Several New Year’s events with hundreds or even thousands of guests are still planning to pop the corks. Infectious disease experts worry this means we’ll drop the ball and ring in new superspreader-y times.

San Francisco has canceled its official New Year’s Eve fireworks display, but several huge New Year’s Eve blowout gatherings are still currently scheduled to go on. The SF Symphony is still holding its Darren Criss cabaret show at 2,700-seat Davies Symphony Hall. 8,500-seat Bill Graham Civic Auditorium has a big electronica show lined up for Friday night. Huge events are still booked at the Regency, the Westfield Centre, and on party yachts galore. Some huge rave thingy at Fort Mason has 1,700 guests who responded ‘Going’ or ‘Interested’ on Facebook, while the annual New Year’s Day rager It's A New Day + Breakfast Of Champions Block Party has 4,300 such guests.  

“I’m a little bit nervous right now,” UCSF professor of medicine Dr. Peter Chin-Hong tells SFist, as these parties come as San Francisco has just suffered four consecutive record-breaking days of new COVID-19 cases.

He told us this because we reached out to some of the leading doctors and infectious disease experts at UCSF, to see if there was some safe way we could navigate these large gatherings, or if the dizzying surge of Omicron infections meant an almost certain case of COVID-19 infection to ring in the new year for anyone who attends a large event.

The consensus was that you will definitely be exposed to COVID-19 if you attend a gathering with hundreds or thousands of people. In fact, you’re pretty damn-near certain to suffer a COVID exposure even if you’re around only 25 people.

“Our new data would indicate that in a crowd of 25 people – even if they all feel well – it’s nearly certain that someone will have COVID,” UCSF Department of Medicine Chair Dr. Bob Wachter tells us. “Given how infectious Omicron is, there is a decent chance that this person will infect others there.”

“I wouldn’t do it, at least without everyone masked, sadly,” Wachter says.

These remarks are not official government guidance, they’re just answers to New Year’s Eve questions we asked to some of the city’s leading doctors and infectious disease experts. The mayor, health director Dr. Grant Colfax, and health officer Dr. Susan Philip may update the city’s guidance before New Year’s Eve. Moreover, our conversations with them took place just hours after the CDC adjusted their estimate of Omicron variant presence, and doctors were still digesting this new information. Still, there is little question that the COVID-19 landscape is vastly scarier than it was just ten days ago.

“If you had asked me a week ago or even two weeks ago, I would probably have been okay with folks attending such an event if there were some safeguards in place, like masking indoors, vaccination checks, etcetera,” Dr. Chin-Hong says. “But now, since we’re kind of in the middle of an infection fire, I would probably be nervous with only [checking] vaccination status, particularly indoors.

“Outdoors is one thing. But indoors, in a big auditorium, makes me sort of shudder.”

UCSF professor of epidemiology and biostatistics Dr. George Rutherford points to “the epitome” of safe event protocols, the Warriors game protocols at Chase Arena. That policy absolutely mandates a booster shot on top of the original vaccination, requires everyone to  wear masks the whole time, and has a separate section for eating and drinking. Your event is unlikely to have even one of these policies in place, let alone all of them. But he feels an event can be safe with those precautions in place, and more.

“It depends on what the density is,” Dr. Rutherford tells us. “As long as you have enough space where people can spread out six feet distance between parties, I think that’s doable. But there are lots of other parameters.”

“Does everybody have to be boosted to get in? What are you going to do about kids who can’t get boosted yet? Are you going to test at the door? Does everybody have to wear masks?” he asks. “There are lots of questions like that.”

(Incidentally, San Francisco just announced Wednesday that boosters will be required for attending mega-events of 1,000 people before, but only after Feb. 1.)

A tiny handful of events are turning to rapid COVID testing before entry as a mitigation measure, but that’s a costly tactic that large events are unlikely to utilize. “Even with [rapid testing] I’d still be nervous,” Chin-Hong says. “That would make it safer. But It’s hard to do that with such a huge event.”

And even the current “proof of vaccination” standard appears wholly inadequate for the Omicron variant. “I have said for weeks that ‘fully vaccinated’ should be that you are up to date with your vaccinations, which now means three shots,” Wachter says.

The difference in boostered and non-boostered protection is stark.

“The CDC revised downward their estimate of the proportion of cases that were Omicron vs. the proportion that were Delta,” Dr. Rutherford tells us. “In Region 9 [Arizona, California, Hawaii, Nevada] where we are, it’s like 55-45, Omicron to Delta. Two shots are adequate for Delta, as long as they’re within the last several months. But they are not adequate for Omicron.”

“For Omicron, a two-shot [Pfizer] regimen gives you 36% vaccine efficacy. And a three-shot gives you a 75% effectiveness,” he explains. “It’s that kind of jump. You basically double up on effectiveness with a third dose.”

But at last count, a measly two Bay Area restaurants are requiring a booster shot, and neither is the host of any of these huge New Year’s blowouts. That’s unlikely to change, considering that more restrictions means fewer ticket sales, and ticket sales seem to be promoters’ main concern at the moment.  

But what about events like the Fort Mason blowout, or Breakfast of Champions, where I can spend my whole time outdoors? I can use outdoor bars, outdoor porta-potties, and never go inside. Isn’t that perfectly safe?

Nope. People, porta-potties are an Omicron variant threat vector.  

“There is some evidence that Omicron probably lingers in the air longer than Delta did,” according to Dr. Chin-Hong. “If you take the most infectious agent that we know about, measles, the reason it’s so infectious is that it can stay in the air for up to two hours. Someone with measles could use the porta-potty, you use it, you can get measles.”

So yes, it’s possible you can contract Omicron-variant COVID just by using the porta-potty. “If we think Omicron [transmission] is somewhere between chickenpox and measles, one could theoretically think of that kind of situation,” he says.

Chin-Hong sees San Francisco at a fork in the road right now, and with looming superspreader events poised to potentially set us back. He says San Francisco could be the “poster child of the U.S. again, or we can evolve into a dicier time.” But encouraging data from South Africa gives hope that paradoxically, the Omicron variant may present a path out of this long pandemic mess.  

“If this Omicron will just blaze through very quickly, it won’t be this prolonged suffering,” he says. “It’s like a roller coaster. You buckle the seat belt, and before you know it, the ride will be done. In South Africa, it’s already coming down very quickly.”

Yeah, yeah, New Year's Eve is a big deal calendar event, and we didn’t get to do our parties last year, and the events are sitting there for us to whoop it up at this year. But this calendar event happens to coincide with remarkable defining crossroads of COVID-19. We could be at a turning point where Omicron helps foster a lasting immunity, or these New Year’s parties could be superspreaders that beget yet another goddamned Greek-letter variant that further upends our lives.

“Right now we’re in a watershed moment,” Chin-Hong says. “ It’s a very seminal moment right now. That’s where we are.”

Related: SF Cancels New Year’s Eve Fireworks Display Amidst Skyrocketing COVID-19 Case Count [SFist]

Image: EYE HEART SAN FRANCISCO NEW YEAR’S EVE 2021-2022 via Fort Mason