For a City That Followed Covid Rules, Will Omicron Change the Playbook?
San Francisco has endured mask mandates, vaccination requirements and lockdowns. Now with the first U.S. case of the Omicron variant, no one’s sure what comes next.,
SAN FRANCISCO — For two years, San Franciscans have been pandemic poster children. When Covid-19 hit, the city was among the first in the nation to declare a state of emergency.
Masks have been de rigueur since April 2020. The vaccination rate is among the world’s highest. When the wildly popular In-N-Out Burger stand at Fisherman’s Wharf refused to ask customers for proof of inoculation, the city shut down its indoor dining. “In-N-Out(side),” the city public health department scolded via tweet.
No matter: On Wednesday, as health authorities confirmed that the Omicron variant of the coronavirus had arrived in the United States, the first known case was in San Francisco. The infected person, who authorities said was self-isolating and participating in aggressive contact tracing, had noticed symptoms after returning from South Africa, where the variant was first identified.
Now the city that has led the nation in coronavirus caution is preparing to hunker down. Again. Maybe harder.
“We were thinking of maybe traveling again in the spring,” sighed Linda Wollman, 67, a retiree who has not seen her European relatives since the pandemic started, and who has avoided crowds, restaurants and anyone who is unvaccinated, except her 15-month-old grandson.
“Now I guess we’ll just lay low. Or lay lower. If that’s at all possible.”
Health officials braced for pandemic fatigue across the country this week as word spread that the new variant had reached California, with the inevitability of cases being identified elsewhere.
By Thursday morning, a second case was reported in Minnesota, in a resident who had recently traveled to an anime convention in New York, suggesting that the variant already had begun to circulate.
Omicron carries more than 50 genetic mutations that in theory may make it both more contagious and less vulnerable to the body’s immune defenses than previous variants. Available vaccines may still offer substantial protection against severe illness and death following infection with the variant, but much remains unknown.
Most of the mutations are on the virus’s spike protein, which the existing vaccines target. Federal officials are asking vaccinated people to get booster shots and the makers of the two most effective vaccines, Pfizer-BioNTech and Moderna, are preparing to reformulate their shots, if needed.
But it remains unclear whether Omicron will change the anti-coronavirus playbook. If the new variant turns out to be more transmissible than, say, the Delta variant, officials said, health guidance may stiffen — more vigilance about masking indoors, sterner requirements for boosters.
“It’s worth re-asking the question, ‘I’ve started to get a little less careful than I was — is that the right thing?'” said Dr. Bob Wachter, a professor and chair of the department of medicine at University of California, San Francisco. “If, psychologically, you need a month to get prepared to move backwards, you should get ready for the possibility.”
That could be tough. The options government officials have to control the spread of the virus have proved to be politically limited in this country, even where communities have been open to restrictions. California’s health measures saved countless lives, for instance, but also helped fuel a recall effort against Gov. Gavin Newsom this year.
In the rural north end of the state, the Butte County town of Oroville recently declared itself a “constitutional republic” in a mostly symbolic move to protest pandemic mandates. Just 49 percent of the county’s residents are fully vaccinated, with more than double the cases per 100,000 people than in San Francisco.
“Every step that enforces a new or more stringent rule comes with blowback,” Dr. Wachter said.
In the aftermath of the identification of the Omicron variant in the United States, President Biden extended a mask requirement on buses, trains and airplanes through mid-March and offered insurance reimbursement for at-home coronavirus tests, along with better access to those tests for people without insurance. Dr. Anthony S. Fauci, the president’s top medical adviser, exhorted Americans to take advantage of vaccines.
“We have 60 million people in this country who are not vaccinated who are eligible to be vaccinated,” Dr. Fauci said. “Let’s get them vaccinated. Let’s get the people vaccinated, boosted. Let’s get the children vaccinated.”
In California, that was the message, too. At a news conference in the Central Valley, where the virus has raged amid persistent vaccine resistance, Mr. Newsom said he did not expect to reinstate shelter-in-place orders or classroom closures, although the state planned to increase coronavirus testing at airports among travelers from countries designated by the Centers for Disease Control and Prevention.
Much still depends on the actions of individual Californians, he said: whether they heed his repeated, urgent calls to get vaccinations or booster shots, for instance, and whether they take other precautions, like adhering to mask mandates.
“It’s important for folks to understand we have agency,” the governor said. “People have been thriving with these vaccines.”
In San Francisco, as word spread of the discovery of the Omicron variant among its residents, many were less “thriving” than resigned to the measures that have become a literal way of life in the city. Before the variant showed up, the city had been engaged in a robust public chiding of the mayor, who had been caught on Instagram on an indoor dance floor without a mask.
Edlyn Kloefkorn, who has an 85-year-old mother at home on dialysis and a fifth grader who had just gotten his second dose of vaccine on Sunday, wondered whether her family’s life would ever return to their old normal.
“If they don’t start giving the other countries vaccines,” she said, picking her son up from the St. Cecilia School in the West Portal neighborhood of the city, “this is never going to end.”
At the Ferry Building, a food hall and marketplace on San Francisco Bay, diners on the outdoor patio worried about fresh economic disruption.
“I hope we retain the flexibility we have and businesses keep opening up,” said Evelyn Arevalo, a business analyst at a biotech company who had come outside to decompress with a coloring sheet and a bowl of butternut squash soup.
Allen Cooper, 53, who flew into San Francisco from Denver last week to meet with Bay Area-based colleagues, wondered what this would mean for his work’s return-to-office date on Jan. 18. “Hopefully there’s not another reality that we have to adapt to yet again,” Mr. Cooper said.
At a Christmas tree lighting at Civic Center Plaza, where vaccinations were required for municipal employees inside the V.I.P. tent and masks were encouraged in the outdoor crowd of several hundred onlookers, Dale Parker, 62, said he was tiring of health restrictions.
He said he was now used to the complex risk calculus that he made before deciding to come out to the festive gathering — the number of people, how far apart they were, the case rate in the city, the fact that he himself was vaccinated — but he is tiring of the restrictions that San Francisco is under, including the city’s indoor mask mandate for public spaces.
“I think people should have a choice,” he said.
Alisa Bat, 28, stood on the outskirts of the crowd in a red Santa hat — an attempt to get into the holiday mood while minimizing risk. She said she was worried about the Omicron variant but also “trying to escape” from thinking about it.
Dr. Wachter, a fellow San Franciscan, echoed many of his neighbors, noting that for the next few weeks at least, the Delta variant is much more likely than the Omicron variant to infect him. He said he plans to maintain his current level of precautions.
“If you decide to go to an indoor restaurant,” he said, “your risk is no different than it was last week.”