San Francisco health director warns Delta-driven surge could sharply raise hospitalizations; urges vaccination

Director Grant Colfax said the city is seeing a "very high climbing rate" of COVID-19 cases driven by the Delta variant and urged vaccination as the primary tool to avert severe illness and death.

Colfax showed updated modeling and case data, noting San Franciscoases rose from about 1 per 100,000 in late June to roughly 22 per 100,000 and that, "under these scenarios ... our cases will go up very deeply" with a projected peak of over 400 daily reported cases around Aug. 20 and a hospital census that could peak around Sept. 3 at about 336 people with COVID-19. He said the vast majority of projected hospitalizations and deaths would be among people who are not fully vaccinated.

The director described several features of the department
nalysis: Delta is plausibly both more transmissible and more likely to cause severe disease than earlier variants; models assume no additional mitigation beyond current behavior; and hospitalization rates could rise two weeks after case increases. He said the model estimates "about 257 more deaths due to the Delta variant" under the scenario shown.

Colfax called vaccines "the ticket out of this continued serious situation," adding, "we will get some degree of breakthrough infections ... but I really think we need to continue to focus on the importance of vaccines." He reported the cityurrently averages roughly 45050 first doses per day and that about 77% of eligible residents aged 12 and up have received a full vaccine series, translating to approximately 70% of the total population.

To make vaccination more convenient, DPH launched a "Vax to You" program that will send vaccination teams to sites where small groups (about five to 15 people) request on-site vaccination; Colfax said the program will operate Tuesday through Saturday and already has requests.

Commissioners pressed Colfax on testing capacity, turnaround times and hospital staffing. Colfax said DPH currently performs about 40% of the city's testing and that labs can experience longer turnaround times as demand rises. On hospital staffing he said hospital CEOs have told DPH they expect to have the beds and staffing needed to manage the projected peak, though he warned "it will be a huge strain on the system."

Colfax said DPH would prioritize a targeted response focused on school safety supports, shelters and neighborhoods with the highest prevalence of infection, rather than attempting the broad, citywide mobilization used in earlier surges. He also noted reduced surge staffing compared with 2020 and the resulting need to focus limited personnel where they are most needed.

The Health Commission asked for more detailed age and testing breakdowns for future reports and for follow-up data on whether increased pediatric cases emerge; Colfax said he would provide updated data to commissioners and continue to brief the commission as models and local indicators change.