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

Hospitalizations, recorded infections, positivity rates and wastewater numbers are down. R Number models hover around 1.

The U.S. Food and Drug Administration has authorized a new booster, with minimal data showing effectiveness or duration. Has the Biden Administration set the shots up to fail? The decision, made some time ago, raises questions not only for this fall and winter, but also for long-term trust in future vaccines, not to mention public health.

Even though Margaret Thatcher famously declared “there is no such thing as society,” the covid pandemic has revealed that yes, societies do exist, and societal responses were remarkably heterogeneous among similar groups like the G7. This article explores that heterogeneity and the policy implications flowing from it.

Last week, I noted the Biden Administration’s failure to follow up Trump’s successful (if shamelessly excessive) support for the mRna vaccine. This week, two Senate Trump-lite Republicans have written a letter to President Biden, criticizing the Administration’s lack of covid urgency and calling for Operation Warp Speed 2.0 to produce a pan-coronavirus nasal vaccine that will actually reduce infections and provide durable protection against the emergence of new variants. Is this a glimmer of hope?

Don’t bet on it. Sen. Kirsten Gillibrand (D-NY) says, “I think the president decided we’re in a good place right now. We’ve really gotten over the hump of COVID.” Note: that attitude will make it far more difficult to convince people to take the new booster.

A new study (preprint) from the University of California, San Francisco, shows the vaccine helped reduce the infectiousness of those infected in California prisons. Yes, vaccines can reduce infectiousness and transmission, but not for very long.

Infections may have been milder for most during the recent, and ongoing, wave, but there are now so many infected that the absolute number of deaths and sick people has become noticeable. Covid may have generated “a kind of epidemiological aftershock” leaving people susceptible to a huge range of other conditions, threatening health systems already struggling with insufficient resources.

A current example seems to be Britain, as explained in this long thread, which traces current excess mortality in the U.K. to the defunding and understaffing of the National Health System. In the U.S. no such public system exists, and it is unclear whether profit-hungry private hospitals have yet to learn the lessons of covid.

Unrestrained transmission has also led to an increase in absolute numbers of “long covid” cases, putting extra strain on hospitals and healthcare workers.

Long covid may be keeping up to 4 million people out of work.

Here’s a thread on long covid brain science.

Scroll down for today’s covid numbers.

Have hospitalizations have taken a substantial dip? On August 27, the San Francisco Department of Health reported 66 covid hospitalizations, or about 7.5 covid hospitalizations per 100,000 residents (based on an 874,000 population). This represents a 29 percent drop from last week. On the other hand, ICU patients are back in double digits (12). The California Department of Public Health reports as of August 30, there were 69 covid patients in SF hospitals with 12 patients in ICU. For the week ending August 28, the CDC says there were 58 new admissions, a 25 percent decrease from the previous week. The CDC won’t say (like state and local officials) which hospitals are included in their survey. DPH refuses to report on admissions, and continues to hide how many covid positive patients were hospitalized “for” covid, and how many “with” covid.

The latest report from the U.S. Department of Health and Human Services shows Zuckerberg San Francisco General Hospital with 15 covid patients and 11 ICU beds available, while across the Mission, CPMC had 11 covid patients and 5 ICU beds available. Of 105 reported covid patients in the City, 44 were at either SFGH or UCSF. Usually, the two hospitals generally account for 50 percent or more of the covid patients. This has not held during the recent wave. At least 81 ICU beds are available among reporting hospitals (which do not include the Veterans Administration or Laguna Honda). The California DPH reports that as of August 30, SF had 89 ICU beds available. Whether those beds are actually “staffed” neither the city nor the state will say.

Between June 27 and August 26, DPH recorded 1,032 new infections among Mission residents (a decrease of 10 percent from our last report) or 176 new infections per 10,000 residents. During that period, Bayview Hunters Point had the highest rate at 306 new infections per 10,000 residents. It was the only neighborhood in the City with a rate over 300. Of 38 neighborhoods, 10 had rates above 200 per 10,000 residents, 9 in the east and southeast sectors of the City. Lakeshore, the least vaccinated neighborhood, had a rate of 135 per 100,000 residents

DPH reports on August 23, the 7-day average of daily new infections recorded in the City dropped to 152 or approximately 17.4 new infections per 100,000 residents (based on an 874,000 population), a decrease of approximately 12 percent from last week. According to DPH, the 7-day average infection rate among vaccinated residents was 15.8 per 100,000 “fully vaccinated” residents and 49.9 per 100,000 unvaccinated residents. It is unclear whether “fully vaccinated” means 2, 3 or 4 doses. The New York Times said the 7-day average on August 23 was 176. On August 30, the Times says the 7-day average is 171, a 19 percent decrease over the past two weeks. Wastewater monitoring shows covid declining in the City’s southeast sewers (well below where it was last month) and rising a bit in the west. This report comes from the Stanford model.

As of August 26, DPH says Latinxs have had a 9.9 percent positivity rate so far in August; Asians 9.8 percent; Pacific Islanders 8.6 percent; Whites 7.3 percent; Native Americans 6.9 percent; Blacks 6.7 percent; and Multi-racials have had a positivity rate of 6.5 percent so far in August.

On August 23, the 7-day rolling Citywide average positivity rate dropped 7 percent during the past week to 8.1 percent, the lowest positivity rate since April 30. Since last week, the average daily testing dropped approximately 4 percent. It is the lowest average daily testing number since June 6, 2020. Between June 27 and August 26 (of this year), the Mission had a positivity rate of 11.7 percent, a 6.4 percent drop from last week’s report.

Since August 18, 1,366 San Francisco residents received their first or second shot. Vaccination rates in SF show virtually no change for the past two or three months. 90 percent of all San Franciscans have received one shot, 85 percent two shots and 64 percent have received at least one booster. As of August 30, DPH estimates 70 percent of Asian San Franciscans have received at least one booster; Whites 59 percent; Latinxs 57 percent; Pacific Islanders 55 percent; Native Americans 52 percent; and 51 percent of Blacks have received at least one booster.

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

The total number of covid-related deaths in San Francisco has surpassed 1,000. Although the case fatality rate is substantially down, the absolute number of deaths continues to rise. Twenty-three new covid-related deaths have been reported since our last report, bringing the total since the beginning of the year to 310. July had the sixth-highest monthly death total recorded during the pandemic. DPH refuses to report how many were vaccinated. It only provides cumulative information on race, ethnicity or socioeconomic status. 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 makes R Number estimates very uncertain. Covid R Estimation on August 26 estimated the San Francisco R Number at 1.01 while its estimate for the California R Number on August 29 was 1.03. The ensemble, on August 28, estimated the San Francisco R Number at .94 and the California R Number at .83. Note: Only one model in the ensemble shows SF above 1.

Since August 1, there have been 41 recorded infections and 1 death in nursing homes (“skilled nursing facilities”). In Single Room Occupancy hotels (“SROs”) there have been 75 recorded infections and 1 death.

As of August 26, DPH reports 80 infections so far this month among the City’s unhoused. The total number of unhoused covid deaths reported by DPH is 13.

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Mark Rabine has lived in the Mission for over 40 years. "What a long strange trip it's been." He has maintained our Covid tracker through most of the pandemic, taking some breaks with his search for the Mission's best fried-chicken sandwich and now its best noodles. When the Warriors make the playoffs, he writes up his take on the games.

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  1. Can we also just acknowledge that recorded infection rates are basically useless now, considering that there is *no* system in place for recording at-home tests, which comprise the vast majority now? What’s more, many testing sites have closed.

    Could you include more of a disclaimer that those numbers are, by design, going to be artificially low?

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    1. Definitely true, Miriam. Hospitalization is artificially high, however, since they do not differentiate between “for covid” and “with covid”. Deaths could be high for the same reason and because in 2020 there was an economic incentive for hospitals to classify patients as “covid patients”. On the other hand, they were likely low at the beginning when we didn’t even know about Covid. How are you using these numbers is the more interesting question, to me. What difference does it make, in your opinion, if there are a lot of “cases” in the community (and what is “a lot”?) vs not that many cases ( and what is “not that many”)? The numbers only really matter if they inform some actual policy decision based on a specific goal. What’s the goal i.e. what numbers are you shooting for? What is the strategy to achieve it?

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  2. The next SF Health Commission meeting is this Tuesday, 9/6, at 4pm PST. These meetings are open to the public. I’ll post details on how to join remotely and comment, for anyone interested in demanding better Covid mitigations now.

    Can’t make the meeting? You can e-mail a public comment to be included into the written record.

    E-mail: Subject Line: Public Comment

    These meetings are on the first and third Tuesday of every month.

    Let SF DPH know where you stand! The more of us there are demanding better Covid mitigation measures, the harder it is for them to ignore us!

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  3. > Even though Margaret Thatcher famously declared “there is no such thing as society,”

    Well who am I to believe, Margaret Thatcher, or George Costanza? I am told that even the Joker takes the Costanzaite position.

    The Daily Beast suggests that Thatcher was making a different point, not that there are only Ayn Rand individuals working for their own selfish interests and so no society, but that “society” is made up of individuals all working together.

    thedailybeast dot com/context-for-margaret-thatchers-there-is-no-such-thing-as-society-remarks

    > I think we have gone through a period when too many children and people have been given to understand “I have a problem, it is the Government’s job to cope with it!” or “I have a problem, I will go and get a grant to cope with it!” “I am homeless, the Government must house me!” and so they are casting their problems on society and who is society? There is no such thing! There are individual men and women and there are families and no government can do anything except through people and people look to themselves first… There is no such thing as society. There is living tapestry of men and women and people and the beauty of that tapestry and the quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate.’

    What she said confuses me (just a caveman) but I think while extolling the virtues of community she is also dismissing the need for a strong government provided social safety net. Boo to that!

    Gillibrand was tone deaf and Biden too for that matter, and gah, yes, good on Inhofe and Burr for calling for a renewed drive for better vaccines and my understanding is that a nasal vaccine would be far better than the in your arm approach as it would strengthen those cells and regions that first encounter the virus.

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  4. I was in The Mission just yesterday, after having an appointment nearby (where everyone mercifully masked up). After picking up some things at Valencia Whole Foods, I went past Serrano’s Pizza, pondering whether to go inside, where no one inside – not the staff nor the few customers – was masked. What sealed it for me were the pair of gentrifiers at one of the outside tables talking about how well-off they were and how many international trips they were planning. Even as I was there for just a minute or two, both mentioned having caught COVID before – one saying he and his partner had gotten it “a couple times”, but “What’re you gonna do, stay inside all the time?”

    Spoken like two privileged white colonisers who can afford for the pandemic to be “over” smack-dab in the middle of a neighbourhood hit hard by it. Never mind the fact that each COVID infection (and re-infection) brings the infected one step closer to Long COVID or death… naw, let’s all just go full YOLO as the US now has the lowest life expectancy its had in decades: Coincidentally, that downward slide started two years ago. What happened in that time to drop our life expectancy, I wonder? 🤔

    I then walked down to Taqueria San Jose where everyone on staff was masked, where the 6-ft. social distance markers were still on the floor, and where the door was kept open the whole time. I think that place may become my new go-to, now that the fire-damaged Los Coyotes is closed (permanently?).

    I’ve said it before, I’ll say it again – follow the science.
    Get vaxxed. 💉
    Get boosted. 💉
    Mask up. 😷
    Social distance. ↔️

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    1. 1. There is no “the science.” There are legitimate disagreements among scientists on a whole host of issues related to COVID restrictions and their efficacy.

      2. The harms from any particular intervention need to be considered along with the benefits when evaluating the intervention. The documentation of the massive harms inflicted on our kids from closing schools, for example, should give people pause before they lock them down again. I wouldn’t say that decision was very scientific but political, and the harms have fallen disproportionately on the most vulnerable folks of low economic status. Maybe lock down was worth it anyway but, of course, no good trials were conducted to get good data on whether or not such policies had significant benefits that outweighed depriving millions of kids of 2 years of critical development.

      3. The restrictions are over. They have been over in Europe for many months and here in the US they are over for all but tiny enclaves in liberal big cities. That may be wrong, and a lot of harm could be coming our way as a result but the way to mitigate those harms is not to call everyone idiots and uncaring monsters. There are folks looking at “the science” and concluding the evidence for some of these interventions is weak and/or that the harms outweigh the benefits. Good that you found a restaurant in SF where you can feel comfortable; that seems very hard to do but I don’t get out all that much. I predict this will get harder to do and, should you venture outside the bay area, I guarantee it will be impossible. Even though you don’t want to be, you are in the same situation as the vast majority of us; making individual decisions about the best course of action in any particular circumstance.

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      1. Since I won’t ever reply to your misinformation here again – especially when one child-per-day dies of COVID ( ) and the removal of all mandates has lead to a scholastic surge larger than any before ( ) – then I’ll tell you what you can do, ❄️:

        See how my handle is highlighted? Try going to my site, ’cause I won’t engage your harmful misinfo here just ’cause you’re so insecure you have to troll others’ comments. Or is that too hard for you (like wearing a 😷)?

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        1. “I don’t agree with you, so you must be an insecure, misinforming, troll, blah blah, insult, insult, etc.”
          I don’t think that is how “science” usually works. I think it’s supposed to be about examining and getting better data/ evidence, making evidence-based claims, and listening / replying to counter arguments in a search for the truth. Maybe that’s just how I wish it could be (being so insecure and all) since I don’t have any skills in the insult department. I have yet to see, even the most creative insult hurler, convince people who think differently to change their minds, but it does seem to be a very popular tactic these days. A good study might reveal how effective that tactic is versus other forms of persuasion but there I go again, talking science when I could be thinking of clever (or, let’s be honest, not so clever) ways to denigrate others. Fine for you not to reply but I welcome your point of view if you change your mind and decide to engage again in the future. I like hearing from folks who have something new (to me) to say and have different points of view. I think the insults are a waste of time but they don’t affect me at all so that’s yours and others’ choice to make. Be well and take care.

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