City response to COVID is not alright

When the coronavirus first emerged among us, it would have felt churlish to berate over-burdened public health bureaucracies for their errors and omissions. But it has been six months now. Lydia Chavez and Hayden Manseau of Mission Local have looked into what we can all sense about San Francisco's neglect of the Mission neighborhood. Their reporting is judicious, intelligent, and scathing,

... fuzzy math [is] being deployed to measure how the city is doing in its battle against Covid-19. The city’s seven-day average case rate for the week of Sept. 7 per was 6.8 per 100,000 residents. ... The city’s seven-day average case rate for the same week in September was 2.3 for white residents, 4.71 for Asian Americans, 6.5 for Blacks and 16.4 for Latinx ... In a transmissible virus, researchers said, it’s dangerous to allow the impact on segments of the population to be diluted by tossing them in with everyone else. Those harder-to-reach but persistent cases become all the more important to stop the spread of the virus.

... The numbers the city publishes to keep the city informed on how we are doing paint an overly optimistic picture. But perhaps worse is that the city’s strategy to rid San Francisco of Covid-19 appears to be less urgent in the communities that it knows are high risk.  That model leaves everyone vulnerable. 

There's some good news amid the criticism.

... San Francisco has had a remarkably low death rate, but here too, the racial disparities are apparent: Of the 99 Covid-19 deaths, Asians comprise 31 percent of the deaths, compared to their 34 percent of the population; Latinx, 27 percent, compared to their 15 percent of the population; Whites, 17 percent, compared to their 40 percent of the population; and Blacks, 8 percent, compared to their 5 percent of the population.

Because the death rate has been so low, the city has been able to focus on cases, but testing has not been aimed at the most impacted populations.

The powers-that-be have excuses for their omissions.

... Resources are still limited but, as the Health Department likes to point out, San Francisco now tests more than most cities. Most of those tests are done at the city’s SoMa and Embarcadero testing sites, where the positivity rates are at 1 to 2 percent, according to sources. ...The sites are available by appointment only and easily accessible if you have a car. Both are also accessible by public transportation, but that requires extra time 

... Stefan Baral, a Johns Hopkins University epidemiologist, said that testing sites around the country are “set up for those who can take a few hours off from work compared to the people who are more shift workers.” This testing approach disadvantages people who are carrying the greatest burden during lockdown, he added. 

... Covid strategies across the country, said Baral ... “focus on the protection of the wealthy.”

The experts consulted by Mission Local think the city's future with the pandemic looks threatening.

Despite the solid citywide average, pandemic fatigue and a sagging economy, San Francisco cannot let its guard down, epidemiologists say.  

“If we are seeing an overrepresentation of cases in one group, the logical next step is to tailor interventions to match that need,” said [Tomi] Akinyemiju, [a professor in Population Health Studies at Duke University specializing in epidemiologic methods.] 

Akinyemiju envisions what will happen without such tailored interventions: “Cases will continue to spread in those groups, the healthcare system will be taxed because many individuals in the most impacted groups don’t have access to healthcare, and we will continue to see Covid transmission throughout the city.”

The Mission neighborhood and the city of San Francisco are extraordinarily fortunate to have Mission Local producing quality local journalism in this time of media contraction. If you care about knowing about the 'hood, throw them some cash!