San Francisco Must do More to Stop COVID-19

If you only read national news media you’d think San Francisco is a COVID-19 success story, but our response is sorely lacking in many areas

Despite rave reviews and pats on the back from national media, San Francisco’s response to the coronavirus crisis can only be described as inadequate. While it may be true that we have avoided the severity of the outbreaks seen in Southern California and New York, that doesn’t tell the whole story. Generic shelter-in-place orders and citywide testing goals leave many people still vulnerable, which means no foreseeable end to shelter-in-place. The city is failing to transparently present information, has presented no comprehensive plan to tackle coronavirus, and has no discernible plans to ensure front-line workers and vulnerable populations receive necessary protections. 

The city needs to track and share data

In order to ensure the safety of its residents, San Francisco needs to track and share more data on testing and contact tracing with the public. It also needs to use that data to drive any policy changes in terms of relaxing shelter-in-place and determining the most effective ways to reduce the spread of COVID-19. Recently, the city lifted shelter in place for various activities, including construction. However, the city has neither presented any plan to track cases contracted by construction workers returning to work, nor have they devised any triggers for suspending these resumed activities if they prove to increase transmission. The city’s failure to enact clear and public rollback policies raises the already-high risk that the mayor will cave to political pressure at the expense of public health. If construction work is shown to be spreading the virus, the mayor, a supreme ally of developers — with open FBI corruption investigations into her friends’ and staff’s gifts from developers — might not roll back these activities. Conversely, construction work could pose no risk, and data demonstrating this could lead to further reduction in shelter-in-place orders for other activities. Without any publicly-shared data, the city leaves its residents in the dark as to the effects of these policies. 

The city needs to care for its most vulnerable

Consistently, the city has ignored risks faced by its most vulnerable communities. The city’s own data shows that coronavirus has disproportionately affected its south-east neighborhoods, and the majority of cases have stricken our Latino population—mainly front-line workers. The unhoused face extraordinary risks, including subpar access to testing and safe places to practice social distancing. Many people have died in nursing homes, too. Yet, even as we see the alarming spread of COVID-19 among our most vulnerable communities, we have no data as to who is being tested. It would be easy to claim testing is sufficient and the percentage of infections is down if testing occurs only for certain demographics and leaves out others. Furthermore, the city has neither established goals for tests within these communities nor publicized attempts to trace cases and inform residents. Testing and tracing in undocumented communities must be handled with care, because of the threat of deportation and language barriers. The city must have specific goals to test and trace within these communities, and plans to protect undocumented workers from ICE. One plan could be to cite any ICE employee as violating shelter-in-place orders, and even arresting ICE employees in order to discourage any ICE presence in the city. If vulnerable populations do not receive tests despite overwhelmingly bearing the brunt of the infection, our city is effectively rolling the dice on those communities’ lives for the sake of the city’s optics, and in some cases, for the sake of profits earned from the afflicted community’s labor.

The city needs to test more

Overall, while the city has expanded its testing options and plans to expand contact tracing, the city has not explained to the public how it plans to reach the goals it has set for itself. The city set a goal of performing 2 tests per 1000 residents per day, but has not even met the smaller goal set by the Governor of 1.5 tests per 1000 residents per day. Likewise, the 90-90-90-90 contact tracing goal—to reach 90% of all newly diagnosed COVID-19 patients; ensure that 90% of those patients are able to safely isolate; reach 90% of the patient’s close contacts and ensure that 90% of those contacts go into quarantine for two weeks—requires significant coordination and follow-up, but the city has provided no insight as to how this will work. 

The city needs to look out for workers

The city has emphasized testing, and made some transportation available, but has otherwise done little to protect our most vulnerable communities, especially frontline workers. While a worker can report a business for not following guidelines, there does not seem to be any systematic inspection and accountability to ensure businesses are held responsible. Workers could face retribution for complaining, and may rather take the risk of getting infected than lose a vital source of income. The city must inspect all open businesses to ensure that they follow all safety measures, and to ensure that all workers have protective equipment, along with facilities for hand washing and time to take breaks. The city should publish data on these businesses, highlighting businesses that do not protect workers and are discouraging testing, so that public pressure can change this behavior.  

The city needs to address the elephant in the room

Moreover, the idea of ensuring quarantine reveals the looming issue the city faces: its unwillingness to address the precarious economic state of the most vulnerable populations. How can a working person suddenly quarantine for two weeks? The city has offered housing to front line workers, but without proactive tracing and testing and grassroots campaign to quickly move recently diagnosed people into these housing options, workers will spread the disease to other people in the household and infections will continue to grow. Recent stories on contact tracing show a nascent program that focuses on virtual interaction, but only a community based network of testing, tracing and self isolation will limit the disease. Front line workers are not using the available housing. The city needs to ensure they do. Also, Housing intended for the unhoused is still unoccupied. Our failure to house our unhoused neighbors has been an ongoing issue, and seems intentional on the part of the mayor. Mayor Breed has ignored supervisors’ legislation and has used her emergency powers not to help the unhoused, but to instead disregard the elected Board of Supervisors, to the detriment of public health.

The city should plan for the future

Finally as the city gets more specific data, and can catch and trace more cases and perform more tests, it should look to ways to imagine a new San Francisco. One that is less car-dependent, with slow and open streets that allow neighborhood businesses to reopen, using car-free streets to help maintain social distancing and allowing some downtown businesses to move quickly into residential neighborhoods and use outdoor areas.