A12 EZ RE THE WASHINGTON POST.MONDAY, AUGUST 3 , 2020
part of the bargain for reopening
— an unspoken trade-off for some
in exchange for restarting the
economy. But the speed and size of
the increase has created a c hal-
lenge for some government offi-
cials.
“There’s always a balance be-
tween trying to protect public
health and trying to get the econo-
my running again and get people
back to some semblance of normal
lives,” said Nick Moss, interim
health officer for Alameda County.
The county of 1.67 million peo-
ple, which encompasses Oakland,
has the most cases in the area. It
had 11,324 confirmed cases of the
virus at the end of July, up from
4,271 on June 15. Like the rest of
the Bay Area, Alameda’s low-in-
come neighborhoods have been
hit hardest. Just over half of the
posi tive cases are Latino resi-
dents, despite the county’s popula-
tion being just 22 percent Latino.
It’s also the home of the Tesla
auto plant, which reopened before
the county gave the okay and has
had workers fall ill.
Alameda County made it to the
second stage of reopening, permit-
ting some outdoor dining. Just as
it was about to allow “high-risk”
business activity such as indoor
dining, salons and barbershops at
the start of July, Alameda hit the
brakes.
Across the bay, Breed, the San
Francisco mayor, hit pause on
June 26, delaying the scheduled
reopening of hair salons, gyms,
museums, indoor dining at res-
taurants and outdoor drinking at
bars.
Pushing the numbers up in
Marin County was a major out-
break at San Quentin State Prison,
where 2,170 prisoners got sick and
19 died.Francisco neighborhoods to study
how the virus is spreading.
When the group tested an en-
tire census tract in the city’s Mis-
sion District for the virus and anti-
bodies, it found that Latino resi-
dents accounted for 95 percent of
the cases despite representing
40 percent of the neighborhood.
While most people were shelter-
ing, the Latino population was
working and sometimes bringing
back the virus to more densely
populated homes, Bibbins-Do-
mingo said.
Valerie Francisco-Menchavez,
an associate professor of sociology
at San Francisco State University,
is working on research about Fili-
pino home caregivers during the
pandemic. The workers are essen-
tial, she says, but they’re also invis-
ible.
“In the reopening plan, I wished
that the question that politicians
would ask is not how many deaths
can be allowed in Black and
Brown communities. Not how
many deaths can we live with so
people can eat, go play golf, go to
SoulCycle,” said Francisco-
Menchavez.
Rosalie Amacan is a nurse in a
covid-19 unit at a hospital and a
caretaker for a special-needs
child. She also owns two Bay Area
care homes for developmentally
delayed adults. She has kept work-
ing, and is strict about following
safety precautions. But she’s con-
stantly worried. She said reopen-
ings happened too soon, putting
workers li ke her at risk.
“For Filipinos, most of us are
health-care workers and we go to
seve ral jobs,” said Amacan, who
lives in San Francisco. “It’s b ecause
the demand is there, and I feel like
I have to. It’s hard to say no.”
An increase in cases was alwaysnorth of the city. Popular outdoor
destinations there were packed
with cars on a recent weekend as
people, some wearing masks,
crowded the hiking trails and pic-
nic areas.
Some rule-breaking indoor
gatherings are also taking place.
One couple held a wedding with
100 guests in San Francisco in
early July. The couple and several
guests tested positive for the coro-
navirus, according to the San
Francisco Chronicle.
There was also some confusion
among residents as the counties,
once reassuringly in sync, splin-
tered on reopening strategies and
timelines. Marin allowed hair sa-
lons to open and indoor dining for
groups as large as 10 on June 29.
San Mateo stayed with the state-
recommended guidelines. Alame-
da, Contra Costa, Santa Clara and
San Francisco allowed some out-
door dining and retail at different
points in June.
Demographic data and ongoing
research indicate that essential
workers here are facing higher
risk, especially those such as day
laborers, cleaners and home
health aides.
“We’re the ones out there every
day,” said Jay Campos, a bus opera-
tor in San Francisco who drives
the late-night lines from 10 p.m. to
5 a.m. Campos, who lives in the
East Bay, said he has relatives in
New York who fell ill and worries
about keeping his three children
healthy.
“We can’t ignore the fact that
some of this is on the backs of
low-wage workers,” Kirsten Bib-
bins-Domingo said of the earlier
push to reopen. Bibbins-Domingo
leads UCSF’s covid-19 community
public health initiative, which has
been blanket-testing specific Santaining the virus.
“We were dubbed the ‘Califor-
nia miracle,’ ” said Peter Chin-
Hong, a medical professor at
UCSF who specializes in infec-
tious diseases. “Then Memorial
Day hit, and that was probably the
turning point in California.”
Justin Donnelly used to ride the
Caltrain every day from his home
in downtown San Francisco to
work at a Stanford University
chemistry lab. As the shelter-in-
place orders took hold, he started
driving in, breezing along empty
freeways. Over the past three
weeks, he has noticed a slowdown
on the city’s roads as he drives
home midday.
For about two months, the 24-
year-old was only seeing two
friends whom he dubbed his
“quarantine pod.” But he has slow-
ly expanded that pod to a few more
friends he’ll see inside. Everything
else is outside only, he said, noting
that he is following research indi-
cating infection transmission out-
doors is rarer than indoors.
“It seems like a better way to
manage the risk,” he said.
BART ridership is still 89 per-
cent below its baseline amount,
though it has been rising slightly
since the end of May. The number
of people boarding San Francisco’s
MUNI buses in July is down
70 percent year over year, also a
small rise from its low point in
May.
But the number of people driv-
ing across the Golden Gate Bridge
has doubled since its low point in
early April, a sign that people re-
turning to work and other activi-
ties are choosing driving over pub-
lic transit.
Residents of San Francisco also
travel across the bridge for hiking
and beaches in Marin County, justthe coronavirus pandemic
To make matters worse, the
surge has again stressed the mass
testing apparatus, prompting de-
lays in getting test slots and receiv-
ing results.
Veterinarian Steven Randle,
who frequently interacts with peo-
ple for his job, got tested on
June 27 in San Francisco. His neg-
ative test results came 16 days
late r.
“It became completely point-
less by that point in time, because I
would have technically done my
14-day quarantine if it was posi-
tive,” Randle said.
Many white-collar profession-
als here have been working from
home for about five months now,
and sheltering in place almost as
long.
Melinda Byerley recently saw
friends in person for the first time
since March. In the backyard of
the friends’ Mountain View home,
she measured out 10 feet of space.
She brought her own food, used a
bathroom that had an outdoor
entrance, and wore a mask except
when eating or drinking.
Byerley, a start-up founder,
knows she is being highly cau-
tious, usually only leaving her San
Francisco home to run or go gro-
cery shopping. But even as she
stays sheltered, the region is start-
ing to change around her.
“If y ou’re in your 20s and don’t
have kids, the calculus is differ-
ent,” said the 50-year-old. “You
miss your friends. I almost can’t
blame them in some ways. You
move to the city for that excite-
ment, and it’s gone for now.”
Location data from SafeGraph,
a company that collects pings
from cellphones, shows that peo-
ple in the region were staying at
home more, earlier, than much of
the rest of the state.
Around the last week of April,
San Francisco seemed to be the
most careful, with 50 percent of
the population staying home, ac-
cording to Aref Darzi, research
associate at the Maryland Trans-
portation Institute, which uses lo-
cation data from phones to track
human movement across the
United States. By the end of May,
as reopenings began, people start-
ed going out more. The number
went to 44 percent.
“I think as things opened we
didn’t have enough clarity of mes-
sage that opening brings risks and
shared responsibility,” said Srija
Srinivasan, the deputy chief of
health for San Mateo County. “It
brings a need for more adherence,
not less.”
Jason Harrison, an emergency
room nurse at UCSF Health who
has seen an uptick in cases, says he
knows it’s hard to fathom how
destructive and real the disease is
when you don’t personally know
someone who has had it.
He tries to make it as real as
possible for the people in his cir-
cle. He tries to keep his family and
friends informed about what’s
safe as much as possible without
coming off as a “nag.”
“To the average person, unless
it’s actually affecting their friends
and family, it’s still just a news
story,” he said.
[email protected]
[email protected]average of 877 cases a day at the
end of July from 217 a day in
mid-June.
Medical experts say a slow but
steady rise in complacency is
worsening the case count. Contact
tracers ha ve told public health re-
searchers that people are getting
sick after indoor gatherings. And
the numbers show that Latino res-
idents and essential workers are
being hit the hardest.
Many people who live here say
they are worn out — t hat a hermit-
like existence is impossible for
months on end. Tired of being
stuck at home, friends and fami-
lies are starting to gather again,
and some parents are letting their
children use still-closed play-
grounds, ducking under the cau-
tion tape that has been wrapped
around jungle gyms since March.
Gretchen Flores, who works in
patient admissions at San Francis-
co General Hospital, has seen
more people with covid-19, the
disease caused by the virus, enter
the hospital in recent weeks — as
well as more and more people out
and about near her house in San
Bruno, south of the city.
Siva Raj, a t ech worker who
lives in Pleasanton, has seen an
increase in riders on his occasion-
al BART train trips into San Fran-
cisco to visit friends.
After months of barely seeing
anyone, Natalie Duvalsaint, a t ech
recruiter who lives in Oakland,
has started having small wine
nights with friends, and visits with
other friends outside and at a d is-
tance. The rising case counts are
worrisome, she said. But staying
inside and not seeing anyone can
take a toll on mental health.
“We need to shelter in place and
[practice] social distancing, but
what about people with mental
health issues?” she said. “I’m very
extroverted, and I get kind of
down if I don’t see people for a
week and a half.”
The Bay Area is still in a better
place than many parts of Califor-
nia and other large cities. It had
reported a total 53,086 positive
cases and 817 deaths at the end of
July.
That’s relatively low in compar-
ison to other large communities
such as Miami and Los Angeles.
And California itself is experienc-
ing a dramatic surge in cases,
mostly concentrated in Southern
California. Gov. Gavin Newsom
(D) rolled back reopening plans in
mid-July, ordering all bars and
indoor dining closed for the entire
state, and gyms, hair salons and
houses of worship shuttered for
at-risk counties.
But one by one, Bay Area coun-
ties have all been added to a state
watch list, which pl aces additional
restrictions on what can be open.
San Francisco Mayor London
Breed — heralded early in the pan-
demic as an example of a public
official corralling her city into
compliance — issued a h arsh re-
minder to city residents in a public
message when the county was re-
cently added to the list.
“We have a s mall window of
time right now to get our cases
under control before we could see
the large outbreak that we’re see-
ing around this country,” she said,
adding that any business reopen-
ings would be paused indefinitely.
The sudden increase in cases
comes despite the early and tough
steps six counties here took on
March 16, shutting down busi-
nesses and closing schools. Silicon
Valley tech companies — t he most
influential residents — set the
tone in early March, sending most
of their white-collar employees
home to work remotely. And for
months, it seemed as though it
were working.
“What it bought us was 3½
months of relative calm, relatively
few cases, astoundingly few
deaths, and an opportunity to
build up capacity,” said Robert Wa-
chter, chair of the University of
California at San Francisco’s de-
partment of medicine. “What it
also bought us was a little bit of
complacency.”
That’s something Felix Castillo,
a bus operator for San Francisco’s
MUNI public transit system, sees
as more people catch rides.
“What’s scary about now is no
one is scared anymore, everyone is
relaxed,” Castillo said. “I think it’s
the most stressed I’ve been.”
Throughout the pandemic, Cas-
tillo has been crisscrossing the city
on different bus lines during his
daytime shifts, attempting to en-
force the city’s mask rule for rid-
ers. Most people use face cover-
ings now, but he recounts tense
exchanges with some who
wouldn’t. His cousin, another
MUNI operator, was spit on re-
cently by a rider who refused to
use a m ask.
In late spring, Bay Area resi-
dents’ confidence was bolstered
by how well the state and local
governments seemed to be con-
SAN FRANCISCO FROM A
Experts point to complacency as factor in Bay Area’s surge
PHOTOS BY MELINA MARA/THE WASHINGTON POSTTOP: Pedestrians on the streets of San Francisco, where Mayor London Breed recently told residents: “We have a small window of time
right now to get our ca ses under control before we could see the large outbreak that we’re seeing around this country.” ABOVE: Bus riders
make their way through the Mission neighborhood. “No one is scared anymore, everyone is relaxed,” one worried bus operator said.