COVID hospitalizations are once again on the rise across the Bay Area, with clear upticks visible in the East Bay and in Santa Clara County as we big this first post-election week. Case counts are also rising in San Francisco and elsewhere, confirming concerns expressed ten days ago by Public Health Director Dr. Grant Colfax.

Cases rise in San Francisco: San Francisco added 114 new cases on Monday, 107 new cases on Sunday, and 107 new cases on Saturday, marking three of the highest daily new case counts since mid-August, when cases were surging across the state. Such surges are typically followed by surges in hospitalized patients, and though that has not yet happened in SF there are upticks in hospitalizations in nearby counties that may presage one here. San Francisco may risk back-sliding from the "Yellow" back to the "Orange" tier under the state's reopening guidelines if the trend continues — though city officials have remained conservative and have not allowed businesses to increase capacities beyond "Orange" levels. SF currently has 42 COVID patients in hospitals, with 11 of those in ICU beds.

Santa Clara County sounds alarms: Santa Clara County had one of its highest daily upticks in cases to date on Sunday, adding 353 new cases. It marked a 1.4% jump in one day, to just under 26,500 cumulative cases in the county. "This surge in COVID-19 cases is not what we want to see going into the fall and winter holiday season," said county Health Officer Dr. Sara Cody, per KPIX. She added that there was no clear source for the uptick, saying, "We don’t have a clear signals of particular groups or sub-populations or clear super spreader events that would explain this surge." The county is also seeing a jump in hospitalizations, which hit 138 on Sunday — the highest patient count in the county, including confirmed and suspected COVID patients, since September 5. In a news release, the county warned residents that "Indoor dining, gathering in private homes with people outside of one’s household, and becoming complacent with 'pandemic fatigue,' all elevate the risk of COVID-19 transmission."

East Bay sees spikes, too: Last week, Contra Costa County officials began warning that the county may slide back from the "Orange" to the "Red" tier, and we'll know that for certain by tomorrow (Tuesday). The county's adjusted rate of new infections per 100,000 ticked up in the last several days alone into "Red" territory, and today Contra Costa added 150 new cases. Hospitalizations jumped 26% in the county as of today, from 50 to 63, with ICU patients up over 60% — and hospitalizations jumped up 10% in neighboring Alameda County on Sunday as well.

Holiday travel, gatherings being discouraged: The Bay Area's coalition of health officers on Monday issued guidance for holiday travel and Thanksgiving get-togethers. None of this is new, but they are specifically recommending that if you and your pod want to have a Thanksgiving meal together, it ought to still be outside and perhaps everyone involved should refrain from risky activities like indoor restaurant dining and getting haircuts/pedicures for at least a week beforehand. Officials are still recommending that people not take non-essential trips for the holidays.

Newsom warns of tier changes: In a briefing on Monday, Governor Gavin Newsom said that the state's overall 14-day test positivity rate had gone up to 3.7% in the last three weeks from a low of 2.5% on October 19. He warned that some counties would be sliding back on the four-tier scale for reopening, and he specifically mentioned Shasta, Mono, Kings, and Alpine counties. He says early evidence from contact tracing suggests Halloween gatherings may be partly to blame — and in-home gatherings are a consistent theme among the newly infected, according to California's contact-tracing data.