For most Californians, handwashing is a matter of turning on their home faucet. And while it is no substitute for other guidelines, handwashing is a surprisingly effective measure against the coronavirus. Unfortunately, not everyone can implement this public health guidance. The state’s homeless population has difficulties, and so do residents with inadequate plumbing.

Nationally, plumbing issues—such as lack of running water—can make regular handwashing almost impossible, and California is no exception. The American Community Survey, conducted by the US Census Bureau, collects national- and state-representative information about housing characteristics. In more than 6,300 housing units in California, people lack adequate plumbing, meaning they have no piped hot and cold water, no bathtub or shower, or no flush toilet.

Californians across the state live in units with inadequate plumbing, including in counties being monitored for coronavirus spikes due to worsening virus indicators. Napa and Imperial Counties have slightly lower rates of housing with substandard plumbing than Sacramento and San Mateo. Of the state’s 58 counties, San Francisco has the highest rate. At about 1.8 percent, housing in San Francisco is over four times more likely than housing in Los Angeles to lack adequate plumbing.

The four counties with the highest rates of inadequate plumbing all have poverty rates exceeding 18%. Inadequacy differs by region as well: housing in Shasta, Yolo, and Humboldt Counties lacks hot and cold piped water at the highest rates, while housing in largely urban San Francisco, Alameda, and Los Angeles Counties tends to lack a shower or tub.

The coronavirus pandemic may compound struggles for those who live in housing with substandard plumbing. Over half of these units (57%) also lack a kitchen, making it hard for people to prepare meals at home. Affected individuals disproportionately face health and health care challenges. Compared to people living in modern facilities, those in housing with substandard plumbing are about twice as likely to be disabled (20% vs. 10%) and more likely to have no health insurance (13% vs. 8%). Furthermore, these units are much more likely to be single-person households (22% vs. 9%), which raises broader concerns about mental health: people living alone could be more at risk of loneliness during the pandemic.

Reducing virus spread through frequent handwashing is a vital part of managing the COVID-19 pandemic. But not every California household has the plumbing to meet basic hygiene needs. Addressing this deficiency would take time and effort, but adequate plumbing is part of the foundation of improved health for the communities we live in.

The post Lack of Plumbing Makes Preventing COVID-19 Troublesome appeared first on Los Gatos News And Events.

For most Californians, handwashing is a matter of turning on their home faucet. And while it is no substitute for other guidelines, handwashing is a surprisingly effective measure against the coronavirus. Unfortunately, not everyone can implement this public health guidance. The state’s homeless population has difficulties, and so do residents with inadequate plumbing.

Nationally, plumbing issues—such as lack of running water—can make regular handwashing almost impossible, and California is no exception. The American Community Survey, conducted by the US Census Bureau, collects national- and state-representative information about housing characteristics. In more than 6,300 housing units in California, people lack adequate plumbing, meaning they have no piped hot and cold water, no bathtub or shower, or no flush toilet.

Californians across the state live in units with inadequate plumbing, including in counties being monitored for coronavirus spikes due to worsening virus indicators. Napa and Imperial Counties have slightly lower rates of housing with substandard plumbing than Sacramento and San Mateo. Of the state’s 58 counties, San Francisco has the highest rate. At about 1.8 percent, housing in San Francisco is over four times more likely than housing in Los Angeles to lack adequate plumbing.

The four counties with the highest rates of inadequate plumbing all have poverty rates exceeding 18%. Inadequacy differs by region as well: housing in Shasta, Yolo, and Humboldt Counties lacks hot and cold piped water at the highest rates, while housing in largely urban San Francisco, Alameda, and Los Angeles Counties tends to lack a shower or tub.

The coronavirus pandemic may compound struggles for those who live in housing with substandard plumbing. Over half of these units (57%) also lack a kitchen, making it hard for people to prepare meals at home. Affected individuals disproportionately face health and health care challenges. Compared to people living in modern facilities, those in housing with substandard plumbing are about twice as likely to be disabled (20% vs. 10%) and more likely to have no health insurance (13% vs. 8%). Furthermore, these units are much more likely to be single-person households (22% vs. 9%), which raises broader concerns about mental health: people living alone could be more at risk of loneliness during the pandemic.

Reducing virus spread through frequent handwashing is a vital part of managing the COVID-19 pandemic. But not every California household has the plumbing to meet basic hygiene needs. Addressing this deficiency would take time and effort, but adequate plumbing is part of the foundation of improved health for the communities we live in.

The post Lack of Plumbing Makes Combating COVID-19 Tough appeared first on Los Gatos News And Events.

By Elizabeth Turnbull

It has been close to two since months Kshama Sawants Latest political victory was confirmed. The longest serving member of the Seattle City Council had staved off a recall by just over 300 votes.

Today, Sawant’s strategies appear largely unchanged — centering around rent control, union building, and protections for the working class.

Sawant will not say what her plans would have been if she had lost.

“I can’t really answer that question on a personal level,” Sawant told CHS in an interview last week. “In the history of movement building there are both victories and defeats, victories and setbacks, so if we had had a set back then of course we would have continued Socialist Alternative and I would have continued our political activism.”

Sawant said that any decision about her seat on the council or a run for a higher office would ultimately be made collectively with the local chapter of Socialist alternativethe activist organization she leads and that provides the foundation for her office’s work.

Ahead of the election in December, Sawant’s office tabled in various parts of the city and went hard on their rent control agenda, centering her political identity in her involvement with the working class.

While Sawant’s strong rhetoric remained consistent throughout her efforts to overcome the recall effort, Sawant, and others on her team, admitted that there was uncertainty along the way.

“There was definitely sort of some nervousness,” said Bia Lacombe, a community organizer in Sawant’s office. ”[We were] hoping for the results that we got.”

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Before the December vote, Sawant focused her energy on rent control and rallying the working class.

“Defeating the recall has redoubled my determination,” Sawant said. “We need to bring that kind of leadership that will allow working people to reach their full potential.”

A new, powerful front for Sawant’s fighting spirit is forming in the Starbucks line on Broadway and at the coffee giant’s cafes across the country.

This week, the socialist council veteran led her counterparts in approving a resolution voicing the council’s support for the unionizing cafe workers in the city. Along the way, Sawant also bashed Democrats for tepid labor support and pilloried council members Alex Pederson other Sarah Nelson for staining on the Starbucks vote.

Sawant also successfully pushed her office’s socialist wonkery into the resolution with a passage voicing the council’s support for “card check neutrality,” a growing movement to replace or augment elections supervised by the National Labor Relations Board with negotiated agreements between union representatives.

City Council backs Seattle Starbucks unionization efforts

In Sawant’s eyes, if workers can succeed in forming a union in the city where Starbucks is headquartered, the effects may be felt for workers across the nation, including those working for other corporations.

“Imagine if the Starbucks union gets established and wins fair contracts,” Sawant said. “That will be nothing short of an earthquake in the fast food sector and the service industry.”

The recall victory is playing out in other ways, too. Some of the more than $1 million raised by the Kshama Solidarity campaign to defend her seat is now being used to fight for Seattle labor rights. Sawant has donated $10,000 of her solidarity fund to Starbucks Workers United and she has condemned “union busting,” which Starbucks has denied.

The hope, Sawant says, is to improve living standards for Starbucks workers and that some sort of chain reaction may occur in which more workers in the private sector unionize.

“It will be an almighty battle that we have to conduct,” Sawant said.

Sawant also intends to keep pushing for rent control efforts in Seattle and to advocate for renters rights. Sawant says there is a power imbalance in place between tenants and landlords where renters are forced to pay their rent or be evicted, while landlords are able to hold off on fixing maintenance issues, and face little repercussions.

While she does not have legislation to address this specific imbalance yet, Sawant said her team is investigating with the hope of potentially introducing legislation in the future.

“I don’t want to imply that we already have legislation. We don’t, because we are just investigating it,” Sawant said. “We are just now looking into it and as I said in the committee, we are going to be looking for avenues for legislation to close any existing loopholes.”

In the meantime, Sawant is still advocating for a rent control policy which would dictate that rent be tied with inflation rates and she says that, for now, the eviction moratorium should remain in place “for as long as the public health emergency lasts.”

“City council members and the mayor— we are all working safely from home. We are having meetings on Zoom,” Sawant said. “So if the city is not COVID safe enough for elected officials to go out, then how dare they lift the moratorium for ordinary people.”

As the longest serving member on the city council, Sawant successfully avoided the most recent attempt to remove her from office, but her socialism and political style remain on trial.

While her critics view the Trotskyist council member as a divisive figure, thousands in the city and around the world view Sawant as a hero for the working class, willing to stand up to corporations, and to work alongside the average person that is struggling to make ends meet.

At this point in her ideology and political career, Sawant is not surprised by the polarity of opinions about her. For Sawant, this is yet again an illustration of class struggle.

“If billionaires like Howard Schultz, if corporate landlords, if Amazon executives, if these people started liking what I was doing, I would be seriously worried that I was selling out,” Sawant said. “If you’re truly fighting for working people, you will end up angering big business.”

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The post ‘Really combating for working folks’ — Sawant on defeating the recall and plans for shifting ahead in Seattle’s District 3 appeared first on Los Gatos News And Events.

June 16, 2021

A photo courtesy of the San Francisco Fire by Christopher G. Yock.

Courtesy of the San Francisco Fire

A 21-year-old veteran from the San Francisco Fire Department died on the morning of Jan.

Christopher G. Yock, 58, died at home just hours after fighting the incident with a “medical emergency,” which a San Francisco Fire spokesperson told the San Francisco Chronicle was cardiac arrest. (SFGATE and the San Francisco Chronicle are both owned by Hearst, but operate independently.)

The fire broke out on the top floor of SFO’s private parking garage, affecting eight cars and treating one person for shortness of breath. The fire was extinguished after an hour.

Yock, a San Rafael resident, was remembered as a dedicated firefighter, San Francisco lover, and “beloved fire chief” with an intimate knowledge of the local food scene, according to his obituary. He leaves behind his son Cayden and siblings Jennifer and Jeffery.

A vigil will be held on Thursday at 4 p.m. at St. Ignatius Church in San Francisco and donations can be made to a scholarship fund for Cayden. There will also be a memorial service in St. Ignatius on Friday at 1 p.m.

SFGATE news editor Amy Graff contributed to this story.

Joshua Bote is Assistant News Editor at SFGATE. He grew up in the Los Angeles area, went to UC Berkeley, and previously worked as a reporter for USA Today and a music writer for NPR. Email: joshua.bote@sfgate.com

The post San Francisco firefighter lifeless after combating ‘important’ SFO parking storage blaze appeared first on Los Gatos News And Events.

San Francisco officials and community groups continue to work to reduce hatred, prejudice and related violence, including a march along the Upper Great Highway scheduled for Sunday.

On Saturday, Mayor London Breed, the city’s human rights commission and community leaders launched the Solidarity Campaign to unite Asian-American and Pacific Islanders, Blacks, Latinx, Indians and multiracial communities.

“San Francisco is stronger when we are united and work together,” Breed said in a statement. “We must continue to come together to denounce all forms of hatred, bias and discrimination.”

Launched at the Civic Center Plaza, the campaign featured intergenerational discussions, storytelling, and sharing successful examples of allies and why it’s important to stand together.

Event attendees put together “solidarity packs” that included children’s books, family cards for the Asian Art Museum, mental health resources, and information on public and personal safety.

The kits will be distributed to residents in Chinatown, Bayview Hunters Point, Tenderloin and other areas.

San Francisco’s efforts to reduce racially motivated violence come because crimes against members of the Asian-American and Pacific islander communities have increased since the pandemic began.

According to Chinese for Affirmative Action, there have been 3,795 reports of such crimes in the US as of March 2020, 43% of them in California. And approximately 24% of all racially motivated violence reported in California occurred in San Francisco.

“When we stand together in solidarity, we have strength,” said Jon Osaki, executive director of the Japanese Community Youth Council, in a statement. “It is more important than ever that we stop pointing and the violence that is tearing us apart.”

Regional and community leaders also hosted an event in Millbrae Saturday in support of communities of Asia-American and Pacific islanders. The organizers of the United in Action with Asians rally and march said their goal was to improve the overall safety, awareness and protection of Asian Americans and Pacific Islanders or AAPI communities and communities in general.

The Sunday event in San Francisco, which seeks safety for AAPI communities, is scheduled for 1 p.m. Participants will meet at the junction of the Upper Great Highway on Sloat Boulevard. In addition to the march, there will be speeches, performances and resource tables.

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From Dr. Marcy Adelman-

Although the San Francisco eviction moratorium has been extended to November 30th and additional laws are pending to extend it through December 31st, evictions and threats of evictions have continued. The moratorium does not apply to non-payment cases, Ellis Act cases, or cases of violence or public safety.

Legal Assistance to the Elderly (LAE) has quietly and effectively provided free legal assistance to low-income seniors and adults with disabilities in San Francisco for over 40 years. I asked Laura Slade Chiera, Executive Director, about LAE’s services during the pandemic. She told me for the San Francisco Bay Times, “We have received requests for help with protection against physical abuse, help with unemployment, and assess early retirement, rent payments, and access to health care issues. But by far the largest percentage of calls revolve around evictions or fear of eviction. “

“Many of the calls come from those who are most at risk,” she added. “For example, a disabled trans woman who speaks monolingual Spanish in her late fifties received an eviction notice. She had been in her apartment for 11 years and had paid her rent during the pandemic. She spent the whole winter in her apartment without heating, despite repeatedly asking the landlord to repair it. In addition, she was harassed by the property management team, who made transphobic and racist remarks to her and her friends and harassed her about her immigration status. During this stressful time, a roommate left to help pay the rent. And an operation that kept her from work resulted in her unable to pay the rent. She felt hopeless and was afraid for her future. ”

“She asked us for help,” Chiera continued. “Faced with a defense based on retaliation for demanding repairs, the landlord canceled the owner’s eviction. LAE was able to secure the client’s rental support during this time, and with the eviction threat gone, the client was able to find a new roommate to help pay the ongoing rent. The landlord has carried out the necessary repairs at reasonable times of the day and our customers’ lives have returned to normal. “

LAE’s customers are as diverse as the city itself: blacks, indigenous people, Latinx, API, LGBT, seniors and people with HIV. LAE is a frontline nonprofit that is saving people from homelessness by helping people stay in their homes.

Chiera said: “A large number of calls have come from people living in SRO or single occupancy hotels. SROs are small, rented, furnished rooms in multi-tenant buildings in which the tenants share the kitchen, toilet and bathroom. Tenants are afraid of what could happen to them if they are evicted in the middle of a pandemic. “

She continued: “At the beginning of the pandemic it was particularly tough for the people in the SROs. People were encouraged to stay in their room. These rooms are 8 x 8 in size. Getting food or home care was a challenge. You can understand what a stressful environment this was and how it affected a person’s physical and mental health. “

“It was also a challenging time for the staff,” she added. “Despite the health risk for our older clients, we still had to appear in person in court and at hearings. The staff worried about their customers and themselves. It was very stressful. But we did it together. “

Chiera has been the Executive Director of LAE since 2016. Under her leadership, LAE has increased its budget, tripled its staff and, consequently, increased its impact on senior citizens at risk in San Francisco. Although the majority of cases focus on home preservation, LAE has several other areas of practice, including helping seniors and disabled adults struggling with debt collection; Problem with fraud; physical or financial abuse; and assistance with problems related to Medi-Cal, Medicare and In-Home Supportive Services. In addition, LAE, in partnership with the AIDS Legal Referral Panel, provides life planning for older LGBTQ adults and adults with disabilities who require a basic will and health care instructions.

In the past year, LAE opened about 1,550 new cases. With so many of their customers lacking access to technology services like Zoom, they expanded their mobile services, met customers at home, and exchanged documents through the mail. They also worked closely with the Latino Task Force’s COVID-19 Response Centers in the Excelsior and Bay View neighborhoods, which provide housing law services.

Chiera concluded, “It’s too easy to get cynical about the city’s problems. It is important to remember that the people we serve built this city and now it is our turn to help them. You may have worked all your life but still cannot keep up with rising rents. The city needs to expand housing subsidies and provide more affordable and accessible services and health care at home. San Francisco can do this. “

Legal assistance for the elderly: https://laesf.org/

AIDS Legal Referral Panel: https://tinyurl.com/575xs89h

Dr. Marcy Adelman, psychologist and LGBTQ + longevity advocate and political advisor, is responsible for the Aging in Community column. She is a member of the California Commission on Aging, the board of directors of the Alzheimer’s Association of Northern California, the California Master Plan on Aging Equity Advisory Committee, and the San Francisco Dignity Fund Oversight and Advisory Committee. She is the co-founder of Openhouse, the only nonprofit in San Francisco that focuses solely on the health and wellbeing of LGBTQ + older adults.

Published on October 21, 2021

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Monique LeSarre, the doctor who directs the Rafiki Coalition for Health and Wellness, sat at a folding table at the entrance to the testing tent. In the nineteen-eighties and nineties, when Rafiki helped Black residents devastated by H.I.V. get care, the organization was known as the Black Coalition on AIDS (B.C.A.); as H.I.V. treatment improved, B.C.A. changed its name and broadened its services. “When I heard about the outbreaks in the Bronx and Detroit, I knew this was going to hit our Black neighborhoods,” LeSarre told me. Like Havlir, LeSarre lived through San Francisco’s H.I.V. epidemic and has connections and expertise from that period. To combat the stigma and general ignorance around H.I.V., community organizers like LeSarre, as well as politicians, health officials, and doctors of all kinds, built an infrastructure of trust and communication connecting the city’s government, universities, and marginalized communities. This network has been invaluable during the coronavirus pandemic. In places such as Texas’s Rio Grande Valley, where poor and minority communities are more alienated from their local governments, it has been nearly impossible for health officials to mount a humane and targeted intervention, and cases have surged.

In such interventions, the last mile is crucial. Kim Rhoads, a cancer researcher and associate professor of epidemiology and biostatistics at U.C.S.F., and Kevin Epps, a community-outreach coördinator and documentarian—he is known for his 2003 film “Straight Outta Hunters Point”—brought to Havlir’s team an intimate knowledge of the southern neighborhoods of San Francisco, as well as a wide range of contacts, built over decades, who could spread the word. “If you don’t have community buy-in, there’s always going to be a level of distrust that makes these things almost impossible to run,” Rhoads told me. Over the course of a week, Epps executed what he called a “guerrilla marketing campaign” in District 10, which includes Hunters Point, Bayview, and Sunnydale. “This was door-to-door, posters, putting it out on social media,” Epps said. “I even was out on the corner with a bullhorn.” Epps combatted rampant misinformation. “Early on, a lot of Black people had heard they couldn’t get the virus,” he said. “Even more didn’t want to sign up for testing because they heard Google was running it and thought all their information was going to get stolen.” (The testing sites run by Havlir and her colleagues used Chan-Zuckerberg BioHub/U.C.S.F. labs; Verily, a research organization that is operated by Google’s parent company, runs most of the testing in the Bay Area.) “They’ve all known me for years,” Epps concluded. “That got through some of the trust issues.”

By May, the testing-trace-and-isolate efforts mounted by U.C.S.F. and the Latino Task Force had tested 3,953 people, isolating many of them at a time when the first wave was at its most dangerous. The testing had side benefits: it included a world-class community-based communications effort, designed to inform non-English speakers, and spurred the creation of a new municipal program, Right to Recover, which offered wage replacement to workers who needed to stay home. During the same period, the city’s health department, working at Laguna Honda and other S.N.F.s, was able to take direct action to safeguard an unusually high proportion of the metro region’s most vulnerable elderly residents. All of this happened in a part of the country that had shut down early enough to prevent massive viral spread. But the shutdowns weren’t the end of the response; they were the beginning.

The testing effort drew a map of infection in San Francisco; that map illuminated not just the physical location of the virus but the socioeconomic dynamics of its dispersion. It showed that infections among people who could work from home were relatively rare. Instead, most transmission took place in poor neighborhoods, or in workplaces where people huddled together: nursing homes, restaurant kitchens, meatpacking plants. Differences in case numbers reflected the distribution of certain kinds of workers and workplaces. Berkeley had a low infection rate partly because it had done a good job with its S.N.F.s, but it also helped that there were so few of them. A city is more likely to beat the coronavirus if the indigent elderly who live in understaffed S.N.F.s and the poor essential workers who attend to them cannot afford to live there. Berkeley, in effect, had priced out the worst of the pandemic.

East Palo Alto, known locally as E.P.A., is a good example of a Bay Area city that has suffered during the pandemic without the shield of gentrification. Situated between the marshy south end of San Francisco Bay and the wealthy communities of Menlo Park and Palo Alto, it is home to about thirty thousand people; although it’s just a few miles from Stanford’s campus, no well-funded projects headed by superstar epidemiologists took place within its borders. Its history is deeply intertwined with the story of race in the Bay Area. In the nineteen-thirties and forties, Japanese-American farmers lived on its land; after they were placed in internment camps during the Second World War, Black domestic workers moved in, and for the next fifty years East Palo Alto was a Black city. In the sixties and seventies, Nairobi College, a radical training space for Black and Latino youth inspired by the Third World Liberation movement, was run out of private homes and meeting spaces there. East Palo Alto was devastated by the crack epidemic—in 1992, it was called “the murder capital” of America—and the Black population was eventually replaced almost entirely by working-class Latino immigrants. Latinos now make up more than sixty per cent of the city’s population. The majority are undocumented, and many are essential workers. E.P.A. residents live so close to Facebook’s headquarters, in Menlo Park, that some have taken to stealing the bikes that Facebook employees use to get around campus and tricking them out.

“We’re last in census response and last in voter turnout,” Walfred Solorzano, an East Palo Alto city clerk, told me. “And we’re first in coronavirus.” In early July, at a time when a surge in COVID cases had prompted Governor Gavin Newsom to shut large parts of the state back down, I went for a bike ride around East Palo Alto with Solorzano and a couple of his friends. We started off in Jack Farrell Park, where protesters had painted a mural of George Floyd on one of the concrete walls. The park was surrounded by single-story, single-family homes, most of them fenced off from the street and in disrepair. “Lots more people live in these houses than you’d think,” Solorzano said. “Families living in garages, stacked up inside the houses. So when one of them gets sick with corona, everyone’s gonna get it.”

We headed out toward the industrial flats, on the shores of the bay, passing the new office buildings that housed Amazon’s Web Services operation. On our right was the former site of Whiskey Gulch, once the city’s main street and night-life district; it was now a modern corporate fortress, with gated parking, a bottleneck entrance, and two large, beige buildings bookending a Four Seasons Hotel. Because of the lockdowns, the site was completely empty. “All of this is in E.P.A., but on their Web site they say it’s Silicon Valley. It’s like they’re ashamed to be associated with the city,” Solorzano said. “This space used to have the Nairobi Cultural Center here, and all these old businesses that meant a lot to the people who have been here a long time.”

As we biked, Solorzano summarized the state of testing in East Palo Alto. More Latinos had been getting tested, having been persuaded by word-of-mouth campaigns. Still, he said, many people, especially African-Americans, were hesitant. “I think they might feel this apathy,” he said. “They’ve just seen every promise get broken, and maybe they’re just giving up.” This hopelessness has extended into the winter. East Palo Alto’s test-positivity rates have hovered around fifteen to eighteen per cent, which is roughly five to six times higher than the surge that shut San Francisco back down this winter; at times, rates have reached thirty per cent.

After beginning its response with broad, early shutdowns, San Francisco and its surrounding cities and counties faced a challenge. How do you manage a pandemic in a city where some people can afford to tutor their kids in pods, have all their groceries delivered, and leave the city at a moment’s notice for houses in Tahoe, on the northern coast, or even in Hawaii, while others live in tent cities? Confronting the pandemic required the coöperation of young, relatively affluent residents who could work from home; it also demanded targeted interventions among low-income essential workers, immigrants, the poor, and people in nursing homes. San Francisco, perhaps more than any other city in the country, has particularly stark gaps between these groups.

“It’s not been easy,” Mayor Breed told me, when I asked her about the city’s response in Latino neighborhoods, where people fear that coöperating with health officials will ensnare them in an immigration dragnet. “There’s definitely a trust issue there. I can’t control ICE. I can only control what we’re able to do. We’ve made it clear to people, whether for the census or for testing, that we don’t share information with ICE and that we’re there to provide support, but that message takes a lot of work.” Kim Rhoads explained the other side of the problem: communicating the inequalities of the pandemic to white voters. “It’s so complicated,” she said. “We don’t want it to be called a Latinx disease here, so we have to be very careful about that.” She added, “You can’t just say that the Latinx community is contracting the virus without explaining exactly why. You have to say who is still going to work in food plants, who are the essential workers in kitchens and delivering groceries.” To describe the racial inequalities of the pandemic, she concluded, is also to risk “inciting the worst anti-Latinx sentiments.”

In the coronavirus’s winter wave, San Francisco and the Bay Area have not been spared. Infection rates, while still comparatively low, have spiked; for the first time since the start of the pandemic, I.C.U.s and emergency rooms are inching toward full capacity. But the approaches used in the spring and summer—hyper-localized targeting; an emphasis on the hardest-hit communities; the coördination of disparate resources in hospitals, clinics, academia, the community, and government—are just as relevant now. You still have to look for the virus. Having found it, you can suppress its spread; you can also, in the months to come, vaccinate at-risk populations.

After finishing up their studies in San Francisco, the U.C.S.F. team went across the bay to Alameda County. In an initiative led by Alicia Fernández, a physician and researcher, they set up testing sites in Deep East and West Oakland, both traditionally Black neighborhoods, and Fruitvale, a majority-Latino neighborhood that, despite being situated in the center of the relatively calm Bay Area, had some of the highest test-positivity rates in the country. In Fruitvale, the researchers determined that the epicenter of the outbreak wasn’t the Latino community in general but a group of Mayan workers from Guatemala who speak the indigenous Mam language. Rhoads and her colleagues believe that these sorts of specific insights, which are currently vital for testing, isolation, and education, will also be needed when it comes time to distribute vaccines. The U.C.S.F. team has learned to fine-tune its testing efforts; it has discovered, for instance, that, while scheduled-mass-testing sites work well within Latino and Asian neighborhoods, Black residents in Oakland are more likely to visit pop-up testing sites. “The same issues with testing are going to be present with the vaccine,” Rhoads said. “A lot of health-care institutions and even research universities have this vision that, if they provide it, people will come. That’s just never been true, and it’s certainly not going to start being true now. We need to meet people where they are.”

The architects of San Francisco’s coronavirus response may find a receptive ear in the Biden Administration: three U.C.S.F. faculty members, with a broad combined range of expertise, from biostatistics to emergency-room management, will serve on the President’s coronavirus advisory board. But it’s worth asking if any top-down effort can replicate the city’s success in a country that now averages more than two hundred thousand new confirmed cases per day. Even the best plans require basic infrastructure; in San Francisco, much of that infrastructure had been put in place long before the pandemic arrived. It is difficult, in a matter of months, to build bridges between minority populations and local governments, or to fix long-standing problems with understaffing in privately run nursing homes. Around the country, even well-intentioned test-and-trace programs have struggled to reach vulnerable people who, afraid of the government, do not want to share their names and contacts with a stranger on the phone. While Operation Warp Speed, the Trump Administration’s effort to produce and distribute a vaccine, has found success, no similar effort has been aimed at the protection of nursing homes, which, nine months into the pandemic, still account for forty per cent of COVID-19 deaths nationwide. (In individual states, the figure has sometimes risen to more than seventy per cent.)

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