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At the time, it was unclear whether people would return to offices after the pandemic, and some businesses raised concerns about safety and cleanliness of San Francisco’s streets.

The report acknowledges that in recent years improvements had been made to cleanliness at the facility.

There was also a 286% increase in the number of the most dirty streets, graded "D" for cleanliness.

The poor state of the hospital was also raised as repair and cleanliness was below expected standards, with several cases of pigeons being found in trauma theatres or on the theatre corridor.

“We’re looking at the number of uses, length of duration, user experience, cleanliness and other factors.”