How to keep city services running, despite the omicron variant, is of concern to Mayor London Breed.
As of Tuesday, there are 168 police officers and 135 members of the fire department who are in quarantine.
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"Front line workers will be putting in overtime to make up for their quarantined colleagues, trash is still being picked up, police are still patrolling and fire fighters stand ready to respond," assured Breed.
While the omicron surge has not yet peaked, there is some optimism. This time, hospitalizations are much lower related to the number of COVID cases.
"Our vaccinations and boosters are doing what we believe them to do right now, which is prevent many people from getting sick and being hospitalized," said the Director of San Francisco's Public Health Department, Dr. Grant Colfax.
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The health department again vowed to keep schools open, but reminded families that vaccinations and COVID testing are key in order to keep students and staff safe.
Like many cities, San Francisco has a shortage of rapid tests.
"Unfortunately, because of supply chain issues these kits are hard to come by but we expect them to arrive in weekly deliveries starting in mid January, added Colfax.
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"We're saving lives, but in the meantime we're going to experience challenges with the economy," the mayor warned residents.
A few restaurants have been forced to pause because of staff that have had to quarantine. The Golden Gate Restaurant Association told us reservations are also down.
"Do we have any customers? And you're starting to see even my two restaurants really like 20 percent of what you would normally see on the books for reservations. People are self selecting to not go out as well," said the director of the Golden Gate Restaurant Association, Laurie Thomas.