The Atlantic: The City That Has Flattened the Coronavirus Curve

RUSSELL BERMAN, THE ATLANTIC

London Breed wasn’t going to wait around for COVID-19.

San Francisco had yet to confirm a single case of the coronavirus when Breed, the city’s 45-year-old first-term mayor, declared a state of emergency in late February. Two weeks later, Breed’s decision to ban gatherings of more than 1,000 people forced the hand of the Bay Area’s beloved Golden State Warriors, who this year moved into San Francisco’s Chase Center after nearly a half century in Oakland. Her decision, along with the NBA’s first positive case of the coronavirus, set in motion a chain of events that effectively shut down all of the nation’s major sports leagues.

At the time, Breed heard criticism that she was moving too quickly.

“Not anymore!” she told me with a chuckle when we spoke by phone this week.

Nearly a month after those initial orders to enforce social distancing, San Francisco and the broader Bay Area have emerged as a national model for how early and aggressive action can prevent the explosive rise in cases that has overwhelmed hospitals in New York, where leaders were slower to respond. San Francisco’s case count of 857 as of April 10—with just 13 recorded deaths due to the coronavirus—is much lower than that in metropolises of comparable size such as New Orleans, Detroit, Boston, and Washington, D.C. The city’s curve is low and flattening, and patients are not flooding into its emergency rooms.

“All evidence suggests that they are doing much better, and the simplest explanation for that is that they did take social-distancing measures very seriously and they did it early,” says Emily Gurley, an epidemiologist at Johns Hopkins University, which has been tracking the global COVID-19 outbreak.

San Francisco and California as a whole have struggled much more than New York to ramp up testing capacity, raising the possibility that the relatively low number of confirmed cases paints an overly rosy picture of the crisis there. But epidemiologists and public-health officials say that while positive cases are surely being undercounted—as they are across the country—San Francisco’s stable public-health system and low death count offer validation of its success so far.

“We’re seeing that our hospital beds are not very full at this point,” Yvonne Maldonado, an epidemiologist at Stanford Medical School, told me. “We’re just not seeing a big spike there.”

“Deaths are hard to hide,” adds Cyrus Shahpar, a San Francisco–based director at Resolve to Save Lives, a nonprofit that combats global epidemics.

Breed ordered businesses closed and issued a citywide shelter-in-place policy effective on March 17, at a point when San Francisco had fewer than 50 confirmed coronavirus cases. (California Governor Gavin Newsom followed with a similar statewide order a few days later.) On that date, New York City already had more than 2,000 positive cases. But New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio, reluctant either to shutter schools or issue a stay-at-home directive for the nation’s largest city, didn’t take similar action for several days. By the time New York City fully shut down on March 22, more than 10,000 cases were reported across its five boroughs.

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