Zuckerberg San Francisco General Hospital

With the long-awaited state vaccine mandate scheduled to kick in at midnight, hundreds of employees at the already short-staffed Zuckerberg San Francisco General Hospital stand to be fired. 

Some 234 Department of Public Health employees remained unvaccinated as of Sept. 29, and an additional 75 failed to report their vaccination status. Of those, 152 unvaccinated employees work at General Hospital, alongside 64 who have failed to report their status. 

These numbers are a small fraction of overall Department of Public Health employees. Some 95.6 percent of DPH workers are vaccinated. But the minuscule percentage of unvaccinated employees still represents a significant number of people because DPH is big: 7,474 employees. 

It’s also significant because the hospital is already deeply understaffed — and, as the city’s trauma center, it cannot scale back its offerings without dire consequences. 

“We are already on 12-hour shifts without lunch, meals, or rest breaks. That happens on the regular,” says Heather Bollinger, an emergency room nurse at SFGH since 2007. “We are offering overtime in the emergency department on every single shift. They are starting to mandate people work overtime.” 

With fewer workers to fill the gaps, Bollinger predicted “mandatory overtime, burnout, and undue burden.” 

Vaccination numbers for the Department of Public Health as of Sept. 28. City officials are hoping these numbers will be reduced as tonight’s deadline draws ever nearer.

Mission Local is informed that the bulk of unvaccinated Department of Public Health employees work as nurses, nursing assistants, medical assistants, licensed vocational nurses, eligibility clerks, and in housekeeping. 

Separate and apart from the wisdom or righteousness of vaccine mandates — and everyone contacted for this story supported them, in principle — the resultant firing of potentially hundreds of health workers figures to exacerbate a bad situation at the hospital. Front-line workers wondered whether the Department of Public Health had planned adequately in advance.

“We can do the best we can, and also make it clear that it’s not going to be helpful for us to work with people who are making others sick and making patients vulnerable,” said longtime nurse Sasha Cuttler. 

Regarding the Department of Public Health’s plan to make up for what figures to be a sudden exit of many frontline workers, Cuttler says he and his fellow nurses haven’t been kept in the loop. 

“They have had a very difficult time following the safe staffing ratios that have been on the books and in our contracts — for a very long time,” he said. “So, I don’t know what their plan is as far as whether they’re planning to do something about it.” 

Multiple calls and emails to the Department of Public Health querying how gaps will be filled in the coming days and weeks have not been returned. City sources have mentioned Mayor London Breed’s recent extension of an emergency proclamation that smooths out the city’s normally sclerotic hiring practices: The Department of Public Health, in 2019, reported that it required up to 220 days to hire a nurse and 419 to land a behavioral health technician. The hiring process contained no fewer than 34 steps. 

There are purportedly plans in the offing to undertake accelerated mass-hiring events, such as the onboarding of 150 nurses in a few weeks at the onset of the pandemic. 

Certainly, that could be done again. But even with the rosiest and most accelerated of timelines, the next several weeks could be even more difficult than usual at SFGH. 

And, considering the demand for healthcare workers across the nation, it may not be easy to lure workers into San Francisco’s notoriously difficult trauma hospital. 

Potential hires are “faced with the option of working mandatory overtime in a critically understaffed setting with an extremely challenging patient population and incredibly thin resources or taking a $20,000 sign-on bonus in Idaho or Pennsylvania or New York,” sums up Bollinger. 

The city is banking that the nearly 500 people on its potential hires list do not want to relocate to Idaho or Pennsylvania or New York. It’s also banking that, as the clock ticks down to 11:59 p.m. on Sept. 30, reluctant employees will opt to take the shot. 

The pending deadline is for “employees who are assigned to or routinely work onsite in High-Risk settings or other Health Care Facilities.” Workers who do not receive a vaccination or disclose their status will be terminated for “failing to meet a work condition.” 

As of yesterday, 32,412 city employees were vaccinated (92.2 percent). Some 2,252 were unvaccinated (6 percent) and 337 had declined to report (1 percent). 

Desk-bound city employees are mandated to return to the office on Nov. 1. As that date approaches, city sources anticipate a goodly number of resignations and retirements from workers who have grown accustomed to working remotely and will search for new jobs that allow for that to continue. 

For front-line nurses, that’s not an option. So they will continue coming to work — which, they say, grows harder every day.

“During the HIV-AIDS pandemic, misinformation was shared on tightly hand-written leaflets posted on telephone poles,” said Cuttler, who’s worked on and off for the Department of Public Health since 1987. 

“Now we’ve put the author of pandemic misinformation’s name on Zuckerberg San Francisco General Hospital.” 

Update, Oct. 1: From the Department of Public Health: “As of September 30, there were 113 staff employed by SFDPH at the hospital who remained unvaccinated for COVID-19 and 54 who had not reported their vaccination status. These numbers combined represent 5% of the SFDPH workforce at this facility.” 


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Managing Editor/Columnist. Joe was born in San Francisco, raised in the Bay Area, and attended U.C. Berkeley. He never left.

“Your humble narrator” was a writer and columnist for SF Weekly from 2007 to 2015, and a senior editor at San Francisco Magazine from 2015 to 2017. You may also have read his work in the Guardian (U.S. and U.K.); San Francisco Public Press; San Francisco Chronicle; San Francisco Examiner; Dallas Morning News; and elsewhere.

He resides in the Excelsior with his wife and three (!) kids, 4.3 miles from his birthplace and 5,474 from hers.

The Northern California branch of the Society of Professional Journalists named Eskenazi the 2019 Journalist of the Year.

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  1. The logic of “we don’t know enough” about a vaccine that has reduced serious acute illness and deaths for 100’s of millions of people(as well as having shown effective in laboratory tests) is exactly the same as the logic of doubting the reality of climate change and that all species have come into existence by a process of natural evolution. It’s not about not knowing enough, it’s about knowing too much that is simply not true.

    I wouldn’t agree to receive health care from anyone who thinks that way.

  2. I’m a UCSF employee who works at SFGH and I’m not vaccinated. Thursday, Sept 30, I was informed that I can no longer come to work. This issue was never addressed because I had an exemption from UCSF. I have taken all safety precautions and preventative measures. I am your community’s phlebotomist while I was pregnant from 2019-2020. I am also running the rapid COVID swabs for this community. I am the one making sure you get your results right away when you’re in emergency room and operating room.

    I do plan to get the vaccine, but there needs to be a better regimen. I think every vaccinated person should have gotten their antibody levels checked each month and booster should have given earlier. Maybe a regimen like hepatitis B vaccine.

    We also need to look at side effects like myocardial problems or clots. We might need to just go back to the drawing board and recreate a safer vaccine.

  3. @Joe – Awesome, and I say important to interview nurses from the 8% for DPH who rather not get the vaccine. This too is valuable information and important to be part of the conversation. One sided conversations are not representative, nor inclusive.

    What we have experienced in the past 1.5 years and are to this day is unprecedented. So many are just focused on vaccine or else. It is not as simple as get the jab or else, there are valid concerns around this from scientists, medical professionals and humans all around the world.

    You cannot compare the COVID-19 vaccine to others like polio, smallpox, measles etc.

    There are other countries who did not/do not have the privilege to vaccinate their populations at similar rates as Western Rich countries. They have found ways to contain and treat COVID-19, including preventative care. To think that vaccinating everyone will get us out of the pandemic in itself is an irrational thought. It is NOT the only way, it’s a bandaid and we have far bigger issues that are not being talked about or centered in the conversation.

    More and more scientists and medical professionals are speaking out about this as well and saying that they have big concerns on the COVID-19 response and especially with rushing to vaccinate all kids. That the Governor of California is now mandating state wide kids to be vaccinated is alarming to me. Very alarming even.

    There are a lot of pieces from the conversation that are not being shared and told, and that is a problem in itself. Anytime there is a one sided conversation, non inclusive conversation, especially this widespread it is dangerous. This hurts all of us, even if you can’t see that or understand that, it does.

    For those that refer to science we are in the middle of it all – we are all part of one big experiment and results are collected as we go. Science in itself is a continuous study of understanding, experimenting, discovering and collecting data. With COVID-19 there is still a lot we don’t know, as is with the COVID-19 vaccines. We are learning all this information in real time.

    I understand those who get vaccinated and I understand those who want to wait, are hesitant or choose not to at all.

    Lastly, it is sad to me that the very people (nurses and medical professionals) who risked their lives, who were on the front lines of it all, who worked and are working overtime, with limited resources, with minimum pay are now being furloughed because they don’t want to comply with a mandate. If they have been successful to work safely all this time, then why can’t those measures still be applied? It doesn’t make sense to me.

  4. The union failed us…they went silent with the exception from a coworker who was a shop steward. We kept asking for answers and had to jump through hoops. Had to write a rebuttal to the exemption and told to go on leave, unpaid. DPH strings us along with the hope of a job, on to hear the director tell us we won’t be able to work on campus at all. The N95 was the new scarlet letter, the new yellow star. I moved 500 miles almost 4 years ago for this job I thought I would be retiring from and now I’ve had to walk away. What happened to my body, my choice?

    1. You have the choice and you made it. Now you must accept the consequences of your decision. All the people who made their choice not to get vaccinated need to grow up and stop acting like the world owes you a participation trophy.

      1. So do you feel like you earned a participation trophy for taking the jab ? Is that why you’re on here on your soapbox proclaiming righteousness.

  5. It’s your right to not be vaccinated, but it’s not your right to infect others.
    Of the medical professionals to denies Science and Facts is beyond belief.
    Very simple get the Jab or be furloughed…
    Your choice…

  6. Retention bonuses for those that remain at Zuckerberg San Francisco General Hospital would be helpful. Financially, it is in the hospital‘s best interest to do so.

  7. Joe, it would be really awesome if you interviewed nurses from the 8% for DPH who rather not get the vaccine. We all have different world views yet know we don’t want this vaccine. To remind you, we worked countless hours, reusing PPE, overtime, & short staffed the last 1.5 years, there was no issue.. until this vaccine. It’s been almost 2 years, we as nurses know best the consequences but some rather manage in other ways. Many of us have natural immunity, families to feed but no one cares. We want to be heard and keep our jobs. I and others are willing to wear N95s and be tested yet we’re in limbo unaware about our exemptions and not allowed to show to work. Pls interview us, give both sides to the masses.the fact that it’s vaccination for the end all be all is irrational and going to impact staffing in a negative way. There’s ways to be safe and not get the vaccine. Not to mention staffing is awful!!!! If only the city residents knew.

    1. it’s science, not “world views” or “beliefs”.
      polio, smallpox and diphtheria vaccines fit your “world view”?
      “many of us have natural immunity”??? a hospital is not a healing or wellness center where “beliefs” are accepted.
      i’m really taken aback that people trained in health sciences (!) would behave so irrationally.

    2. I’m curious how you feel about the flu shot requirement? I recently started working for UCSF and for the first time in my life had to get a flu shot because it’s required there for all employees. (This was right before the pandemic hit.) I was scared of the flu shot, but felt worried about inadvertently killing an elderly person with my germs so I did it. I had never worked somewhere with so many vulnerable people so this was all new to me. When the vaccine rolled around, I figured it was the same: Scary shot versus unintentionally infecting someone more medically vulnerable? Though I do wonder if maybe if it would be sufficient to let people who don’t want a vaccine to test once or twice a week. I’m not a doctor, etc. – just a lowish level employee who watches all of the UCSF Town Halls and tries to understand the science.

    3. Thank you for posting this comment. I do agree it’s strange these nurses were not interviewed for the story. I respect the incredible work you’ve done.

  8. Forced medical intervention was always wrong and will always be wrong. Totalitarian takeover were always justified with emergencies and always will be. What makes you people think it’s something different this time? Please educate me!

  9. It is unfortunate that our union, local 1021 of SEIU has felt obligated to represent and fight for employees who refuse the jab. Better that they provide leadership and support the only rational way to get this pandemic over with and that is vaccines. They should not be optional for healthcare workers.

        1. I know of 5 people who have gotten covid in the last 3 months and they are all vaccinated and yet they are allowed to walk into any bar, restaurant or event and get in by showing their vaccination card. The card doesn’t tell whether you’re covid negative or positive at the time of entry and these five people whether they know if they’re positive of not can transmit the virus, so everyone is a threat, vaxed or unvaxed. My unvaxed friends have not gotten covid yet, yet they are not allowed entry to restaurants, bars and events. This is discrimination and to fire someone for being unvaxed is unjust.

    1. Agree!! I emailed them asking how they came to the decision to fight this and why weren’t all members given a vote. They never answered.