The last four daily totals of new COVID infections from the San Francisco Department of Public Health are higher than any others previously in the pandemic, as Omicron rages across the region. But should we be as anxious about this as in previous surges?

Experts have been cautioning that we probably should not put quite as much stock in case numbers as we enter the endemic phase of COVID-19 — and the Omicron variant may be the first of many that will be widespread for years, perhaps every winter. Also, in South Africa where the variant was first detected, there has been a very rapid drop-off in cases one month after a surge was first occurring, so we may have that to look forward to as well.

But for now, the Bay Area is in the grips of its second winter surge in COVID infection — the fourth surge for us in this pandemic. As SFist reported on Monday, San Francisco's Department of Public Health (DPH) just recorded two of the highest single-day totals of new COVID infections in the pandemic to date — and now we have four days worth of data showing these record numbers. Previous high-water marks in cases came on January 4, 2021, when we saw 558 new cases, and on July 29, when the Delta variant drove the daily total to 446. But the four days beginning Monday, December 20 have officially seen the highest numbers of infections SF has seen since March 2020 — 12/20: 569; 12/21: 860; 12/22: 894; 12/23: 964.

These are still preliminary totals and may rise as more test samples get reported — and we still don't have totals in from the holiday weekend or Monday. But what's clear is that the week leading up to Christmas will go down as the worst in the pandemic for San Francisco in terms of new case counts — even though the Omicron variant appears to produce much milder illness in most vaccinated and boosted people.

The rate of test-positivity in San Francisco also looks likely to jump well above previous surges. Currently, 5.2% of all tests being taken are coming back positive, but the rate is sure to rise in the coming days, and the previous high-water mark was 6.3% on July 29.

Hospitalizations have risen in SF and the Bay Area, but not nearly as rapidly as the case counts — and we'll have to wait a week or so before we can truly assess the surge's impact on the region's hospitals. Still, hospitalizations rose 13.6% on Sunday in the Bay Area, and over 10% on Monday, pointing to the beginning of a wave. There are now more COVID patients in regional hospitals — 526 — than on any day since early October.

Statewide, hospitalizations have ticked up almost 25% since December 20, and are similarly back to levels from early October. Still, this represents less than a quarter of the number of COVID patients in California hospitals during the latter part of December and early January in last winter's surge.

Infectious disease experts have been predicting for weeks that, given the state's high vaccination rate overall, the Omicron surge would likely produce manageable rates of hospitalization — particularly in the well-vaccinated Bay Area.

But unknowns remain, and a new report out of the UK questions whether Omicron is intrinsically less severe than earlier variants, or if it is simply appearing less severe statistically because so many infected people have some form of immunity — either from vaccines or prior infections. Once Omicron hits a large pocket of unvaccinated people who were not previously infected, we could see many more severe outcomes.

Whether or not we should be terrified into isolation by this surge is going to be a matter of personal risk tolerance and mitigation.

"I think on the surface it looks really scary like a horror movie, But in reality, our hospitals in the Bay Area are still doing well,” said UCSF infectious disease expert Dr. Peter Chin-Hong, speaking to KPIX on Monday. “My biggest anxiety in the Bay Area is not necessarily overrunning the intensive care units and not having enough ventilators like in the old days. But it’s rather about the disruption to the way of life."

Related: Bay Area Coronavirus Information — Updated Daily

Daily New COVID Cases In SF the Highest Recorded Since January

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