DPH deputy director reports steady COVID declines, outlines booster and masking guidance

Deputy Director Navina Bhabha reported to the San Francisco Health Commission on Oct. 19 that the city's Delta surge has declined markedly and that COVID metrics permit cautious planning for winter.

"The Delta surge peaked at 35.6, and we've been on a steady decline since then," Bhabha said, adding that the seven-day case average in San Francisco stood at about 7.7 cases per 100,000. Hospitalizations have fallen, she said: "We have 48 individuals in the hospital with 13 in the ICU." She also said the reproductive number is about 0.87.

Bhabha outlined vaccine coverage and booster guidance. She said 76% of San Franciscans had completed a primary series, 84% of residents 12 and older were fully vaccinated, and 91% of residents older than 65 had completed vaccination. Pfizer boosters have obtained full authorization and availability, while Moderna and Johnson & Johnson were awaiting final FDA sign-off and CDC guidance.

On masking, Bhabha summarized a regional agreement among Bay Area health officers that sets three criteria for lifting an indoor mask mandate: remaining in CDC's "moderate" (yellow) community level for at least three weeks, reaching either 80% of the jurisdiction fully vaccinated or eight weeks elapsed since authorization for 11-year-olds, and low, stable hospitalizations. She added that "San Francisco had some specific indoor masking mandates that it's lifting" for "stable cohorts" where every participant is fully vaccinated and the setting is controlled, citing examples such as certain offices, gyms and some college classes. Masks remain required in settings with intermixing of cohorts: retail, restaurants and bars, public transit, healthcare settings, schools and childcare.

Commissioners asked clarifying questions. When Commissioner Chow referenced nearby counties that had already lifted mandates, Bhabha said Santa Cruz was not part of the Bay Area county agreement. Commissioner Green asked whether pregnant people were included among priority groups for boosters; Bhabha said she believed pregnant people would fall into the 1849-with-underlying-conditions category and said she would confirm guidance.

Bhabha cautioned that easing restrictions can lead to temporary increases in transmission and stressed the importance of boosters and monitoring hospitalizations as the city moves into winter.

What's next: Bhabha said the department is tracking booster authorizations for Moderna and J&J and will follow FDA and CDC guidance on mixing-and-matching boosters and eligibility expansion.