Bay Area not yet in yellow tier as virus cases climb

Renewed surge in other parts of country marks warning sign

Coronavirus cases across the Bay Area are lower than they were in March, but they’ve leveled off recently and for the first time in months, not one of the nine counties is expected to move to a less restrictive tier in the state’s reopening blueprint in the coming week.

Public health and infectious disease experts say that’s a good thing.

“We are not at the point where the virus is done with us yet, and so caution is still warranted,” Dr. Susan Philip, San Francisco’s health officer, said plainly at a news conference this week.

San Francisco is the Bay Area county that has come closest to satisfying the state’s criteria for advancing to the least restrictive yellow tier, which would allow for nearly all businesses to reopen,

though at no more than half capacity. The city had been preparing to move to yellow next week but reported case counts were slightly too high.

Average daily cases for the Bay Area are 23% lower this month than for the same time in March. But new cases have plateaued over the past two weeks, halting the encouraging decline from the winter surge. In four Bay Area counties — Napa, Alameda, San Francisco and Santa Clara — case counts rose during the first week of April.

The Bay Area’s progress against the virus generally matches California’s as a whole. Both the state and the region are averaging about five to six new cases per 100,000 residents a day. Yet much of the rest of the country is experiencing a surge in cases — as are many countries.

“If we were an island, I wouldn’t be quite as concerned,” said Dr. John Swartzberg, an infectious disease expert at UC Berkeley. “But we’re not.”

Across the country, new cases rose by 2% this week over last, the Centers for Disease Control and Prevention reported Friday. On Thursday alone, more than 74,000 new coronavirus cases were reported, with many of the infections in younger people, said the agency’s director, Dr. Rochelle Walensky.

Michigan and Minnesota are experiencing dangerous surges. And around the world, cases are soaring in Italy, Germany, Brazil and India.

Swartzberg said California is doing comparatively well in part because a highly contagious variant known as B.1.1.7, which is now the dominant strain across the United States, is still not prevalent in the Bay Area or most of the state.

That variant — roughly 50% more contagious than the original virus — is wreaking havoc elsewhere in the country, even as many states are racing to open up their economy.

What that means for the Bay Area is that “no one can really say which direction this will go,” Swartzberg said. “If we’re going to err, let’s err on the side of being conservative.”

In the Bay Area at least, there won’t be much opportunity to reopen further any time soon. On Thursday, San Francisco unveiled an “expanded orange” plan that will take effect next week and allow some lowkey business expansions and the resumption of certain indoor events.

The tier movements happen every Tuesday, and this coming week is the first time in two months that no Bay Area county will advance.

Now the earliest San Francisco or any other county could move to the yellow tier is April 20. Napa County was at risk of being moved to a more restrictive tier next week, but California released new rules — tying low hospitalization rates to tier movement — that will likely keep it in orange.

With a goal of beating back the virus by June, Gov. Gavin Newsom announced Tuesday that he will end the state’s colorcoded reopening tiers on June 15 and permit almost all sectors of the economy to open at or near full capacity, assuming the state continues to meet aggressive vaccination goals and hospitalizations for COVID19 remain low.

Most Bay Area counties have so far vaccinated no more than half of their adult residents. Those rates may accelerate after Thursday, when everyone at least 16 years old will become eligible for a shot. But limited supplies of doses remain a problem in California and other states.

“Once we’ve passed a critical threshold of vaccinations, we’ll probably feel a little more at ease to open,” said Dr. Jahan Fahimi, an emergency room physician at UCSF who treats COVID19 patients.

Marin County has vaccinated 62% of residents aged 16 and above, a Chronicle review of records shows. San Francisco, Sonoma and San Mateo counties have vaccinated about 50%, while most others, including Napa, Santa Clara and Alameda counties, are not yet at the halfway mark.

“Most of us would like to see that number at 70%” before reopening, Fahimi said.

Philip, San Francisco’s health director, said that vaccinations will “be our ticket out of the pandemic.”

Yet this period — when cases are creeping up, when variants remain unpredictable and when vaccinations have not yet reached critical mass — is not the right moment for counties to leap ahead to reopen, she said.

Noting that San Francisco’s hospitalizations have also risen slightly in the past few days, although they remain much lower than during the pandemic’s three surges, Philip said that reopening now would make it that much harder to prevent a surge.

“We were on such a roll, weren’t we?” she said of the declining case counts since the winter. “I think we will get there. But we don’t know exactly when that will be.”