The masks have come off in many places around the Bay Area, and daily COVID case numbers continue their downward trajectory — but they haven't hit the rock-bottom levels of the early summer or late fall yet, and we're probably a good few weeks away from such a lull.
It is truly exhausting to still be talking about this. But as long as UCSF experts still think it's meaningful and as long as the CDC still has pretty much all of California in the "red" tier for high transmission, it's probably irresponsible to ignore the ongoing pandemic completely. You may have made some riskier choices in the last week or so, after SF and other local counties broadly lifted their indoor mask mandates, but maybe you haven't! There's still plenty of virus to go around, at least according to week-old numbers from the SF Department of Public Health. And these should also be looked at with the caveat that there's likely a significant number of new Omicron cases going unrecorded because people are doing at-home tests, or they're not testing at all if the symptoms are super mild.
Below is the CDC's latest graph looking at the last year, and you can see cases are down 41% from a week ago — but we are still looking at case numbers in San Francisco that are around as high as the peak of the Delta wave last August.
Compare that with the SF DPH chart, which looks at the seven-day rolling average of new cases, and which is currently over a week behind. The last number reflected in the chart is from Feb. 13, with a daily running average of 256 cases per day — somewhat below the Delta peak of 311 cases on August 2, and 89% below the Omicron peak of 2,390 cases on January 9.
So, if you live in SF you may not currently know ten people who are sick, like you might have in early January. But you might still know one person, or you might still be slightly at risk yourself, depending on where you've been.
The data, combined with the assumption that many cases are now going uncounted, means this surge isn't fully over — and as has been said approximately a trillion times since the start of this, we're not "out of the woods," still. We're still back in mid-December territory, numbers-wise.
UCSF's Dr. Bob Wachter published another one of his famous threads over the weekend in which he doubled down on his chosen "safe" threshold for transmission: 10 daily cases per 100,000 residents, with a test-positivity rate of 2-3%. As of Saturday, San Francisco was still seeing over 30 new daily cases per 100,000 residents, with a test-positivity rate of 6.4%.
Wachter is forecasting that the city will hit around 10 cases per 100,000 — or about 90 cases per day — by March 1, and that test-positivity even for asymptomatic people will continue trending downward at UCSF's hospitals. Until then, he says, he'll remain a bit cautious in public in indoor settings, and he adds, "even after I start removing my mask for indoor dining & some get-togethers, I’ll keep it with me and will not hesitate to whip it out when I perceive I’m in a high-risk setting, or w/ high-risk people."
Back to my threshold of 10 cases/100K/day. As I mentioned, it's what I’ve used for 18 months, yet so much has changed.— Bob Wachter (@Bob_Wachter) February 19, 2022
Below is my analysis of things that make me want to raise vs lower the #, & why they currently cancel out, landing me pretty much right where I started. (14/25) pic.twitter.com/yFrUsLTPlr
He adds that there are still good arguments for avoiding getting Omicron, even if it promises to likely be mild if you're vaccinated and boosted. Risks for long COVID are still not well understood, and he'd be much more cavalier — even as a 64-year-old — he says, if Paxlovid, Pfizer's oral COVID treatment that's shown to greatly reduce the risk of severe infection and long COVID, were widely available. He estimates that the drug will likely only be made available to high-risk patients until, perhaps, next year.
But your own level of risk aversion is your own, and we're all going to be navigating the world of endemic COVID as we see fit — and likely as we face threats from new variants in the coming months. But with growing "herd immunity" nationwide, both from boosters and previous infections, some experts contend that future waves are not likely to be very severe.
Photo: Darwin Bell