Health Commission hears COVID-19 surge update, new SORT overdose response and vaccine milestones

Grant Colfax, director of the San Francisco Department of Public Health, told the Health Commission that the city is watching a tentative downward trend in COVID-19 case rates but continues to respond to a surge driven by the Delta variant.

Colfax said San Francisco has recorded "over 44,000" diagnosed COVID-19 cases and 570 deaths. He told commissioners the most recent case-rate figures had dropped from a recent high toward about 24.9 cases per 100,000 residents and that the estimated reproductive rate — an imperfect, lagging measure based on hospitalizations — had fallen from a July peak of about 1.75 to just below 1 in recent days. "Hospitalizations, thankfully, because of our very high vaccine rate, have not reached the peaks that they did over the winter surge," he added, reporting 106 people hospitalized, including 35 in intensive care, as of Aug. 13.

Colfax also described the new Street Overdose Response Team (SORT), announced by Mayor Breed on July 30, which "will respond citywide to overdose calls" and seek to connect people who have recently overdosed with harm-reduction supplies, treatment, social services and housing. SORT was described as an effort to prioritize outreach to people at high risk of overdose death; Colfax said the team would initially operate 12 hours a day with plans for fuller deployment in 2022.

The director briefed the commission on a health officer order issued Aug. 12 that requires patrons at indoor establishments that serve food or drink, gyms and indoor events with 1,000 or more attendees to show proof of vaccination beginning Aug. 20; Colfax said employees at those venues will be expected to be fully vaccinated by the fall. Colfax emphasized vaccination as "the way out" of the pandemic and urged continued focus on high-risk populations, shelters, skilled nursing facilities and communities facing disproportionate harm.

Jonathan Sears, who leads the vaccine branch, gave a detailed presentation on the city's three-pronged vaccine strategy of high-volume vaccination sites, neighborhood access sites and pharmacy/mobile strategies. Sears said the city's high-volume sites and health system partners administered nearly 480,000 doses, neighborhood sites have delivered just over 46,000 doses, and mobile teams have provided roughly 10,000 vaccinations through about 350 mobile events. He said San Francisco is "the first major US city to administer first doses to over 80 percent of the eligible population," and said the city had reached roughly 85 percent of the currently eligible population with at least one dose and 71 percent completion of the vaccine series among residents of all ages.

Commissioners praised the department's vaccination efforts and asked about implementation details for additional doses for people who are immunocompromised and the timeline for broader booster shots. Sears and Colfax said the department is awaiting and aligning with federal and state guidance (CDC and CDPH) and is prioritizing rollout for immunocompromised individuals while planning for broader pediatric expansion and possible boosters later in the fall.

The commission received no public comment on the COVID items and scheduled no vote on guidance; Colfax and Sears said DPH would return with implementation plans and more details as federal and state recommendations evolve.

The presentation materials and data cited during the briefing were drawn from DPH modeling work (noted to include UC Berkeley collaborators) and department surveillance; the commission emphasized continuing focus on inequities and neighborhood-level outreach.