San Francisco and the Greater Bay Area pioneered the implementation of the country’s first regional stay-at-home order in early 2020 when the coronavirus first hit. And the region boasts relatively low cumulative mortality rates throughout the epidemic.
But as cases escalate and the public eager to go beyond the rules, San Francisco is facing some scrutiny for its decision not to return to indoor mask mandates.
Crossing the Gulf of San Francisco, Alameda County officials – who are home to Oakland – last week issued a new indoor mask mandate. And while Los Angeles County has outlined the criteria that would trigger the same, officials say it could be the end of the month.
But San Francisco and the rest of the Gulf region have blocked the reinstatement of the mask mandate, saying they did not see the need.
This has caused panic among some San Francisco residents, who have regularly vented their anger at the city’s health commission meetings, urging them to re-enforce the global indoor mask order, or at least order for a public transport system under the city.
The counties in Santa Clara and San Francisco had the worst coronavirus case rates in California: 401 and 400 coronavirus cases per week, for every 100,000 inhabitants, according to the Times analysis of state statistics released Tuesday. A rate of 100 and above is considered a high degree of transmission.
But San Francisco health official Dr. Susan Phillips said Tuesday the city has the nation’s highest vaccination rates, high-quality masks and anti-COVID medications, and the ability to accept patients in hospitals.
In San Francisco, 84% of residents have completed their primary immunization series; In Santa Clara County, it’s 86%; And in Alameda County, it’s 83%. In contrast, LA County’s vaccination rate is 72%; The national vaccination rate is 67%.
Philip credited San Francisco’s health orders for its earlier tough approach to saving lives. “This has enabled San Francisco to be proud of having the lowest mortality rate of any major city and any major county in the United States,” he said at Tuesday’s Health Commission meeting.
But this stage of the epidemic is different.
“The cases are high – they are still high – although they are lower than the Omicron increase of BA.1 this winter. And the serious illnesses admitted to the hospital are not as high as in the winter increase, fortunately,” Philip said. “We now have high quality masks like N95s, KN95s and KF94s readily available. Most importantly, our city has one of the highest vaccination rates in the world. “
San Francisco Health Director Dr. Grant Colefax added that the city’s “hospital capacity is sufficient to care for people with coma.”
Still, mask orders may be needed again in the future if there is a new variant that causes serious illness that cannot be prevented by existing vaccines or treated with drugs, Philip said.
“It simply came to our notice then. But if it does, we should go back to generalized commands, including masking mandates, and enforce them strictly, “Philip said.
Some residents expressed frustration with Philip’s decision.
Alyssa Matros, 75, speaking to health commissioners, said the lack of a mask mandate on the city’s subway and rail system had forced her to abandon Muni and take Bay Area Rapid Transit instead. BART has a mask order on its commuter rail system but travels in few places.
“As a recently retired San Francisco Unified School District teacher, I envisioned a life that, even with COVID, I would be able to ride Muni to doctor’s appointments, parks and museums,” she told commissioners. “I have underlying health problems, which makes COVID and long COVID scary. I have a medically weak husband with limited mobility, and two 1-year-old grandchildren who are too young for vaccinations. I have to keep them safe.”
Dr. Sarah Cody, Santa Clara County’s director of public health and health officer, told a news conference in May that she did not intend to rearrange the mask mandate for the Gulf’s most populous county.
“At this point, we have no plans to do anything but align with the state regarding the need for masks,” Cody said at the time. “The state still strongly recommends wearing masks indoors, and we still strongly recommend wearing masks indoors.”
The growth of new weekly coronavirus-positive patients in hospitals is a measure that triggers mask recommendations from U.S. Centers for Disease Control and Prevention, Cody told the Santa Clara County Board of Supervisors on Tuesday that the most significant impacts are hospitals. Reporting from the current wave is that workers are sick with COVID-19.
“We’ve never seen so many people with this wave who are seriously ill and need to be hospitalized for their COVID infection. Of course, we’re seeing some of that, but not the dramatic ones we’ve seen in other waves,” Cody said. .
In contrast, health officials in Almeida County, east of San Francisco and north of Santa Clara County, re-enforced the mask order last week. Auckland, the second-most populous county in the Gulf region, does not have a new housing requirement in Berkeley, which has a separate public health department.
“Rising COVID cases in Almeida County are now hospitalizing more people,” Almeida County Health Officer Dr. Nicholas Moss said in a statement. “We cannot ignore the data, and we cannot predict when this wave will end. Putting back our masks gives us the best opportunity to limit the impact of long-term waves in our communities.”
Some praised Moss’s move.
“These decisions are not taken lightly. I appreciate the courageous leadership of the Almeida County Health Officer and hope it will be enough to spread the word. ” Tweeted Dr. Noah Aboelata, a family physician and chief executive of the Roots Community Health Center in Oakland.
Almeida County’s latest order has some exceptions, such as allowing gym people to be “actively involved in the period of hard work” without masks.
At last week’s campus briefing, Dr. George Rutherford, a UC San Francisco epidemiologist and infectious disease specialist, asked a colleague why he thought San Francisco did not have a mask mandate.
“These are really very close calls,” Rutherford said.
Elected officials have differing views on the mask mandate. In February, Cindy Chभेvez, a member of the Santa Clara County Board of Supervisors, criticized the state’s decision to maintain more local mask orders than necessary.
In Alameda County, by contrast, County Supervisor Keith Carson said in mid-February that he was to continue the local mask mandate for a longer period. Moss, Almeida County Health Officer, agreed in February to lift the indoor mask mandate as soon as the state allows counties to do so.
In Los Angeles County, Public Health Director Barbara Ferrer has repeatedly said that if the county is defined as a high COVID-19 community level as defined by the CDC, authorities will restore the global mask mandate in indoor settings for those 2 and up.
Once a county has entered the high COVID-19 community level, the CDC recommends global masking in indoor public settings.
Ferrer said last week that he appreciated Almeida County’s decision to restore the mask mandate. She also expressed support for other organizations, such as UCLA, to implement the mask orders, saying local leaders were looking at community data to make decisions that would provide “maximum protection, especially for those most vulnerable.”
LA County has already placed local mask orders on public transport settings, such as buses, trains, app-held vehicles, subway stations and airport terminals.
Compared to the San Francisco Bay Area, Los Angeles County is structurally more at risk for the worst effects of coronavirus, according to research, due to the relatively high levels of poverty and the large number of overcrowded communities.
LA County’s cumulative COVID-19 mortality rate is significantly higher than in the Gulf region.
“At this point there is an impressive body of respected research into how masks reduce the risk for individuals and how to reduce viral transmission in the community,” Ferrer said.