City collaborates on BART testing pop-up, but new data shows hardest-hit neighborhoods remain least-tested

The San Francisco Department of Health’s decision to run a testing site the two days before Christmas with the Latino Task Force was months in the making — often painful months of surging virus infections for the Latinx community. 

And, if the two-day pop-up at the 24th Street BART Plaza goes well, both DPH and the Latino Task Force would like to see it continue.

While this development is welcomed and applauded, Jon Jacobo, who heads the health committee for the Latino Task Force, has reiterated throughout the pandemic that he felt like the house was on fire and DPH was speeding right past it. He’s optimistic, however, that the new collaboration promises a more permanent change. 

We’ve written about the Latino Task Force’s formation, and its success has served the Mission District well, but it also demonstrates how critical strong local advocacy groups can be if the city fails to mete out resources equitably. And that is especially clear in testing, where sustained pressure — not the data and the science — appears to be the elixir for moving public health officials to increase testing where case rates are high.

Indeed, the Department of Public Health’s newly released testing data shows a stark picture of how testing resources have consistently — over the last nine months — failed to reach the most impacted communities and neighborhoods. While the Mission’s testing rate has improved modestly, and is likely to continue to improve if the pop-up becomes permanent, other neighborhoods are virtual testing deserts. 

The neighborhoods with the highest positivity rates in the last two months — Bayview-Hunters Point (5.9 percent), Visitacion Valley (5.79 percent), Portola (4.6 percent), and Excelsior (4.32 percent) — rank at the bottom in testing rates, according to the new DPH tracker. Of the 39 neighborhoods listed in the city’s data tracker, Bayview ranks 19th, Visitacion Valley 35th, Portola 31st and the Excelsior 27th. The Mission’s most recent positivity rate is 3.53 percent, making it the eighth highest. It ranks 14th in testing. 

The Mission is the neighborhood with the highest number of cases, adding 672 new cases between November 20 and December 19 for a  total of 2,698 cases. The total number of cases becomes more important when the rate of reproduction, known as the R number, is above 1, as it has been for two months. Essentially, more covid-positive residents means more reproduction, and more spread of the virus.

Peter Khoury, a data scientist who lives in the Mission District, plotted the DPH neighborhood testing and positivity data over time and more recently. “The city has only moved very marginally to those places,” where outbreaks are happening, he said.

Of the top six neighborhoods with the highest testing rates — Potrero Hill, Mission Bay, Financial District/South Beach, Castro, Marina, and Haight Ashbury, only the Marina has a positivity rate above 2 percent — 2.2 percent

Much of this testing is likely done by private providers, who account for 45 percent of all tests reported by DPH. But for months, a large part of the city’s testing resources have gone to such low-risk residents, the so-called “worried wealthy.” 

The city has not separated out ethnicity or neighborhood data from its own testing sites, but the data we’ve been able to obtain shows that, during the course of the pandemic, more than 70 percent of the DPH tests were done at the Embarcadero and SoMa sites, where virtually any city resident or worker could get an appointment. And, throughout that time, the positivity rates at those sites remained low, according to researchers.  

While the city closed the SoMa site and moved its 500 tests a day to the Alemany Farmer’s Market in mid-November, 1,700 tests a day have remained at the Embarcadero. The city’s most recent data for October and November shows that the Embarcadero site accounted for 68 percent of the city-controlled tests despite a positivity rate of 1.18 percent. 

DPH’s recent decision to collaborate with the Latino Task Force recognized that disparity and moved, at least for the moment, 700 of its 1,700 tests a day at the Embarcadero site to the Mission pop-up. 

If the site becomes permanent, it will make a substantial difference in who DPH is reaching with its testing resources. Already, earlier UCSF/Latino Task Force testing campaigns have demonstrated that BART Plaza testing at 24th Street captures a majority of Latinx testers, most of whom are low-wage workers.

However, the DPH data also suggests that the city will have to look beyond the Mission and add more low-barrier testing in places like Bayview, Visitacion Valley and Portola. Over eight weeks in October and November, DPH provided a total of roughly 4,000 tests to each of those three high-risk neighborhoods. That compares to 108,494 tests over the same period at the Embarcadero, where testers were low-risk.  

Tracy Gallardo, who is on the executive committee of the Latino Task Force and works as an aide to District 10 Supervisor Shamann Walton, said the community groups in the Bayview have only recently had the bandwidth to do more advocacy on testing. “They were all putting out fires,” said Gallardo.

Moreover, she said, the Latino Task Force had the advantage of being Latinos focused on Latinos, a population has had the dubious distinction of accounting for 45 to 50 percent of the city’s Covid-19 cases. 

And, despite seeing these numbers every day — and reading the research reports produced from the UCSF/Latino Task Force’s testing campaigns — it has taken the city’s health department a full nine months to even begin moving a larger portion of its testing resources into the Mission. 

The recent collaboration, Jacobo said, came after a week of tirades provoked by a Mission Local article pointing out the Embarcadero’s low positivity, but high testing numbers. “I was on one for a few days about the inequities,” he said. 

Gallardo said that Bayview’s population is represented by strong Black, Asian and Samoan community organizations, but did not have one collective group that acted in unison. 

Visitacion Valley also has a mixed population, with many seniors. To get testing there during an outbreak over the summer, it took intervention by UCSF’s Dr. Kim Rhoads and Dr. Monique LeSarre, the executive director of the Rafiki Coalition, a center for health and wellness in Bayview. LeSarre’s organization was one of ten organizations that the city recently funded for work to mitigate the impacts of Covid-19.

While the new funds offer some hope, as of now, the year of the pandemic will end with high rates of infection and relatively little testing in most of the city’s high-risk neighborhoods.

Annika Hom contributed to this story.