San Francisco health officials recommend two-week social-distancing measures after two coronavirus cases

Dr. Grant Colfax, director of the San Francisco Department of Public Health, on March 10, 2020, urged immediate social-distancing measures and announced a two-week initial period of recommendations after the city confirmed two coronavirus cases among residents.

Colfax said the measures aim to “reduce the times and places where people come together” and to protect those most vulnerable, noting that if the city waits until there are multiple confirmed cases and deaths, "the window of opportunity we have now will have closed." He described the measures as disruptive but necessary and said local recommendations align with nearby counties and CDC guidance.

The health department's recommendations included: 1) Vulnerable populations — people 60 and older or those with chronic conditions should avoid gatherings of about 50 people or more and stay home when possible; 2) Workplaces — suspend nonessential employee travel, minimize close contact at work, expand telecommuting and sick-leave flexibility, and avoid requiring doctor's notes; 3) Large gatherings — cancel or postpone nonessential events such as concerts and conventions and ensure handwashing and sanitizing if events proceed; 4) Schools — DPH will work with schools and districts when cases occur and may recommend closures; equip schools with hand sanitizer and tissues and reschedule large events; 5) Transit — increase cleaning of vehicles and stations and provide hand hygiene supplies; 6) Health-care and long-term-care settings — screen staff and visitors and turn away those with symptoms; the public should avoid visiting hospitals and long-term-care facilities when possible.

Colfax also announced a new city text-alert service: text COVID-19 SF ("COVID-nineteen SF" in the transcript) to 888777 for official updates, and directed residents to sfdph.org for more information.

In a question-and-answer session, the city's director of emergency management, Mary Ellen Carroll, said the state and federal authorities were coordinating testing related to a cruise ship and that San Francisco was awaiting further lab results; officials said more than a hundred passengers or crew with San Francisco ties had been contacted and were told to call health-care providers if symptomatic. Colfax said that as of that afternoon there were no additional confirmed positive tests beyond the two cases announced earlier.

Reporters asked whether the city has legal authority to compel private event cancellations; Colfax and Carroll characterized the announced items as recommendations and said the city would follow the guidance for city-run events but did not claim the power to force private venues to cancel. Colfax acknowledged the economic hardship the measures could cause and said city leaders and partners were exploring potential sources of support while prioritizing public health.

Why it matters: The guidance represented an early effort by San Francisco public health officials to slow community transmission of COVID-19 and to prioritize protection of older adults and people with chronic conditions, while introducing a citywide official information channel.

Provenance: The recommendations, examples and Q&A appear in the meeting transcript of the DPH briefing on March 10, 2020.