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SF projects dire COVID figures for worst case scenario, but how accurate are they?

While the coronavirus surges across San Francisco again, city officials are bracing for the worst possible outcome: mass infections by the fall, potentially overloading the city’s health care system, and a sharp uptick in the city’s death toll.

In a virtual press conference Thursday, San Francisco Department of Public Health Dr. Grant Colfax confirmed the number of hospitalized COVID patients is higher than it’s ever been, underscoring the urgent need for city residents to self-correct in mitigating the spread of the virus. During the last peak in April, 94 people were hospitalized. Six weeks ago, that figure dropped down to 26. But by late July, the number of those hospitalized jumped up to 107. Of those, Colfax noted, one-quarter are in intensive care.

“In just 10 days, this month we went from 5,000 to 6,000 cases of COVID-19,” he said. “Let me be clear: We are in a major surge of COVID-19. The virus is moving fast and more people are getting very ill. If this continues at current rates we estimate on average we will have more than 750 San Franciscans in the hospital by mid-October and more than 600 deaths from COVID-19 in 2020. [The] worst case scenario puts us at 2,400 hospitalizations and 1,800 deaths. These scenarios become more likely as each day goes by with the current trends.”

Such figures seem frightening, but at this point, they are still preventable. The city has recorded 6,423 cases and 58 deaths as of Thursday. Colfax noted San Francisco’s hospitals aren’t overwhelmed like they were in New York, but that “it is extremely sobering that we have reached this point.”

Dr. George Rutherford, professor of epidemiology at University of California, San Francisco, mostly agrees with the city’s assessment and current projections. While the current R0 score is just north of 1 — substantially lower than it was a week or so ago — the figures the city predicts for the near future likely still hold weight.

“They have been accurate in the past,” Rutherford says of projections for up to 4-6 weeks ahead. “As you go out further it’s anybody’s guess. We use a variety of inputs to get estimates for where things could be, [but] it’s not like we have a pool about this or are betting on it. They’re meant for planning purposes. If [Colfax] is putting those numbers out there, that’s what they’re planning on.”

City officials are currently working to find the best ways to weather a surge in hospitalizations. On Thursday, Colfax and District 2 Supervisor Catherine Stefani announced a 93 person-capacity low acuity care center for non-COVID patients to free up hospital beds for coronavirus cases. And an additional floor was previously opened up for COVID patients at Saint Francis Memorial Hospital.

As for what might happen later on this year, Rutherford is less certain about the city’s estimates. While the notion that an average of more than 750 people daily could be hospitalized is plausible, he’s not so sure about the predicted death toll of 600, noting it “seems a bit far off.”

“But if this starts getting back into nursing homes or if we get so many young people infected we see them spread into the ICU and mortuaries that’s going to be very problematic,” he adds.

As for those worst-case-scenario numbers? It’s still hard to say. There is a possibility that that could happen, Rutherford says, but that outcome is far from certain at this point. “That’s the problem with modeling out too far,” he says, “you get wide-ranging numbers, but you’ve got to plan on something.”

All this aside, the future scenario that Rutherford is really concerned about isn’t strictly about the coronavirus — it’s about the flu, too. “Is everybody going to be slow to get flu shots, and are we going to start flooding emergency departments with people with influenza and people with COVID at the same time?”

It’s a scary thought, but he adds the best way for San Franciscans to prevent overwhelming hospitals is to follow recommendations from the health department — to do the things that are within their power.

“They can stay home when they’re sick, they can avoid going indoors, they can get a flu shot,” he says. “That’s what they can control.”

And they should follow the advice Colfax delivered again on Thursday: “Please wear a mask. It’s not that hard.”

Alyssa Pereira is a culture editor at SFGate. Email: alyssa.pereira@sfgate.com | Twitter: @alyspereira