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Health Department outlines color‑coded COVID indicators and prepares variance application to state
Summary
San Francisco Department of Public Health presented new color‑coded indicators showing hospital capacity in green while cases sit in 'yellow,' and Deputy Health Officer Dr. Baba described a county variance application that would allow limited local departures from the state's reopening roadmap if hospitals and containment metrics meet state criteria.
San Francisco’s Department of Public Health told the Health Commission on Tuesday that the city’s new color‑coded indicator system shows the hospital system currently meeting targets while case counts remain level and testing has increased markedly.
Grant Colfax, the department director, said the department’s indicators are designed to give San Franciscans a quick read on local risk. “San Franciscans have done a terrific job of slowing the spread of the coronavirus,” Colfax said, noting the department’s dashboard and public data tracker were updated and available to view. He reported 2,971 confirmed cases in the city to date and 46 deaths, and said the city is running a seven‑day testing average of roughly 2,000–2,500 tests per day (the department’s prior target was 1,800 per day).
Colfax described the indicator framework as five measures: hospital system capacity, confirmed cases, testing, contact tracing, and personal protective equipment. He emphasized hospital metrics as the most important early warning. “The key indicator on this are our health care system indicators,” Colfax said, and noted triggers are based on percentage changes in hospitalizations (green defined as <10% change over seven days; yellow 10–15%; level 3 15–20%; level 4 >20%). The department said the indicators will be updated weekly.
Deputy Health Officer Dr. Baba explained why the city is preparing a variance application to the state: a variance permits local public‑health officers to re‑sequence or accelerate certain reopenings where local metrics, containment plans and hospital surge capacity satisfy state criteria. The variance application requires attestations and materials on epidemiologic stability, essential workforce protections, testing and surveillance capacity, contact tracing and containment plans for vulnerable populations (including nursing homes and people experiencing homelessness), and hospital ability to surge. Dr. Baba said the department aimed to assemble the application and supporting letters (including from hospitals and the Board of Supervisors) within about 7–14 days.
Commissioners pressed the department on several operational points: the relationship between the detailed metric matrix and the simplified public scorecard; whether reproduction rate estimates (R) will be used in real time; how the department is accounting for interjurisdictional movement and transportation risks; and equity considerations for mask access and outreach. Colfax and Dr. Baba said the detailed matrix translates into the public colors but no single color will automatically determine action, that reproduction‑rate estimates are calculated with lag and are therefore confirmatory rather than decision‑grade in real time, and that equity is a central pillar of the containment plan. The department reported contact‑tracing performance near green (about 87% of contacts identified and about 85% reached) and PPE holdings at roughly 89% of the department’s 30‑day supply goal.
The presentation closed with a reminder that reopening remains a balance of risk: the department will continue to monitor indicators, issue weekly updates, and adjust guidance as necessary. The next procedural step on the variance will be submission to the mayor and a Board of Supervisors vote on a support letter, after which the state will review the county application.
