Despite hysterical headlines about shoplifting and overdoses, San Francisco has suffered hundreds, sometimes even thousands fewer COVID-19 deaths than other major U.S. cities, relative to population size.

On any given day, the national news media finds another angle to decry how “unsafe” San Francisco is these days. The New York Post's resident conservative dickwad Rich Lowry complained of “the city’s unwillingness to govern itself,” and oh I’m sure this is not a racist dog whistle, saying “mobs of looters are grabbing goods.” Some media reports cite other cities’ incidents, but say “near San Francisco,” just to ride that wave of hysteria. And many outlets like the Economist ran hard with “more people in San Francisco died of overdoses than of COVID-19,” which is tragically true, but not true for the reasons they might think.

You see, all of these reports maintain a pretty massive blind spot. San Francisco is actually the safest city in the U.S. when it comes to COVID-19 deaths. And if the rest of the nation had had San Francisco’s level of public health caution, healthcare quality, and public safety adherence up to now, there would be more than 500,000 fewer dead Americans. (Though some luck in the early pandemic spared the West Coast from some of the horror that New York and New Jersey experienced in March-April of 2020.)

UCSF Department of Medicine chair Dr. Bob Wachter had a semi-viral tweet a little over a week back that really got us thinking. He noted that San Francisco has “1/3rd the US per capita rate” of COVID-19 deaths. So SFist did a little experiment and sized up the current COVID-19 death rates of the top 20 largest U.S. cities by population, and sure enough, San Francisco now has the lowest death rate of any American city by far. Why is this?

“It’s a complex multifactorial equation,” Dr. Wachter tells SFist. “But at least part of the explanation is the public health and vaccine-related behaviors. For those who find these behaviors to be hardships, the question of ‘Was it worth it?’ arises. With many hundreds, perhaps thousands, of deaths averted in SF, that doesn’t strike me as a hard question.”

You’ll want to see the proof, and here it is. We took the 20 largest U.S. cities and compared their COVID-19 deaths per 100,000 residents by county as reported in the New York Times. Cities and counties have to be entered manually, but we entered each, and here’s how the 20 largest U.S. cities size up in COVID-19 deaths per 100,000 residents.

New York City 419

Houston 383

Jacksonville 299

San Antonio 285.5

Phoenix 278

Los Angeles 272

Philadelphia  262

Fort Worth     244

Chicago   239

Indianapolis 235.6

Dallas 215

Austin   186

Columbus 184.5

Washington, DC 170

Denver  144

San Diego    131

Charlotte 117

San Jose  101

Seattle        93.8

San Francisco 77

To summarize; Jacksonville, Florida has nearly quadruple the COVID fatality rate of San Francisco. Houston, Texas has nearly five times the COVID fatality rate of San Francisco. New York City has about five and a half times the COVID fatality rate of San Francisco.

To date, San Francisco has recorded 679 deaths from COVID among residents. The nine-county Bay Area has seen just over 6,900. New York City has seen nearly 35,000.

SFist is not the first to discuss this. The Chronicle covered the city's low mortality at length in September 2020, and UCSF doctors had a panel on the topic in March. But these rates have had ups and downs. Los Angeles had a lower death rate than SF for a period this past June. So things can change, and this is no time to spike footballs or throw away masks. But clearly, San Francisco has done something very, very right.

“SF has some natural advantages; temperate weather but so does much of the country relative wealth and many who can work from home,” Wachter adds. He also attributes our low mortality rate success to “good health and lower obesity rate, [and a] strong medical system.”

But those are minor contributing factors. The bottom line is that San Francisco buys into masking and vaccination, and those are basically the only two factors that matter. That’s why our death rate is two-thirds lower than America at large. Otherwise, “I don’t think you can explain away two-thirds of the deaths,” Wachter tells SFist.

Related: UCSF Docs Discuss SF's Remarkably Low COVID Mortality Rate, and Whether the Vaccinated Should Fear Variants [SFist]

Image: @erondu via Unsplash