Surge’s effect:
Officials point to vaccination rates amid delta surge
Despite renewed indoor mask rules, no stricter lockdowns are foreseen by state and Bay Area health officials.
The spike in coronavirus cases driven by the delta variant has prompted the return of a familiar restriction to the Bay Area: an indoor mask mandate for everyone.
But could this latest surge bring back a far more disruptive measure in the Bay Area or even statewide — namely, lockdown orders?
The answer so far, according to California and many county officials, is no.
That’s because this surge is distinctive from others over the past year and a half: It’s the first to strike after the widespread rollout of COVID19 vaccines, and both the coronavirus and public health tools
for fighting it have changed considerably.
The California Department of Public Health said in an email Thursday that between masking, testing and more than 75% of eligible individuals in the state having received at least one vaccine dose, lockdowns would not be necessary.
“California can continue to keep businesses open and get kids back in classrooms safely,” the department said.
The San Francisco and Alameda County health departments also said this week that they are not considering a shelterin place order. That is also the case for San Mateo County, according to Department of Public Health public information officer Preston Merchant.
Laine Hendricks, public information officer for Marin County’s Department of Public Health, said the same, adding that the county is seeing only about onethird of the number of cases it experienced last January, with the majority now among the unvaccinated.
The state and local response seems to mirror the message from the federal level. On ABC’s “This Week,” White House medical adviser Dr. Anthony Fauci said lockdowns are not a probable future scenario for the U.S., despite the surges. Francis Collins, director of the National Institutes of Health, recently said that the country wants to “avoid lockdowns at all costs.”
Experts point to several reasons why a lockdown at this point seems not just unlikely, but exceedingly so.
“A lockdown is a public health measure of last resort,” said infectious disease expert Dr. Warner Greene, an infectious disease expert with the Gladstone Institutes in San Francisco. “We have all the tools that can prevent any requirement for a lockdown.”
Vaccines
The most powerful tool, officials say, is the presence of COVID19 vaccines. The Bay Area is one of the most vaccinated places in the country, with San Francisco the first major city in the U.S. to reach the milestone of 80% of eligible residents receiving at least one vaccine dose.
The recent return of universal indoor mask mandates in much of the Bay Area and a few other counties — plus state and federal recommendations for indoor masking by all — was prompted by findings that in the delta phase of the pandemic, postvaccination breakthrough infections remain uncommon but are not rare.
However, data shows the vaccines are highly effective at preventing severe illness, including from the highly transmissible delta variant. In the Bay Area and across the country, COVID19 hospitalizations and deaths are now occurring overwhelmingly among unvaccinated people.
But officials say far too many remain unvaccinated to stem the delta surge. Places like San Francisco are working on many fronts to increase their rates, including sending mobile units to homes and workplaces, and offering specials for Stern Grove music festival attendees.
“Now, with the vaccine, we can protect everyone,” Greene said.
He added that he thinks the rampant spread of delta in Louisiana, Arkansas, Missouri and Florida has prompted many vaccine holdouts to change their minds.
“It’s sad that it’s what it takes, but I think the death and the destruction ... is helping some people move forward getting a vaccine,” he said.
Hospitalizations
The second reason why lockdowns aren’t on the table has to do with hospitalization rates — which go hand in hand with vaccination rates. So far, of the more than 3,000 patients hospitalized with COVID19 in San Francisco, only 16 were vaccinated.
Experts say that tracks with what they have been saying for months: The vast majority of hospitalizations and deaths are now among the unvaccinated.
And given the Bay Area’s relatively high vaccination rates, it isn’t seeing its hospital system overburdened — yet.
“The only time we would consider more restrictive policies would be to help keep our hospitalization capacity intact,” said Hendricks of Marin County’s health department. “What is reassuring right now is even though we’re experiencing a spike in cases, it’s not as significant as what we experienced in December or January.”
Experts say one wild card would be the emergence of a variant that can evade the current vaccines — but so far no variant has been completely vaccineresistant.
Knowledge and experience
Infectious disease experts also emphasized that at this stage in the pandemic, we know much more about how to keep the people and places around us safe — through measures including masking, social distancing, ventilation and other nuanced approaches.
“I think we’ve recognized that a lockdown is a really brutal and blunt tool, and even in the face of a significant surge we can keep people safe by doing other things that are less damaging to people’s mental health, to the economy (and) in the case of schools — kids.” said Dr. Bob Wachter, UCSF’s Department of Medicine Chair.
“As a city and region, we are in a very different position now than when he had to place a shelter in place health order last year,” said a spokesperson for the San Francisco Department of Public Health. “Then, we knew little about how the COVID19 virus spreads and were still deciphering which were the best preventative measures to put in place. Now we have a wealth of knowledge, and we have vaccines.”
The Bay Area’s new indoor mask mandate is one important element of what UCSF infectious disease expert Monica Gandhi says aligns with Israel’s “soft suppression” plan that could be coming to the U.S.
That approach consists of three elements: maintaining indoor masking requirements, a vaccine passport program, and vaccine boosters for elderly and immunocompromised individuals.
San Francisco is already allowing booster shots for those who received the singledose Johnson & Johnson vaccine, and the city is also exploring requiring proof of vaccination to enter restaurants and gyms, as New York City has done.