Masks on 24th Street. Photo by Lydia Chávez

The San Francisco Director of Public Health said at a morning press conference that cases and hospitalizations are surging in this city, and “if we do not do better, we are looking at major problems.”

Dr. Grant Colfax went on to describe a scenario in which San Francisco could have an average peak of 900 hospitalizations by early October. 

“And just to put this in some frame of reference, on our last surge in April, we peaked at 94 cases,” he said. “This average scenario of 900 cases is nearly 10 times worse. And it is certainly not the worst-case scenario that we could have by that time; models show that we could have thousands of hospitalized cases by then.”

The reproductive rate of the virus, cases, hospitalizations, and the length of time it is taking to get test results have all increased. 

All reopening measures have ground to a full stop. And rollbacks may be in the works if the numbers fail to improve, he said. 

Colfax began by talking about the reproductive rate, which the city estimates at 1.3 — meaning the average patient infects 1.3 other people. This means the problem is growing; any number above 1 is cause for concern. 

“If we do not do better, we are looking at major problems,” he said.

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“It is certainly possible if our conditions do not improve, a rollback may become necessary in San Francisco and other places in the Bay Area as well,” he said. 

Colfax blamed the increase on two factors — more gatherings and an increase in essential workers who are testing positive for the virus. He said the city was monitoring the precautions businesses are taking and urged residents to avoid large gatherings, wear masks and practice social distancing. 

Read an inspiring piece on Jose Montes and how he copes with the pandemic. 

Case rates, he said, have increased to 7.7 per 100,000. The goal is 1.8 per 100,000. Hospitalization rates are increasing at 33 percent, compared to the goal of no more than 10 percent, and the city’s supply of PPE, personal protective equipment, is down to 78 percent of where the city would want it to be. 

He blamed the decline in PPE to “increased national demand.” 

The county’s nine hospitals remained able to handle any immediate surge. “Right now,” he said. “we have 27 percent of our acute care beds available and 28 percent of our intensive care units available.”

In response to a question about outdoor dining and whether that would be shut down, Colfax said that it was clear indoor activities were riskier, but he said, “we are looking to determine if the increase is driven by outdoor dining.” 

He encouraged the public to call 311 if they saw restaurants not adhering to the safety protocols of making and distancing. 

“We have been and we continue to be in a period of uncertainty,” he said.  

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Founder/Executive Editor. I’ve been a Mission resident since 1998 and a professor emeritus at Berkeley’s J-school since 2019 when I retired. I got my start in newspapers at the Albuquerque Tribune in the city where I was born and raised. Like many local news outlets, The Tribune no longer exists. I left daily newspapers after working at The New York Times for the business, foreign and city desks. Lucky for all of us, it is still there.

As an old friend once pointed out, local has long been in my bones. My Master’s Project at Columbia, later published in New York Magazine, was on New York City’s experiment in community boards.

Right now I'm trying to figure out how you make that long-held interest in local news sustainable. The answer continues to elude me.

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  1. SF’s official COVID numbers have never looked real. No new cases in 2 days? No deaths in weeks? A 1.07% mortality rate on reported cases? How do we reconcile these ‘facts’ with Dr. Colfax’s comments? What is going on here?

    1. Please point to when there had been no new cases in 2 days. Since March 10, the lowest number of cases in a day has been 5. Note there are two ways of recording cases per day. One is taking the total case number reported every day and subtract the previous day. This does not account for the date the positive test was taken. The second way is the record of the positive tests for a specific date. There is a lag in the determination of the second way, so the numbers do change over time as they sort out the date when the positive test was given.

      1.07% CFR is within the 0.4% to 1.1% range of actual infection rate determined in medical papers. One model (sorry forget which) uses 1% actual infection rate for early in the pandemic and 0.75% later. Another model uses 0.8%. Higher CFR can be caused be several factors such as older more vulnerable population, overwhelmed hospitals, or inadequate testing in which actual cases are not detected because no test was taken. Note California CFR is now down to ~2.1%. It was around 4% in mid-May. With more testing, more cases are detected so the CFR comes down. Really high CFR such as in ~8% to 10% in NY state during peak of pandemic there was driven by both actual cases not being detected due to tests not being available and by overwhelmed hospitals reducing the care provided to patients. SF CFR of ~1.1% is comparable to New Zealand (1.4%) and Hong Kong (0.6%), locales which are generally considered to have controlled their outbreaks. Note this is not saying that SF has controlled its outbreak. That remains to be seen in the weeks ahead due to lag in seeing the effects of taken in the past few days aimed at reducing infection rate.

  2. If a city like SF with a population of about 900000 cannot handle the hospitalization of 900 then there is a much serious problem than covid-19 … I just don t get it 4+ months 50 deaths (about 15 per month) to end up with 1/2 of the restaurants and more than 1/2 of the bars in the city permanently out of business … God knows how many Salons, massage places, gyms will also be part of the collateral damage .. filthy and stinking streets while dangerous lunatics are roaming the streets day and night… broken car windows every night… what a total mess and no accountability whatsoever from the mayor and its administration

    1. Kacem, the only dangerous lunatics are the parasitic tech CEOS like you coming into SF, sucking up all the resources and creating the environment to drive up rent and leave people homeless, and then are surprised that there are “dangerous lunatics” on the streets. If you don’t like it here then you can either actively work to be part of the solution, or you can take Neuron Edge and and get the fuck out of here. Leave SF so that people who actually appreciate the city can thrive.

      1. You must be ill, I mean mentally; it s called psychosis … when a person cannot distinguish between reality and imagination

    2. “dangerous lunatics”??? Please move to Marin County already. You will not be missed and you’ll be happier surrounded by your fellow Nimbys.

  3. Let’s see BLM Protests, SkateBombs, etc. Not that surprising the numbers increasing. Perhaps a bit of outdoor dining. We’re a smart lot we’ll get back to where we need to be. Keep the faith.

  4. I’m a senior and have health reasons to be extra scared of COVID because of a pre-existing respiratory condition.

    In the period of March, April May, June, I was going out of my apartment less than once a week in order to be safe. I bundled tasks and did only what was necessary. That’s when the case count were sometimes in the single digits. Now that the case count is in the 50’s to 174 range, I’m having to leave my apartment like six times a week to move my car from getting a parking ticket. The new car ticketing policy makes it seem like the time to safe guard our health is over. That COVID is finished, like politicians say, but not like Doctors say.

    The COVID virus thing is getting real, the first big wave of infections is coming, they shouldn’t give parking tickets so we can safely shelter in place.

    Thank you for your excellent reporting.
    Mission Local has the best reporters of any paper in the City. It looks out for the people, not just the big interests.
    Thank You

  5. It’s definitely outdoor dining, especially places where the crowd gets so large that they congregate in the sidewalk with their drinks as well as taking all the tables. I got deliberately coughed on by some drunk guy at the Liberties the other day as a warning to not walk too close to his party.

    1. The sidewalk at The Lookout at 16th and Market is far too small for the number of tables and people. People are jam packed into the parklets on Valencia St. North Beach sidewalks are no better. The #1 thing the city can do TODAY to prevent a rollback is to close more streets and let people spread out.

    2. Nonsense. The real spread are gatherings. I was at GG park this weekend and I saw three well-attended kid parties with no one masked.

      This is happening all over the city.