San Francisco changes COVID protocols as New Year’s Eve approaches

‘I wouldn’t be going to some giant party’

As San Franciscans reevaluate New Year’s Eve plans amid yet another COVID-19 surge, federal and local public health officials have been busy making changes of their own.

On Monday, the Centers for Disease Control and Prevention reduced the recommended isolation time for individuals who test positive for COVID-19 from 10 days to five, if asymptomatic, followed by five days of wearing a well-fitted mask when around others.

Then on Wednesday, San Francisco reinstated its universal indoor mask mandate and began urging establishments such as bars, restaurants and gyms to include booster shots as part of their proof of vaccination checks.

“As COVID-19 becomes endemic, we need to ensure everyone eligible gets vaccinated and boosted, we sustain our hospital capacity and protect the most vulnerable. These updates to the Health Order help us achieve that,” said Grant Colfax, S.F. Director of Public Health.

Cases locally are rising three times faster than during the summer delta surge. San Francisco’s 7-day average case count reached an all-time high of 630 on Dec. 28, according to the New York Times COVID-19 tracker, and cases are expected to continue to increase in the short term.

While hospitalizations have remained relatively low across San Francisco, city health officials told The Examiner, “We are just getting to the point where we would expect an uptick” in hospitalizations following a spike in cases.

In light of the sudden surge, city officials are assessing holiday plans. On Tuesday, Mayor London Breed announced the New Year’s Eve fireworks show will be canceled.

“These are the things we have to be doing. San Francisco’s case rate right now is higher than the state’s average, and I don’t know if I have ever seen that in the pandemic. And hospitalizations are increasing disturbingly fast,” said John Swartzberg, an infectious disease specialist and professor of infectious diseases at UC Berkeley’s School of Public Health.

Despite the setbacks, some of the nation’s top infectious disease experts say the shorter isolation and quarantine recommendations make sense alongside a growing body of research showing that the rapidly-spreading omicron variant incubates faster and cases are milder among people who are vaccinated.

“This is warranted,” said George Rutherford, an infectious disease expert at UCSF, regarding shorter isolation requirements for people who test positive for COVID-19. “What you want to do is have an appropriate isolation period, not twice as long as it needs to be.”

For most vaccinated people, five days of isolation will be enough to no longer be contagious. But those who are unvaccinated or have more severe cases may continue to shed the virus after five days, prompting experts like Swartzberg to point out that testing and masking are still essential.

“Generally speaking, I’m OK with it. I think it will lead to more spread, but it will also lead to critical workers to our society being able to function,” said Swartzberg. “I think we may have hit a balance.”

CDC officials said their decision is based upon omicron data from places such as Norway, South Africa and most recently Nebraska, where a study of an omicron outbreak showed the variant has a shorter incubation period — three days compared to four to six days with the delta variant — and was less severe than other variants for the vast majority of vaccinated individuals.

But the pressure to change the 10-day waiting period also came from communities scrambling to keep businesses and essential services going while the omicron variant spreads rapidly through the United States.

“The omicron variant is spreading quickly and has the potential to impact all facets of our society. These updates ensure people can safely continue their daily lives,” said CDC Director Rochelle Walensky.

Still, some health experts and labor representatives have cried foul at the CDC’s decision, saying it increases health risks for workers who may not have adequate health care or paid sick leave. National labor representatives from groups such as the Association of Flight Attendants have meanwhile warned the new CDC guidance could put pressure on employees to return to work too soon.

“Already the lack of paid sick leave creates pressure on workers to come to work sick. Corporations that fail to recognize this with paid sick leave, or pressure workers to come to work sick or face discipline, are failing their workers and their customers,” said Sara Nelson, president of the flight attendants union.

Peter Chin-Hong, another infectious disease expert at UCSF, said he feels cautiously optimistic about allowing people to return to their lives if they are not showing symptoms of COVID and continue to wear a mask around others.

“With delta, about 15% of cases were going to the hospital, and in general with omicron we are seeing about 5% or less,” he said.

One big lingering concern he and other public health officials across the country fear as holiday gatherings continue is that there is now a greater emphasis on individual responsibility to make safe choices after being exposed to or testing positive for COVID.

Currently, 81% of eligible San Franciscans are fully vaccinated and 55% have received a booster dose. With cases and hospitalizations rising, doctors and city leaders are advising everyone to take precautions on New Year’s Eve.

Swartzberg said canceling events such as the fireworks show is the right move. “The problem we are having now to a large extent is because omicron decided to put its head up at the time of year when everyone is gathering for the holidays,” he said.

As people travel and gather for the holidays, public health officials recommend everyone gets vaccinated, boosted and tested ahead of visiting others, and wears N95 or other well-fitted masks.

“The rapid test helps with how infectious you are; it’s not meant to diagnose you. And everyone (at the party) has to do it,” said Chin-Hong, who plans to spend the holiday with his immediate family. “There are still people who are sick and we’ve had an increase in hospitalizations in the Bay, but nothing compared to last year.”

Swartzberg said he will be spending the night at home with his wife and a bottle of champagne. And Rutherford will be dining at a restaurant with a small group in Oakland, which recently announced it will require patrons to show proof of vaccination to eat indoors. San Francisco has had a similar policy for indoor bars and establishments since the summer.

Restaurants and small businesses struggling to stay properly staffed amid the recent surge may find some relief with the relaxed quarantine rules.

“There will be so many cases here that a whole variety of business sectors will be left without enough people,” said Rutherford. “Restaurants will need people who can wait tables.”

For those just trying to make it through another confusing holiday season, Rutherford’s advice is simple: “You need to be vaccinated and boosted and around people who are vaccinated and boosted. Don’t have your mask down unless you need to. And I wouldn’t be going to some giant party.”

sjohnson@sfexaminer.com

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