First Wave of the COVID-19 Pandemic Crashes In Southeast San Francisco
New York Governor Andrew Cuomo spoke at his daily briefing on April 23, 2020 and addressed, for the first time in the national dialogue, the perfect storm generated by the COVID-19 pandemic’s impact on dense low income, industrialized communities of color where cardiopulmonary diseases like asthma are exacerbated by exposure to the novel coronavirus along with air pollution and toxins from low paying service work in polluting industries.
On April 20, 2020, the San Francisco Department of Public Health released a map of confirmed cases of COVID-19 by zip code. That map corresponds to EPA mapping of city zip codes with the highest particulate matter emissions in tons per year.
Of note, over 20 tons of particulate emissions are generated in the 94124 zip code each year by construction dust, polluting industries and mobile sources. The 94124 zip code ranks second highest in COVID-19 cases per 10,000 population. An estimated 35 people live in the 94124 zip code. In interpreting the citywide COVID — 19 case map it is crucial to note that while the zipcodes 94110 and 94112 report the highest number of cases, they represent wide geographic areas with populations double to triple that of 94124.
Prepared statements issued by San Francisco Mayor London Breed include the grossly inaccurate misinformation: “I want to stress that when it comes to coronavirus, no zip code or neighborhood is inherently safer than another.”
This is obviously not true! The San Francisco COVID-19 Response Map clearly identifies regions of the cities westside with fewer than 4 cases reported. Indeed the 94132 zip code I reside in has NO reported cases and is not even included in the San Francisco mapping.
The most important information missing from the SFDPH COVID-19 case map are zip codes for the cities 21 reported deaths. Demographic breakdown of COVID — 19 deaths by race, gender and age show 11 were Asian, the majority male and over 60 years in age. The zip code distribution for San Francisco’s COVID-19 deaths is not documented.
We know the 94124 zip code harbors inordinate incidences of cardiopulmonary diseases, diabetes and disabilities that increase the risk of contracting COVID-19. We know lung diseases caused by chronic exposure to airborne toxins look exactly like COVID -19 lung diseases and are called Interstitial Lung Disease (ILD).
Interstitial lung disease occurs in both COVID-19 infection and in people chronically exposed to air pollution. Little focus has been given to the fact the disproportionate incidence of COVID-19 cases and deaths occurring in densely populated low income communities of color- like San Francisco’s Bayview Hunters Point 94124 zip code- are contributed to by co-morbid risk of damage to the same regions of the lung by both toxic air contaminants and the novel corona virus.
The interstitium is a lace like tissue spread throughout the lungs that supports the air sacs and allows the gas exchange between the blood stream and the lungs. Interstitial lung disease is caused by thickening and scarring of the interstitium that interferes with oxygen exchange.
Peter Boraschi, MD concludes COVID-19 pulmonary involvement is really an interstitial pneumonia and discusses imaging features of Corona Virus disease 2019 finding “all patients showed ground glass opacity” on xray imaging. https://www.ncbi/nlm.nih.gov/pmc/articles/PMC7158787.
“In December 2019, a new type of coronavirus pneumonia (COVID-19) emerged in Wuan and spread rapidly to China and over 100 countries around the world. The lung injury and repair caused by COVID-19 has many similarities with the onset and progression of interstitial lung disease. “Chinese researchers discuss challenges and management of COVID-19 in Interstitial Lung Disease. https://pubmedncbi.nlm.nih.gov/32198915
In a March 2019 letter to Mayor London Breed, Tomas Aragon, MD DrPH, SFDPH Director of Population Health, documented a 31% increase in lung cancer in men residing in the 94124 zip code he attributed to cigarette smoking. There has been no corresponding increase in smoking in the 94124 zip code to warrant that conclusion. Indeed, the 2019 SFDPH Community Health Needs Assessment documents an 18% decline in tobacco retailers, a 10% decline in the number of packs of cigarettes sold in San Francisco and finds the 94124 zip code has an incidence of cigarette packs sold that is lower than many east and westside zip codes.
The Hunters Point Community Biomonitoring Program encourages all 35,492 residents of the high risk 94124 zip code to seek diagnostic and antibody testing for COVID-19 along with urinary screening for airborne toxins known to be present at the federal Superfund site and polluting industries. HP Biomonitoring is committed to offering expert clinical nutrition consultations and referrals for standard of care evaluation of symptoms due to interstitial and fibrotic lung disease caused by exposure to toxic, allergic and infectious agents.