'A World Apart': UCSF Offers Free Mass Coronavirus Testing to Residents in Bolinas and SF's Mission District

In what’s believed to be a first-of-its-kind study, researchers from UCSF are aiming to test as many residents as possible in both the small Marin County community of Bolinas and in San Francisco's bustling Mission District, an ambitious effort to learn more about how the coronavirus is spreading in very different socioeconomic communities.

The initiative began on Monday in Bolinas, where medical staff and volunteers, donning personal protective equipment, set up a drive-thru site at the local fire station. There they began testing residents for both the virus and its antibodies, using nasal swabs and a finger-prick blood test.

Testing in the Mission is scheduled to begin Saturday at Garfield Park, with additional community locations to be announced.

In both locations, testing is free and slated to take place over four consecutive days (with a possible fifth day in the Mission). Residents can schedule appointments online:

• Bolinas appointments
• Mission District appointments

The nasal swab samples, which test for the virus, will be processed at UCSF's lab first. Researchers aim to return test results within 72 hours. Antibody results — used to help identify people who may have been exposed to the virus or have recovered from the COVID-19 infection — will take longer.

The project also includes contact tracing, in which researchers will notify residents who are infected, find their recent contacts and advise them to quarantine.

Cyrus Harmon, president and CEO of Olema Pharmaceuticals, a biotech company, and venture capitalist Jyri Engeström, both residents of the tiny, largely white, unincorporated town of Bolinas, led the testing effort there. To date, they have raised about $330,000, with the objective testing nearly all of the town's roughly 1,600 residents.

It's important to start testing healthy people, Harmon said, to better understand "the dynamics of the virus, how it spreads, what the degree of spread via asymptomatic carriers is, and if, as much of the evidence seems to suggest today, there really is a great deal of transmission via asymptomatic carriers."

He and Engeström were inspired by the town of Vo Euganeo in Italy, which was able to test nearly all of its 3,300 residents for the virus, and subsequently help control its spread.

"And so the idea was maybe we could do something like that here, and do it in a way that other communities could learn from what we've done,” Harmon said, noting that most Marin County residents can now only get tested for the coronavirus with a doctor's referral.

"It was really hard to get tested. And we wanted to figure out, well, what can we do to broaden the availability of testing," he said. "We wanted to do this in a way that wasn't taking away from any of the existing testing capacity of the county."

When the two reached out to UCSF's Division of Infectious Diseases for support, they learned that researchers there were already planning a similar endeavor in a nearby, but notably different place. In collaboration with the Latino Task Force on COVID-19 and the San Francisco Department of Public Health, the team set out to offer free tests to the roughly 5,700 Mission District residents — the majority of whom are Latino — living between South Van Ness and Harrison Street and Cesar Chavez and 23rd streets.

A map of COVID-19 cases, which San Francisco officials released Monday, shows the 94110 ZIP code — in the the Mission District — as having the most infections in the city. Citywide, 25% of positive cases are among Latinos, even though they make up only 15% of San Francisco's population.

"This likely reflects risk factors such as living in crowded conditions, and whether residents have sufficient support to stay home and reduce their outings," Mayor London Breed's office stated in a press release.

Dr. Bryan Greenhouse, a UCSF professor of medicine involved in the project, said the Mission District and Bolinas, while geographically close, are "a world apart" in most other respects, and comparing test results could yield valuable insights.

The study "will hopefully provide a nice spectrum of what we might expect to see elsewhere in the Bay Area," he said.

Greenhouse added that researchers need to develop a better understanding of how the virus spreads before any shelter-in-place orders or other restrictions can be safely lifted.

"What needs to happen before we can feel comfortable loosening things up is that we have to have a very, very good ability to detect and respond to infections, and that's got to be much better than what we've got right now," Greenhouse said.