Why COVID-19 deaths are lower in San Francisco (so far)

COVID-19 deaths are lower in San Francisco
COVID-19 deaths are lower in San Francisco
Sutter Health California Pacific Medical Center (CPMC) Van Ness Campus hospital, located at 1101 Van Ness Ave. at the intersection of Geary Blvd. in San Francisco (credit: Amanda Barnes, Southland Industries)

Many theories abound as to why COVID-19 deaths are lower in San Francisco. This article in USA Today reviews several of them. But before reviewing the possible reasons, we should also be clear that it’s not time to celebrate just yet. The city, state and nation are still in the throes of this pandemic. However, if the current trends in San Francisco hold true, there is a great deal to learn for the future.


Why COVID-19 deaths are lower in San Francisco?

San Francisco infamously instituted a shelter-in-place order on Monday, March 16th. This was the first city in the nation to do so. The idea was so novel to the American public that most were unfamiliar with the phrase. The entire state of California followed suit on March 19th. It’s accepted as conventional wisdom that staying home and isolating is very effective in reducing spread. This epidemiological recommendation bore fruit in San Francisco.


But even before March 16th, the tech companies in the Bay Area, with many of the residents living in San Francisco proper, told their employees to start working from home. While working from home may not be an option in many parts of the country, tech jobs in the Bay Area, and everywhere, are inherently conducive to working remotely. This pre-emptive, unofficial shelter in place was also very helpful in slowing the spread of COVID-19.


Aside from telling folks to stay inside or social distance when they’re out, ensuring they isolate themselves is another matter. There were certainly instances when SF residents were out and not social distancing. But these instances were the exception rather than the rule. Which leads to the other potential reason why COVID-19 deaths are lower in San Francisco.


San Francisco is home base to many delivery services. Aside from New York City, no city is so saturated with food or grocery delivery service options. This is another potential factor in adherence to the shelter in place orders. It’s just plain easier to stay home! Want any variety of cuisine? Call DoorDash, PostMates, UberEats or Caviar. With so many Lyft and Uber drivers available but without traditional rideshare customers, they’re available to deliver food or groceries. Anyone that has ordered food delivery prior to the COVID pandemic knows, it always took at least an hour to get your food. Since the shelter in place designation was instituted, delivery can be measured in minutes rather than hours.


Where’s the evidence that COVID-19 deaths are lower in San Francisco?

The rising number of people testing positive is often the measure of the growing pandemic. But the more significant measure of illness is the number of hospital admissions. The COVID-19 positive patients requiring admission are the sickest and mostly likely to tax the healthcare system. The folks that test positive but are able to stay at home and recover without incident are not the focus of our healthcare resources.


As an active member of Sutter Health’s California Pacific Medical Center hospital staff, I receive updates everyday regarding the number of inpatients with COVID-19. The data includes both person’s under investigation (PUI) and test-positive, confirmed COVID-19 patients.


Thus far, the data over the last week and a half shows that the number of suspected COVID-19 and confirmed COVID-19 patients rose from 22 patients across all three Sutter hospitals in San Francisco, to a peak of 37 and then trended downwards to 22 suspected or confirmed patients as of Tuesday morning, April 7th.


Again, it’s too early to break out the champagne. But if this snapshot offers any optimism, the early actions by tech companies and government officials, and the relative ease with which to abide by those actions, has served San Francisco well.



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