Degree iethan we had known. That indicates that the virus was probably introduced and circulating in our community again, far earlier than we had known. Autops samples from two who died on february 6th and the 17th were positive for the virus. A 57yearold woman and a 69 yearold man. The same for a third who died on march 6th. A 7oyearold man. The county first reported a death on march 9th as the first. Of course testing was extremely limited at this point. None of the people had any significant travel historrdg the Health Department so this points to community spread. One other thing of note from that news conference. Santa clara will record the race and ethnicity of all cases. New, napa changing and extending its shelter at home order. It allows with social distancing, construction, drive in religious services and landscaping gardening, not for cosmetic purposes, use of golf courses and driving ranges. The county order includes a strong recommendation that everybody wear face coverings when in public or shared spaces. The governorss press conference underway. Lets listenn. We laid out six specific indications that would guide our de based upon health, science, real data, not politics, not pressure. Those indicators created a framework for Decision Making that we committed to update you on, on a weekly basis. Today we will update you on those six key indicators that are informing our Decision Making as it relates to changing modifying the stay at home order. We will dive deep into one of those indicators specifically on the area of testing, tracking, tracing, isolating and quarantine. The doctor will make that presentation in just a moment. First, i wanted to set things up and create a context for this discussion. I deeply recognize, deeply understand the desire for people to hear directly from the administration, from the state and its leadership about the answer to when. When can we go back to normal a vast majority of you recognize that decision needs to be guided on the basis of the virus and its spread, decisions on the basis always first and foremopublic h the pressure to answer that question, nonetheless is very real. Nobody wants to be able to share that information more with you than i do. I wish i could prescribe a specific date to say when we can turn out the light switch and go back to normal. We have tried to make it clear that will no light switch and there is no date in terms of our capacity to provide the kind of clarity that i know so many of you demand and deserve. The clarity, however, we are providing today is the clarity of indicators that guide that Decision Making and the framework that allows us to organize around six specific themes and teams to every single damon for conditions on the ground. Its driven not by idealogy but uevidence and by the curation o best practices. Not just across the state, across the country but from around the rest of the world. We led with that first indication that we will talk about more around testing, tracking, tracing, isolating and quarantine. We included in five more indicators, considerations that we must around making sure we protect the most at risk. Our seniors and Skilled Nursing facilities. Nursing homes, assisted living centers, those that are at risk out in the streets and sidewalks. The homeless, people with compromised immune systems, we laid out that framework for the second indicator. How we protect the most at risk. The third indicator was around hospital capacity, Health Care Delivery capacity, not only with in the Hospital System but the creation and the opportunity to provide alternative care sites and facilities. Utma resources and the people and the protective gear to make sure that the Health Workers healthy and safe at the same time. We had a 4th around therapy. We talk about vaccines. We are uniquely positioned because of the National Institute of health in the state of california. We are blessed with some of the finest Research Institutions and hospitals doing studies and advanced partnerships in this state. Its its respectfully among the most robust of any state in this nation. Therapies, also is a category that guides our Decision Making. The issue obviously of businesses. Issues related to schools and physical facilities is another area that guides our consideration. Thats number 5. I made it clear in the past that we wont just open things. We will have to open things and modify how we conduct our business. How we educate our kids, how we take care of our children and we talked about four plans. Just a week ago and what that looks like in terms of practicing physical distancing is we begin to process the considerations for reopening the economic sectors in the society. Finally the issue of what happens if we over compensate. What if we get ahead of ourselves and we start to see a surge of new cases, hospitalizations, people in icus, what our capacity to reinstate some of the the paci project t spots and some confidence. In doing so and in you that doing so is appropriate and we will abide by those rules at the same time. Its not lost on us, trust is the most important commodity. Build that trust with you. 40 million to make sure we are continuing to practice social distancing, and abiding by these guidelines, recommendations and directives. We recognize we are testing that trust every day because of the deep desire for people too begin to know when they can get back to work, when they can go back out and recreate and enjoy the beautiful parks and beaches in the state of california. So, today we want to further that conversation. I want you to know you will be left [inaudible] if you woke up to this discussion and we are going to hear at we arreg doatday. D to making those announcements. We wont wait week to week to make those announcements. I am ready to make the following announcement. We have been working with our partners in Washington State and oregon, guided by their experts and guided by their examples and helping us to inform our own efforts here in the state of california. Based upon number 3 and the work we have done together in providing alternative care sites, the incredible work that the hospitals have done to decompress their existing facilities and provide capacity to increase surge and incredible work force thats been put together. We are in a position today to begin to pull back and lean in by beginning to schedule surgeries once again throughout not only the Hospital System but the broader Health Care Delivery system. These are surgeries that, yes, are scheduled but also are essential. Tumors, heart valves, the need for people to get the kind of care that they deserve. If its delayed it becomes denied. It gets delayed, becomes acute. Thats a health issue. So, beyond just the issue of the virus, we are working with our Health Directors and throughout the Health Care Delivery system getting them up and running. We will be thoughtful about how we do that. We will not over load the system at peril of not being able to maintain the surge capacity. We recognize any time we begin to toggle back and start opening things back up we have to look every day at the date a the dashboard of information coming back to make sure that we are adjusting to these new decisions and maintaining an understanding that we need to be aware about the intended consequences of es des ose ndar search availability if there is a large surge we are monitoring that. That is foundational in terms again of this dimmer, not light switch that we are advancing in terms of just beginning to shift things but recognize that the shift, that dial could be turned up or that dial could be turned back in realtime. This is for us a Significant Health first focus announcement today tobegin to augment the stay at home order. To do it with an eye on Public Health and making sure we secure the safety of our Health Care Delivery system. Caregirs, keeping them time. Vi that is the announcement we wanted to make today as it relates to changing that stay at home order which is determined by adaptiv expertise making which is focused on the indications giving us that green light. We wanted to talk about another indication. I referenced the issues of testing and tracing which will be foundational to our broader efforts to get to those othe when retail storesopen, eatiarm available again. Testing becomes foundational. I have a number of things i at while it at we have provided testing for 465,327 individuals, that not e to meet the needs of all of you and to meet our expectations as it relates to our capacity to begin to move even further in terms of augmenting and changing the stay at home orders. 465,000 plus tests have been done. We went from 2,000 tests on average a day in march, just a few weeks ago. We made announcements with the new Testing Task Force that committed to few ago d aractuat ,5 tesa day. Ghnow are about 16,000 tests a day. Forgive me for building all these numbers, perhaps confusing you but to say that from 2,000 at the end of march to now a goal by the end of april of 25,000 tests. 16,000 on average today. Get to 25,000 by the end of this month. Our goal is north of 60,000 tests a day. Thats part 1 goal. Thats a short term goal over the next number of months we want to have a minimum of 60,000 tests. We are hoping to get closer to 80,000. Its 60 to 80,000 is the framework. The minimum being 60,000 tests a day. Our entire pcr test, thats the swab based test capacity, instruments that exist in the state of california, if 100 were at full throttle and everything was tested because we had all the supply chains intact and ready to go, about 95,000 tests we could conduct a pcr test. These are not the serological tests. The pcr test, the swab based test that many of you recognize. The instruments have the capacity to get up to 95,000. We believe that we can quiet not only to 25 shortly but that 60 to 80,000 range with in your existing framework of expectation on when supplies are coming in, when more equipment will avail themselves and when more sites present themselves and communities all across this state. Thats Something Else i wanted to share with you. We are significantly increasing the sites of availability at the same time. We are increasing capacity with in the existing system. There are hundreds and hundreds of testing sites in the state of california. Well in excess of 600. There are 251core sites that really make up the back bone of our testing system in the state of california. We did detailed surveys of those 251 sites, about what they need to increase capacity. 50 to 55 of those that we surveyed said their number one need is swabs. Others suggested they need viral transport methods and the old media that is used to take the swab and put it into a little kit and send it off to be diagnosed. The diagnostic side less stress though always critical. The rna extraction, the reagents, substantially many of those roadblocks have been lifted. Still an issue but not as significant as half of those that were surveyed saying that its really now getting the speciman thats the biggertyci i just got off the phone with the president less than an hour ago. We had a very specific conversation about not just the survey but the need for swabs. A very pointed and honest conversation. The president secured and gave me the confidence that we will receive just this week a minimum of 100,000 swabs. Thats the ability to collect 100,000 samples. That will becoming to the state of california this week. He said then we will be provided 250,000 swabs next week. He said third week expect to see a substantial increase above the 250,000. That was a very good phone call. I want to thank the president not only for being available for a phone call at a moments notice but being willing to directly commit to all of us in the state of california to substantial increase in supply of the swabs. That will go a long way to give us all more confidence that we can meet some of the testing goals, he stretch goals and help the concerns around the it 2a 51 site that have reported a need for more swabs. That specifically is an advancement on our commitment to do more in this space. We have a second commitment that we are making public today to do more and thats a commitment to make sure all california residents are tested. What i mean by that is not all 40 million of us. That would be ideal but in every part of the state where we are not leaving communities behind. One of the big struggles we have had in the last few weeks of this pandemic is getting to rural and remote parts of the state and getting up testing sites and making them available. One of the other frustrating things is getting into our urban centers and making sure that we are getting into black and brown communities, and doing justice to people that are also under served even in these remarkablely enriched and well resourced communities. So, today we are announcing 86 new sites that will become operational, that are focused from a so cio economic lens, focusing on black and brown communities and on rural communitiesw. He have put together a heat map of the state where we define testing deserts. We to start to plug these programs into these sites. Edo the others optim serve and they are providing 80 specific new sites end to end testing, these sites will provide a kind of continuity that we need to advance our collective goals in this test, in this state to reach these testing goals. I want to just thank those two companies for authority rob ust conversations we have had and im pleased today to make that announcement that we are moving in that direction. In addition to that we made a commitment with Abbott Laboratories for 1. 5 million serological tests, 1. 5130 million facilities in the state of california. I caution people in this space as i have been cautioned in this space around serology broadly defined, the focus on antibodies. Its been a point of attention, with the Community Surveillance mind set that was done in early april. First by stanford, 3300 or so l in and then parship in southern california. Those tests got a lot of attention but they also generated a little bit of controversy about what they are and what they are not. We dont use the tests for diag in, ostics. Still traditional pcr, swab based test. Theres some open ended questions around the tests and antibodies and immunity. I want to caution people in the space. A lot of energy and excitement in this space. I share that energy. I share that excitement with the deal we made with abbott just on the 1. 5 million tests with them alone. I caution all of us as that information comes in, as more peer review is done in this space, that all of us start to understand while it can be helpful in terms of guiding our framework and indicating for reopening its not at this moment a panacea but it could be profoundly significant and we are certainly going to do our part in addition to procuring pcr tests. We will do the same to provide the serology tests to people alacross this state. Much easier test, these blood tests and much more capacity to deliver those tests but, again, our testing numbers are predicated on more traditional pcr tests at the moment thats the foundation to which we will build. Our foundation in terms of testing doesnt mean much unless you can begin protocols to track and trace. We in the state of california have a long history of testing and tracking and tracing patients. The history of tb, the have been running testing, tracking and tracing protocols for stds. Very robust tracing thats been done throughout the state of california and thats bassed. Hiv a lot of testing and tracing and tracking done in that space. I say all that to make this point. We arent starting our tracing program from scratch. You have trained professional workers and local Health Department that do this every single day. The question thats asked of us now is to do it at a scale that we have not seen but the good news again is all of that resource is enriched and exists and persists all across the state. We want to build bottom up on that work. What we have been doing is surveying not only the local capacity and work force but the ability to retrain and set priorities for the state work force. We have the Governmental Group that has been doing surveys of state workers to wil do differrkhelp supp and trac s. Ods we lieve wehave the capacity to build a army of tracers beginning a goal of 10,000. That is now our stated goal to train these tracers, get 10,000 people up and operational. Building off the local infrastructure, supplementing it as we can at the state level and supporting it to the extent with any volunteer work force. We want the professionals first to guide these efforts as these tracing is not just about numbers but quality. That quality, again, is about enriching the ne. We have a new Training Academy that we will be putting up online in this space to help support that work of those ten thousand individuals and we will get a data set that will allow us to track the trackers and track the tracing thats done throughout the state of california. We will start to organize it in a more central manner. 86 new sites, testing sites in Rural California and deep in urban california to make sure that we are culturally competent. Capacity to increase testing by multiples, aided and supported by the support today that the president offered in terms of our speciman collection. The capacity, again, to support that tracing, that will lead to questions of isolating which has to be regional and quarantine which is an economic issue as well which is part and parcel of what the doctor is here to talk more about. He will dive deeper into this space. I want you to know this space is one of six. Not all six are the same. All of them are important but this one may be among the most important in terms of loosen up our stay at home orders. That is why we felt today it deserved more attention in terms of our focus and socializing that focus here with you. Forgive the the length of that opening comment. Ly introduce dr. Galley. Thank you, governor. Good afternoon. Its a pleasure to be back with you. I want to build upon the explanation. Reminder of our six indications and to say a couple of more things. To focus on this concept of its not a switch. Its a dimmer. We are always looking at how quickly we move that dimmer. Understanding where we are with the data. Where we are with our preparedness and making sure that we have all of our partners including our to make sure we all move together. That we continue to look at different ways to build upon that information so that we in a responsible but swift way move the dimmer. We know the impact is great as we stay at home. Making sure that we do this great balance of projecting around coronavirus and focusing on broad health for the communities and our citizens of california. We also know that there will are a couple of issues that are must haves. You have heard us talk on a daily, at least weekly basis ability the pursuit of protective equipment, ppe. We know that we need to have significant amounts before we can move d with any of our plans to modify our stay at home order. The governor spoke about the great work we have done in our Health Care Systems to prepare with beds, ventilators, people, supplies, that is secure is a very important thing we continue to maintain so that we can safely and responsibly move forward with modifying some of our stay at home orders according to our phases. I want to say a deep thank you to our local public Health Departments. The directors, the Public Health officers in those regions for their great communication and effort working with us so that we have all of the local data, all the local thoughts on how we build forward avpuas the or stay at home dire us to rk oup ofthe indications. Those have been formed. Those are meeting regularly and reporting in each of those work groups has presence from our local Public Health leaders to make sure we take all of the information from across the state and informs our Decision Making. So it is its been wonderful week of progress and now i want to spend a little bit more time talking about that first indication. Our ability to monitor and protect our communities through our testing, our ability to do contact tracing, isolating and supporting those who are positive or who have those real wanted to remind you about the elevated care for the sick within our hospitals. We want to prevent infection of those who are at high risk for severe disease. We want to build the capacity to protect the health and well being of the public and we want to reduce the social emotional and economic disruptions that many of us are facing. So these indicators are really formed around these four goals. I want to spend a moment a little bit on our data. We have been telling you day over day, our numbers and hospitals, in icus, and as we look at these over the last many weeks, especially since we have instituted this statewide stayathome order, we see ourselves tracking in what we call our range