Much like the rest of the nation, San Francisco is seeing a surge in cases of COVID-19. Since the beginning of November, cases have risen from approximately 3.7 infections per 100,00 people to nine per 100,000. As a result, on Tuesday Mayor London Breed and Department of Public Health Director Grant Colfax announced that indoor dining would be halted, and gym and movie theater capacity reduced to mitigate the spread of the disease.
The rise in COVID rates hasn’t come at a good time for San Francisco — at least, not from a testing standpoint. SoMa’s testing site at Seventh and Brannan streets shuttered earlier this month, pending its move to the Alemany Farmers Market, where it is scheduled to reopen Nov. 17.
That leaves Embarcadero as the main city-subsidized testing facility for city and essential workers, but even with the capacity to conduct 1,500 tests a day, it’s fully booked two weeks out. No tests were available to book on Tuesday. Or Wednesday. Or Thursday. A pop-up screen suggests those needing tests visit their medical provider; but from personal experience, scheduling a COVID test through a doctor requires a lot of phone calls, adequate health insurance and the freedom to wait several days for results.
As a result, the lack of appointments at Embarcadero and SoMa could have an outsized impact on smaller, neighborhood testing sites, many of which target those most vulnerable to catching the disease: low or no-income residents and working-class people of color.
Jon Jacobo, the health committee chair for the Latino Task Force, manages a Mission neighborhood testing site at Alabama and 19th streets. He says that on average the testing site conducts 200 to 250 tests per week. But recently, they’ve seen a sharp spike. Last week there were 384 tests done. The week before, 395. On Thursday afternoon, Jacobo said they were on track to hit their capacity of 400 tests by the end of the week.
Across The City, another neighborhood site is seeing an increase in demand for tests. Glide runs tests for the Tenderloin neighborhood on Tuesdays and Wednesdays. It has the capacity to run 250 tests a day, and according to the deputy director of programs, numbers in early November have been higher than usual.
Part of this, no doubt, is due to increased messaging from the media and city about a rise in COVID rates. But Jacobo says that since the SoMa testing site closed and Embarcadero filled up, the demographics at the Mission location have changed.
“At first it was just our Black and Brown community, and now it’s a lot of employees from a nearby company that has their headquarters down the street,” he said. While no one is turned away, Jacobo is concerned about reaching those proven to be highly vulnerable to the disease: low-income Latinx residents, many of whom work outside of the home.
For that community, running out of tests could be catastrophic. Positive rates in the Mission have averaged around 9 to 11 percent. In contrast, the large Embarcadero testing site only sees a 1 to 2 percent positivity rate. If those deemed lower-risk take valuable appointment spots in higher-risk communities, there could be an outsized effect on not just statistics but also rates of spread.
Which really begs the question: Who should be tested, and where? For example, Embarcadero has 300 daily spots reserved for city employees, who can often get same-day appointments. But not all city employees are frontline workers, and this system can push nonprofit employees who work with high-risk populations to visit neighborhood sites when appointments fill up.
Moving forward, it’s clear there has to be a greater investment in testing resources overall, particularly in anticipation of winter spikes in COVID. Large-scale drive-through sites like Embarcadero need to increase capacity, to draw in those who are fine entering a slew of information into their iPhones to schedule an appointment 10 days away.
At the same time, neighborhood sites need to be built up to be robust enough to handle fluctuations in testing demand. And this, Jacobo says, is where The City falls short. There is currently no plan to open a new testing location in SoMa. There’s no testing site in the Haight. Or the Sunset. Or the Richmond.
“I believe that everyone in historically redlined communities throughout San Francisco should have access to a low barrier testing facility,” Jacobo says. “It’s incumbent on the Department of Public Health to make sure they’re partnering with community experts to make these sites come to life.
“Follow the data and see where it leads,” he adds. “It is poor fiscal management to test everybody at Embarcadero, and not target the communities that are most impacted.”
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