San Francisco health director: city remains in state's orange tier; testing, targeted equity investments to expand

San Francisco Health Director Grant Colfax told the Health Commission that, under new state guidance, counties must meet an equity metric or demonstrate targeted investments to move to less-restrictive COVID tiers, and that San Francisco currently sits in the state's orange (moderate) tier. Colfax said the department is working with the state on an equity plan that will identify disproportionately impacted populations and targeted interventions.

Colfax reported that the city has recorded about 11,500 diagnosed COVID-19 cases and 111 deaths to date and that local hospital indicators remain favorable: hospital capacity and intensive-care indicators were in the green, he said, while case rate recently fell from red to orange. "We're at 0.92" for the reproductive rate, Colfax said, summarizing the city's best estimate of transmission dynamics. He added that testing capacity has been expanded to roughly 4,500 tests per day on a seven-day average and that the Department of Public Health is rolling out pop-up, mobile and alternative testing targeted to neighborhoods with higher test-positivity.

The director emphasized equity and community-focused services. Colfax said the city's pop-up and community clinic testing has yielded higher positivity among Latinx residents and that the department is expanding low-barrier testing and "wraparound" services at those sites to reach people most affected. He also highlighted use of isolation and quarantine hotels, noting nearly half of hotel clients identified as Latino and that many lacked a housing situation that would permit safe isolation.

Colfax highlighted Mayor London Breed's announcement of a $28 million package to expand COVID supports for San Francisco's Latino community and said the funds will include additional testing, contact tracing, prevention messaging and supports to ensure people do not go without care.

In question-and-answer, commissioners asked how residents should report suspected violations and how the department will communicate complex health orders to families. Dr. Aragon, the city's health officer, advised residents to report complaints through 311 so the COVID command center can log and route them to the community-education-and-response team for follow-up. Colfax said the Joint Information Center is working on plain-language summaries of health orders, especially for orders affecting children and families.

Colfax framed the city's overall reopening as intentionally cautious: "we can be more restrictive than the state" and the department will watch indicators closely, especially as flu season approaches. He said PPE stockpiles for DPH were adequate for a 30-day supply and that the department is monitoring hospital capacity and community behavior as reopening proceeds.

The commission did not take a formal vote on COVID policy at the meeting; Colfax said additional data and a fuller briefing would follow in subsequent COVID updates.