Dr. Diane Havlir challenged the dogma on HIV treatment. Now she’s taking on Covid-19

‘The virus will surge, if we let it.’

The tone was celebratory for the first half-hour of a late September UCSF forum, as Mayor London Breed and others applauded the city’s success combatting Covid-19, including the remarkably low death rate and a drop in cases.

These are all very good things. And when Dr. Diane Havlir, the slight and always impeccably dressed chief of UCSF’s Division of HIV/AIDS, Infectious Disease, and Global Medicine, spoke next, she credited the trifecta of public, political and community action for the city’s good fortune. But there the accolades ended.

 “One of the reasons that we’ve been successful in HIV is, we don’t pat ourselves on the back too much and we keep on saying, ‘this is not good enough,’” said Havlir, in typically measured tones. 

With covid, Havlir sees a fast-moving virus in which the city’s knowledge base changes daily and the virus retains its ability to spread and surprise. What has remained consistent, she pointed out, was the startling disparity in the coronavirus’s impact. The city’s Latinx residents – 15 percent of the city’s population – represent 50 percent of its Covid-19 cases. 

Havlir watched that disparity emerge in mid-March, when Latinx patients began to fill the beds at Zuckerberg San Francisco General Hospital and Trauma Center, the provider for the city’s indigent and undocumented populations, where many of UCSF’s high-flying researchers, like Havlir, still see patients. 

Up until then, Havlir had spent a lifetime researching and influencing the global trajectory of HIV/AIDS treatment – the mysterious new disease that, as a 23-year-old medical student, she first read about in a June 1981 CDC morbidity report. Now, at 62, she was seeing another medical disaster unfold, and one of the communities worst affected lived right outside the hospital’s doors. So, nearly four decades after HIV/AIDS grabbed her attention and became her life’s work, Havlir’s intelligence locked on the covid pandemic. 

Over the months that followed, Havlir forged an unusually close bond with the Mission’s Latinx community leaders to test, study and track the virus whose spiky proteins attached themselves so relentlessly to the most vulnerable populations. 

Each testing study produced new findings, new challenges and new ways that San Francisco’s political and public health officials might vanquish the virus. But only recently has the city translated Havlir’s results into action by heeding the findings of these studies to open more low-barrier testing in the city’s southeastern neighborhoods where covid has thrived. If, like the rest of the country, San Francisco experiences another surge, Havlir’s relentless research and alliance with community leaders could very well be the roadmap that prevents a winter calamity.     

The goal is to address some of the toughest epidemiological challenges covid presents – why it thrives in certain places and how the city can best attend to and treat those communities. As in her AIDS research, Havlir looks at a pandemic to find the impacted populations not being treated. “It’s not their problem,” she said. “It’s our problem to figure out how to reach them.”