Sunday was supposed to be a rare day off for Dr. Dr. Toma�s Arago�n after weeks of working around-the-clock.
Instead, the San Francisco public health officer was jolted awake by an urgent 7:39 a.m. text message from his boss.
"Can you set up a call with San Mateo and Santa Clara health officers this a.m., so we can discuss us all getting on the same page this week with aggressive actions, thanks," said the message from Dr. Grant Colfax, director of San Francisco's Department of Public Health.
"Will do, getting up now," Arago�n responded.
It was March 15, two days before St. Patrick's Day, a heavy partying holiday and nightmare scenario for public health officials.
The novel coronavirus was spreading stealthily across the San Francisco Bay Area and public health officials were alarmed by the explosion of deaths in Italy and elsewhere around the globe. Silicon Valley would be next, case counts indicated.
Until then, they had primarily focused on banning mass gatherings. But they knew more had to be done _ and wanted to present a united front.
Within a few hours of the text, Bay Area public health leaders jumped on a series of calls to debate options, including the most dramatic _ a lockdown order that would shutter businesses, isolate families and force millions of residents to stay home.
They decided they had no choice. And they were able to move swiftly because they had a secret weapon: a decadeslong alliance seeded in the early days of the AIDS epidemic that shields them from political blowback when they need to make difficult decisions.
Together, they would issue the nation's first stay-at-home order, likely saving thousands of lives and charting the course for much of the country. Three days later, Gov. Gavin Newsom followed with his own order for California. New York came next, as have dozens of states since.
"This was one exhausting and difficult day for all of us," Aragon later wrote in his journal. "We all wish we did not have to do this."
Now, officials nationwide are weighing how to lift isolation orders as the rate of COVID-19 transmission slows _ and protests against the orders mount. The Bay Area is again poised to lead, but with a warning: All of this could be for naught if it isn't done right.
