Since the novel coronavirus was first recognized as a serious public health threat, experts have considered large-scale testing to be a critically important tool in efforts to head off COVID-19 infections and deaths. As US testing volume fell short of levels called for by governors and scientists, the epidemic spread from coast to coast. COVID-19 has claimed far more lives in the US than in any other country, and data show that the national toll of suffering and death weighs heaviest on communities of color.
While COVID-19 deaths and case counts on a per capita basis have been less extreme in California than in other places, the lagging pace of testing in the state’s communities of color remains a serious problem. For example, in San Francisco, Latinos account for 43% of confirmed COVID-19 infections, even though they represent only 15% of San Francisco’s total population, according to the latest testing data and census tally.
That glaring disparity motivated me to contribute time and energy to make testing more available. I volunteered for Unidos en Salud, a project designed to help city health agencies gather data to guide quarantine, isolation, and outreach activities — and to reduce health disparities experienced by people of color. When I agreed to spend a weekend working with many other San Francisco community volunteers, including a dozen UCSF physicians and nurses, I wasn’t sure what to expect. All I knew was that I would be working at a free COVID-19 testing site in a neighborhood park in San Francisco’s Mission District.
My role was to coordinate more than a dozen community volunteers who were managing the registration and screening process to support the clinical activities.
Two days before testing began, nearly 100 volunteers joined an hour-long Zoom training facilitated by members of Unidos en Salud, a partnership between UCSF, the Latino Task Force for COVID-19, and Zuckerberg San Francisco General Hospital. We learned about the program’s overall goals, logistics for the testing days, and testing process. The volunteers represented a multiplicity of races and ethnic groups, hinting at the diverse experiences that brought us together. Our common thread was that all are passionate about ensuring that members of an underrepresented, high-risk community receive the testing and support they need.
What We Did, and How the Community Responded
On the first day of testing, I walked into Parque Niños Unidos at 7 AM with my face-covering in place. I was greeted by what I assumed were smiling faces from medical and community volunteers wearing masks. As we organized ourselves, there was peaceful yet powerful energy in the air. I was the lead community volunteer, and it was my job to make sure our team members had their assignments before learning how to use the registration and screening technology.
We needed to ensure that each of the five testing tents had bilingual volunteers in place. About half of our community volunteers communicated in both English and Spanish. I asked a volunteer to manage the queue, acting as a kind of concierge for each person being tested.
For eight hours a day over four days, our team collected about 950 samples, both PCR (nasal swab) and serology (antibody). People of all ages lined up around the block in safely distanced formation to be tested. On the first day, I observed several multigenerational family members who came together. On the second day, there were more families and an increase in day laborers and people from group homes. We designated a testing tent to prioritize people who were symptomatic. During my two-day stint, registration volunteers sent three or four people directly to this tent.
One family brought a young girl, about five years old, to get tested, She was terribly frightened. It broke my heart to hear her cries, and yet I knew her entire family needed to get tested. Fortunately, we had pediatric medical volunteers. I was moved by the skills they used to make the girl feel comfortable even as she went through the discomfort of the test. They all celebrated with her when she was done. It was a poignant reminder of how crucial our health care workers are in so many ways. I am very thankful for all that they do, every day.
Helping Hard-to-Test Populations
Although the study targeted a specific Mission District census tract, we did not ask anyone to prove their identity. Our goal was to test as many community members as possible, and we were well aware of the fears around identity and citizenship that might deter participation. I observed only a few people from just outside the census tract who volunteered their addresses. The Latino community was well represented.
A couple of people in the queue were experiencing homelessness, and that presented a challenge in the registration process. We tried to collect at least one of three ways to deliver the test results — email, phone, or mail at a physical address. For those who didn’t have any of these delivery options, we identified the cross streets where they reside or spend most of their time. This ensured that the team could follow up to share results.
Participants who later learned they had tested positive were referred to community resources to help them self-quarantine and get needed care.
Seeing the People Behind the Data
Before I decided to volunteer for this effort, I had read data that show how communities of color have worse health outcomes than other populations and how COVID-19 is highlighting this gap in health equity. It wasn’t until I participated in this project that I got a clearer understanding of the people behind the data. While each of us has a different experience, I saw during those two days that my San Francisco neighbors share many commonalities with each other and with me.
We have hopes and dreams. We take care of our families and do anything in our power to make sure those we love are healthy and happy. We need and want to work to support and feed our families. We are frightened of a virus that is disrupting our communities on an enormous scale.
Culturally competent and inclusive testing for COVID-19 is not a fringe idea. It’s an absolute necessity. Expanded testing for both symptomatic and asymptomatic people in San Francisco and in communities across the state gives me hope. When you are able to contribute compassion, attention, and care, you realize how deeply satisfying it is to ensure that all communities get access to the care they need and deserve.
Unidos en Salud needs volunteers for testing starting this week in San Francisco’s Bayview and Sunnydale neighborhoods. To learn more about this opportunity, visit the organization’s website and click on the Volunteer link.
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