San Francisco Bay Clinical Trial Unit: Expanding COVID-19 Testing in Heavily Impacted Communities in San Francisco

Project Summary/AbstractAs of mid-May, 2020, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus thatcauses COVID-19 disease, has been diagnosed in more than 1.3 million persons in the United States andaccounted for more than 80,000 US deaths. Identifying persons infected with SARS-CoV-2 before theypresent to health care can reduce transmission and flatten the epidemic curve. The San Francisco BayArea was particularly hard hit early in the COVID-19 pandemic in the United States, and like many partsof the United States, has substantial racial/ethnic disparities in the distribution of cases of COVID-19 inthe City. The eastern parts of the City have the highest case rates, with most heavily impactedcommunities including the Mission, Bayview and Sunnydale neighborhoods, and the Tenderloin, butrelatively few COVID-19 testing sites exist there. In addition, outbreaks have been occurring incongregate living situations in San Francisco, where testing can be difficult to perform. We plan toincrease SARS-CoV-2 testing through 2 low-barrier testing approaches to identify previouslyundiagnosed persons. First, we will use a mobile testing unit to reach persons in facilities andneighborhoods where COVID-19 rates are high. Second, we will conduct testing through a communitymobilization event in a heavily impacted neighborhood in the southeast San Francisco, testing morethan 3000 persons over a four-day time period. We will integrate HIV testing into SARS-CoV-2 testing, asrates of HIV testing have dramatically declined since the beginning of the COVID-19 pandemic, and thereis substantial overlap in the populations at risk of both types of infection. These activities will have theadditional benefit of increasing capacity at the 2 Clinical Research Sites of the San Francisco Bay ClinicalTrials Unit to conduct COVID-19 research, including trials of vaccines and therapeutic interventions.