Mayor London Breed and Director of Public Health Dr. Grant Colfax speak at the Oceanview covid-19 testing site on September 18, 2020. Photo by Juan Carlos Lara.

San Francisco has so far evaded the state’s most restrictive reopening tier, but it will get there this week if Covid-19 cases continue to climb at the current rate, Director of Public Health Grant Colfax Tuesday.

If the county shifts from the red tier, the second-most restrictive, to the purple tier, the indoor operations of gyms, fitness centers, zoos, museums, houses of worship, and movie theaters must stop. With the exception of grocery stores, retail capacity would also drop from 50 to 25 percent.

At a press conference Tuesday, Colfax said, “we are hovering just below 13 cases per 100,000 people per day” – the case rate that would put us in the most restrictive tier. 

“I take little comfort in the fact that we have not yet been assigned the purple tier,” Colfax said. “[But] the line is going pretty much straight up, in terms of our number of cases per day, so we do expect to be assigned.”

The new daily cases and case rates continue to increase and break records, with the city reporting 118 new cases per day by Nov. 18, compared to 95 new cases a week earlier. Two weeks earlier, new cases were at 73 a day. 

The positivity rate has been gradually increasing, too, and is currently at 2.15 percent, compared to a city low of 0.81 percent last month. The highest positivity rate so far has been 13.47 percent in April, and the rate during the summer surge in July hit 3.8 percent, data shows. During the month of October, the Bayview and Mission reported more than double the citywide rate. 

Though high case rates are starting to appear in higher-income neighborhoods during the citywide surge, many of the new cases continue to plague low-income and underserved communities, specifically in the southeast sector and in Latinx communities. 

Colfax said resources such as free city tests, which have been given in record amounts, should be prioritized for these communities, especially residents who don’t have insurance, who are essential workers, or have covid symptoms. Residents with insurance and symptoms should get tested by their healthcare providers, he urged.

To that end, the city moved its fixed SoMa site to the Alemany Farmers’ Market, closer to the city’s southeastern neighborhoods, November 17. At SoMa, it is unclear how many of those tested were Latinx, because the city has yet to release any testing data broken down by ethnicity. 

Hospitalizations, though relatively low, have doubled since the end of October. As of today, there are 54 people hospitalized with covid, and there is plenty of hospital capacity. Still, a rise in hospitalizations and deaths will likely trail the rising cases, especially if hospitals become overwhelmed.

“If that happens, simply and tragically, people will die,” Colfax said. “As we’ve seen across the nation and in the state, this can change very quickly.”

Fortunately, so far, death rates remain relatively stable, with 158 total reported deaths. San Francisco remains the largest metropolitan city with the lowest covid death rate per capita. 

Keeping cases down and preventing a color-tier shift could prevent scores of shut-down businesses and a state mandated “limited stay at home order,” which restricts all nonessential businesses and the gathering of people from different households from 10 p.m. to 5 a.m. 

Restaurants operating outdoor pick-up will be exempt, though outdoor seating would end by 10 p.m., Torres said. Orders are enforceable 48 hours from the color-tier shift, meaning businesses likely have one day to shut down operation if that occurs.

“I want to very much thank the business community out there for their cooperation, for their diligence and initiative,” Joaquín Torres, the director of the Office of Economic and Workforce Development, said at the conference.

“How we [behave individually] over the next two weeks is going to dictate what the next two months look like.”

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Annika Hom is our inequality reporter through our partnership with Report for America. Annika was born and raised in the Bay Area. She previously interned at SF Weekly and the Boston Globe where she focused on local news and immigration. She is a proud Chinese and Filipina American. She has a twin brother that (contrary to soap opera tropes) is not evil.

Follow her on Twitter at @AnnikaHom.

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