Has San Francisco reached its COVID peak?

While California’s rollout of the COVID-19 vaccine continues to be bumpy amid the deadliest days of the pandemic, the latest numbers on new cases and hospitalizations from the San Francisco Department of Public Health reveal the surge may be easing in the city.

In a Tuesday update, San Francisco Health Director Dr. Grant Colfax said while the number of new daily cases remains higher than before the explosion of cases after Thanksgiving, the most recent data shows promising signs. The case rate is currently 38.3 per 100,000 people, down slightly from the high of 42.5 new cases per 100,000 on Jan. 10.

“This trend is promising, but it’s too early to know for sure so we simply can not let our guard down,” Colfax said. “Our current number per 100,000 is far higher than our summer surge when we peaked at just 15.4, but we are still doing better than California as a whole where the average is 100.9 per 100,000.” (Note: According to the Centers for Disease Control and Prevention, the rate per 100,000 in California was 90.3 as of Jan. 20.)

The post-holiday rise in hospitalizations is beginning to trend down “just barely” with the weekly change in hospitalization rate declining by 1%, Colfax said.

“That rate in change is important because it reflects the demand put on our hospitals for acute care and ICU beds to care for COVID-19 and other patients,” he noted. “Again, this is promising and hopeful news.”

With cases finally starting to decline slightly and the distribution of vaccines slowly increasing, some may be wondering: Did San Francisco hit its peak?

“I think the answer is yes,” said UCSF epidemiologist Dr. George Rutherford. “We’ve seen the positivity rate start to go down. We’ve seen cases start to go down. We’re seeing hospitalizations go down. We’ll start to see ICU admissions go down and then we’ll see deaths go down. So I say yeah, probably. It think we’re on our way down.”

Rutherford said this with caution, noting that numbers can easily increase if people stop wearing masks and social distancing. “You have to be careful,” he warned. “It could bounce right back up.”

Health officials are in a race against time, not only as patients continue to become sick and die but as the virus mutates into forms that can spread much more easily.

An L452R variant has been found in at least a dozen counties and was identified in several large outbreaks in Santa Clara, San Francisco and Monterey counties.

Rutherford believes the new variants are unlikely to cause a major surge in San Francisco if people wear their face coverings, don’t gather and follow public health guidelines.

“What causes outbreaks is people not wearing masks and not socially distancing and getting into crowded situations,” he said. “If it’s one strain or another, they all cause outbreaks. Some may transmit more than others, but at the end of the day it’s all behavioral.”

UCSF infectious disease doctor Dr. Peter Chin-Hong agreed numbers are trending slightly down, but he’s hesitant to say S.F. hit its highest peak; Chin-Hong is worried about the L452R variant, which is increasingly being identified in cases.

“That rate of increase is making me worry it’s going to be the U.K. variant all over again,” Chin-Hong said. “It’s becoming a larger part of the genotype scene. It suggests it’s taking over the COVID.”

He said he also worries people will become less vigilant in following the public health orders. “Just when it’s getting warm and the vaccine hope is there, I’m worried we’ll slack off,” said Chin-Hong, noting that people will still need to wear masks after they’ve been vaccinated. “Until there’s consistency in the numbers, I can’t say for certain we’ve hit the peak.”

Across California, infection indicators are “all showing trends in the right direction,” state Health and Human Services Secretary Dr. Mark Ghaly said. A surge following Christmas and New Year’s had been feared on top of the surge after Halloween and Thanksgiving that drove case levels and hospitalizations to record levels.

Only a couple of weeks ago, it was feared some hospitals in Los Angeles and other hard-hit areas might have to begin rationing care as they ran out of surge capacity as regular beds were filled.

But statewide hospitalizations are down 8.5% over 14 days, with the number of intensive care patients also easing. Hospitals that had been seeing 3,500 new patients each day are now seeing 2,500 to 2,900 daily admissions — still distressingly high, but “quite a significant reduction,” Ghaly said.