The San Francisco “Miracle” and Need for Continued Vigilance

A thoughtful article was published this week by Dr. Martha Lincoln, a medical and cultural anthropologist at San Francisco State University. She points out (with numerous examples) that countries viewing themselves as “exceptional” or “outliers” have had worse public-health outcomes when it has come to COVID-19 response (link below).

Similarly, San Francisco has been viewed as having an “exceptional” early response to coronavirus particularly at the outset of the pandemic. In fact, I have used the San Francisco Health Department as a example in my blog posts of a constructive epidemic response.

Their epidemic curve (presented below), with rates once 10 to 15 fold lower than those in Los Angeles suffered the same mid-July surge seen here. For the week ending 9/11, Los Angeles had 7.53 daily cases per 100,000 population; San Francisco 6.51.

Managing a respiratory pandemic requires singular and sustained focus. While we are all cheering lower numbers, these current rates are still too high. According to the Harvard Global Health Initiative, rates between 1-9 cases per 100,000 population require rigorous test and trace programs to ward off accelerated spread.

I think any of us when we take an objective look at COVID-19 testing, tracing and supported isolation efforts in California all know that we are hardly being rigorous. San Francisco did an amazing job in containing COVID-19 – until they didn’t.


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