This is one disease I thought I wouldn’t have to worry about. Wrong.

There are always health issues to think about as you get older. Cholesterol, blood pressure, hearing, eyesight … Comes with the territory. Then there was COVID.

But I never once imagined that in my adult life in San Francisco I would have to worry about … measles.

Yeah, measles, that disease our parents talked about back in the early 1960s. The virus that spread quickly and could cause severe complications—but was easily preventable with a vaccine.

I’m pretty sure I got that vaccine. When I was a kid, almost everyone who had a pediatrician got every vaccine; they even lined us all up in the gym and gave us the polio shots in school. By the time I was in college, it wasn’t much of an issue; in 1981, cases were down by 80 percent, and in 2000, the Centers for Disease Control said it was effectively eliminated in this country.

And yet, this week I got a press release from the Department of Public Health:

SAN FRANCISCO – With the recent rise of measles cases nationally, San Francisco joins Bay Area health officials in urging everyone to get the measles vaccination if they are not sure if they got it or if they did not have measles as a child, and to be aware of the signs and symptoms of measles after travel or exposure …

About one in five unvaccinated people in the United States who get measles are hospitalized, and nearly one to three of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, according to CDC. Measles presents the greatest risk to children under five years of age, adults over 20 years of age, those who are pregnant, and people with compromised immune systems.

While the risk in the Bay Area is relatively low, DPH says,

Over 300 measles cases have been reported in the United States as of March 14, 2025. This includes a large outbreak among primarily unvaccinated children in Texas and nearby states. At this time, there have been two deaths. These were the first measles deaths in the United States since 2015.

People from Texas travel to California. People from California go to Texas. Measles is one of the most infectious diseases known to science … and it’s on its way here.

Why? Because in this weird world of Donald Trump and RFK Jr., people haven’t been getting their kids vaccinated. That’s not just an awful tragedy for the kids who are dying; it’s a risk to the rest of society.

San Francisco is home to a lot of immune-compromised people. Measles is really dangerous for them, and for older people. The vaccine I probably got, in the early 1960s, apparently isn’t that effective in the long term, so now my doctor suggested I get vaccinated again, which is fine—it’s safe and effective and takes just a few minutes.

But you know, what the actual fuck.

For years, harm reduction has been a key part of San Francisco’s policy on substance use. This is the town that helped pioneer needle-exchange, allowing IV drug users to get clean syringes in the worst of the HIV pandemic. The city has followed a national guideline called “Housing First,” based on the concept that it’s hard to get sober or address mental illness when you are living on the streets.

Not too long ago, former Mayor London Breed, along with state Sen. Scott Wiener and then-Assemblymember David Chiu, pushed to legalize safe-consumption sites for IV drug users—because it saves lives. As Vitka Eisen, director of Healthright 360, likes to say, “when you overdose and die you never get a second chance.” Gov. Gavin Newsom vetoed the bill that would have allowed the city to move in that direction.

Of course, Breed later changed her position. In the final years of her administration, the city started to back away from harm reduction.

Now Sup. Matt Dorsey wants to push all the way back to the days when the primary solution to substance use was total abstinence and sobriety—which not only has never worked, but (like telling kids the only solution to teenage pregnancy is abstinence) often causes serious problems.

Dorsey is introducing a bill that would “establish the cessation of illicit drug use and attainment of long-term recovery from substance use disorders as the primary objective of the City’s drug policy.”

It that’s the primary objective, then harm reduction gets cast aside. Safe injection sites are not in the picture.

Housing First is already under attack on the national level.

Oh, and the local technorati oligarchs are going after it here:

Paul Boden, director of the Western Regional Advocacy Project, told me this is a classic example of how Trump-style politics (and the Democrats aren’t exempt) works: You take a concept like Housing First, but don’t fund it (in fact, the feds have radically cut funding for public housing), don’t provide local government with the resources to provide the services that keep people housed—and then you say it’s a failure.

“It’s such bullshit,” he said.

And yet, Dorsey’s approach going to be policy in San Francisco. That measure, which will come up at the Rules Committee in 30 days, has seven co-sponsors—Dorsey, all of the new conservatives, and Rafael Mandelman and Myrna Melgar.

Mandelman and Mayor Daniel Lurie just celebrated the start of a new “Entertainment Zone” in Cole Valley, where people can party and drink on the streets:

Mayor Daniel Lurie and Board of Supervisors President Rafael Mandelman today celebrated the successful launch of San Francisco’s newest entertainment zone. Established by legislation led by Mayor Lurie and President Mandelman, the new entertainment zone is in the vibrant Cole Valley commercial corridor, making it the city’s first outside of downtown. The entertainment zone kicked off yesterday evening with Cole Valley Nights, a four-month neighborhood street market series that is active on the second Thursday of each month through June 2025.

That is, wealthy, housed people don’t have to be sober. Party on.