This Time Around, SF's Covid Surge Has Solutions, Experts Say

San Francisco CA

31 July, 2021

5:10 PM

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By Lydia Chávez and Annika Hom, Mission Local July 30, 2021 (Updated 3:50 P.M.) - San Francisco is in the midst of a surge, but this time around we know how to contain the virus — testing, isolation, masking, and vaccinations now. After weeks of none, or very few positives, at the testing sites at 24th and Capp and Alabama street, doctors saw positives shoot up starting last week – with positivity rates ranging from 5 to 9 percent. Citywide, positivity rates are at 4.8 percent and 7.6 percent among Latinx residents. "It's something we have not seen since the summer of last year," said Jon Jacobo, the head of the health committee for the Latino Task Force, which runs the Mission sites with UCSF and the San Francisco Department of Public Health. "We want to play offense," he said adding that they are recommending vaccinations, tests, masks and isolation for those who test positive. Dr. Diane Havlir, UCSF researcher and leader of the covid testing campaigns in the Mission District and other vulnerable communities, wrote in an email that the delta variant is now dominant in San Francisco and it "is more transmissible." Havlir said that the Latino Task Force and UCSF have expanded testing days at the Mission sites. "Access to testing is critical during a surge," she said. Beyond getting vaccinated, testing, isolation and masking can break chains of transmission, Havlir wrote. "Indoor masking is a simple, easy intervention that can have immediate effect; it should be used on a temporary basis during a surge," she added. Los Angeles implemented a mask mandate about two weeks ago. So far, San Francisco has recommended masking, but has not yet declared a mandate. The Center for Disease Control also recommends masking indoors for everyone, a change in policy that, according to reporting from the Washington Post, came after researchers saw data showing a highly contagious delta variant — one that may be as likely to be transmitted by the vaccinated and unvaccinated, according to that data. UCSF professor of medicine Dr. Monica Gandhi disagreed that unvaccinated and vaccinated people are "equally" likely to transmit the delta variant. On Twitter, she linked a CDC study on Provincetown, where an outbreak occurred among mostly vaccinated people on July 4, and underscored that the agency did not state that unvaccinated people are as transmissible as vaccinated people. "I think [delta] is very transmissible. I don't think 'equally' is fair use to yet," she said. "That seems logically implausible." Cultures or serial viral load testing are needed before making such assertions, she added. While vaccinated residents are turning up positive, they are not getting severe symptoms. Havlir wrote in an email that infections among the vaccinated should not be a deterrent to getting vaccinated. "We expected to see this during a surge because these vaccines work extremely well to prevent serious infection/hospitalization but they are less effective for preventing infections," Havlir wrote. "Unvaccinated persons who get COVID infection are at a much higher risk to be hospitalized." Gandhi and other medical experts concur and said that the concerns over mild breakthrough cases are partially due to poor public messaging. The public assumed that vaccines would "miraculously prevent all infection" when they're meant to curb serious disease, hospitalization and death, she said. When it comes to this, vaccines are significantly succeeding; the fact that most hospitalizations and severe illness occur among the unvaccinated is still true. "The vaccines were produced, and they are delivering," Gandhi said. The vaccinated residents who tested positive in the Mission are generally asymptomatic or have very mild symptoms, Jacobo said. To encourage more vaccinations and testing, researchers at the 24th and Capp site will begin offering free testing for diabetes and HIV on Sunday. It's unclear whether the San Francisco Department of Public Health (DPH) is doing any contact tracing to contain the virus. The data monitoring contact tracing has been taken down from the city's covid tracker. Moreover, there is no published data on who is being hospitalized in San Francisco — either on ethnicity, age, or vaccination status. Questions to DPH have not yet been answered, but we will update this piece when we get a response. Update: The San Francisco Department of Public Health reported late today that: "there are 86 COVID-19 patients in San Francisco hospitals of which 24 are in the ICU. This includes both residents and non-residents. The COVID-19 hospitalization census reached 256 during the third surge. There have been 16 clinically validated fully vaccinated San Franciscans who have ever been hospitalized due to COVID-19. On case rates, DPH wrote: The 7-day rolling average among fully vaccinated individuals and not fully vaccinated individuals shows the trend in new cases. We calculate the rolling average by averaging the new cases for a particular day with the prior 6 days. Citywide, the 7-Day Rolling Average of Case Rate is 22.7 per 100,000 for all cases; 36.8 for not fully vaccinated residents and 16.2 per 100,000 for fully vaccinated. This information will be updated weekly here. The full press release is here. End Update Gandhi said that when a virus becomes "endemic like this," it's difficult to contact trace outbreaks. She said that a vaccine mandate is the next step, especially for those in public-facing jobs and healthcare workers. The mayor said earlier this week that in addition to a mask mandate, a vaccine mandate is being considered. Already, San Francisco requires all city employees to be vaccinated and hundreds of city bars are barring unvaccinated folks. President Joe Biden similarly declared that federal workers must show vaccination status or follow stringent health protocols. Meanwhile, Jacobo said the Latino Task Force is "pushing the city on increased testing capacity. Again, like you literally closed shop. You went away." The large testing site at the Embarcadero closed earlier this year. The Alemany Market testing remains, as do many neighborhood sites. Hours and appointments can be found here. Larger sites, Jacobo said, need to be reopened. At present, the city's seven-day rolling average on testing is 4,378 compared to more than 9,000 in January. After weeks of testing 50 to 100 residents at the two sites, demand shot up last week. On Thursday at the Alabama site, the line started on Alabama Street and swung around to 20th Street. "I'm testing to make sure I am negative before I go to Seattle," said Hugo Ortiz, who waited in line on Thursday. Another person in line, Mila, said she may have been exposed at work, and was in line to find out if she too had the virus. While symptoms may be mild, Havlir said anyone who tests positive should isolate and family members or roommates should also be tested. Low-barrier testing and vaccinations in the Mission District 24th and Capp Street: Saturdays and Sundays 9-4. Monday and Tuesdays 9-1. This Sunday at Capp Street testers will launch free testing for diabetes and HIV as well as help signing on for health care. Alabama Street: 10-4 on Thursdays Elsewhere in the city sites can be found here. Mission Local covers San Francisco from the vantage point of the Mission, a neighborhood with all of the promise and problems of a major city. You can support Mission Local here.