UCSF Responds to Surge in COVID-19 Cases Among Employees, Learners

By Kristen Bole and Lisa Cisneros

people walk across a crosswalk at UCSF Parnassus Heights campus

UCSF San Francisco is responding to an increase in COVID-19 cases, which is mirroring the rise in cases across the Bay Area. Photo by Susan Merrell

UC San Francisco is responding to an increase in the number of community-acquired COVID-19 cases among its employees and learners, reflecting an overall Bay Area trend in new infections due to the growing prevalence of the highly contagious Delta variant.

While the increase in new cases after five months of decline is frustrating, when put into context with what’s happening in San Francisco, UCSF’s infection rate is on par with the city’s “when you do the math,” says Ralph Gonzales, MD, chief innovation officer for UCSF Health who has been monitoring positive cases of COVID-19 at UCSF since the start of the pandemic.

“As San Francisco goes, so goes UCSF,” Gonzales explains. “The city is reporting 206 cases per day, which is the equivalent of 23.5 cases per day per 100,000 people. That rate is very similar to UCSF, which is seeing about eight new cases per day out of a total population of 35,000 employees and learners. That equals 22.9 cases per day per 100,000.”

Encouraging Vaccinations to Combat COVID-19

Since UCSF began vaccinating employees and learners in December 2020, it has prioritized vaccinating as many people as soon as they were eligible, as recommended by public health experts. The importance of getting vaccinated was strengthened when the UC Office of the President issued a mandatory vaccination policy requiring everyone who steps foot on any UC campus to be vaccinated or be approved for an exemption or deferral for the safety and wellbeing of the entire university community. UCSF set a deadline for Sept. 1 for complying with that policy.

“We appreciate your compliance with this policy and with all the public health measures outlined by UCSF and public health officials,” Josh Adler, MD, chief clinical officer at UCSF Health said in an Aug. 3 message to the UCSF community. “We share your hope that we can soon turn the tide on this pandemic.” 

While no vaccine offers 100 percent protection, public health research shows that three vaccines currently authorized by the U.S. Food and Drug Administration for Emergency Use Authorization are highly effective in reducing both the spread of COVID-19 variants and the risk of hospitalization or death from the disease. 

man receives a COVID-19 vaccination shot

Dennis Hom (right) a patient support assistant at UCSF Medical Center, gets a COVID-19 shot from Matthew Aludino in December 2020. UCSF continues to provide easy access to vaccinations at drop-in sites at UCSF. Photo by Susan Merrell

Although new research shows that vaccinated people can become infected and carry high levels of the coronavirus, it’s important to know that these cases are uncommon considering how many more cases would occur if people were not vaccinated. Nationwide, the vast majority of new cases, hospitalizations and deaths are among unvaccinated individuals. 

The Biden administration is making a renewed push for vaccinations, after reaching its goal of 70 percent of all adults receiving at least one dose. But with large numbers of people still unvaccinated, those vaccinated will continue to be exposed to the Delta variant, which now accounts for at least 93 percent of all sequenced coronavirus in the nation, according to the U.S. Centers for Disease Control and Prevention.

The virulence of the Delta variant of the coronavirus is proving to be formidable to even vaccinated individuals in San Francisco, where 70 percent of the population is fully vaccinated, and at UCSF where more than 90 percent of all faculty, staff, students and trainees are fully vaccinated. 

UCSF’s number of breakthrough cases is expected given that 32,000 individuals are fully vaccinated. Since the Delta strain emerged as the dominant COVID-19 strain in the San Francisco Bay Area starting June 28, UCSF has had 183 employees or learners test positive for COVID-19 out of a total UCSF population of about 35,000 individuals. Here are the facts: 

  • Only two have been linked to an exposure at work; and most have been linked to exposures to unvaccinated individuals, including their own children not yet eligible for a vaccine. 
  • These include 146 UCSF Health employees and learners and 37 UCSF researchers, staff and students. 
  • Of those, 153 had been vaccinated and 30 were unvaccinated.
  • Unvaccinated employees and learners were 3 to 5 times more likely to become infected and 25 times more likely to be hospitalized.
  • Two people – one vaccinated and one unvaccinated – required hospitalization. 

Again, these results reflect how highly protective the vaccines remain seven months after the first group of employees and learners received their vaccines. 

“Our data show that these vaccines averted more than 500 COVID-19 cases among our internal UCSF community since the Delta variant began to spread in late June,” Gonzales says. “Without vaccinations, we would expect to have seen 767 COVID-19 cases during that time, given the positivity rate among unvaccinated individuals.”

That timing coincides with when cities began easing public health orders and reopening businesses, giving people a feeling of freedom to begin hosting gatherings, traveling on vacations, dining in restaurants and shopping in stores.

At UCSF, the majority breakthrough cases have caused mild symptoms, such as a runny nose, sore throat and headaches. Some employees and students feeling cold-like symptoms came to campus, not thinking they had COVID. Seeing this trend emerge, UCSF added more questions to its mandatory digital daily health screener to catch these symptoms earlier and to get those who fail to pass the screener tested. Anyone with any symptoms at all is advised to stay home and get tested. 

Tracking COVID and Taking Action

UCSF leaders are carefully monitoring the new cases across the campus and health system through ongoing extensive testing, health screening, and contact tracing efforts. UCSF has consistently reported its COVID case count on the coronavirus website, through its e-newsletters and forums, including at regularly scheduled virtual town halls. 

UCSF’s response to the uptick in new cases has been swift. Recently, UCSF has taken these actions:

  • Reinstating indoor masking requirements for everyone in campus buildings on July 15, ahead of the city and state, which mandated indoor masking in public places effective Aug. 3;
  • Imposing a mandatory quarantine for those who were exposed to COVID-19 in their households, given the higher transmission risk based on the duration of close contact with an infected person;
  • Providing easy access to vaccinations at drop-in sites at UCSF;
  • Requiring everyone who comes on campus to comply with the UC-wide vaccination policy to either get vaccinated or approved for an exception due to a medical condition, religious objection, disability accommodation, or a deferral because of pregnancy; 
  • Expanding access to COVID-19 tests at several UCSF locations; and
  • Revising its digital daily health screener to catch mild symptoms earlier before employees or learners come to campus.

Meanwhile, many UCSF administrative employees have continued working remotely since the citywide mandatory stay-at-home-order was issued in March 2020, with a planned return date of Oct. 1. 

UCSF officials will reassess that date and other safety measures, depending on the state of the pandemic in the coming weeks, and will remain ready to pivot as needed to protect the health and safety of its workforce and student body.