Fentanyl is killing more San Franciscans than coronavirus, according to a new report from the city’s Chief Medical Examiner.

COVID-19 was the leading cause of death in the US in the first week of January 2021, according to CDC data summed up by Scientific American. The Journal of the American Medical Association (JAMA) says it’s probably going to stay that way for some time, or at least, until we have a new U.S. president who is not actively aiding and abetting the spread of the virus. But COVID-19 is not the current leading cause of death here in San Francisco. According to a new report from SF’s Chief Medical Examiner, 699 people died from accidental drug overdoses in 2020.  

Compare that to the coronavirus death toll on SFist’s daily Bay Area Coronavirus Information tracker, which currently shows 241 deaths as of January 14. But that number was 235 deaths on January 1, 2020. Which means there were just triple the number of accidental drug overdose deaths than COVID-19 deaths in San Francisco during the year 2020.  

Image: SF Chief Medical Examiner

As we see in the graph above, fentanyl was the No. 1 drug overdose killer, accounting for around 500, or two-thirds of those deaths. Methamphetamine is a distant second at about 350 deaths, followed by cocaine at just over 200 fatal overdoses. Contrary to popular stereotypes, heroin accounted for less than 100 overdoses, and is not in the top three causes.

According to KTVU, that’s a record number of SF drug overdoses. "The volume of these types of deaths has increased — particularly in 2020 — over the last couple of years," Dr. Luke Rodda, the top toxicologist who signed the report, told the station. "Every single one is someone's loved one."

The temptation may be to say — and you will surely see this in the social media comments — that San Francisco is wrong to focus on COVID-19 public safety measures and should instead round up and incarcerate all the filthy, homeless drug addicts. This is totally inaccurate. As we’ve reported before, shelter-in-place is driving up the overdose numbers because people are using alone, in solitude.  

"The one golden rule of overuse prevention is to try to not use alone, and the shelter-in-place order said to keep yourself safe, you need to isolate," Drug Overdose Prevention and Education Project (DOPE Project) manager Kristen Marshall told SFGate. "That’s just the opposite. People at high risk went into isolation and that heightened the risk. The chaos put people at higher risk. The worst months were in the dead of the summer when it was most chaotic for this community.”

Moreover, the vast majority of overdose victims were not homeless. The medical examiner report noted that 71% of the victims did have a fixed address, whereas only 27% did not, and in 2% of cases this could not be determined.

This could have been a lot worse. The DOPE Project says that more than 3,000 potentially fatal overdose victims were saved by interventions with the spray product Narcan. Marshall wrote a primer last month on how to administer Narcan (the stuff is available for free, by the way), if you want to make a difference in this overdose crisis.

Related: Pandemic Leads To Epidemic of Fentanyl Overdoses In SF [SFist]

Image: @jairlazarofuentes via Unsplash