San Francisco health director reports sharp drop in COVID-19 cases and outlines easing of indoor masking rules

Grant Colfax, San Francisco's director of health, told the city's Health Commission that local COVID-19 case rates and hospitalizations have dropped dramatically from the recent Omicron surge and that DPH will align much of its guidance with recent state changes.

"We are now at 16.5 cases," Colfax said, citing San Francisco's cases per 100,000 residents and noting the steep decline from the Omicron peak. He told commissioners the city currently has adequate hospital capacity and 91 people diagnosed with COVID-19 in San Francisco hospitals, including some patients admitted for other reasons who tested positive on admission.

The presentation emphasized vaccine protection: Colfax said about 83 percent of residents have completed an initial vaccine series and roughly 65 percent have received a booster. He said vaccines remain highly protective against severe disease even when infections occur.

Colfax described changes to public-health orders that largely align with state guidance: masking will no longer be required for patrons in most indoor public settings, though masks remain strongly recommended, particularly for the unvaccinated and in designated high‑risk settings. He said the requirement for proof of vaccination or testing at large events will be relaxed to accept an initial completed series or a negative test, rather than requiring an up‑to‑date booster.

Dr. Susan Phillip, the city's health officer, clarified how the city will apply existing proof-of-vaccination and testing rules in certain settings. "For settings in which we currently require either vaccination or proof of testing — that includes restaurants, bars and gyms — we will, for the time being, continue to require those measures," Phillip told the Commission. She said proof of the initial vaccine series or a negative test will be sufficient; boosters are not required to enter those settings at this time.

Commissioners pressed staff on testing and vaccine access. Colfax said the city has testing capacity at public sites and that primary-care providers are required by health order to provide testing within 24 hours for symptomatic patients. He encouraged people to use provider testing, city sites, pharmacies and home tests and said DPH is working with partners to "right-size" testing and vaccination capacity to be ready for future surges.

The Commission did not take action on the update; Colfax said DPH would continue to monitor CDC and FDA developments, including potential eligibility changes for younger children or additional booster recommendations.