhoused people who die in the city each year.

Preble Street said 64 people without long-term shelter died this year from a variety of causes. The youngest was 22, and the oldest was 80, the organization said. At least eight of them were veterans. Two people froze to death while sleeping outside, the organization said.

Preble Street didn’t specify when in 2020 the exposure deaths occurred, and Portland spokeswoman Jessica Grondin said the city had no information “that two people recently died outside because of the elements.”

In the previous decade, the number of deaths in the homeless community had climbed from 20 to a previous high of 43 in 2019.

“The health implications of people experiencing chronic and or unsheltered homelessness are devastating,” said Mark Swann, Preble Street’s executive director.

“Eighty four percent of people who are homeless and unsheltered experience physical health conditions. Worse, the life expectancy of our friends who endure chronic homelessness is 28 years shorter, on average, than that of people who are housed. We lost 64 people this year,” Swann said. “As a community, we cannot continue to let our most vulnerable neighbors slip through the cracks.”

In many of the cases, the causes of death are similar to those in the general population, and include chronic health disorders, liver disease, cancer, heart conditions, suicide and accidental overdoses. One of those who died in 2020 was a longtime community advocate for people in recovery from substance use disorder, Preble Street said.

While the deaths aren’t blamed directly on COVID-19, the pandemic has made life more challenging for people who are already more vulnerable, advocates said.

Preble Street does not identify the individuals who become part of the annual count, although the first names of those who died are read aloud each year during a vigil on the winter solstice.

One of them was Kim Hood, 51, who died in September from complications associated with hepatitis C, said her boyfriend, Tom Bolduc. For the last year of her life, Hood was frequently hospitalized because of her disease. Although researchers have developed effective treatments and even a cure for hepatitis C, Bolduc, 55, said Hood never agreed to start the treatment because she was wary of its side-effects, and didn’t want to go through the process without a stable place to live.

Since before the pandemic hit, Bolduc said he took care of Hood, but had to cut back his work in construction to day-labor jobs. They spent time together at the city’s shelter at the Portland Expo, where people had designated spaces and cots.

“It’s an amazing place for people who are sick,” Bolduc said.  “We ended up at a hotel. I couldn’t work. There were no jobs, and I took care of her. I had to change her diapers, feed her, give her a shower.  (Doing it in a hotel) is always better than the alternative (of) sleeping outside or sleeping in your car or sleeping in the shelter.”

Andrew Bove, Preble Street’s director of the Street Outreach Collaborative, said the pandemic has made the lives of unhoused people even harder with new layers of complication required to complete basic life tasks. Providers who work at agencies like Preble also have struggled to connect their clients while working from home. And homeless people who in the past were nearby to their case workers are now more dispersed in hotel rooms paid for by the state.

“The increased isolation and disconnection has had reverberating effects on the population, both with their mental health and their ability to connect with  health care,” Bove said. “It was hard enough to get people to go to doctor appoints before the pandemic.”

Portland has Maine’s largest homeless population by far, in part because people from other Maine communities come to the city for emergency shelter, food and other assistance. And the city and private agencies have struggled to maintain shelter and other services for them, especially this year.

The complications brought by the pandemic have made providing access to shelter, food and medical care for people living on the street even more difficult. Hundreds of people are now being sheltered in hotel rooms in and around Portland to avoid crowding in the city’s adult and family shelters.

And in recent months, the number of people with nowhere else to go has again approached record levels.

On one night in early November, 539 people were using some sort of emergency shelter provided by the city, close to the high-water mark for a single night. On average in November, 401 people accessed city-run shelters each night, the city said, and the number does not include additional people who received General Assistance to pay for hotel rooms but did not register at a shelter.

The recently monthly figures show a sharp increase in the number of homeless families from a year ago. This year, the city helped an average 64 families in November, comprising 193 people, up from an average of 46 homeless families, comprising 144 people, who sought assistance in November 2019.

At the same time, two efforts to create new, permanent shelters to serve the city’s homeless remain in flux. The city is still designing a new 150-to-200-bed shelter slated for Riverside Street. And Preble Street has filed an application to convert its former day room in the Bayside neighborhood into a 40-bed shelter.

Preble Street usually organizes a vigil on the winter solstice, the longest night of the year, to remember those who died. But, because of the pandemic, the organization  held the event virtually this year, with a 10-minute video memorializing those who were lost.

Jim Devine, a volunteer advocate with Homeless Voices for Justice and who was unhoused for years while he struggled with alcoholism, said the pandemic has made life even more difficult for people experiencing homelessness. The public spaces where people gathered, got warm or sought help are closed.

“The library was a nice place to hang out on a cold day, now it’s closed,” Devine said. “The (Preble Street) day shelter is shut down. The soup kitchen is shut down. Everything is shut down. I’m sure there’s a number of people on the street right now because there’s a limited number of places to go.”