Refocus our energy, sense of purpose, and optimism and faith that will get through times challenging, times like today. Difficult moments that all of us are working through. To reconcile the world were living in, to reconcile the need to pay our rent, our mortgage, to understand whether or not we can educate our kids at home with all of the other burdens, challenges that we face within the household and where we are going as a state and as a nation. The old addage, we are nothing but a mirror of our consistent thoughts. Whatever we tend to focus on, we find more of. And if you are like me, you are focused on the nightly news its a of xiety running week. Through ose oadcas. A lot ofthis induced. Focusing on what this nation and the world is doing to meet this pandemic head on. That stress is manifest. That stress is real. And all of us work through that stress differently. No one can moralize how some people deal with it verses others. Some people are coping quite well. Others are struggling, understandably. Struggling to because they lost their job and they dont have a paycheck. Struggling because their kids are not at school. Struggling in ways where theyre having a hard time sleeping. Where theyre a little bit shorter. A little bit more irritable. And they are prone to doing things that are not healthy. They may be drinking more than they meanjust adult beverages. High sugar drinks. They may not be taking time to breathe. They may not even be taking time to reflect on their own health. And the need to exercise. To hydrate. And to focus on reaching out and embracing someone else or frd saying, kn . , calling a can i recognize. We all recognize the nature of this moment. I just want folks to know that staying at home doesnt mean youre alone. That as a state, we are here to do what we can to support you. And to be there at a time of need. Ive tasked thee Surgeon General of the state of california dr. Harris burke to put together a strategy and a protocol to help support you and to support care givers that need the peer to peer support. A little psychological first aid themselves to get through the day and continue to thrive, not just survive in terms of the workload as they are taking care of people all throughout i ha asked to nsider the physic needs of californians in the context of addressing the issues of this virus, but the brain health needs, the Mental Health. After all the brain is part of the body. There is nothing to be ashamed by recognizing your own limitations in terms of the stress and the angst that you may feel. In fact, there is probably no one stronger than when he or she recognizes those stress points. So we are putting out guidelines. We are putting out guidance. Not only to our health plans in the state of california both on the private side and on the public side our medical system, but we are also putting a play book together for you. A checklist. As adults, as care givers, but a checklist for our children. As everythingjustsaid is translated very differently into our children. Our children are not able to communicate words like this. Boy, im completely stressed out. Not a young child. Maybe a teenager, but not a young child. They may have a tummy ache. They may not be sleeping as well. They are particularly irritable. My daughter a few weeks ago she threw her bed over because she was so upset when i told her its likely that she wasnt going to go back to school and see her friends this school year. Everybody man tests this differently and our children are most vulnerable because they are not able to communicate as effectively as many of the adults and care givers. So we have a play book for them as well. A checklist for our children as well. And we have resources. We have on casite we have 16 hotlines we have made available including text chat lines where people can address their particular needs as it relates to domestic violence. Intimate partner battering. Were seeing increasing in times of stress. And the need to get help. You can call that hotline. Elder abuse. We obviously have to take care of our seniors. We have a hotline for that. Child abuse. We have a hotline for that. Teens, teens feeling deep emotional stress that are feeling in crisis. We have teen crisis hotline. All of these things available in many, many languages. Its up to 170 languages in some instances. Lgbtq and their unique challenges. Across the spectrum supports, Substance Abuse, alcohol abuse, all of those hotlines. All of those resource sites are available on covid19. Ca. Gov to help support you during these times of needs. There is also a concern and i will ask the doctor to come up in a second around secondary health effects. We talk about your physical health making sure we stay at home. We practice social distancing. We continue to do what we must in terms of personal hygiene, washing our hands, and the like. But its also true that stress hormones prey the kind of anxiety. It impacts your blood pressure. It impacts your heart. It will increase the likelihood of a stroke. It can impact your diabetes. It can certainly impact your sense of well being and depression and the like. So the secondary Health Impacts are a big part of what were also looking to respond to. And that is, again, the purpose of the guidance we are putting out today and the incredible work that our Surgeon General has been doing to integrate the Behavioral Mental Health side of the world and the Substance Abuse side of the world. She has been working for many, many weeks to put together the guidance that we are putting out today and to meet these challenges head on and to be there and extend a hand for you at this time of great stress and need. Let me just ask her to come on up. Surgeon general we are proud to have our own Surgeon General. But her expertise has been and continues to be Trauma Informed Care. A world expert in this space. And she is bringing that expeise tohelp address this moment so all of us can work through that fear and anxiety as we all are capable of doing with resiliency and the capacity to adapt in the moment. With that dr. Burke harris. Thank you, governor. The actions were all taking to slow the spread of coronavirus, physical distancing, hand washing, wearing problems are critically necessary. While we keep our physical distance, our social supports to maintain emotional and Spiritual Connection are more important than ever for our physical and Mental Health. The Health Impacts of coronavirus go beyond infection and covid disease. It is important to recognize that stress related to the pandemic that many are feeling right now compounded by the economic distress due to lost wages, employment, and financial assets. Plus School Closures and sustained physical distancing can trigger the biological response. During times of heightened stress, our body makes more stress hormones including adrenaline and court seoul. And these can effect our health, our behaviors, and our emotions. Over activity of the stress response can be associated with a variety of symptoms. Some of which are familiar and others that are less well known. Familiar symptoms include changes in sleep and appetite. And increased risk of Substance Use and dependence. And family violent. Headache, abdominal pain and digestive asthma exacerbations and increased risk of infection are also associated with an over active stress response. Its important to know these changes are not just in your head. And to begin to identify how stress shows up for you, physically, emotionally, and behavioral. Individuals that have a history of trauma or adversity may also be at greater risk. The good news there are simple ways, simple things you can do every day at home to protect your and your familys health. Safe, stable, and nurturing relationships help to protect our brains and bodies from the harmful effects of stress and adversity. Healthy nutrition, regular exercise, mindfulness like meditation, good sleep hygiene and staying connected to our social supports and getting Mental Health care all help to decrease stress hormones and increase our health. We have brought together evidence guidance in the you are ongeneral play book on stress relief. And additional play book for care givers and kids that offers practical tools and tips that you can add to your daily routine. Weve also developed guidance for health plans and Health Care Providers on addressing stress related Health Concerns during this pandemic including how to implement Trauma Informed Care and supporting provider resilience. That information is available at asaware. Org. If you are concerned about the effects of stress on your health, call your doctor or he professionalneed visit the emotional support and well being page at covid19. Ca. Gov. Thank you, doctor. And the Surgeon General will be available for questions in a moment. I want to remind everything. We are bigger than anything we face. So i know the fear and anxiety we all have but let us have faith. Faith conquers all and know this will pass. This will pass. Let me give you an update of where we are in the total number of positive cases in this state and sense of optimism in terms of the curve in california bending. It is bending but it is also stretching. I want to make that point anthe updated are currently tested positive for covid 19. That represents a 10. 7 increase over yesterday. Hotel, or rather hospitalizations in the state of california and icu beds, again, those are the numbers i look at first thing every morning, the hospitalization numbers went up to 2,611 yesterday. That is about a 4. 1 increase from the previous day. Icus went up to 1108. That is a 2. 1 increase over the course of the last 24 hours. 2. 1 will take. Of course, too many. We want to see that number go down, not up. But these are not the double digit increases we are seeing in hospitalization rates or icu rates that we saw even a week or so y stretch of the imagination that well continue to see these declines. Its so only reenforce the importance of maintaining physical distancing and continuing our stay at home policy that has helped bend the curve in the state of california. But that curve continues to rise, just not at the slope that originally was projected without the kind of interventions these nonpharmaceutical interventions like physical distancing have provided us inin that today, continue in that spirit to meet yes this moment, and to continue to do more to practice the physical distancing and social distancing that are required. There are, fortunate unfortunately 374 who have lost their lives. So that is the Progress Report in terms of the numbers. I want to remind everybody that this state continues to take advantage of every hour of every day. Every moment to make sure that we are prepared for any surge and prepared for the long haul. I talked about the curve bending, but also stretching. And that is why i just want to impress upon people, our modeling shows that were not at peak in a week or two that we are seeing a slow and steady increase. But its moderate. And its moderate again because of the actions all of you have taken in terms of the physical distancing. That moderate increase has allowed us to do what we did yesterday and that was to announce the 4,613 alternative care sites to help us decompress our Hospital System. Its allowed us tobegin to process the 89,000 people that have filled out the application on their health core website and begin to triage individuals and their unique expertise and capacity so that we can staff those alternative care sites. And procure more personal protective gear. Well have more of that tomorrow. I want to say briefly on the ventilators, i couldnt be more proud of the good work that my fellow governors are doing all across this country. And as a group and we couldnt be more a state to be sending those ventilators back east and just know that the first ones will arrive in new york and new jersey and illinois tonight. Two planes are going out with those beds back east and into the state of illinois. We have four other states that we will be sending ventilators to as well. I want to thank all of those governors for all the good work they are doing, all the hard work they are doing. And the constant engagement back and forth as we deal with different point in time in terms of the acuity of the covid 19 response. And they are certainly in those states dealing with a curve that puts deep pressure on their Health Care Delivery system. We are able to provide those resources and confidently know that those supports will be reciprocated by those governors and states unquestionably so. Again the spirit of this moment, the spirit of people stepping upped to challenge. I just want to end by saying, you can step up to this challenge, as always, by going to our serve. Ca. Gov website. Which will ayou to match your particular interest in volunteering your time. It could just be time to make call strangers to check in on them. Time to do a little bit of volunteering in our food banks. Time to donate blood. Time to find whatever your skill set is and to find a resource guide and map on that site to help match your particular expertise and willingness to help support others in your community. I encourage you all to check out that website as well. With that we are happy to take any questions and talk about the resource guides and what we put out in terms of all of these hotlines in terms of brain health and physical health. And i want to compliment andcongratulate our Surgeon General for all of her outstanding work and her teams work to put together a very sub cititive guide that has been deeply researched and deeply considerate to help folks deal with the very deep anxiety and stress they face today. With that, i will happily take some questions. After we wrote about a peak coming in may or the beginning of a peak in may, there has been a lot of questions from readers about why the stay at home order wouldnt cause that peak to happen sooner. Given incubation periods for the virus and so many people have been home for the last three weeks and not in the community spreading the virus. Im curious if you can explain why the peak would be coming in may. And also how many ventilators you expect to meet at that time. Let me ask dr. Gally who is here who has been working our models on a daily basis. We begin those morning briefs with those models. Thank you for the question. Thank you, governor. As the governor said we continue to look at those models every single day. We match them up, not just with what the model says, but what we are actually experiencing on the ground in our hospitals and icus. And we know that the bending or flattening of the curve means two things. It means our peak comes down. But it also goes further out. So when we hear about the various models suggesting that april is the time when we see that peak or really that peak rate of surge, we know that our efforts and congratulations to all the californians that are growing with us in that direction to flatten the curve, further out. So our thinking around may and late may means that it follows this idea of flattening. So its not just the reduction down. Its moving it out. The governor said it eloquently just a moment ago. And that is exactly what those models show. In terms of your question about how many icu beds that we might need, we know that we started with roughly 10,000 and that number of ventilators. And reno that we are looking to get somewhere between an additional 15 and 20 more to reach about 2530,000 ventilators in the state of california. We know that we dont need this at this moment. We see and are in communication with our hospitals on a very regular basis to insure that they have the ventilators on hand to take care of the patients who are coming through their doors. But we anticithose down the road in next month and in the month of june. Yesterday i made an announcement. May not have been piup by everybody. But buzz of the great work that has been done by our hospitals. All 416 hospitals in the state of california, they had originally assessed an inventory of 7,587 ventilators. They came back after repurposing, refurbishing and doing even more work to get ventilators within the system 3 from outside of the system. They now have an inventory of 11,036. That number is dynamic as they are ordering ventilators from sources across the country and the world right now. In addition we know that we had originally estimated, not estimated, we initially announced we 2 ventils that we liia. Tobe refurbished. We talked a lot about how they had gotten refurbished. And in addition to that, we have sourced a few thousand ventilators that are on their way that have been procured, checks have been cut, and we will be receiving the first shipment early this week. And that for all of those reasons we felt we were well positioned to lend those 500 ventilators to the states most in need. So that was the determination. We feel we are adequately resourced for the moment. Again in a Dynamic World where things can change but we are confident the number of ventilators we currently have in possession are adequate to the task in the very short term. I have a question about the 500 ventilators that we loaned yesterday. I just want to be clear on exactly what role california played in deciding where they would go. The Vice President yesterday said in the white house briefing, he laid out states he would go to. He did not mention new york, new jersey, and illinois. He may have misspoked but im wondering, did we play any role at all in deciding where those ventilators would go . We did. 100 going to new york. 100 going to new jersey. 100 going to illinois. Vice president was correct, ventilators are going to d. C. , delaware. Ventilators are going to maryland and likely nevada. So that was the determination. It was done through the collective wisdom of our partners at fema and i will remind you, we have Extraordinary Partnership with fema both from the acting director peter gainer and our regional director bob fenton. It was done in collaboration with their expectations in need of what was required of the moment on the upon that data and that collaborative engagement we made those determinations working together including with the Vice President and his task force. Hi, thank you. Im trying to get a bit of clarity on the number of open hospital beds that there are statewide. Not just the total that the system could handle. Is it thousands . Are we talking about tens of thousands of open hospital beds that are available to covid 19 patients. We know that l. A. County had about 1600 hospital beds. Including 300icu in beds available. Can you tell us how many statewide beds are open right now. We think that is a credit fall number. We have done an amazing job. The Hospital System has done a remarkable job at decompressing their own system. At a great cost to the Hospital System. Economic cost. But they have done a remarkable job at slack. And that is reducing the number of elected surgeries. Trauma is down because ed numbers are down and as a consequence, they have prepared. So we have surge numbers and then the slack, the availability within the existing footprint of those 75,000 licensed beds. Those numbers change on a daily basis. You referenced los angeles county. Might as well ask the former head of that county Health Department our hss secretary to fill in more details about the statewide numbers. So again thank you for raising what is increasingly an important number which is a slack in the system. Meaning, those beds that are available now to us that might not have been if the hospitals as a collective had done a number of the things that the governor has mentioned. And that he has urged them to do. To prepare for covid 19 surge. We know that in each region that there are hundreds if not thousands of beds available. We are working closely with the big systems to track that on a regular basis. To try to get that so we can quantify it. We dont have a clear estimate statewide. The l. A. Number has hovered between 14 to 1600. And that is in the collective Hospital System within that region. We expect that a number of hospitals are doing the same in terms of collecting that information. And that, that number will be made available. When the governor speaks about the need for 50,000 total beds cor slack bed e, we must capacity. And its not just available beds. It means bed in an available room. It also has to take into account a bed that has to map a patient in that bed. And all the equipment with ppe that goes with it. All of that must come together to nuance that total bed number in order for us to feel confident that, that is a space a patient can go during our surge planning processes. Next question. Governor, thanks as always. I have a question how this is playing out across the state. Obviously california a very big place. And a lot of geographic call and political regions here. We are hearing many are more resistant to some of these. Congressman nuance was criticizing you about this. Im curious, has that made at d is not on the same page but we have been enlivened by the spirit of collaboration and cooperation, broadly across the state of california. And i have been impressed, but ive also made the point, not only have i been impressed, but its exampled in hospitalization numbers, and the icu numbers. It has helped us bend the curve. I want to press the pond, people kicked important, the imperative of continuing physical distancing, and not taking their foot off the pedal. Not taking things for granted, not flocking, in terms of their own behavior. And not getting cabin fever. Which, trust me, its the reason we made the announcement today with our Surgeon General. Because we recognize no anxieties that people are facing check. Most of the state are doing a fantastic job. There are some pockets, not just enroll parts of the state, but some coastal parts of the state. And i will make this crystal clear, the expectation with the weather not turning, and the sun beginning to shine more brightly, and things warming up, that there will be ongoing