Key Public Health Indicators

Containing COVID-19 in San Francisco
Safely reopening San Francisco requires a strong partnership among city leaders, public health experts, businesses, and the community. Our commitment to safely moving forward together comes with the awareness that reopening too quickly may pose health risks and economic setbacks.
The key health indicators shown below are an important tool the City uses to monitor the level of COVID-19 in our community, and assess the ability of our health care system to respond to the pandemic.
The key health indicators are grouped into these areas:

Understanding the indicators and their use

The indicators are not an on/off switch for the reopening. Instead, public health experts will use indicators to consider various policy changes and make recommendations during each stage of the City’s reopening plan.

The City's role is to make informed choices based on data, science and evidence in partnership with public health experts, businesses, and the community.

The role for all of us is to continue taking precautions and following public health orders, which will take into account the information here along with additional data.

Each indicator has four color levels to show where we are in relation to our targets. 

The colors are:
We are meeting our target. San Franciscans must continue to take precautions as they are a big part of our success.
We are not meeting our target. The City will evaluate the other indicators and additional data before further loosening of public health orders. San Franciscans must continue to take precautions, to help us get to green.
We are not meeting our target. The City will consider pausing or dialing back reopening based on the status of the other indicators and additional data. San Franciscans should take stronger precautions.
We are far from reaching our target. The City will strongly consider increasing stay home restrictions, and possibly pause or dial back reopening, based on the status of the other indicators and additional data. San Franciscans may need to change behavior to help achieve improvements.

What do I do with this information?
These indicators reflect the City's decision-making process. They inform actions taken by the City to keep San Franciscans safe.
These indicators are not meant to change your own actions. San Franciscans must always take precautions as long as we are in this emergency. The City will communicate any needed changes to behaviors through public health orders and recommendations through, social media, and community outreach.

Indicators considered together and with other data

The nature of disease spread is dynamic. This means the City must continuously re-evaluate direction to keep San Franciscans safe.
The following indicators and their levels inform but do not dictate the direction of re-opening. The Health Officer may take actions based on other factors.
For example, the evidence is clear that pandemics exploit the existing inequities in our society.  Some communities are more affected because of systemic racism, income insecurity, housing conditions, and structural inequalities.
From the start, we have focused our coronavirus response on vulnerable populations who are 60 or older or have underlying health conditions, people in congregate settings and members of communities that are disproportionately affected by the pandemic.
Our reopening efforts must take into account the experience of low-wage workers, people who must leave home to work, workers who live in crowded conditions, and structurally vulnerable communities most affected by both the pandemic and the socio-economic impacts of the stay-home orders.

Hospital System

Key question: has there been an increase in COVID-related hospitalizations, and do we have the capacity to treat severe cases of COVID-19?
Rate of Weekly Change in COVID Positive Hospitalizations
The rate of change in COVID-19 hospitalizations is important because it reflects the demand put on our hospitals for acute care and ICU beds to care for COVID-19 patients. Our goal is to keep the increase in COVID-19 hospitalizations to less than 10%.
7-day Average Percentage of Acute Care Beds Available
Acute care hospital beds are for patients who need to stay in the hospital for an extended period of time to receive treatment. The number of available acute care beds helps us gauge the ability of our health care system to handle a potential surge of COVID-19 patients. Our goal is to maintain at least 15% availability in acute care beds.
7-day Average Percentage of ICU Beds Available
Doctors, nurses, and hospital staff care for patients who are seriously ill and need specialized care using intensive care unit (ICU) hospital beds. For example, patients in ICU beds may need ventilators. The number of available intensive care beds helps us gauge the ability of our health care system to handle a potential surge of seriously ill COVID-19 patients. Our goal is to maintain at least 20% availability in intensive care unit beds.


Key question: are there early indicators of increase in COVID-19 positive cases?
Average New Cases per Day per 100,000 Residents
The average number of new cases per day indicates how many San Franciscans are testing positive and confirmed as a new case for each day. The measure is normalized to San Francisco’s population to allow comparison to other counties and states. We also present the 7-day average number of new cases per day. Our goal is for average new cases to decline to less than 1.8 per 100,000.
Data is lagged to show the most reliable day of data. Learn about how this data is updated.


Key question: are we testing enough to detect COVID-19 cases?
7-day Average Tests Collected per Day
To identify new COVID-19 cases, the City needs the ability and capacity to test people who may have contracted the virus. We are currently testing more people, and focusing testing on vulnerable populations, groups with a higher risk of exposure, and people with symptoms. Our goal is to test an average of 1,800 San Franciscans per day.
Data is lagged to show the most reliable day of data. Learn about how this data is updated.

Contact Tracing

Key question: are contact tracing operations reaching enough people touched by COVID-19?
Percent of Cases Reached for Contact Tracing over the Prior Two Weeks
Contact tracing is a key tool for preventing new infections. The first step is to reach out to people who are COVID-19 positive to make sure they have the resources they need to isolate and help figure out whom they might have exposed without knowing it, so those individuals can also be contacted. By helping both cases and their close contacts to self-isolate, we can limit the spread of the virus, and keep case numbers down. Our goal is to reach 90% of people who test positive for COVID-19.
Percent of Named Contacts Reached for Contact Tracing over the Prior Two Weeks
Contact tracing also involves reaching out to individuals who have been in contact with someone who tested positive for COVID-19 and linking them to free, confidential testing and support services. Contact tracers do not share information about who may have exposed a person - this information is confidential and cannot be shared. Our goal is to reach 90% of the contacts that newly infected patients are able to identify.
*Since San Francisco’s transition to the CalConnect case investigation and contact tracing system, we are working to align these metrics with statewide contact tracing metric definitions. In line with statewide guidance, cases reported 10+ days from the date of specimen collection are excluded from the case interviewed metric, as contact tracing for these cases is no longer recommended. Contacts named 10+ days from the date of last exposure are excluded from the contact notified metric, as contact tracing for these contacts is no longer recommended.

Personal Protective Equipment

Key question: do we have enough PPE to protect our health care workers?
Percentage of Essential PPE Categories with at least a 30-day Supply
Personal Protective Equipment (PPE) is critical to the health and safety of health care workers. By ensuring we have a 30-day supply of essential PPE on hand, we can have greater confidence in our ability to safely treat a potential surge of COVID-19 patients. The indicator reflects the percentage of essential PPE that has at least a 30 day supply.

About these indicators

These indicators and the corresponding color levels, were chosen by public health officials based on the best current science in order to provide a high-level picture of the COVID-19 emergency and our system's preparedness. The San Francisco Department of Public Health tracks these indicators and additional data in order to keep residents safe, particularly those in vulnerable populations and those at high risk of contracting COVID-19.
These indicators are aligned with California and Bay Area priorities, though the specific data shown above will be unique to San Francisco because of our health system and the data accessible here. These indicators may be updated as public health officials continue to track new research and data.