While California's rollout of the COVID-19 vaccine continues to be bumpy amid the deadliest days of the pandemic, the latest numbers on new cases and hospitalizations from the San Francisco Department of Public Health reveal the surge may be easing in the city.
In a Tuesday update, San Francisco Health Director Dr. Grant Colfax said while the number of new daily cases remains higher than before the explosion of cases after Thanksgiving, the most recent data shows promising signs. The case rate is currently 38.3 per 100,000 people, down slightly from the high of 42.5 new cases per 100,000 on Jan. 10.
"This trend is promising, but it’s too early to know for sure so we simply can not let our guard down," Colfax said. "Our current number per 100,000 is far higher than our summer surge when we peaked at just 15.4, but we are still doing better than California as a whole where the average is 100.9 per 100,000." (Note: According to the Centers for Disease Control and Prevention, the rate per 100,000 in California was 90.3 as of Jan. 20.)
The post-holiday rise in hospitalizations is beginning to trend down "just barely" with the weekly change in hospitalization rate declining by 1%, Colfax said.
"That rate in change is important because it reflects the demand put on our hospitals for acute care and ICU beds to care for COVID-19 and other patients," he noted. "Again, this is promising and hopeful news."
With cases finally starting to decline slightly and the distribution of vaccines slowly increasing, some may be wondering: Did San Francisco hit its peak?
"I think the answer is yes," said UCSF epidemiologist Dr. George Rutherford. "We’ve seen the positivity rate start to go down. We’ve seen cases start to go down. We’re seeing hospitalizations go down. We’ll start to see ICU admissions go down and then we’ll see deaths go down. So I say yeah, probably. It think we’re on our way down."
Rutherford said this with caution, noting that numbers can easily increase if people stop wearing masks and social distancing. "You have to be careful," he warned. "It could bounce right back up."
Health officials are in a race against time, not only as patients continue to become sick and die but as the virus mutates into forms that can spread much more easily.
An L452R variant has been found in at least a dozen counties and was identified in several large outbreaks in Santa Clara, San Francisco and Monterey counties.
Rutherford believes the new variants are unlikely to cause a major surge in San Francisco if people wear their face coverings, don't gather and follow public health guidelines.
"What causes outbreaks is people not wearing masks and not socially distancing and getting into crowded situations," he said. "If it’s one strain or another, they all cause outbreaks. Some may transmit more than others, but at the end of the day it’s all behavioral."
UCSF infectious disease doctor Dr. Peter Chin-Hong agreed numbers are trending slightly down, but he's hesitant to say S.F. hit its highest peak; Chin-Hong is worried about the L452R variant, which is increasingly being identified in cases.
"That rate of increase is making me worry it’s going to be the U.K. variant all over again," Chin-Hong said. "It’s becoming a larger part of the genotype scene. It suggests it’s taking over the COVID."
He said he also worries people will become less vigilant in following the public health orders. "Just when it’s getting warm and the vaccine hope is there, I’m worried we’ll slack off," said Chin-Hong, noting that people will still need to wear masks after they've been vaccinated. "Until there’s consistency in the numbers, I can't say for certain we've hit the peak."
Michael Piazza took this photo of the crowds at Dolores Park in San Francisco, Cali. on Saturday, Aug 1, 2020.
Instagram / @piazzatronAcross California, infection indicators are “all showing trends in the right direction," state Health and Human Services Secretary Dr. Mark Ghaly said. A surge following Christmas and New Year's had been feared on top of the surge after Halloween and Thanksgiving that drove case levels and hospitalizations to record levels.
Only a couple of weeks ago, it was feared some hospitals in Los Angeles and other hard-hit areas might have to begin rationing care as they ran out of surge capacity as regular beds were filled.
But statewide hospitalizations are down 8.5% over 14 days, with the number of intensive care patients also easing. Hospitals that had been seeing 3,500 new patients each day are now seeing 2,500 to 2,900 daily admissions — still distressingly high, but “quite a significant reduction," Ghaly said.
The statewide positivity for the virus fell below 10% for the first time in weeks, and each infected individual is now infecting less than one other person — a recipe for an eventual decline in cases.
“These are rays of hope shining through,” Ghaly said.
Deaths continue at a frightening pace, however. More than 6,700 people have died in the last two weeks. In Los Angeles County, so many people have died that the air quality board temporarily amended its rules to allow for more cremations.
While these numbers are all promising, the distribution of vaccines has been discouraging.
So far 3.2 million doses have been shipped to California and 1.5 million have been administered, Ghaly said. That exceeds Gov. Gavin Newsom's goal of getting an additional 1 million shots in arms over a 10-day period, but Ghaly could not say if the state met Newsom's self-imposed Friday deadline for doing so, citing lagging reports.
The delay in administering the remaining 1.7 million doses may be because some have not actually arrived in the state yet, and some have been earmarked for those needing second doses or for the mass vaccination sites, he said.
S.F.’s public health department said it's likely to run out of vaccine Thursday, in part because the state pulled back on administering a batch of Moderna shots after several health workers in San Diego had a bad reaction.
The county health department received 12,000 doses last week and had expected the same amount this week, but it received only 1,775.
“This unreliable source makes it very hard to plan,” Colfax said.
Chin-Hong is hopeful the vaccine distribution will speed up in coming weeks as President Joe Biden implements his vaccine plan aimed at boosting supply.
"I think with a new administration it will give clarity to the problems and maybe put some money behind it," he said. "You can’t do this overnight. Public health has been underfunded for many years. You can’t just shoot a movie without preparing the actors and the sets all done and have everybody training. I think what its reflecting is lack of a centralized health system. I think people have been disappointed. I’m hopeful with everything will get better.""
The Associated Press contributed to this story.
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