As the coronavirus emerges again in San Francisco, city officials are preparing for the worst possible outcome: massive infections from the fall, potentially overloading the city’s health care system and a sharp rise in the death toll in the city.
In a virtual press conference on Thursday, Dr. Grant Colfax of the San Francisco Department of Public Health confirmed that the number of patients hospitalized with COVID is higher than ever, underscoring the urgent need for residents of the city correct themselves to mitigate the spread of the virus. During the last spike in April, 94 people were hospitalized. Six weeks ago, that number dropped to 26. But at the end of July, the number of those hospitalized increased to 107. Of those, Colfax noted, a quarter are in intensive care.
“In just 10 days, this month we went from 5,000 to 6,000 cases of COVID-19,” he said. “Let me be clear: We are in a big rush for COVID-19. The virus is moving fast and more people are getting sick. If this continues at current rates, we estimate that on average we will have more than 750 San Franciscans in the hospital at mid-October and more than 600 deaths from COVID-19 in 2020. [The] The worst case scenario places us at 2,400 hospitalizations and 1,800 deaths. These scenarios become more likely as the day progresses with current trends. “
Such figures seem frightening, but at this point, they are still avoidable. The city has recorded 6,423 cases and 58 deaths as of Thursday. Colfax noted that San Francisco hospitals are not overwhelmed as they are in New York, but that “it is extremely sobering that we have reached this point.”
Dr. George Rutherford, professor of epidemiology at the University of California, San Francisco, agrees with the city’s current assessment and projections. While R0’s current score is just north of 1, substantially lower than a week or so ago, the numbers the city predicts for the near future are likely to still weigh.
“They have been accurate in the past,” says Rutherford of projections of up to 4-6 weeks ahead. “As you go, no one knows. We use a variety of inputs to get estimates of where things might be, [but] It is not that we have a group on this or bet on it. They are intended for planning purposes. Yes [Colfax] is to put those numbers out there, that’s what they’re planning. “
City officials are currently working to find the best ways to resist an increase in hospitalizations. On Thursday, Colfax and District 2 Supervisor Catherine Stefani announced a 93-person low-acuity care facility for non-COVID patients to free hospital beds for coronavirus cases. And previously an additional floor for COVID patients was opened at Saint Francis Memorial Hospital.
As for what could happen later this year, Rutherford is less certain about the city’s estimates. While the idea that an average of more than 750 people a day could be hospitalized is plausible, he is not so sure about the expected number of deaths at 600, noting that “it seems a bit far.”
“But if this begins to return to the nursing homes or if we infect so many infected young people, we see them scattered to the ICU and to the mortuary, which will be very problematic,” he adds.
As for those worst-case numbers? It is still difficult to say. There is a chance that could happen, says Rutherford, but that outcome is far from certain at the moment. “That’s the problem with modeling too far,” he says, “you get ample numbers, but you have to plan something.”
All this aside, the future scenario that really worries Rutherford is not strictly about the coronavirus, but also the flu. “Is everyone going to be slow to get a flu shot, and are we going to start flooding emergency departments with people with influenza and people with COVID at the same time?”
It’s a scary thought, but he adds that the best way for Franciscans to avoid overwhelming hospitals is to follow the recommendations of the health department: do things that are within their reach.
“They can stay home when they are sick, they can avoid getting in, they can get a flu shot,” he says. “That is what they can control.”
And they must follow Colfax’s advice again on Thursday: “Please wear a mask. It’s not that difficult.”
Alyssa Pereira is a culture editor at SFGate. Email: [email protected] | Twitter: @alyspereira
