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What San Franciscans should know about the BA.2 Omicron variant

a woman in a mask swabs a mans nose
Mission District residents get tested for COVID-19 at the testing site on 24th and Capp streets on Monday, December 20, 2021. | Camille Cohen | Source: Camille Cohen/The Standard

With proof of vaccination no longer required at local venues and pandemic fears subsiding along with case counts, many San Franciscans have been enjoying this year’s early spring heatwave maskless. 

But an uptick in local Covid cases driven by the more infectious BA.2 Omicron subvariant has sparked concerns of another wave. While a handful of alarmist headlines have touted San Francisco’s high Covid rates compared to the rest of the state, the truth is more complex, and some experts maintain that the facts on the ground in San Francisco paint a more optimistic picture. 

Still, knowledge is power, so here’s what you need to know about the current state of the pandemic in San Francisco.  

What Should I Know About Omicron BA.2? 

The Omicron BA.2 subvariant has become the dominant strain of the virus both nationally and locally, taking over from the primary Omicron subvariant, BA.1, which drove the previous surge of cases that started late last year. The bad news is that research has shown the new subvariant is potentially 30% to 50% more transmissible than its viral cousin. 

On the other hand, there has been no evidence to show that BA.2 causes more severe illness, according to the World Health Organization. Additionally, the WHO has said that prior infection with BA.1 provides strong protection from reinfection by BA.2.

Is It Time to Panic Buy Toilet Paper Again?

It’s true that San Francisco currently has the highest case counts of any county in California, around 13 cases per 100,000 people. But context is important: That number is only a fraction of the 274 cases per 100,000 people the city saw during the peak of the Omicron wave. Some experts have positioned San Francisco’s marginally higher case counts compared to other counties as a positive sign of the city’s robust testing infrastructure. Deaths and hospitalizations due to Covid, which have been the primary metrics used by officials to determine restrictions, remain low. 

As of April 3, 18 Covid patients were hospitalized in San Francisco, with three individuals in intensive care. That compares with 286 hospitalized patients with 42 in the ICU at the peak of the previous Omicron wave. 

“Hospitalizations and ICU numbers can lag, but if not budging, they are a good indicator of how sick people are getting,” said Dr. Peter Chin-Hong, an infectious disease expert at UCSF.

What’s the Latest on Vaccines? 

The Food and Drug Administration and the Centers for Disease Control authorized a fourth Covid vaccine dose of the Pfizer or Moderna vaccine for everyone 50 and older, as well as a fifth dose for certain populations with compromised immune systems. 

The CDC also recommended that all adults who received two doses of Johnson & Johnson’s vaccine get third shots of Pfizer or Moderna based on research conducted by the agency. Around 83% of San Franciscans have completed their initial series of vaccinations, 66% of residents have received a booster shot, and public officials continue to encourage everyone to get a vaccine. 

What About These New Covid Treatments I’ve Heard About? 

The San Francisco Department of Public Health recently put out a health alert to notify high-risk populations of their eligibility for an array of medicines that have come to market to combat the disease. 

Vulnerable populations eligible for treatment must have tested positive for Covid, and be either immunocompromised, over 65, at risk for serious illness because of an existing chronic condition, unvaccinated or pregnant. The current medications that are on the market are the oral medications Paxlovid and molnupiravir, as well as the monoclonal antibody treatment Bebtelovimab.

Sotrovimab, another monoclonal antibody developed by GlaxoSmithKline and Vir Biotechnology, had its regulatory authorization pulled by the FDA because of concerns about its effectiveness against BA.2 

Some health care facilities, including UCSF are also offering Evusheld, which is meant for use as a preventative measure—or prophylaxis—for patients who are immunocompromised or who are not vaccinated. 

“Even for the elderly and immune-compromised we are in a very different place than a year ago as Paxlovid and other therapies can keep you out of the hospital,” Chin-Hong said, adding that it is important to seek care early to prevent serious illness. 

How Should I Prepare for a Surge in Covid Cases?

Chin-Hong said it’s useful to track case numbers and wastewater surveillance data to keep a handle on the current situation of the virus, but most residents shouldn’t be too concerned about day-to-day changes, particularly if they are boosted. 

Experts have recommended stocking up on Covid supplies while they are readily available, including rapid antigen tests and high-quality masks, and be prepared to utilize these protective measures if case counts do rise to concerning levels. 

While most masking requirements have been lifted in public spaces, restaurants and schools, both state and local guidelines continue to say they are “strongly recommended” in most settings.

Kevin Truong can be reached at