By all accounts, the first day of the Tenderloin pop-up COVID-19 testing site went terribly last week.
“The first day was awful,” admitted Ken Kim, senior director of programs at Glide Memorial Church, of the May 20 opening day. Glide and Code Tenderloin are the two community partners for the site, which is run by Verily, a subsidiary of Google’s parent company, Alphabet. The company’s back-end system required appointments to be made online through a Google account, which presented the first set of barriers to residents of the Tenderloin.
Mission Local’s reporter witnessed denizens of the traditionally low-income neighborhood being turned away from the testing site and told to return when they had a phone.
But over the next couple days, things improved, and workarounds were put in place: Verily gave Glide a list of pre-made Google accounts it could hand out to people who didn’t have Gmail addresses; the appointment system, which the back-end engineers couldn’t disable completely, went largely ignored by on-site staff; and a second walk-up registration area, closer to the testing site at the Tenderloin Recreation Center than Glide is, was staffed by people from the Coalition on Homelessness.
“We’ve reduced some barriers in a very kludgy, unofficial way,” said Brian Edwards, an advocate with the Coalition on Homelessness. “No one should have been getting turned away since Thursday.”
But the next set of hurdles to clear started this week, even before the site opened again on Thursday to offer more tests: How will people without computers (or possibly even smartphones) log in to their Google accounts to check their test results?
“That’s going to be the trick of it,” Kim said. “That’s what we’re trying to pilot — for us to figure out a system where people can come back and get their results from us.”
It’s not uncommon to deliver test results online. In the UCSF Mission Study, most people received their results online after being sent a code via text message or email, Diane Jones, a retired HIV nurse who helped with the study, said — although anyone who tested positive was called directly by a doctor or nurse.
People tested at the Hunters View testing site in the Bayview have the option of being called, receiving an email, or checking back in with the Bayview Child Health Center to ask if their results are ready. Clients can even list a street block where they can normally be found, and staff will try to locate them there.
With Verily, however, the primary way to see your results is by logging in with the same Google account you used when you signed up to be tested. If someone who got tested kept their appointment card with their Google account and password on it, the next step for them is finding a computer. That may not be easy for many Tenderloin dwellers, pandemic or not.
“We can tell them some drop-ins where they can [use a computer], and that’s what we’ve been doing. But it’s still going to be a barrier. It depends if that drop-in is within distance of wherever you’re headed,” Edwards said. Getting help at Glide is an option for some, but not for every unhoused person. “That’s not really a drop-in distance, especially when you need to leave all your shit back there and cross your fingers it’s still there when you come back.”
And if someone no longer has their paperwork with their Google login printed on it, it gets even trickier. “Holding onto a piece of paper if you don’t have a shelf to put it on is [harder],” Edwards said.
Kim said Glide has been keeping a list of people it helped register. That list discloses individuals’ Google logins, but not their passwords. In some cases, Glide helped clients change the pre-made passwords from a random string to something they might have a chance of remembering, and set up password hints in Google. Glide can help clients through that process to recover their password, but it isn’t foolproof.
“We’re hoping it’s a small percentage of the people we have to do this stuff with, to help them get access to whatever they need,” Kim said. But he stressed that this is very much a pilot program and a work in progress. “I think we will be working with Google and Verily on that process. … Honestly, we still need to figure it out.”
Rob Avila, a Glide spokesman, said that as of Tuesday 25 people had come by Glide to access their results. Of those, only 11 had test results available. The rest will need to return. “The process is going okay, though it’s still early and they won’t know how well it’s working until they have some more people and results to connect,” he said.
In a written statement, Verily said people who test positive will also receive a phone call if they test positive.
It’s unclear how many people were tested at the Tenderloin site last week. Some approximations had the figure at more than 1,000, while other estimates pegged it in the 600 to 700 range. The Health Department has not yet responded to a request for a breakdown of the number of tests per day.
A more interesting number may be how many people log back into the system to check their results after they’ve been tested. Presumably only Verily will be able to provide that figure, but information from that company has in general not been forthcoming. The company declined requests for an interview and issued written statements through a PR firm.
Those statements, among other claims, still insisted that “no email [is] needed” to be tested at the site. That’s arguably true, but only by parsing words to a high degree.
Is an email account strictly required? No — but a Google login is. And the type of Google login most people have are Gmail accounts, so saying “Gmail account” becomes shorthand for “Google account.” The city’s own website plainly states “you need a Gmail account to register” at the Tenderloin site.
The Electronic Frontier Foundation has also raised privacy concerns with Verily’s approach of requiring Google accounts at all.
“While Verily has said that it needs to use Google accounts to verify information, it hasn’t explained why it can’t use a less invasive form of identification,” Hayley Tsukayama, a legislative policy analyst for EFF, told Mission Local.
The pop-up testing site will be in the Tenderloin for another week, testing people from 10 a.m. to 4 p.m. on Thursday, May 28, through Monday, June 1. After that, the original plan announced by the mayor’s office called for it to “move to another high-need neighborhood,” but where that will be remains to be seen.