And now there are 4x as many deaths due to drug overdoses (by fentanyl alone) than Covid! [1]

If you really care about public safety, you should pay attention to homelessness, drug addiction, and the problems in the streets! It's killing people 4x as fast as Covid, and yet nobody cares! This is exactly the problem that GP was talking about, and you come back with a smug "well our Covid rates are really low" comment.

You're ignoring the point by looking only at Covid. Look at the rest of the data. A city is more than its covid rate.

[1] https://www.sfchronicle.com/bayarea/heatherknight/article/Tw...

> Older Black men living alone in residential hotels are dying at rates far higher than their portion of the city population. And yet most of us will see these statistics, think they’re a shame, and quickly move on.

> Even as [we] devote tremendous time and attention to quashing COVID-19, another public health epidemic that has killed far fewer San Franciscans. As of Saturday, that tally was 123.

> We’re a city that freaks out about a jogger running past without a mask, but doesn’t blink at someone injecting themselves in the neck on a Tenderloin sidewalk.

> That puts San Francisco on track to lose more than 700 people to drugs in 2020 — or nearly two every day. That’s a shocking rise from the 441 people who died of drug overdoses in 2019 and the 259 who died the year before that.

The article suggests the number was already growing at an alarming rate even before covid. While this is tragic, I'm not sure we can attribute these deaths solely to covid lockdowns.

It also behooves us to consider the practicality of public health measures. It's extremely easy for a californian mayor to tell people to stay home/wear masks and get a relatively high level of compliance. Getting people to stop using drugs is a much taller order.

I’m pretty sure the solution to fentanyl overdose deaths has almost nothing to do with getting people to stop using drugs.

> If you really care about public safety, you should pay attention to homelessness, drug addiction, and the problems in the streets! It's killing people 4x as fast as Covid, and yet nobody cares!

And do WHAT, for them? What concrete thing are you supposed to DO?

No matter what YOU think is a solution, most of the homeless will refuse consent. Now what?

You can't just force a person into mental health or drug treatment without their consent unless they commit a crime or are an immediate danger to themselves.

Needle exchanges help. Methadone clinics help. And for the people who don't comply?

Most of the "homeless solutions" are effectively "move them somewhere else--preferably jail". That's really what people who want SF to "get control" of the homeless problem actually want.

Edit: Okay all you genius downvoters, let's hear your "solutions" for the SF homeless problem. I'm waiting with bated breath for your glorious insights ...

I upvoted you because I want to discuss your point.

I have a theory that homelessness is an industry that employs tons of people who are unable to find work elsewhere. The homeless are the product.

Non profit org, public sector employees, donations, city employees, univ PhD researchers, grants etc...for every dollar, more than 60%(I will have to look up the exact number)..will go towards managing the homeless rather than aiding the homeless find a roof over their heads.

This might seem like a cynical way to view this but there is no reason why SF is spending in excess of 500 million dollars in ONE YEAR and still have homeless on the street.

There is literally zero incentive to solve homelessness. Now imagine the problem is resolved..how many people will be out of work? These are not drug addicts or mentally ill..they are educated and normal functioning people who need jobs..they need to be employed. Without a job, they will be unemployed and likely unhoused due to economic necessity.

Of course, people can migrate out of bay area. That would be the rational thing to do. Millions of immigrants do this every single day. But Americans won’t travel coast to coast in the worlds most boring homogeneous country where any freeway or Walmart or mcD in CA is no diff than in NH if economic survival and upward mobility is the imperative.

That’s my 2c anyways.

Someone originally turned me on to CityJournal here on HN some years ago. I'm pretty sure it was this article that did it buried in some comment https://www.city-journal.org/html/sidewalks-san-francisco-13.... I'm not sure if it was coined there but the author uses this term the "homelessness-industrial complex". It was a pretty shocking thing to read back then to contemplate something so cynical, but I think these outcomes can manifest even without outright malice and scheming. So I hear you on the cynical take being a downer, it's all so frustrating the lack of progress.

We have hundreds if not thousands homeless and heroin consuments in the capital of Switzerland. However not many deaths. There are multiple things including giving them straight up clean heroin for, free that really helped getting this 'under control'.

Don't be so quick to assume that this is due to policy. SF county also has one of the lowest marriage and birth rates in the country. Large households, multi-generational households, are one the biggest contributors to the rate of spread.

SF has plenty of those. Marriage and birth rates are low but immigrant populations are high. There are plenty of crowded multi-generational households in SF, it's just that they're largely immigrants rather than native-born San Franciscans starting families. (This is also born out in the racial COVID statistics, where infection rates are much higher for Hispanics and lower-income Asians than for whites and high-income Asians.)

Exactly. SF is one of the safest places to live in the US right now (as it relates to COVID)

The problem, of course, is that you can replicate that level of safety, if it matters to you, anywhere, by locking yourself in your house.

Since the US isn't an island, anytime SF loosens up, CV will immediately spike anyway, so no real advantage gained.

You end up creating a backlash.

If the vaccines live up to their advance billing some small number of lives will be saved, but it is very unclear whether, in the long run, more lives will be lost to the costs of a severe lockdown than saved by it.

Doctors, nurses, EMTs, transit agency workers, taxi drivers, grocery workers, bank tellers, police, firemen, street cleaners, nursing home staff – none of them can lock themselves in their house and continue to get paychecks like the average tech worker. Creating a safe environment for essential workers, homeless, elderly and otherwise financially struggling folks is something most other cities are failing at, and I'm happy San Francisco is not prioritizing the feelings of bros who need to go out to bars.

Other than doctors, can any of those groups actually still afford to live in SF?

They still work in SF, whether they live there or not.

> it is very unclear whether, in the long run, more lives will be lost to the costs of a severe lockdown than saved by it

I have yet to see data that shows any evidence of this theory. If you are aware of any existing data that points to this conclusion, I'd love to see it.

Of course there isn't data about the long-term societal effects of a global lockdown in a modern society. But there are huge numbers of kids being denied education and social interaction right now. There are people who have lost money and are not eating right or living in healthy conditions, etc. So there are clearly going to be massive negative impacts from the mitigation, and nobody will know the scale for decades to come.

For example, just US children are on track to miss 9 million vaccinations in 2020. [1]

Worldwide poverty and deferred healthcare for vaccines and cancer screenings will have a decade the rack up an order of magnitude more deaths than will ever be directly attributed to COVID.

https://www.nytimes.com/2020/11/18/health/coronavirus-childh...

Children can, and, according to the CDC, should get vaccinations during lockdowns.

"CDC and the American Academy of Pediatrics (AAP) recommend every child continues to receive routine vaccinations during the COVID-19 outbreak." [0]

Personally, I'm hoping vaccinations against COVID are what ends the pandemic.

[0] https://www.cdc.gov/vaccines/parents/visit/vaccination-durin....

Did you know that the Spanish flu of 1918 wasn't really Spanish?

Edit: Okay so maybe I skipped to the punchline. Just trying to say politics influences data or lack of data.

> The problem, of course, is that you can replicate that level of safety, if it matters to you, anywhere, by locking yourself in your house.

Yeah. But this idea breaks down as soon as one needs to leave the house for basic necessities. In that case, you would be much better off in a community which takes the issue seriously.

> more lives will be lost to the costs of a severe lockdown than saved by it

Not many lives should be lost by lockdowns, if at all. Perhaps if this issue wasn't so politicized, governments could intervene (and some have, in Europe) to help those in need.

The only reasonable hypothesis I've heard for an increase in number of deaths due to lockdown is suicide and deferred medical care for non-COVID cases.

The US is running at an average 1500 deaths a day now.

We lost about 132 deaths per day from suicide in 2019. Even if that doubles, that leave a lot of room for additional deaths due to deferred medical care. The numbers just don't add up.

Just to be a bit pedantic, these aren’t apples and oranges comparisons. It’s common to measure lives lost in quality-of-life adjusted years, since losing an 85-year old to COVID is a lot different than losing a 20-year old to suicide or due to deferred medical treatment. (The ages are exaggerated, but obviously COVID victims tend to be much older.)

"Since April, 1.9 million excess years of life have been lost, 13% above historical average. Over the course of the pandemic, we found age and sex contributions to excess YLL have shifted. Deaths among adults 65 and older accounted for 80% of excess YLL in April but only 36% of excess YLL in June. Since April, working age adults 20-64 have accounted for 47% of excess YLL, and males 20 to 64 have contributed 34%."

April, May, and June had around 10% excess YLL. July and August had 17.5% excess YLL.

https://healthcostinstitute.org/hcci-research/the-impact-of-...

And? The parent point was that lockdowns might cause other kinds of death (suicide, deferred medical treatment). All-cause mortality obviously encodes those non-COVID deaths, there is no way to tell them apart. Since the cited study lacks the necessary data (and openly states as much), using it to support any claims about the impact of COVID vs lockdowns is simply begging the question.

My point was that dismissing COVID because it "only affects the elderly" is not accurate.

The data I've seen on suicides is cautiously optimistic in many places.

"Nevertheless, a reasonably consistent picture is beginning to emerge from high income countries. Reports suggest either no rise in suicide rates (Massachusetts, USA11; Victoria, Australia13; England14) or a fall (Japan,9 Norway15) in the early months of the pandemic. The picture is much less clear in low income countries, where the safety nets available in better resourced settings may be lacking. News reports of police data from Nepal suggest a rise in suicides,12 whereas an analysis of data from Peru suggests the opposite.10"

https://www.bmj.com/content/371/bmj.m4352

There is good data saying that people have delayed medical care (including me), but I can't find anything about detailed results.

On the other hand, if you are trying to distinguish COVID from the effects of trying to control it, I would like to point out that none of the "lockdown" restrictions have restricted access to medical care. That is either a personal choice or a consequence of overwhelmed facilities.

I'm not dismissing it, and your quote is not something that I ever said -- who are you quoting?

> If the vaccines live up to their advance billing some small number of lives will be saved, but it is very unclear whether, in the long run, more lives will be lost to the costs of a severe lockdown than saved by it.

https://youtu.be/bzh6HwN0gbw?t=398

Better yet, watch the whole thing. And check the public numbers.

Stop spreading misinformation.

In the past 14 days, 99.798% of residents in San Francisco County have NOT received a positive COVID-19 test.

See for yourself at https://thecovidcomplex.com/state/california/san%20francisco...

Full disclosure, I built this website. Data is sourced from the New York Times. It’s the same dataset they use to power the interactive map that was linked. And I just discovered I have an error sharing links to counties with spaces. Go figure lol

Edit: 4 minutes since posting and a downvote. At least explain yourself.

Didn't downvote you, but that 99.7% number is a bit meaningless unless you also state the number of people who were tested at all. Not receiving a positive result due to not being tested in the first place means nothing.

Hi, I appreciate the comment and discussion.

I disagree with the statement that the number is meaningless. Media outlets are free to singularly report the number of positive cases. I see it all over mainstream media (CNN being the worst offender), Twitter, etc.

What's the issue with simply reversing that metric to show many people are COVID negative?

Final note, I'm happy to make updates based on additional data but public datasets are slim pickings. And I'm not in to tapping individual state/county datasets.

NYT publishes daily case counts and death counts across the United States by county.

edit: COVID negative is unequivocally the incorrect term to use. That was a mental mistake on my part. The specific term I use is “did not get a positive COVID test”.

Large numbers of positive results are an entirely different kind of data than large numbers of the opposite (neutral + negative).

One shows the minimum scale of the problem - if it's big, that's a problem, even if it's no bigger than the value reported. E.g. if 10% tested positive, that'd be unambiguously worrying / news-worthy.

The other shows the maximum awareness of a problem. If it's big, you have no idea if awareness is low (many neutrals) or if incidence is low (many negatives). Everyone in SF could have COVID, and that 99.798% number could still be factually correct. Or it could be that only those .202% got it. There's no way to know from that number alone.

First, just because some entity does it, "The Media", doesn't mean it's good.

Second, the number of positive cases is an affirmative result from people that have taken, and failed, covid tests. Your metric takes people who have never taken a test and lumps them into "COVID negative," which is pretty self-evidently extremely misleading.

> metric takes people who have never taken a test and lumps them into "COVID negative,"

True, but the statistic is still useful with respect to comparisons to other locations in the country under the same reporting constraints.

...which hnrodey didn't include in the comment.

Also, I have consciously avoided the term COVID negative. Exactly why I write “have not had a COVID positive test”.

But you have used it though.

> What's the issue with simply reversing that metric to show many people are COVID negative?

Thanks for calling me out. It was a mistake in my earlier comment and I have added an edit.

I need to do better.

I would report test positivity rate if I had a source. I’m not trying to hide anything.

I contend that if you are not taking a test it’s because you didn’t need a test.

It’s also misleading to report only case positivity. Some areas of the country allow only people who have active symptoms to get a test thereby skewing the results.

This is a very misleading statistic you're providing, especially to people who may not be as data-oriented as us, and also a very broad assumption that definitely doesn't hold. Case positivity is a real number based on number of tests, it's not making inferences on things like the rates among those who haven't been tested.

I understand this is your site and you built it, and it's hard to let that go. But, I would implore you to rethink it until you get the data needed to add real insights to the conversations, not misleading stats based on what you have now.

> I contend that if you are not taking a test it’s because you didn’t need a test.

Another reason you might not take a test is that you don't know you need it.

Life is full of risk and trade-off’s. I document my grievances on the About page.

Asymptotic transmission is real (per the CDC) so I’ll accept that as fact. Ultimately if you view yourself as a high risk then it should be a personal responsibility to protect yourself. I believe my family and I to be low risk - citizens should be free to decide their tolerance for risk and act accordingly. Other families across the country and world have similar feelings about health.

I’m frustrated watching small business owners get crushed, bad their employees lose their livelihood.

There is significant damage being done with shutdowns and lockdowns that is with great chance worse than this disease itself.

I'm frustrated too.

But I think your point is strong enough to be presented without exaggeration or misleading.

The media reports the _known_ positive cases, i.e. those that were confirmed by tests and/or doctor diagnosis. There are also a vast majority of asymptomatic cases which are not generally tested or even contact-traced in the US.

We can't make claims about how much of the population at large is healthy because we don't actually know who is healthy and who is covid-positive/infectious/asymptomatic (and this is precisely why there are indiscriminate mask mandates in SF and elsewhere)

Because while that statement is technically mostly factual, it leads to a implication - like the one you make right here "to show many people are COVID negative" - that this metric somehow means that this many people are COVID negative, which is utterly false.

"Simply reversing" that metric gets a number that mostly shows how many people have not been tested within 14 days and thus noone has any idea on their COVID status. It's negligent to imply that this means that they are or would be negative.

Furthermore, even the original data point seems not literally true - this is based on net new cases, which would exclude people who became a net new case 15 or more days ago but actually have received a positive test recently because they are, for example, in the hospital right now and have gotten a repeated test that shows that they are still positive.

I would argue that making factually true statements for which the obvious implication actually is not true is inappropriate - and if it's not by mistake (as it seems out of your other comments) then it's intentionally misleading and should be downvoted.

I think it's harder to grasp the negative counts, because this is essentially the population of the city almost every day. The statistical change from day to day would be less than 1% so it's hard for humans to grasp a significant increase in cases. If the daily cases were to go up by 10x (2000 daily cases), it would still show 881,000 negative cases. If it went from 881,000 negative to 879,000 negative, should we panic?

On your site, El Paso is still at around 98% negative tests, which makes it appear like everything is under control when in reality the hospitals were mostly overrun and had to send patients outside of the county.

> What's the issue with simply reversing that metric to show many people are COVID negative?

There are three groups. Positive, negative, and untested. The untested group is the biggest, and you can't call them COVID negative, because there's really no reason. They're not (yet) either positive or negative.

I used the term "COVID negative" in an earlier post and that was a huge mistake and that mistake has occurred only on this HN thread. I added an edit to that comment to say I was wrong.

No where on thecovidcomplex.com do I use the term "COVID negative".

I had no idea it was your site.

I didn't, and cannot, downvote. However my BS detector immediately went off when I read the phrase "99.798% of residents in San Francisco County have NOT received a positive COVID-19 test." That percentage doesn't really mean anything in this context. More meaningful might be number of positive test results as compared with total number of tests I suppose.

You should be skeptical of everything you read on the internet.

I applaud people who want to confirm what I have provided. All data is available on the page and I’ve provided links to all sources.

Oh, woah, it's not about confirming what's provided or believing everything on the internet. I'm actually giving you the benefit of the doubt that the raw data is correct, and that the statistic you've provided is correct. I'm questioning why you would give that statistic given the misleading nature of it -- and no, other people doing misleading things is not a good reason (as you imply in other comments).

What proportion of residents of other California counties have not received a positive test? Other states?

It’s all there.

https://thecovidcomplex.com/states

For comparison, San Francisco has about the same COVID-19 death rate as Zimbabwe or Uzbekistan.