Covid-19 Tracker: Are the numbers reliable?

Good morning, Mission, and welcome to Virus Village, your (somewhat regular) Covid-19 data dump.

Covid Tracker will not publish next week.

Hospitalizations and wastewater monitoring are up; recorded infections and positivity rates are down, while R Number models show basicially the same as last week.

A reader writes: “I am wondering now about 2 things: 1. Is there any goal or end that anyone has articulated by health authorities for what they are trying to achieve? and 2. How, exactly, am I or other readers supposed to make sense or make any decisions based on all of these charts and graphs?” Good questions

This piece in The Hill argues the numbers we have today are essentially meaningless. Nothing new. Covid numbers have always been ambiguous, often giving rise to contradictory (or seemingly contradictory) interpretations.

Take, for example, the current situation in Los Angeles hospitals with respect to BA.5. For more on that, here’s a report from the Los Angeles Times. And here’s a tweet from Dr. Jeffrey Klausner, the author of the article above.

However vague and fragmented, the numbers do provide a general picture of trends and levels. But data is just part of the covid story. Though the mantra “follow the science” promotes the primacy of data and the illusion of non-partisan objectivity, the last two years have bluntly shown that policy follows the money and the political currents.

Among other problems, Klausner’s argument — embraced, if not articulated, by many officials and celebrity experts — will lead to less reporting than we have now. 

In San Francisco, the Department of Public Health has cut back on its earlier reporting and has never clarified whether patients were hospitalized “for” or “with” covid. Nor do they name the hospitals included in their reports or even provide the most minimal demographic information.

So we have no sense of who has been mostly affected by the pandemic and cannot know whether resources are being used wisely. For example, we can’t say whether national reports reflect the local reality.

On occasion, Bob Wachter of the University of California, San Francisco, provides screenshots from UCSF, which takes in far more covid patients than other local, private, hospitals.

Are hospitals learning to “live with covid”? This piece concerning the situation with the UK’s National Health System points out how the “for/with” distinction may be misleading when it comes to hospitals “living with covid” or dying from it. 

As public health officials cower, right-wing political groups are busy litigating and threatening litigation to make sure public health institutions remain weak, or become weaker than they are now. 

It doesn’t help when, despite getting enough signatures to put a public health initiative on the ballot this November, organizers decide to hold off, preferring to rely, for now, on Gov. Gavin Newsom’s minimalist initiative.

On the more scientific front, here’s a review of studies on the immunological memory (T cells and B cells) obtained through vaccination and/or infection. Though it suggests enduring protection, it provides little clarity as to level and length of protection. It also does not take into account BA.5 and its successors.

With more transmissible variants causing more infections, not only will there be more hospitalizations, but also more cases of “long covid.” What percentage of infections lead to long covid? It’s hard to tell, in part because there is still no agreed-upon definition of “long covid.”

And the global vaccination debacle all but ensures more variants on the way. 

When a healthcare system is built on private profit, it comes as no surprise that few will prosper while many suffer. It also leaves public health dependent on the financial whims of private companies.

Scroll down for today’s covid numbers.

On July 16, DPH reports there were 138 covid hospitalizations, a 17 percent increase, or about 15.8 covid hospitalizations per 100,000 residents (based on an 874,000 population). ICU patients continue to fluctuate in the high teens and low twenties. The California Department of Public Health reports 135 covid patients in SF hospitals with 24 patients in ICU as of July 19.

The latest report from the U.S. Department of Health and Human Services shows Zuckerberg San Francisco General Hospital with 21 covid patients and 11 ICU beds available, while across the Mission, CPMC had 12 covid patients and 7 ICU beds available. Of 138 reported covid patients in the City, 58 were at either SFGH or UCSF, with at least 84 ICU beds available among reporting hospitals (which do not include the Veterans Administration or Laguna Honda). The California DPH reports that as of July 19, SF had 111 ICU beds available. Whether those beds are actually “staffed” neither the city nor the state will say.

Between May 16 and July 15, DPH recorded 1,588 new infections among Mission residents (an increase of 5.1 percent from last week) or 270 new infections per 10,000 residents. During that period, Bayview Hunters Point had the highest rate at 470 new infections per 10,000 residents. Bayview Hunters Point and Mission Bay were the only neighborhoods with a rate above 400, while 16 others had rates above 300 per 10,000 residents, with 10 in the east and southeast sectors of the City.

DPH reports on July 12, the 7-day average of daily new infections recorded in the City dropped to 402 or approximately 45.9 new infections per 100,000 residents (based on an 874,000 population), an decrease of approximately 5.8 percent. Yesterday the number was 440. According to DPH, the 7-day average infection rate among vaccinated residents was 42 per 100,000 “fully vaccinated” residents and 110.8 per 100,000 unvaccinated residents. It is unclear whether “fully vaccinated” means 2, 3 or 4 doses. According to the New York Times, the 7-day average number on July 12 was 458. The latest report from the Times says the 7-day average on July 19 was 406, an 19 percent decrease over the past two weeks. As noted above, wastewater monitoring appears to be increasing in the southeast sewers,though still less than last month. This report comes from the Stanford model. The state says its reports are delayed due to “supply chain” issues (is there widespread constipation?).

So far in July, Asians have recorded 1,779 infections or 30 percent of the total infections to date; Whites 1,237 infections or 20.8 percent; Latinxs 827 infections or 13.9 percent; Blacks 306 infections or 5.2 percent; Pacific Islanders 36 infections or 0.6 percent; Multi-racials 35 infections or 0.6 percent; and Native Americans have recorded 12 infections or 0.2 percent of the total to date in July.

On July 12, the 7-day rolling Citywide average positivity rate dropped 10 percent during the past week to 14.5 percent, while average daily testing rose approximately 7.4 percent. So far in July, Asians have a positivity rate of 16.4 percent; Latinxs 16 percent; Pacific Islanders 15.4 percent; Multi-racials 14.3 percent;Native American 13.1 percent; Whites 12.2 percent; and Blacks recorded a positivity rate of 12.1 percent to date in July.

Vaccination rates in SF show virtually no change from last week. 90 percent of all San Franciscans have received one shot, 84 percent two shots and 75 percent have received at least one booster. As of July 18, DPH estimates 70 percent of Mission residents have received at least one booster.

For information on where to get vaccinated in and around the Mission, visit our Vaccination Page.

Five new covid-related deaths have been reported (two in July), bringing the total since the beginning of the year to 236. DPH won’t say how many were vaccinated. Nor does it provide information on the race, ethnicity or socio-economic status of those who have recently died. According to DPH “COVID-19 deaths are suspected to be associated with COVID-19. This means COVID-19 is listed as a cause of death or significant condition on the death certificate.” Using a phrase like “suspected to be associated with” indicates the difficulty in determining a covid death. The fog gets denser as DPH reports, as it has for months, only 21 of the deaths are known to have had no underlying conditions, or comorbidities. DPH only supplies cumulative demographic numbers on deaths.

The lack of reliable infection numbers make R Number estimates very uncertain. R number models for the week remained stable. Covid R Estimation on July 15 estimated the San Francisco R Number at 1.09 while its estimate for the California R Number on July 11 was 1.28. The ensemble, as of July 17, estimated the San Francisco R Number at .95 and the California R Number at 1. Note: Four of six models in the ensemble are below 1.

As of July 15, those San Franciscans aged 0-4 recorded 260 infections or 4.4 percent of the recorded infections so far in July; 5-11 234 infections or 3.9 percent; 12-17 178 infections or 4 percent; 18-20 128 infections or 2.2 percent; 21-24 296 infections or 5 percent; 25-29 614 infections or 10.2 percent; 30-39 1,243 infections or 20.9 percent; 40-49 912 infections or 15.4 percent; 50-59 850 infections or 14.3 percent; 60-69 660 infections or 11.1 percent; 70-79 360 infections or 6.1 percent; and those San Franciscans aged 80 and above recorded 202 infections or 3.4 percent of the recorded infections to date in July.