This paper situates a ten-year period of political upheaval in addressing the problem of Single Room Occupancy (SRO) housing in Vancouver, Canada, within an epistemic transformation of public health. Until 1970, the Vancouver Health Department exemplified a colonial history of public health in establishing the city’s skid road as acordon sanitaire. But the 1970s saw a sudden fading of the Department’s authority just as a more collaborative approach to housing policy was emerging. The sunsetting of sanitary enforcement was driven in part by the arrival of a “new public health” that became primarily concerned with defining public health problems and solutions through the regulation of racialized bodies and behaviors—acordon thérapeutique. By the 1980s, this shift constituted an epistemic and regulatory abandonment of SRO housing, leading to the accelerated deterioration of the entire housing stock and costing incalculable human suffering and the loss of lives.