Community-run testing for COVID-19

Here’s a brief summary of how we set up COVID-19 testing for the community in our town of about 1,500 people, with a partnership with UCSF. Why Bolinas? UCSF was interested in testing here because it is rural, and fairly isolated. It is not as wealthy as surrounding communities in the Bay Area. Households in Bolinas, CA have a median annual income of $56,250, below a U.S. median of $61,937. The next community UCSF is testing is The Mission, a dense urban neighborhood in San Francisco, with a median annual income of $92,000–but where the Latinx community has a median annual income of $24,000. This latter study is funded by UCSF grants.

But the real reason this happened is this is a community that takes care of its people. When coronavirus struck, a group got together to make sure vulnerable neighbors had food, and now serve regular meals. Community members distribute masks they have made, there is an emergency fund another resident started for local businesses and people out of work. The disaster relief group made sure everyone had their contact info and a phone tree was set up to check on seniors living alone. If you have money, you give money. If you can make sandwiches, you make sandwiches. If you have organizational skills, you organize. Or you paint signs, direct traffic, make a web site, bring people food, pick up the phone. Someone’s the heart, someone’s the hands, someone’s the head, the pinky, the ears, the nostril–for snorting disdainfully–someone’s even the spleen.

It took about a month of planning to set this up. People keep asking about getting the tests, but the tests aren’t the problem—we actually had too many to choose from, and we’re going to run several tests on the samples we’ll collect. We realized nobody has access to tests because nobody was assembling all the other pieces.

These are all solvable problems, with a bit of work, creativity and collaboration. Let’s not kid ourselves–a lot of work. While diagnostics companies were shipping test kits and labs were ramping up capacity, no one was building an end to end solution for communities. We made it up as we went along. But none of this would have been possible without UCSF Infectious Diseases who is administering the tests.

Here are the missing links:

Popup testing sites (we sourced wedding tents)
Medical professionals to staff it (we found phlebotomists by searching online. Who knew?)
PPE (we went to a dozen small stores in Marin getting protective suits from hardware stores, gloves from restaurant suppliers, masks from friends who sourced them from China)
Tech that made it possible to recruit an entire city by SMS in a few days (a volunteer team of AirBnB engineers built the platform in 2 weeks)
Planning a physical setup for pushing through hundreds of people per day with minimal risk. We designed a 4-lane drive through “freeway” as in the photo above
Partnerships with local community organizations. In our case the Bolinas Fire Protection District, Mesa Park, Bolinas Community Land Trust, and the Coastal Health Alliance
Local volunteers to help in the planning process, getting the word out to the community, including some harder to reach communities. Volunteers are also doing traffic control.
Volunteer coordinator to manage all the people wanting to help!
Translators to spread the word in other local languages
Donors whose generosity makes it happen. We partnered with a non-profit (BCLT) to take donations.
It costs approx. $200 per person, all in. With economies of scale, and a site that is easier to manage it would likely go down significantly.

Today went well, but we still have over 1,000 people to do. Jyri says, “Hoping it will scale in a distributed way. Kind of like the internet used to be?” and Cyrus: “Hopefully this project serves as a model for other communities and as a wake-up call to organizations (cities, counties, states, federal govt, etc…) that _should_ be able to do all of this at scale with much greater efficiency than some ragtag group of volunteers supported by community donations, yet, up to now, haven’t.”

We will publish the blueprint as soon as we have it ready!

This is largely cobbled together from FB comments from Jyri and Cyrus.