I recently presented to our Board of Supervisors (BOS) about the public health issues related to street cleaning. In San Francisco there is increasing public concern about human defecation, discarded syringes and needles, and homeless encampments.1 2 Not too long ago we had an outbreak of shigellosis among our homeless population.3
In San Francisco we deploy an integrated model for controlling infectious diseases that we developed several years ago. We refined the model based on concepts from transmission dynamics (e.g., basic reproductive number), clinical infectious diseases, and infection control. The full explanation of the concepts are in an educational document posted here:4 https://escholarship.org/uc/item/7687z08g
To prepare for the BOS hearing I updated our Model for Controlling Infectious Diseases which is a one-page handout useful for training and as a quick reference guide. Figure 1 displays this handout and the PDF version is available here (Dropbox link). The model was designed for immediate post-disaster planning and for designing mitigation strategies for novel microbial agents.
The Model for CID includes The 7 Habits of Uninfected People. The 7 Habits was developed over the years by asking stakeholders to prioritized core behaviors for preventing the transmission of infectious diseases. The 7 Habits can be adapted to any priority population (e.g., daycare, people who inject drugs). Here are the default 7 habits:
- Safe consumption (e.g., food, water, drug)
- Personal hygiene (including adult toys)
- Covering your cough
- Getting vaccinated
- Using “protection” (condoms, personal protective equipment)
- Reducing special risk (e.g., pregnancy, immunocompromised)
- Basic infection control (standard, contact, droplet, or airborne precautions)
We hope you find this information useful and we welcome and value your feedback and suggestions.
Here is another document that summarizes key concepts: Conducting an outbreak investigation in 7 steps (or less): A Quick Reference Guide (Dropbox link)
Diseased streets. https://www.nbcbayarea.com/news/local/Diseased-Streets-472430013.html↩
Parts of San Francisco dirtier than foreign slums, UC Berkeley infectious disease expert says. https://www.sfgate.com/news/article/San-Francisco-dirty-needles-feces-foreign-slums-12627779.php↩
Shigella outbreak extra rough on S.F.’s vulnerable homeless. https://www.sfgate.com/health/article/Shigella-outbreak-extra-rough-on-S-F-s-6184780.php↩