For those who have begun to engage with the world again, there’s been a strange cognitive dissonance. In grocery stores, on public transportation and airplanes, and in schools and childcare facilities, masks are either required or highly recommended. But in bars, restaurants, clubs, and entertainment venues like Oracle Park and Stern Grove, people are partying bare-faced like it’s 2019.
Different legal orders, different populations, and different levels of comfort and anxiety help explain San Francisco’s checkered masking situation. It’s a bit of an irrational arrangement, with relatively riskier activities seeing less masking than relatively safer ones, but for now, doctors say, so far so good. San Francisco’s incredibly high vaccination rates and low transmission rates mean that even crowded bars in the city, while not risk free, are still probably safer than their counterparts almost anywhere else in the world. However, the Delta variant and a possible post-Fourth of July surge could change things quickly.
“Right now, the environment is safe” for party people, says Peter Chin-Hong, an infectious disease specialist at UCSF. “But things are changing very rapidly, so people have to be on their guard.”
Since California fully reopened on June 15, things have gone fairly smoothly, although new case counts have been ticking up since the beginning of July.
As of July 13, 82 percent of the city’s population 12 and up had received at least one dose of vaccine, and 75 percent had completed their vaccine series. (Only about 50,000 people in the city received the one-dose Johnson and Johnson vaccine.)
But the reopening and the circulation of the more contagious Delta variant have also led to increased transmission rates. On July 13, San Francisco was averaging about 70 new cases per day, according to the New York Times database, which provides more up-to-date statistics than the city. That’s up from a low of about 10 cases per day in early June, but still way down from the winter’s post-holiday surge, when new case counts reached into the 300s. Even as cases shoot up, deaths and hospitalizations have remained low. San Francisco has not recorded a COVID-19 death since June 11.
Those two categories of statistics — new cases vs. deaths and hospitalizations — will be important to distinguish in the next phase of the pandemic, Chin-Hong says. As the Delta variant continues to circulate, which renders existing vaccines somewhat less effective at preventing infection, more vaccinated people will become infected with the coronavirus. But very, very few of them will get sick enough to be hospitalized or die.
“I’m confident that our hospitalizations and deaths will remain very low, because we vaccinated not just most of the people, but we vaccinated really a lot of the people who can get into trouble with COVID,” like seniors and people with preexisting conditions, Chin-Hong says.
In Los Angeles and San Diego counties, 99.8 percent of people who died of COVID-19 over the past six months had not been inoculated against the virus, the Los Angeles Times recently reported. So far, less than half a percent of the 20 million Californians who have been fully vaccinated have tested positive for COVID-19. The percentages of vaccinated people who got sick enough to be hospitalized, or who eventually died, are so minuscule as to be incomprehensible to anybody other than a statistician, at 0.003 percent and 0.00035 percent, respectively.
Where do these statistics leave us?
If you’re vaccinated, going out and enjoying life as normal in San Francisco is still fairly safe, Chin-Hong says. But the specter of the Delta variant, as well as increased tourism from parts of the country with low vaccination rates, mean the future remains murky.
“If you asked me two weeks ago, or at the time of reopening, I would say yeah man, go burn your mask up, light it in a bonfire,” Chin-Hong says. But with the Delta variant beginning to infect vaccinated people in other countries, albeit almost never severely, “people should just be flexible and look at the data. And if you have symptoms, just go in and get tested. If you’re vaccinated, luckily, I can guarantee you that you’re not going to get very sick.” Immunocompromised people who are vaccinated should continue to exercise caution, he emphasizes. And unvaccinated people, it goes without saying, should go get vaccinated.
To err on the safe side, Chin-Hong recommends avoiding extremely crowded bars and clubs, not staying in one particular place too long, and avoiding touristy spots.
The last point speaks to the astonishing geographic variation in vaccination rates across America.
“San Francisco is probably one of the safest places in the world right now,” Chin Hong says. “I’d much prefer to go out in San Francisco… And definitely not go out in Mississippi, Alabama, Missouri, etc.”
Some rural counties in the South and Midwest have vaccination rates of less than 20 percent of the eligible population, compared to more than 75 percent in San Francisco. The vaccination divide tracks closely with political divides. A recent Bloomberg report found that the top 20 percent of counties ranked by support for Biden in the 2020 election had a vaccination rate of 57 percent, as of late June. The 20 percent of counties where Biden performed worst had a vaccination rate of 31 percent.
But even here in San Francisco, people aren’t exactly behaving rationally at this stage in the pandemic.
“People are aligning their risk mitigation practices with psychological comfort, instead of potential disease transmission risk,” Chin-Hong says. “At the Giants game, or at the movie theater, or in the bar, you just want to forget the rest of the world, including COVID.”
Ironically, crowded indoor spaces, where you’re staying in one place for an extended period of time, are where even vaccinated people need to remain cognizant of COVID. The next few weeks should provide more clarity as to just how worried about Delta we should be.
So party on with caution, San Francisco.
Benjamin Schneider is a staff writer. Twitter @urbenschneider