Based on an updated count and confirmation, the number of new COVID-19 cases diagnosed in San Francisco on Monday of last week (11/16) totaled 164, surpassing the previous one-day high of 161 diagnosed cases on July 14.

At the same time, the 7-day average of daily new cases, which peaked at 131 in mid-July and then dropped to 27 in early October, is back up to 110 and climbing, representing the highest moving average since late July and a daily rate of 12.7 cases per 100,000 people versus a local target of 1.8. COVID-19 related hospitalizations are up 34 percent and climbing over the past week as well.

As such, another round of reopening rollbacks could soon hit San Francisco and the county is flirting with being bumped-up into the State’s riskiest “purple” tier, which would further restrict the local roadmap and timeline for reopening the city.

UPDATE (11/25): The average local case rate is now up to 13.1 new cases per 100,000 residents per day, with a 45 percent increase in hospitalizations over the past week. If/when the average case rate hits 14.0, or relative testing volumes drop, San Francisco will be “purple” tiered.

UPDATE (11/26): With the local average number of new daily cases per 100,000 residents having just ticked over 14.0, for an adjusted average daily case rate of over 7.0, San Francisco’s move into the State’s most restrictive “purple” tier should soon be formalized.

UPDATE (11/28): As projected, San Francisco’s move into the State’s “purple” tier has just been formalized. As such, retail establishments, not including grocery stores, will be re-restricted to 25 percent of their legal capacities and all indoor gyms, theaters and indoor cultural attractions, including the zoo and new Skywheel in Golden Gate Park, will be required to close as of noon tomorrow, 11/29. Indoor services at all houses of worship will need to be suspended as well.

In addition, San Francisco will now be subject to the State’s Limited Stay Home Order, which requires all restaurants and non-essential businesses to be closed between 10pm to 5am, as of Monday, 11/30.

And while the Mayor just quoted an average of “118 new cases per day,” the 7-day average of daily new cases in San Francisco is actually up to 137 with a case rate of 15.7 new cases per 100,000 residents per day, which is a new pandemic high, with at least 181 confirmed cases on 11/18 alone and hospitalizations up 63 percent over the past week.

UPDATE (12/4): San Francisco Will Preemptively Adopt New Stay Home Order

51 thoughts on “A New COVID Case High in San Francisco, Rollbacks Loom”
    1. UPDATE: Make that 66 hospitalized patients, with at least 19 in ICUs, as of Monday, with hospitalizations up 45 percent over the past week and the local case rate up to 13.1 new cases per 100,000 residents per day. If/when the local case rate hits 14.0, or relative testing volumes drop, the city will be “purple” tiered.

        1. Make that 84 now hospitalized and climbing at a pace that should see local, resource-intensive hospitalizations due to COVID-19 surpass the current peak of 114 reached in late July, a number which had dropped to 21 in mid-October and has since quadrupled.

        2. Yes BooBug, the caseload is manageable now. But we want to prevent the caseload from becoming unmanageable. This is called a “prediction,” one which we know is accurate because it has happened already all over the country.

          1. That’s why the exponential math and the lag time are so important. You can’t just wait until there are only a few free beds and then lock down. The exponential nature of the spread means that there is a very fine line between under control and out of control. And if thing get bad, they can quickly get extremely bad.

            And that is why you look at cases and not deaths. Because cases are a leading indicator. Once deaths have already started spiking its far too late to do anything.

  1. SS is correct. It is up from 21, with 6 in the ICU, in mid-October. But it is down from 114 total cases and 40 ICU patients, in mid July.

  2. Worth noting that SF daily testing volume is up nearly 50% since the July case peak.

    The latest 7 day avg % test positive is 2.15%. Well below the July peak of 3.80%.

    This is a big increase from early October, but mid-late July was objectively much worse.

    [Editor’s Note: For reference, the local positivity rate averaged under 1 percent in October, having dropped to 0.8 percent om 10/8.]

    1. And in fact, the relatively high testing volume in San Francisco, which has been running over twice the state’s median rate, has kept the County from being bumped-up to the State’s “purple” tier, with the County’s average daily case rate being adjusted by a factor of 0.5 for tiering purposes on account of the relative testing volumes and without which the current average daily case rate would be above the purple threshold of 7.0 cases per 100,000 people.

      1. Yep, in recent weekdays (> 9,000 tests daily on 11/17-19), San Francisco is testing more than 1% of its total population EVERY DAY.

        That’s a good thing!

        But it does make comparing case numbers today to SF case numbers in the past (or vs. other jurisdictions) very apples/oranges.

          1. For a longer perspective, that 2.17% number isn’t that high compared to most of the period since April.

            The test positive % has been below 2.17% during only two periods (late May-late June, mid Sept-early Nov) since April 1.

            Here’s most of the highs and lows of the 7-day avg test positive % back to the beginning of SF COVID numbers for comparison.

            13.47% (4/12)
            3.83% (5/1)
            5.16% (5/5)
            2.66% (5/13)
            2.86% (5/18)
            1.05% (6/15)
            2.47% (6/26)
            2.20% (6/29)
            3.80% (7/20)
            2.26% (8/22)
            2.14% (9/12)
            0.80% (10/8)
            2.17% (11/22)

          2. Keep in mind that testing patterns have changed, with an increase in testing to confirm an assumed negative state versus primarily testing those who were either symptomatic or being contact traced back in April/May, which should have continued to drive the positivity rates down.

            And of course, with the increase in testing, even a flat positivity rate would be indicative of greater spread in the absolute.

  3. At the risk of upsetting SS with facts. Here it goes. 74% of the deaths in SF are folks 71 years old or older. 83% of those who died had at least one underlying condition other than Covid-19.

    1. What’s your point? That we shouldn’t worry about it, because it mostly kills old people? Pretty sure that when you’re 71, you won’t be eager to cash in your chips. And if your number is correct, 26% of deaths are younger folks. Plus, some of the worst Covid outcomes are people who don’t die, but they suffer long-term impairment, often mental, or other long-term issues we don’t even know about yet.

      As for “other underlying conditions” — it’s pretty tough to find anyone over 60 that doesn’t have some “other underlying condition.” But those other conditions didn’t kill those people, and they wouldn’t have died this year were it not for Covid. So again, what’s your point? That anyone with any sort of health issue is expendable?

      1. The Covid Truthers are really really weird.

        Once there’s a vaccine, prepare for them to pivot to “See, it was no big deal!”

      2. Why do folks get upset when they are confronted with data? Accurate data. I am not making a point. I am describing the population that has died from Covid-19 in San Francisco. As for your point that those who had other underlying conditions wouldn’t have died is simply not knowable. We will have to see what the excess deaths are at the end of the year. I suspect many of those would have died without Covid. But I will wait on the data so that it can be reasonably quantified.

        1. I don’t think you’re “upsetting” anyone. You may imagine that you’re the speaker of unpopular truths, but everyone knows that Covid affects more old people than young people. That’s not news. It’s also not news that some young people die too. Maybe we should just believe you when you say that “I am not making a point.”

        2. Why do people who talk about Covid-19 deaths largely being older folks or those with co-morbities think that is a thing?

          I don’t understand it. How is it that life is not enjoyable or worthwhile to someone 70 or older?

          How is it that people cannot manage health issues for decades in the 21st century?

          It’s such a callous, fallacious take. Not to mention the fact that covid-19 scars lungs. The data regarding lung capacities, and how that effects later life, is not here yet.

          1. I think the main thing is that any particular person as in individual has a specific age and a specific set (or lack) of other health issues. So this information is greatly helpful for individuals to asses their specific risk.

            For populations/public health purposes this in theory could help make decisions about balancing economic cost and public health. But the 26% of deaths of younger folk is still a pretty big number. And just like the issue with vaccines that reduce severe disease but don’t stop the spread, people who have low/no symptoms can still spread the disease and the exponential nature of spread means that they can cause a large number of downstream deaths/severe injuries.

          2. I think most people really don’t grasp the nature of exponential math and how small changes in growth rate can drastically affect outcomes. Combine that with the fact that this is a novel disease and a novel situation, so people can make educated guesses about how people and the disease will behave but there are so many factors that nobody really knows for certain. It seems like there is just a very fine line between things being under control and things drastically spiraling out of control. And if you have enough people who get hospitalized and run out of hospital capacity, you start to get excess deaths from other causes as people get triaged out of the hospital care system.

        3. “Why do folks get upset when they are confronted with data?” It’s astonishment at the growing rate of empathy free humanity.

          1. Empathy? For whom? Yes I have empathy for folks who are deprived of earning a living, whose small businesses are shuttered forever. Yes I want to see the risks measured and quantified so people and policy makers can balance the harm of of the disease against the harm of the measures taken to slow the spread. Yes I understand that the protected class is willing to impose almost any deprivation on less fortunate folks, often times for no obvious health benefit. What is allowed and what is prohibited in many instances is determined by political clout and not science. To pretend otherwise is willful ignorance.

          2. When I read comments like “I want to see the risks measured and quantified so people and policy makers can balance the harm of the disease against the harm of the measures taken to slow the spread”, I interpret that to mean “public policy should be directed toward ends that I and members of the owning class like me want to see enacted so that our pecuniary interests are served.”

            The beauty of Internet anonymous commenting is that no one knows you’re a commercial landlord.

            The reality is that such “measuring the risks and balancing” is either largely impossible, due to the lack of comprehensive testing and case tracking, or will simply collapse under pressure from those with the most political clout: the members of the rent-collecting bourgeoisie who want measures “balanced” in favor of “re-opening” so they can go on collecting rents in an undisturbed fashion, the progression of the pandemic be damned.

            The key indicator here is the saying “for no obvious health benefit”. Which begs the question: obvious to whom? And whose “health”?

          3. “Yes I want to see the risks measured and quantified so people and policy makers can balance the harm of of the disease against the harm of the measures taken to slow the spread.”

            Your proposal is to make more work for doctors and nurses so that rentiers can squeeze their tenants more productively?

          4. “Yes I have empathy for folks who are deprived of earning a living, whose small businesses are shuttered forever.”

            Any empathy for the dead people? What about the healthcare workers? Any empathy for them?

      3. Collateral damage to the economy is significant as well and the impact is not as measurable as IFRs and deaths. By the way, deaths are most definitley overstated and many would have perished regardless. Tough to feel bad for an overweight, diabetic smoker who dies from Covid. They and already given up on life and you dont destroy young peoples lives for them. Quarantine the elderly and those with preconditions and let the rest mingle. Our govt response to Covid has been the biggest policy mistake since we went into Iraq based on false information. Fauci and all the clowns at the CDC should be ashamed. Wear a mask/Dont wear a mask.Tests dont work. Go to Chinese New Year parade. Who the hell has faith the vaccine roll out?

        1. editor, i would suggest deleting ignorant garbage like the post above. its borderline pycho “Tough to feel bad for an overweight, diabetic smoker who dies from Covid. They and already given up on life and you dont destroy young peoples lives for them”. the rest of it is just as bad

          1. The editor(s) were doing a great job of keeping things on topic until a couple weeks ago when Cave Dweller (would that be a Troll or a Bear?) started in with the reckless nonsense. Which reminds me – I’ve been annoyed at SS in the past but since the crisis started it’s been very professional here. Thank you, editors.

        2. Tests work, diabetic smokers are human beings, your post is a joke, you should be ashamed, masks work…

      1. Even worse, these are only the medium term effects. No one knows the long term effects because there hasn’t been a long term yet. I will never understand why people don’t take Covid seriously.

        1. I take it very seriously. I mask, distance and wash my hands constantly. What I wont do is live in fear and bow to our leaders who are destroying peoples lives with harsh lock downs.

          1. No one is asking you to live in fear or bow down to anyone. And no one is in lockdown.

            If everyone would wear masks and socially distance, then we would have drastically lower numbers of infections, which would be good for business.

      2. Per your article…”Most people who have coronavirus disease 2019 (COVID-19) recover completely within a few weeks.”

        Did I miss something?

        Stop watching CNN (or Fox) and living in fear. Viruses have been around since the beginning of time. Herds get thinned out. Get over it. Back to work

        1. Most people did not die of smallpox, but a lot of people did. Society could have shrugged its shoulders as smallpox burned through the population and killed millions of people every year. Thankfully, they did not follow your advice.

  4. I think that describing the effected populations and their condition is important to understanding the nature of Covid-19.The word epidemiology comes from the Greek words epi, meaning on or upon, demos, meaning people, and logos, meaning the study of. In other words, the word epidemiology has its roots in the study of what befalls a population.

    Epidemiology is also used to search for determinants, which are the causes and other factors that influence the occurrence of disease and other health-related events. Epidemiologists assume that illness does not occur randomly in a population, but happens only when the right accumulation of risk factors or determinants exists in an individual. To search for these determinants, epidemiologists use analytic epidemiology or epidemiologic studies to provide the “Why” and “How” of such events. They assess whether groups with different rates of disease differ in their demographic characteristics, genetic or immunologic make-up, behaviors, environmental exposures, or other so-called potential risk factors. Ideally, the findings provide sufficient evidence to direct prompt and effective public health control and prevention measures.

    Epidemiology is concerned with the frequency and pattern of health events in a population: Frequency refers not only to the number of health events such as the number of cases of meningitis or diabetes in a population, but also to the relationship of that number to the size of the population. The resulting rate allows epidemiologists to compare disease occurrence across different populations.

    1. That’s right, this is what epidemiology does. Good job! Of course, would have been more impressive if you hadn’t cut and pasted from CDC’s website.

      It’s considered good manners to cite a source when quoting.

  5. “And of course, with the increase in testing, even a flat positivity rate would be indicative of greater spread in the absolute.”

    That’s not true!

    An increase in testing, with a flat positivity rate, just means you’re finding more cases (which is good! because those positive can isolate themselves and not spread it more) it does not indicate “greater spread in the absolute”.

    1. no, more testing with a decreasing positive rate (relative to the increase in testing %) would equal constant rate of spread. increased testing with same positive rate means increased rate of spread. you have to look at relative increase and decrease in both variables

  6. Of course I understand “nature of exponential math”. If one understood power law distribution. You would have a much better idea how Covid-19 is spread.

  7. UPDATE: With the local average number of new daily cases per 100,000 residents having just ticked over 14.0, for an adjusted average daily case rate of over 7.0, San Francisco’s move into the State’s most restrictive “purple” tier should soon be formalized.

  8. UPDATE: As projected, San Francisco’s move into the State’s “purple” tier has just been formalized. As such, retail establishments, not including grocery stores, will be re-restricted to 25 percent of their legal capacities and all indoor gyms, theaters and indoor cultural attractions, including the zoo and Skywheel in Golden Gate Park, will be required to close as of noon tomorrow, 11/29. Indoor services at houses of worship will need to be suspended as well.

    In addition, San Francisco will now be subject to the State’s Limited Stay Home Order, which requires all restaurants and non-essential businesses to be closed between 10pm to 5am, as of Monday, 11/30.

    And while the Mayor just quoted an average of “118 new cases per day,” the 7-day average of daily new cases in San Francisco is actually up to 137 with a case rate of 15.7 new cases per 100,000 residents per day, which is a new pandemic high, with at least 181 confirmed cases on 11/18 alone and hospitalizations up 63 percent over the past week.

  9. UPDATE: The 7-day average of daily new cases in San Francisco is now up to 148 with a case rate of 17.0 new cases per 100,000 residents per day, which is a new pandemic high and climbing, with around 90 people now hospitalized and hospitalizations still on pace to easily surpass the July peak of 114.

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