Four weeks, so through december 21st. First lets bring in the Public Health officer for Alameda County, dr. Nicholas moss to talk about some of these. Dr. Moss, i want to congratulate you. I know you have been in this role on an interim basis but made permanent this week. Thank you. Thank you very much. Its a big job ahead. I want to ask you, what do you think of the statewide curfew . Is it a good idea . Were still waiting to hear the secretarys remarks and get a sense of the details of what the state has in mind, but i would say more broadly were supportive of everything that the state of california is trying to do to keep californians safe, and we think its good for our residents here in Alameda County and across the region to really take a cautious approach to covid, especially with this surge. But again, still waiting to hear the details about this latest set of restrictions. Yeah, still waiting for the details. We know based on what we were able to learn its not as severe and allconsuming as the stayathome order back in march. Are we essentially back to flattening the curve, is that where were at . Thats certainly the goal. I think weve been able to show here in the bay area and there are other parts of the world that have showed that there are things you can do to flatten the curve, to protect our Health Care System and protect our most Vulnerable Community residents. A lot of it is things that weve already had done that we had to do over the summer and that our residents had been living with for a long time. I think if we are diligent about applying some of these tools, that we can flatten the curve in this next surge. Your county just got moved to purple this week. This curfew will affect you. Practically speaking, can you tell us what might change, what will change . Sure. There are some things that have already changed effective this week moving into the purple tier. A lot of indoor activities, indoor dining, movie theaters, indoor entertainment, those had to be closed for rules the state has set for purple tier counties. Those changes are already in effect for Alameda County and again with the announcement today, the states i think theyre calling it a limited shelter at hoem order. That will apply to us as well in Alameda County. So the goal is really both to limit those public spaces where people are gathering indoors but also i think some private spaces where people are gathering indoors because we know the more people are getting together, particularly in indoor settings with masks off, the risk of transmission is just higher there. The indoor gatherings can take place any time of the day. Im wondering about the curfew part, 10 00 p. M. To 5 00 a. M. Which activities and behaviors does that party . Is it frat parties, side shows, hanging out at the bar . You know, i think its a good question for our colleagues at the state in terms of what specifics they had in mind, but i think the idea is to really limit the hours that people are in these situations, less time, fewer people. All of those things are going to help reduce the spread of covid. It could be a range of a number of things, even if its just people are out dining, creating a system or a situation where theyre going home a little bit earlier. Thats just going to introduce the opportunity for virus to spread in our communities. Folks, if youre just joining us, im talking with dr. Moss, the Public Health officer for Alameda County. What were talking about here, the statewide curfew that will be announced any minute from now. Well take that live when it happens. That applies to all purple counties and most of the bay area is in that. Alameda county is one of them. Just about every county except for san mateo, san francisco, marin. Right now dr. Mark ghaly is starting his briefing. Lets listen in. Across the state, and i think you have been tracking as the governor mentioned i would be using my zoom this week to update you on our tier system, our blueprint and then also to really dig into the science and the data about whats happening across california, how we got here and really what the path forward is to make sure we keep our Public Health in mind, we support one another and come together as we have before. As always, i want to begin and give you a bit of the national context. Sadly we have day over day broken new milestones, whether its in cases, hospitalizations or, sadly, deaths across the nation. The midwest in particular has been heavily hit. Really no region of california, of the nation has been spared. The wave of cases that have been happening over weeks now have turned into record high hospitalizations and intensive care unit stays that a number of states are making difficult decisions about how to allocate care, and even though we have the hope of vaccine and the discussions about what lies ahead on that front, we have to take care of the urgency of the day. And in california, as weve enjoyed lower rates of transmission, lower numbers of cases, we, too, are seeing this surge growing faster and faster and we must address it immediately. So todays numbers, although not our highest number ever, frankly, on this sort of surge weve been dealing with, this is our highest number to date, 11,478 covid cases reported widespread across the state, moving our sevenday average to 9,665. This isnt the face of frankly what is a lower than recent number of tests reported. We had been reporting upwards of 200,000 tests across the state. This isnt the face of lab efforts built by the states. We talked to you about our partnership with perk and elmer, but so many Different Health systems, so many different Laboratory Partners have stepped up in california to provide lab testing and covid testing so we can be informed about diagnosis, track the disease and put our Contact Tracing and efforts around supporting isolation when necessary and quarantine at other times so we can stem the tide. We talked, the governor often focuses on test positivity, accurately so. We have seen this number come up from what had been below 3 just weeks ago to now a 14day positivity of 5 and a sevenday positivity concerning up to 5. 6 . We have a goal to keep this as low as possible, to continue to test our communities to find cases, to wraparound those cases, avoid one case becoming many. But this number is one of caution and one that intensifies our resolve to get it back under control. You take a closer look at the 14day positivity, we knew just a couple weeks ago we were at 3. 3 . We were talking to you then about how its climbing and its rising, and it certainly has, nearly 52 increase just over the past two weeks. I know the numbers. It feels like its a small difference from 3. 3 to 5, but its a significant increase in the percentage increase which is, when we focus on not just increases in rates, but this notion of rate of rise in two weeks to have a 52 increase is quite concerning to us across the state. Hospitals, we talk to you about hospitals all the time, that we know that 12 of todays cases will be hospitalized in two to three weeks. That helps put these numbers in context. Weve seen a 63. 6 increase in hospitalizations for covid19 over the past 14 days. Just days ago, reporting that we were just climbing over 3,000 cases in the hospital across the state today, over 4,500. Our icu capacity, one of our most precious resources, that signifies not just the bed in a specialized unit but specialized staff trained to use the equipment and take care of very sick individuals. And ventilators and all the medications and tools that help us support ones respiratory system, those beds have seen an increase of 40. 5 over the last 14 days and have climbed to just over 1,100 individuals in those beds. Just a reminder that, if we look day over day, week over week, weve seen a climb not just in the number of individuals who are hospitalized, but really in the number of new admissions coming through the front doors of Emergency Rooms and hospitals across the state, something that is concerning. So even though that number slowly rises on hospitals much faster are the number of new admissions because what i said earlier, roughly 12 of those individuals, those cases today that test positive, we expect will be in our hospitals in two to three weeks. We talked about not just the rise, but the steep rise, that rate of rise. You look at what we experienced during that first significant surge early on, thats sort of the summer, june and july, a peak rate of increase of about 39. 2 over a sevenday period. Again here were over 50 in the same sevenday period. This doesnt necessarily tell us where well end. Some states across the nation have seen this double in just a week. We know we are still increasing that rate and we arent sure where the peak will be. That is why we certainly need to be laser focused on all things we can do collectively across the state. Just take a look at a couple of important counties. We have 58 in california. We chose two, los angeles county, were often t about how alameda counlos angel drives the state. Weve seen a very populous county. Just at the beginning of the month reporting 1,500 cases a day. A week before that they were hovering about about about aa today 372 cases. All signs point to continued rise in that number and potentially higher numbers today. Madera county, smaller county, geographically separated but still six cases on november 1, today reporting 34 cases. You may say, well, thats still a small number but that rate of increase, 460 over a small 2 1 2 week period is an Important Message to all of us that this can go very quickly. The support for Madera County is important, all counties getting the support they need so we can curb this transmission and ensure our hospitals are prepared for those who need it the most. So what has caused the rise to go so high and so fast . Im often asked this question. Ive been asked on zooms and press conferences before, well, you say it is this, but where is the evidence. You say its that. And we do have plenty of data and evidence around certain sectors, but overall i will say that there is no single culprit. Its a combination of factors. Its certainly the colder weather, more mixing which comes with more opening not just of places indoors and places where you can mask, but places that are indoors that dont have an easy time masking the whole time. Of course, greater travel. Weve enjoyed some events over the last many weeks. In my home county of los angeles, the dodgers, the lakers, we had halloween. We just exited veterans day. Were looking forward to other future events and activities as we go into the winter. Weve had some things to celebrate, some things to protest, coming together in ways that we dont usually always do. All of those things create opportunities for the virus to spread, opportunities where when we put our guard down, it certainly does spread and we know those are factors driving this high transmission. So what does it mean when levels are this high across the state . It really means that activities that you normally do are higherr risk today than a month ago. Weve seen reports of people who say i havent changed my behavior, i was doing the same thing a month ago. Today, because the background transmission rate, the level of covid in our communities is higher, even our everyday activities become higher risk we must be resolved to put up ouf protective guard more than ever. Today we target activities that are particularly high risk while minimizing the disruptions and social connections we all need and desire. Our ability to be more targeted and thoughtful is an important part of our overall message and approach. So a reminder. Ive used this slide many times before about what some of those high risk activities are. We said and talked about the need to mask, and not just mask for part of the time but the whole time. We know when youre eating and drinking the mask comes off. We ask you to keep it off as short a time as possible, to put it back on when youre done eating, done drinking, even if youre getting together six feet apart from friends and others you havent seen outdoors, keeping that ms. Ing on is an important strategy to reduce risk. Activities when youre seeing people that you havent seen in quite some time, people outside of your household, this includes close family members, friends who havent been with you in some time, that just because you know them well on a personal level doesnt necessarily mean that they in any way wouldnt be able to transmit the virus to you or you to them. Activities where its difficult to keep your distance, i often think about playing board games and card games with my kids on the carpet of our living room or employees in a break room. Weve heard about outbreaks at hospitals, not in a patients room, not the icu or emergency room. Certainly that happens, too. But often when staff take their guard down, they think its a moment of rest and, yes, we all need it especially under these difficult conditions, but that isnt a time to take off your mack, enjoy your meal. Its time to keep it up and make sure we do what we can to prevent the spread. Activities that are longer duration, we follow the longer your potential exposure is, the more likely you are to either be infected or spread the infection to someone else. Activities that dont allow plenty of fresh air to circulate. Weve learned a lot in the past couple months, probably one of the most important areas of development with covid is our understanding of the criticality of ventilation, getting fresh air into rooms is really key, having that air circulate frequently over the course of time, each hour, many air circulations, as many as we can achieve, really do reduce the risks. Those settings where its no, sir possible are indeed high risk for all of us. As i was trying to explain this to my own mother here in california, i was thinking about a simple way, almost an equation to understand how we can calculate your risk for covid and really came up with this and that discussion that your chance of being infected is sort of this simple equation on the top. The likelihood of an exposure as that goes up because theres more baseline background virus in our communities that youre in a situation, the duration of exposure going up. That sort of complementing their additive. As that goes up, our chance of getting infected certainly goes up. Its always divided by or reduced by the level of protection that we have, our ability to keep our mask on, our own personal discipline to keep the mask on, not just when youre with those who youre not familiar with, but sometimes especially those when youre with those who youre familiar with. We know more and more the role of household transmission. What i mean by that is i dont mean when youre gathering with people in your house. Its maybe when you return from work or school and mixing with folks where you might have been infected, that being able to protect especially those Vulnerable People in your home by wearing your mask, an important issue and, of course, keeping that separation, that physical distance of at least six feet helps reduce the overall risk. Something that was effective with my own mom, wanted to share it with you today as you think about how we are in this situation that were in california, that certainly that increased exposure is key. Our urging to limit that exposure helps reduce that overall risk and really amping up and elevating our level of protection through the protective factors and different interventions weve been talking about, both the governor and i. Local and national Public Health leaders for many, many months now. So to the announcement of what well be doing in the state of california, we are going to, just as we did back in march, we started with a full stayathome order. It was very effective. Californians came together. We were able to stay ahead of our curve and keep transmission low. Today in a more focused way, based on many things weve learned over the past many months, ill go over those things in just a moment, we are putting forward a limited stayathome order, one that is more targeted, more focused in the following ways. It impacts counties that are in the purple tier. Youll remember on monday we announced 41 counties across california are in the purple tier. Today were not announcing additional counties in the purple tier. In fact, over the past 48 hours we looked at the data, no county across california has moved to a more restrictive tier and certainly no one has moved to a less restrictive tier. Were asking that as part of this targeted limited stayathome order that people are home by 10 00 and stay home until 5 00 a. M. This means that many essential businesses that weve in the past called nonessential businesses, theres a list of whats included and not included. In that category we ask that they close operations by 10 00 p. M. , that people can get home by then and that they stay home and those businesses dont resume operations until at least 5 00 a. M. Throughout all of the purple counties. This order, this Public Health order that will be modified at the state level will be effective november 21st. Thats saturday night at 10 00 p. M. And will go until december 21st at 5 00 a. M. So what does this mean . Im sure many are asking what does this mean. I know ill get many questions on this and look forward to answering those. What does it mean you can still do . I think about my own life and often the need with four young kids to make a late Grocery Store run to make sure were stocked for breakfast in the morning or a meal. Yes, it does mean i can still go to the Grocery Store at 11 00 if that Grocery Store is still open to pick up milk or eggs or whatever i need. My dog doesnt walk very well, hard to get around the block. Yes, i can walk my dog at 11 00 p. M. If thats your tradition and routine. And for restaurants that close their front door at 10 00 doesnt mean the back door to do takeout and delivery is closed. We urge people in a limited way to use restaurants in that way. And for all you Restaurant Operators and owners, thats certainly an opportunity to keep some amount of business going. Why are we doing this and what are we hoping to gain . Its really to avoid further restrictions and weve seen in the past that covid goes from zero to 60 Miles Per Hour very quickly, that were in a place today but that can rapidly change, maybe not statewide, maybe just a handful of counties. Further restrictions is what we hope to avoid. But all tools are on the table. We have the top shelf of the tool box. We continue to use those tools. On the bottom shelf if necessary, we will explore further restrictions, but we hope todays actions, our collective coming together, our resolve to keep our protective behaviors up will help us stem the tide and bring these surging numbers down very, very soon. Again, some reminders of why were doing this today, why now. We want to keep the highest atrisk individuals safe. We know many people who might be out and about even between 10 00 and 5 00 are not the most vulnerable, not our oldest californians, not those with underlying chronic conditions. That said, we know that those who are out who might be enga engaging in higherrisk behaviors, that those infections can quickly spread to other settings. Maybe youre a worker who is out at night with a group of friends, outdoors even and you can track covid and you go the next day to work and it is passed on maybe not the next day but a day or two later to a vulnerable resident in a congregate care facility, exactly the situation that we want to avoid. Weve learned very clearly that its not just about our own personal covid risk, but its about a risk that we infer on others around us because of our choices and behaviors and actions. This is, of course, to keep essential workers safe as well. Those who continue to pick our food, sell our food, prepare our food and many other essential workers across the state, allowing them to come to work with confidence and safety, part of the reason why we do this today. We continue and havent over the last week or two, but its always front of my mind, the disproportionate impact of covid. As we see cases surge, that disproportionate impact still holds. We will see brown and black communities across our state disproportionately impacted, more latinos, more africanamericans, more of our asian neighbors infect ed beca d of some of those conditions of work and other situations. We want to make sure we do all we can to support and protect those populations. Frankly, this is going to help us stop the surge faster and avoid more severe actions and restrictions as weve talked about, and ever so important to remind you that our Hospital Capacity, although we did a tremendous job preparing and have those resources in place, some have been activated. Many wait to be activated, but we want to make sure we protect that Hospital Capacity so those who need care get it and get it in a timely way and in a way thats high quality so they get all of the benefits that they can. So california, as weve reminded before, we were the first state to do a stayathome order. We saw its impact back in march, those difficult days adjusting to the reality of covid. But that kept us ahead of the curve. While other states were experiencing high rates of rise and were working on flattening their curve and a transmission, we didnt really in march experience that radical rise. And just like then, todays actions will help us bring down transmission and flatten our curve this time in a very important and urgent way. This graph, we havent heard it in many months, but we showed you back in martha without an intervention we see these rapid rises, and yes, it comes down, but after a really important toll on all of californians, that without interventions we see high case rates, high impact on our hospitals, but with interventions, with the things that were emphasizing today, along with the many other actions that are already in place, that we can bring this curve down, we can flatten it. We can get it to a point where our Health Care System is able to do what its intended to do, which is take care of the sick in a high quality and complete way. I wanted to remind people because we, today ive already gotten questions, our own team talked about it. Why are you focused on the time period from 10 00 to 6 00 . Why are we not doing what we did in march as we have significant concern around surges. Weve learned a lot. Were a state guided by data and by science. In that data is a great amount of learning, focusing our thinking, our interventions in a way that allows us to be more targeted and do things not in all tiers, not statewide, not for 24 hours of every single day but more focused ways. What are some of those lessons . Its that masks do protect us, not only those around you, but the evidence is clear that they protect you as well. Moving things outdoors significantly reduces the risk of exposure and transmission. We mentioned it already here. We mentioned it for many months. Move things outside, keeping it short. Both of those things helps us reduce transmission. The whole concept of ventilation, about bringing outdoor air indoors, even in all right. Dr. Mark ghaly a curfew for california, the purple counties. Beginning this saturday, you should not be out between 10 00 p. M. And 5 00 a. M. In purple counties unless they are essential trips such as to the Grocery Store. This is expected to last through december 21st. You can continue to watch the live stream of his news tonight several developing as we come on the air. The cdc and what theyre now urging involving thanksgiving. Urging americans not to travel. It comes as nearly 200,000 new cases and nearly 2,000 deaths reported in just the last 24 whos. The cdcs alarming new prediction about the death toll by mid december. Authorities in new york city and across the country taking new action. In california issuing a new curfew tonight. Ohios governor warning hospitalizations are reaching critical levelings. Dr. Anthony fauci at the white house podium for the first time in months and reporters asking where is the president on this virus. What were now learning about a third vaccine tonight showing promise. Late today president elect joe bi