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Colfax: reproductive number may be above 1; reopening plans paused
Summary
San Francisco's public-health director told commissioners the city's reproductive number is estimated at about 1.25, hospital indicators are in the red and the previously planned reopening remains paused; officials urged mask-wearing and social-distancing to avert projected rises in hospitalizations and deaths.
Director Colfax presented the Health Commission with San Francisco's latest COVID-19 indicators on July 7, warning that several measures of transmission and hospital pressure had moved into cautionary zones.
Colfax reported that the city has diagnosed more than 4,000 COVID-19 cases and recorded 50 deaths to date. "Our positivity rate is climbing," Colfax said, noting the 7-day testing and percent-positive trend and uneven reporting caused in part by longer laboratory turnarounds.
The presentation included an estimated reproductive number (R) derived from modeling by Dr. Maya Peterson's group. "The best estimate is about 1.25," Colfax said, while noting uncertainty in the estimate (plausible range ~0.95 to 1.45). He emphasized that an R consistently above 1 will drive increases in cases and hospitalizations that can quickly overwhelm capacity if not checked.
Colfax displayed scenario projections showing higher ICU occupancy and increased deaths if R remains elevated. He asked commissioners to note that some hospital ICU transfers into San Francisco (for example from San Quentin) are not counted in the city's surge statistics but do place demand on city hospitals.
Because of the upward trends, Colfax said the city paused a planned reopening previously targeted for June 29 and took a cautious approach to an intended July 13 reopening. He said if reopening occurs it would not include indoor dining or outdoor bars "due to the risk incumbent in those activities."
Colfax urged continuing prevention measures—masking, distancing, hand hygiene—and called for coordinated messaging across city agencies and partners. He also noted San Francisco's hospital capacity remained relatively healthy by absolute counts (35% availability of acute beds, ~30% ICU availability), while the rates of increase in hospitalization and new cases remained a cause for concern.
Commissioners asked questions about testing availability, hospital council coordination for elective-procedure triage ahead of flu season, and how case transfers across county lines are being handled while San Francisco remains on a separate database system from a statewide Salesforce solution. Colfax and staff described manual cross-county handoffs in the absence of a fully interoperable statewide system and said they were continuing regular discussions with the state team.
The director closed by reiterating that prevention actions now can materially change projected hospital and death outcomes and that the city would continue to monitor data closely ahead of any reopening decisions.
