SAN FRANCISCO - New COVID-19 restrictions are coming in San Francisco and Mayor London Breed could not be more direct about them.
"We've been worried for months, but now it's real, our dangerous winter has arrived," said Breed at a Tuesday news briefing.
The mayor said she would try to give affected businesses some notice before new rules begin, but warned there is little time to spare.
"Let me be clear, as clear as I can be, it's not good," she said.
On World AIDS Day, Breed called on San Franciscans to summon the spirit of resilience they demonstrated when the AIDS epidemic was emerging in the 1980s.
"We are now in the most dangerous period of this pandemic and we need to do everything we can to keep our hospitals from being overrun," declared Breed. "This is about saving lives."
The city is averaging 140 new COVID19 cases daily.
In late October, it was 34 per day.
Coronavirus hospitalizations have doubled in just 10 days, and the trajectory will only worsen once infections from Thanksgiving activities surface.
The city's top health official warned that all medical wards could be full by Christmas.
"San Franciscans sick from COVID-19 during the December holidays with no available beds in our local hospitals," said Dr. Grant Colfax, San Francisco Public Health Officer. "If you or a loved one becomes very ill from the virus, will there be a hospital bed for you?"
For that reason, officials want a subdued San Francisco to retreat even more throughout the holiday season.
"What we are seeing now is a spike unlike anything we have seen in this pandemic," said Breed. "We are in trouble and we are sounding the alarm."
Among the changes being considered: a mandatory two-week quarantine for returning travelers, like the one Santa Clara County has imposed.
Also, there will be stricter limits on the size of social gatherings and business occupancy.
"And as we see places like L.A. County close outdoor dining entirely, I want to be clear, we can't rule it out, unfortunately."
Breed assures restaurants, if outdoor dining is halted, they will get advance notice to adjust their ordering and staffing.
In the Marina District, that was small consolation to one owner.
"It's emotional because people need to make a living," said Ken Lowe, owner of Ace Wasabi Sushi Bar. "I hope we all get through this together but shutting down outdoor dining would be a final nail in the coffin."
San Francisco, now in the state's most restrictive purple tier, recently moved all dining outdoors, closed museums, gyms and entertainment venues, restricted retail and office capacity, and set an overnight curfew.
But Breed and Colfax say those measures are not enough.
"Everything we are asking you to do over the coming weeks and months is about saving lives," said Breed.
The prospect of a heavier lock-down didn't seem to surprise most people.
"We enjoy being outside, being able to do things and eat out but at the same time we can definitely make sacrifices if it means saving lives," said Daniel Thomas, walking his dog with his girlfriend.
Dr. Colfax also referenced World Aids Day in his remarks.
"Every Aids Day I think about the lives we could not save," said Colfax, noting that the early days of the AIDS epidemic offered few tools or guidance, especially compared to COVID19.
"With this one, we already have the knowledge, we know what it takes to fight the virus and we need to do it," he concluded.
But getting people to react with urgency -after 9 months of shifting restrictions- is a challenge.
"I know people are trying, I know people are tired, I know it won't be easy," said Breed. "But I believe in this city and I believe in all of you."
The new rollback orders could be announced as early as Wednesday.
Debora Villalon is a reporter for KTVU. Email Debora at email@example.com and follow her on Twitter@DeboraKTVU