Just when you thought it was safe to go out without a mask during the Covid-19 pandemic in the San Francisco Bay Area, something major changed in the state’s pattern of Covid-19 infections. That something is the Delta Variant, a more transmissible version of the coronavirus which currently accounts for an increasing proportion of cases in the United States.
Largely as a result of the variant — which reportedly has an increased ability to “breakthrough” vaccine protection — case rates are once again on the rise in various parts of the United States. According to the California state government’s Covid-19 tracking portal, cases were trending upwards and were averaging 4.8 cases per 100,0000 people per day as of press time.
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That increase — as well as a test positivity rate which is trending towards 4%, an increase over previous values — has spooked some public health officials. Increased deaths from the variant, largely among the unvaccinated, have also prompted fears about its continued spread. Missouri, where cases are surging, reportedly requested field hospitals in order to keep up with the demand for medical services.
Here in California, several regions aren’t waiting for Federal guidance to take action. In a controversial move, Los Angeles County recently re-imposed its mask mandate for vaccinated people indoors, which had been lifted in June. Previously, the mandate had only applied to the unvaccinated. The move was a response to the Delta variant.
What does that mean for the Bay Area? Are mask mandates coming back? What about lockdowns?
The answer is likely yes. If the Delta variant keeps spreading, it’s likely that mask mandates for vaccinated people will come back at least in some form. According to reporting from ABC 7 News, public health officials in Alameda County and Marin County in the Bay Area are already considering re-imposing mask mandates for vaccinated people, at least when they are indoors in public settings.
Other counties in neighboring areas aren’t waiting. Yolo County and Sacramento County have already begun recommending that all residents wear masks when they are out and about, regardless of their vaccine status. Against Centers for Disease Control guidelines, the state also recently kept its mask mandate for students in schools, a move that is controversial and has led to legal challenges.
With other neighboring counties imposing mandates or recommendations — and with California's other major metropolitan area, Los Angeles, making the move this month — it appears likely that the Bay Area will follow suit in some fashion.
While no one is discussing lockdowns in the Bay Area yet, other parts of the world which are struggling with the Delta variant have already returned to both mask mandates and lockdowns. Australia has imposed lockdowns in response to its own Delta variant surge. As California moves into the Fall, when respiratory illness tends to spike overall, it appears conceivable that lockdowns could return if case rates keep increasing.
Is all this ultimately necessary? Scientifically, that’s not yet clear. As UCSF Doctor Monica Gandhi told the San Francisco Chronicle, although Delta-driven case rates are increasing, hospitalizations and deaths among vaccinated people generally are not. Outdated testing methods may also be leading to artificially high case rates, because many places testing for the virus are not using the proper Cycle Threshold method, Gandhi told the Chronicle.
According to the New York Times, data from other countries with high Delta variant rates backs this up. In England, case rates have increased markedly due to the variant, but both hospitalizations and deaths are trending downwards. Crucially, though, this is among those who are vaccinated — the variant still poses a grave danger to unvaccinated people, most scientists agree.
Again, what does that mean for those of us living here by the Bay? According to doctors like Gandhi, re-imposing mask mandates might be the wrong move. In cities like San Francisco, over 80% of residents have received a Covid-19 shot. That, combined with natural immunity from infections, means that the city may have achieved herd immunity already. Variants like Delta may spread, but that doesn’t necessarily mean they’ll spread exponentially, and it doesn’t necessarily mean they’ll cause harm through deaths or hospitalizations.
Indeed, even with increased case rates, hospitalizations in the Bay Area continue to drop relative to the high numbers seen during Covid-19’s pre-vaccine surges. This would appear to back up Gandhi’s predictions about the variant, at least so far.
Still, officials have some cause for concern. Deaths and hospitalizations are a lagging indicator, which means it can take weeks or months for new cases to lead to a measurable increase in deaths, especially with new treatments on the table. Some officials will probably see increasing case rates and impose new mask mandates or even potentially lockdowns, on the chance that cases seen today will lead to preventable deaths later on.
That might keep some people safe. But it might discourage others from getting vaccinated, doctors like Gandhi worry since the message they’re receiving is that vaccines aren’t enough to stop the new variant, and being vaccinated doesn’t allow them to throw their masks away.
That would be unfortunate, as nearly all scientists agree on one thing: Delta variant or not — getting vaccinated is the best way to protect both individuals and communities from the virus. Increasing vaccination rates is the primary goal today, whether or not mask mandates and lockdowns are needed to keep the variant in check.
