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San Francisco Marin Medical Society Blog


COVID Won't Be Over Until Everyone is Safe: San Francisco's Next Move

San Francisco has been applauded for its aggressive public health response to slow the spread of COVID-19. An existing crisis has grown in scope during this time, however: housing shortages. 

Just seven months ago, the Bay Area faced a grim winter of COVID-19 infections with no apparent end in sight. Today, even with the delta variant looming, over 80 percent of San Francisco residents have received at least one dose of the vaccine, bringing San Francisco “out of the woods,” says Mayor London Breed.

While San Francisco’s COVID-19 numbers remain relatively low compared to that of many large cities, the pandemic exacerbated the city’s stark wealth and racial inequities. Behind the scenes, those living in crowded conditions, working essential jobs, and facing barriers to healthcare access disproportionately experienced the effects of the pandemic. The question now stands: where should the city’s efforts be directed? 

Last month, Mayor Breed proposed San Francisco’s two-year budget, with specific funds allocated to the ongoing COVID-19 response, homelessness, education, affordable housing, and other services. Thus, while still focusing on its immunization efforts, San Francisco is moving into a new phase of pandemic recovery.

San Francisco’s funding proposals reflect a desire for an equitable recovery from the pandemic. By expanding COVID-19 vaccinations and prioritizing those most vulnerable to the virus, the city will rebuild stronger. With these considerations in mind, SFMMS applauds the prioritization of affordable housing and permanent supportive housing initiatives, with a large portion targeted to homeless individuals.

Early in the pandemic, the city funded its first Shelter-in-Place (SIP) hotel, as part of the state’s Project Roomkey, eventually expanding the program to include more hotels. Later, triggered by a need to provide additional housing, San Francisco purchased hundreds of new supportive shelter and services, expanding Project Roomkey to Project Homekey.

What became clear is San Francisco’s urgent need to invest in permanent, supportive housing to break the cycle of chronic homelessness and get people back on their feet. In recent months, local politicians have made this hope a reality by proposing bold policy changes to combat homelessness, including Mayor Breed’s Homelessness Recovery Plan. To initiate such historic change will require a strong sense of empathy and urgency on all levels of political leadership and local support.

Marin County that is also making key investments in supportive housing. Throughout the pandemic, Marin County has also taken advantage of Project Homekey. Based on the program’s benefits, the Marin County Board of Supervisors is expanding its housing to support one of its most at-risk populations - homeless veterans. Marin’s funds will be allocated in the form of $4 million from the state budget with an additional $8 million raised from local partners. This housing will be the first built in Marin to prioritize its homeless veterans. 

Just as Marin is making historical investments to address the needs of its homeless veteran population, San Francisco has an opportunity to make positive ripples that extends to its entire community. By centering housing in its recovery plan, San Francisco will restructure itself through a more equitable lens. 

“Something like a pandemic makes it clear that for a society to be healthy, we need to attend to the health needs of everyone.” says Director of UCSF Center for Vulnerable Populations, Margot Kushel, MD. Poor health extends to an entire community by spreading infectious disease, hindering economic activity, and affecting crime and safety. With these implications in mind, San Francisco can curb the spread of disease and bridge health gaps by investing in rapid permanent supportive housing and affordable housing. 

While looking forward, it is important to reflect. San Francisco and Marin have so much to be proud of. With the joint efforts of its vibrant people, bold leaders, considerable public-health capacity, and expertise that predated the coronavirus pandemic, San Francisco became a trailblazer in slowing COVID-19. Moving forward, San Francisco and Marin can lay the groundwork to become a more resilient and inclusive place to live.

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