City workers adapt rapidly to demands
Response requires new perspectives, professions — some lasting
In an empty corner of Moscone Center, now the headquarters for San Francisco’s pandemic response, a flyer left taped to the wall recently read: “Designated crying area, please limit episode to 15 minutes.”
The sign wasn’t entirely a joke, said Department of Emergency Management director Mary Ellen Carroll, who oversees the COVID command center, where hundreds of city workers toil.
“I haven’t felt like I was going to die this whole time, I have been too busy thinking about how do we respond. But for a lot of people, they have felt that death is at their doorstep,” she said. “There’s a level of trauma that we’ve experienced.”
It’s been a year since the pandemic upended daily life for the Bay Area, including the city of San Francisco’s 36,000 employees. The response to the crisis often demanded flexibility and grueling hours from city workers. While doctors, officers and bus drivers doubled down on their usual duties, more than 11,000 employees deployed as disaster service
workers over the year have found themselves shifting from jobs in afterschool programs and ethics investigations to delivering food to the homeless, providing child care and other urgent duties.
Some of the workers abruptly thrust into helping with the pandemic response beginning last March spoke with The Chronicle about how the past year has changed their perspectives and professions — for some, irrevocably. They told of crying behind masks when a patient was lost to COVID19, or joining meditation training to cope with stress, often while juggling child care and homeschooling.
For many, there is a sense of pride in what’s been accomplished. San Francisco has been praised for its swift pandemic response and has achieved the lowest per capita death rate of any major metropolis in the country. But there is also dismay. The virus has disproportionately affected Black, Latino and Asian San Franciscans, highlighting the city’s extreme socioeconomic inequality. That disparity is still a major issue, Carroll said, though the city is trying to learn from its mistakes by working with community partners and setting up vaccination sites in hardhit neighborhoods.
Although mass vaccination and an end to the pandemic are within sight, the crisis is not over.
‘So much loss’
“There is a renewed energy, because the vaccine is like your ticket out of jail,” Carroll said, but anxiety about current scarce supplies runs high. “I’ve been saying for most of the year that vaccines would be the hardest part.”
Carroll has steeled herself for this experience: She started her career in the city at the Department of Public Health 16 years ago, working on a pandemic plan. San Francisco’s COVID19 response officially started more than a year ago, on Jan. 21, 2020, when the Department of Public Health created an operations center to respond to the virus. The city’s emergency operations center followed a week later. On Feb. 25, Mayor London Breed declared a state of emergency, following similar measures in Santa Clara and San Diego counties, and deployed the first batch of 75 disaster service workers.
But the moment Carroll said she will never forget was when the Bay Area shut down on March 17. Officials fiercely debated whether to lock down the city the day before the shelterinplace was announced, fearful of the economic fallout.
“People were freaking out,” Carroll said. “Ultimately, we absolutely saved hundreds if not thousands of lives because of that decision, and people were right about the consequences . ... That’s clearly one of the hardest things about this. There has been so much loss for everyone.”
Beza Kinefe, who started working night shifts at Laguna Honda Hospital just weeks before the pandemic, has seen that loss firsthand. After the facility found its first positive case on March 22, her unit became the COVID19 ward. She cried at the news, but said management supported her and she’s gained confidence.
Kinefe taught her daughter, 10, and son, 7, to give her “air hugs,” but after a few months started hugging them again. Meanwhile, she and other staff have focused on the mental and physical wellbeing of isolated residents.
Over the past year, the number of cases among Laguna Honda’s estimated 720 workers and 1,500 residents rose and fell, with up to 25 infected patients at a peak. In total, 170 staff and 63 residents contracted the virus. Six residents died.
Kinefe cared for two of those patients until the end, weeping behind her mask when they died.
“Sometimes you cry and nobody sees you, you’re all covered,” Kinefe said as she wiped away tears on a recent video call. “Each death hits us as a new death . ... It’s not a number. It’s a father or a mother or sister to someone.”
Kinefe, along with a vast majority of staff and residents at Laguna Honda, has been vaccinated, and there are no more patients in her unit.
“We are ready to face whatever our profession brings,” she said.
When the pandemic started, San Francisco General Hospital nurse Ramona Soberanis volunteered to care for people exposed to or infected with the virus at an isolation and quarantine hotel. Since then, she’s overseen staff at up to five hotels providing nursing, therapy, food and hygiene to nearly 4,000 patients — a program that researchers recently found reduced the strain on hospitals.
Guests can be COVID19 patients discharged from a hospital or released from jail, homeless people or families exposed to or infected with the virus. The youngest was just 4 days old. Guests have attended virtual school, recited poetry and played instruments during stays ranging from 10 to 30 days.
The hardest part, Soberanis said, is when a patient’s condition worsens. That’s when the team calls the patient’s family as they wait for an ambulance to the hospital. Sometimes, she said, the frightened patients cry.
“We hold their hand and try to reassure them ... knowing in the back of your head, this person might get intubated, we don’t know what’s going to come,” she said on a recent video call. “You try not to cry because you had to be strong for them, but we take it home.”
Over the course of a weekend last March, Kanisha Burdeen shifted from running a Recreation and Park Department afterschool program to providing child care for children of essential workers. At the same time, she was struggling to find someone to watch her 1yearold daughter. And she worried about the children she’d had to leave behind. Only six out of the 23 lowincome kids in her afterschool program were eligible for child care.
“That was extremely hard and very emotional for me because I feel like I was letting them down,” said Burdeen, her voice breaking on a recent call.
On her lunch breaks, Burdeen connected with her old students and their families over Zoom. In September, Burdeen switched from child care to managing a school hub with 14 students. The future of next school year remains uncertain.
“I just walked by faith,” she said. “I’ve stopped the whole preparing thing.”
For some of the nearly 800 city workers currently deployed to disaster service, the new roles they’ve been assigned could become permanent. Tommy McClain, an attorney analyst on the legal affairs and enforcement division of the ethics commission, said he was “thrilled” to get a threeweek assignment in the food security unit June. He’s interested in food and social justice and volunteers with a mutual aid group.
Along with at one point up to 80 others, he helped meet the food needs of seniors sheltering at home, lowincome families and people isolating or quarantining at home or in hotels. He coordinated partnerships with food banks, nonprofits and restaurants making meals for people in need. He also walked the Design District in SoMa, giving food to people living on the streets.
“I was not doing it for gratitude, but the gratitude that we received, that will stay with me for a long time,” McClain said.
“The work has really changed me.”
As a result, McClain moved to the city’s human services agency permanently.
‘This experience will help us’
COVID command chief Carroll doesn’t see an end to the city’s emergency response until sometime next year. She stresses staff selfcare for those she oversees, and she said the mayor forced her to take a week of vacation last summer after a long stretch working 12hour days, including weekends.
COVID19 isn’t the only emergency the city has faced or will face. Climate change and civil unrest also rocked San Francisco last year. The threat of a major earthquake always looms. But Carroll said the pandemic has made the city better prepared for whatever comes next.
She said the pandemic “is just a lifetime of experience that will help us.”