Bay Area an ’emerging hot spot’ for COVID as delta cases jump


The delta variant is driving up coronavirus cases in California, landing the Bay Area on a federal “hot spot” watch list and spurring renewed urgency to get shots into the arms of people who haven’t been vaccinated, even in areas where immunization rates are already high.

In San Francisco, public health officials are now requiring all workers at hospitals, nursing homes, jails and shelters to be vaccinated by Sept. 15. That’s a shift from an earlier order that mandated vaccination only after at least one vaccine was fully approved by the Food and Drug Administration, which now allows the shots under emergency authorization. Stanford Medicine announced a similar policy shift on Friday.

The move comes as cases have more than doubled in parts of the state, including Alameda and Los Angeles counties, and several large outbreaks have been linked to the highly infectious delta variant. A homeless shelter in Santa Rosa was closed last Friday after reporting a few positive cases — since then, about a third of its 150 residents have tested positive, most with confirmed delta cases. Few of the residents were vaccinated.

“There’s no health order that’s going to prevent every infection,” Dr. Susan Philip, the San Francisco health officer, said after issuing the new vaccination requirement. But with delta-fueled cases climbing, “the vaccines are a firewall against COVID-19 in our most vulnerable populations,” she said.

The updated vaccine mandate applies to people who work in any high-risk setting in San Francisco, including those not run by the city or county. That would include, for example, private hospitals and nursing homes. It does not apply to all city workers — including police and firefighters — who will be required to get vaccinated only after vaccines are approved by the FDA.

Although San Francisco has among the highest vaccination rates in California, Philip said virtually everyone must be inoculated in congregate settings or in places that house many high-risk people. At Laguna Honda, the city’s largest skilled nursing home with about 720 residents, 86% of staffers are fully vaccinated.

This chart from the CDC's Community Profile Report shows the San Francisco Bay Area as one of the areas with the largest recent increase in disease burden for its population size.

This chart from the CDC’s Community Profile Report shows the San Francisco Bay Area as one of the areas with the largest recent increase in disease burden for its population size.


At Stanford, all hospital and other health system employees will be required to be vaccinated effective Aug. 15, said spokesperson Lisa Kim. “We join an increasing number of health systems nationally in taking this action with urgency, particularly in light of the emerging threat of highly infectious variants,” she said.

Nationwide, cases are spiking in regions that are under-vaccinated as the delta variant dominates, and federal health officials are concerned that uncontrolled spread of the virus could spawn more mutations. The delta variant is thought to be up to twice as infectious as the original strain of the coronavirus, and 40% to 60% more infectious than the alpha variant, which dominated in the U.S. through the spring.

Delta makes up roughly 40% of new cases in California, but the state should be less vulnerable to surges in cases due to its overall high vaccination rates, combined with high levels of natural immunity from people who have already been infected.

Cases have climbed statewide since June 15, when California lifted almost all public health restrictions — from an average of about 2.5 cases per 100,000 residents a day to 4 per 100,000 recently. Bay Area counties are seeing similar increases.

Those are still relatively low rates, but on Friday, the federal Centers for Disease Control and Prevention listed the Bay Area as an “emerging hot spot” due to rising case numbers over the past week. According to the CDC, cases have climbed 85% for the region week over week.

The positive test rate is still low, at 1.7%, especially compared to other hot spots, which range from 4.3% in Memphis, Tenn., to 11.9% in Jacksonville, Fla.

Hospitalizations have increased, too — by almost 50% in the Bay Area and about 37% across California since June 15. But they’re still down more than 90% from the winter peaks. Hospitalization numbers are similar to those seen during other lulls in the pandemic — the difference this time is that there are almost no health restrictions like mask mandates and bans on public gatherings.

That’s a sign the vaccines are holding up, infectious disease experts said. The optimism is reinforced by the latest death tolls, which have remained at or close to their lowest levels since the pandemic began. Statewide and nationally, more than 99% of people who have died of COVID in recent months were not fully vaccinated.

Read More:Bay Area an ’emerging hot spot’ for COVID as delta cases jump

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