When it comes to taking action during a health crisis, the White House can learn a thing or two from the Mission — and so it decided to.
Last week, the Mission’s own community health organization Unidos en Salud, a collaboration between the Latino Task Force and the University of California, San Francisco that began in the very early days of the pandemic, went to the White House. It joined 15 other hyperlocal groups to share community-led health solutions at the White House’s Covid-19 Equity and What Works Showcase.
At the event, Unidos en Salud stood out because of its sharp data collection and community-centered approach, which led to administering 98,000 Covid-19 tests and 66,000 vaccinations at its local, low-barrier sites.
The other invited groups — who similarly stepped up in their local communities during the pandemic — couldn’t get over Unidos en Salud’s use of tech, said one of the group’s leaders, Susana Rojas.
The Unidos en Salud site, now located on 24th and Capp streets, has scaled up to become what Rojas calls a health “surveillance site.” As it was the only of its kind in the conference, it generated lots of hubbub.
“Everyone who gets tested positive gets sequenced, so we can understand what variant is happening in our community,” Rojas said. “Instead of trying to guess or waiting for the city to come out and say, ‘this is Delta [variant],’ we are informing the city.”
This is possible because its tests are processed and sequenced at the nearby Chan Zuckerberg BioHub.
Last winter, tests processed from Unidos en Salud promptly revealed three cases of Covid-19 associated with the omicron variant, thanks to the sequencing, just as the new variant was popping up in San Francisco. Those cases enabled the attending staff to encourage vaccinations before the holiday season.
Additionally, Unidos en Salud has capitalized on QR codes and digital surveys to keep track of and collect granular data about clients. These questionnaires assisted researchers as they learned about who was getting sick and how: Did the client travel recently? How old were their other household members? Did they have an essential-worker job?
Some of these findings ended up in scientific publications. All of the findings were shared with community.
Significantly, Rojas said, the data informed the types of services Unidos en Salud sought to give Mission and Latinx residents; Covid-19 care packages were dropped off at folks’ doors, diapers were bought for mothers. Acknowledging that folks feared missing work longer than necessary, Unidos designed a special link for covid-positive folks last winter, which enabled them to retest at the front of the line.
All of the White House showcase presenters agreed that communicating new discoveries and changes in the evolving disease was key to maintaining trust between health workers and clients. For example, a commonly asked question: Why should people get vaccinated when people could still get sick? (Vaccination reduces the risk of severe disease and death.)
Dr. Diane Havlir, a Unidos leader, professor and Chief of HIV, Infectious Diseases and Global Medicine Division, said communication about new information helps clients better respond.
“It’s really important to tell people that when we change guidelines, it is because there’s progress,” Havlir said. “People can think when one changes guidelines, you made a mistake. No — it indicates we’re making progress.”
Havlir and Rojas, who presented at the White House, said they also learned from the other presentations. One group, for example, works with primarily Black populations, and was able to increase vaccination rates by introducing inoculations in barbershops. Another indigenous leader partnered with their city and county to lower the vaccination eligibility age to 50, instead of 65, because “in her community, people don’t live to 65,” Rojas recalled. “So having people wait for vaccines available for only 65-year-olds didn’t work in her community.”
Havlir, who has extensive experience in responding to the San Francisco AIDS crisis, agreed that moving beyond traditional health settings — even community clinics — can target harder-to-reach populations easier.
Communities also need a “positive place to go, where you can trust in your questions,” Havlir added. Some might recall Unidos en Salud’s “Cafecito con el doctor,” where medical experts fielded local questions about covid at the 24th Street site.
As the pandemic shifts into a different phase, many of the groups discussed how to advocate for more funding and to keep the ties afloat. “I think the funding is the biggest, over-looming dark cloud. It’s a scary place to be,” Rojas said.
Rojas said the data Unidos collected convinced donors to fund it earlier. And Havlir said the basic conditions still exist.
“The pandemic is still with us, and we’re in a different phase, but if these types of efforts are not continued to be supported, to overall health, we can lose the gains that we made,” Havlir said.
Both women couldn’t help but add: Get your bivalent booster at the Unidos en Salud 24th and Capp site.
Our photo caption initially misidentified the Eisenhower Executive Office Building as the White House