UC San Francisco epidemiologists and infectious disease specialists are partnering with several community organizations and the San Francisco Department of Public Health (SFDPH) to offer comprehensive, voluntary COVID-19 testing to residents of the Bayview, Sunnydale and Visitacion Valley, three medically underserved neighborhoods in the southeast region of the City with significant African-American, Pacific Islander, Chinese and Latinx populations.
The collaboration is the latest example of UCSF’s tightly coordinated work with the City and County of San Francisco, the state of California, and affected communities to respond to the public health crisis presented by COVID-19.
Under the banner “United in Health D10” (a reference to San Francisco’s Supervisory District 10, where the neighborhoods are located), testing for the Bayview will take place on May 30 and 31, 2020, from 9 a.m. to 5 p.m. at Havard Early Education School, 1520 Oakdale Ave; testing for Sunnydale and Visitacion Valley will take place June 1 and 2, 2020, from 9 a.m. to 7 p.m. at Herz Playground, 1701 Visitacion Ave.
United in Health D10 is part of the recently launched UCSF COVID-19 Community Public Health Initiative, which aims to counteract an overall lack of data about the community spread of SARS-CoV-2 that has made the virus hard to track and contain. The initiative, led by Kirsten Bibbins-Domingo, PhD, MD, MAS, vice dean for population health and health equity at the UCSF School of Medicine, focuses on communities and populations disproportionately affected by the virus, and on building robust community partnerships. For example, the initiative recently sponsored a similar testing program in the Mission District, an area that, along with the neighborhoods in United in Health D10, is among the neighborhoods with the highest rate of coronavirus cases in San Francisco.
Although many people who become infected with the coronavirus may never show symptoms, they can still spread the illness. And even those who do experience symptoms may never get sick enough to go to the hospital, and also may not get tested.
“Because we don’t have a treatment for COVID-19 and we do not have a vaccine to prevent it, the only way we will crush this coronavirus is to try to identify people who are positive and are potentially infectious, and to provide whatever support they need to isolate,” said Kim Rhoads, MD, MS, MPH, associate professor of epidemiology and biostatistics, who has spearheaded UCSF’s community engagement efforts for the new testing program.
Goal of Reaching 800 Individuals Per Day
To make this possible, UCSF’s new COVID-19 initiative employs a “wraparound” approach – marshaling the knowledge and networks of trusted community organizations to provide follow-up and support for those with positive test results – that was put in place by UCSF professor of medicine Diane Havlir, MD, during the Mission District testing program.
“Day in and day out, these organizations are there on the ground – pandemic or not – serving the needs of the community and population,” Rhoads said. “They know where the resources are and how to leverage those resources.”
With a goal of reaching 800 individuals per day over a four-day period, both diagnostic (PCR) and serological (antibody) tests will be offered to “all who live, work, play or pray in these diverse, multigenerational neighborhoods,” said Michelle Pierce, MBA, executive director of the Bayview Hunters Point Community Advocates, who has worked closely with Rhoads to engage families and community organizations in the new testing program.
United in Health D10 also benefited from the enthusiastic backing of District 10 Supervisor Shamann Walton, who represents the neighborhoods where the testing will take place. “I’m proud to work with UCSF and District 10 community leaders to bring COVID-19 testing to the Bayview, Sunnydale, and Visitacion Valley,” Walton said. “Like UCSF’s prior study in the Mission, this testing program in D10 will help us to better understand the spread of COVID-19 in San Francisco’s most vulnerable neighborhoods.”
Leveraging UCSF’s Capacity for Sample Analysis
And as with the Mission District study, United in Health D10 takes advantage of greatly increased capacity for COVID-19 sample analysis now available at a new UCSF diagnostic laboratory adjacent to CZ Biohub at Mission Bay. That lab, built from scratch in just eight days in March, is now providing free COVID-19 test results to all 58 county departments of public health in California. The new UCSF lab was made possible in partnership with the Chan Zuckerberg Initiative under the leadership of Biohub Co-President Joe DeRisi, PhD, a professor of biochemistry and biophysics at UCSF.
All participants in the new testing program will receive “care packages” containing information on COVID-19 and community resources, personal protective equipment (PPE) such as masks, and food items.
“They can come and get the care package, and they don't have to get anything else, but we'd like them to get tested, if they want,” said Monique LeSarre, PsyD, executive director of Rafiki Coalition for Health and Wellness, which aims to eliminate health disparities among marginalized communities in San Francisco. “This is an opportunity to learn more about what's happening and to get resources.”
Those who do opt for the testing and are positive for active COVID-19 infection will get immediate follow-up calls from an SFDPH Clinical Response Team, which will work hand-in-hand with community groups to assist with the process of facilitating isolation and quarantine. A Community Wellness Team, through partnerships with local organizations and health care networks, will remain in regular contact with those individuals, and in collaboration with the San Francisco Human Rights Commission, led by Sheryl Davis, EdD, will deliver food, cleaning supplies, and other helpful items for the approximately two-week period required for a person’s immune system to clear the virus.
The diagnostic test for COVID-19 is not perfect, and it also is just a snapshot in time, so those who test negative will be advised to continue to abide by shelter-in-place and social-distancing mandates to protect them from getting infected or infecting others.
“UCSF has been a key partner of the San Francisco Department of Public Health, and together we are doing everything we can to support the health for all our communities in our city,” said Grant Colfax, MD, MPH, director of health for SFDPH. “This program will provide voluntary testing to populations and locations in our city that are most affected by health disparities, by income inequality, and by structural racism. Moreover, this testing effort will help identify and slow the spread of COVID-19 in the community, and help provide critical information to the community, scientists and public health agencies about how the disease spreads and how we can stop it.”
Havlir, the scientific lead of United in Health D10, emphasized that testing is foundational to every other component of the pandemic response that UCSF has mounted in collaboration with the State of California and the City and County of San Francisco, especially as the state and City move to reopen businesses and places of worship.
“This is what we must do in order for us to respond effectively and reopen safely,” said Havlir, chief of the Division of HIV, Infectious Diseases and Global Medicine at Zuckerberg San Francisco General Hospital and Trauma Center. “We need more local community epidemiology like this to get a sense of where we stand, and where active infection may still be occurring, so as public health officials begin to release constraints on movements we can avoid resurgence of the disease.”
In addition to the efforts cited above, UCSF’s closely coordinated response with the City and County of San Francisco and state of California to COVID-19 has included providing forecasting and counseling by UCSF epidemiologists; implementing a statewide contact tracing program in collaboration with the California Department of Health; providing $1 million and clinical expertise for the City to open a COVID-19 unit at Saint Francis Memorial Hospital; and opening a new, 53-bed respiratory isolation unit at UCSF Health’s Mount Zion hospital to expand the city’s overall hospital capacity for potential future surges, while offering dedicated space for current patients.
The proactive effort builds on UCSF’s long-standing commitment to addressing public health crises, which dates back to the University's founding in the mid-19th century, and includes such issues as homelessness, and such diseases as cholera, tuberculosis and HIV/AIDS.
The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF’s primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area.