Nearly one in five people tested at Archbishop Riordan High School have been affected in what health officials are calling a significant tuberculosis outbreak. Let that sink in. A disease most Americans associate with 19th-century novels is spreading through a San Francisco high school at an alarming clip.

To be clear: "affected" can mean either active TB disease or latent TB infection, and the distinction matters. Latent infections aren't contagious and may never become active. But the sheer rate of positive results — roughly 20% of those tested — is enough to raise serious red flags. Health officials have described it bluntly: "This is a big outbreak."

So where's the urgency from City Hall? San Francisco's public health apparatus has spent the last several years focused on harm reduction, equity frameworks, and pandemic recovery branding. Meanwhile, a genuinely dangerous infectious disease is burning through a school community, and the response feels almost muted by comparison. Imagine if 1 in 5 students at any school tested positive for COVID in 2021 — we'd have had press conferences every six hours.

TB is treatable and preventable, but it demands aggressive contact tracing, testing, and follow-up — the unsexy, resource-intensive public health work that doesn't generate social media engagement or political capital. It demands competence, not ideology.

Here's the uncomfortable truth: when a city's public health infrastructure is perpetually stretched thin by competing political priorities and bureaucratic bloat, something eventually slips through the cracks. TB at a high school in a major American city in 2025 isn't just a medical story — it's an accountability story.

The students and families at Riordan deserve a transparent, swift, and well-funded response. Not next month. Now. Every parent in the city should be watching how officials handle this, because it tells you everything about whether the people running public health are focused on actual public health — or just performing it.