Colfax. This question is from the la times. Could doctor colfax explain why the surge would come in the next week or two and is that still plausible . Right now we have 279 cases of diagnosed covid19 patients in San Francisco. We have had three deaths. I cannot predict when the surge will come and how high the surge will be. Our efforts are to flatten the curve. We have taken early aggressive and science informed efforts to flatten the curve as much as possible. Over the next two weeks using the data from our community, the expertise of the scientists that we are working with, we will have a better sense where we are in that curve. I cannot speculate. If i could see the future, i would tell you right now what we need, where we need to be, where we will be in two weeks and what we will need to do to address that in two weeks. Again, from what we know today we are as prepared as we can be. We will continue to mon for the monitor the situation, respond to the rapidly changing situation based on Public Health priorities. That is where we stand today, and that is continuing to be where we will stand tomorrow with following the science and data and facts and being as prepared as possible. Thank you. Thank you that is the final question. This concludes our press conference. Thank you. The hon. London breed good afternoon, everyone. Im San Francisco mayor london breed, and i want to thank the press for joining us, dr. Grant colfax from the department of Public Health, as well as members from laguna honda and dignity. As you know, this is a challenging time for the people of San Francisco and throughout our country. We declared a state of emergency on february 25 of this year to begin the process to prepare for what we know was coming. As of today, we are at 172 cases in San Francisco. We see that continue to rise every single day, and when we look at states all over the country, we know that the early steps we took to not only be prepared but to ask people to stay at home has definitely had an impact on the numbers that we are seeing every single day. But we also know that as dr. Colfax mentioned on monday, it is still going to continue to climb, sadly, things are going to get worse, and its important that we continue to stay at home because it truly does mean that we save lives as a result. We have been working to make sure that we identify the existing resources that we have in our Health Care System and that we look to increase our capacity so that when that surge hits in San Francisco, that we are prepared, but if the numbers hit the way that they are going in a place like new york, there is really going to be a challenge with our system. And when you think about it, San Francisco has many hospitals, we have some of the best health care anywhere, but we are still in a situation that requires a significant rampup, and it requires the need for our state and our federal partners to step up more than they ever have before and to move faster. We see that there have been a lot of challenges with the federal government, but i am grateful for the stimulus package that just passed last night, and i am hopeful that that money makes its way to the people of this city so that folks can survive. But i also hope that it provides us the much needed relief in the Hospital System so we can prepare for the number of beds we clearly will need during this crisis. Right now, we currently have about 1300 medicalsurgical beds and 1200 i. C. U. S. We definitely need a lot more than that,. This is not as easy as opening up the bed. It requires that we have nurses, that we have doctors, that we health care professionals, and we have sufficient p. P. E. To keep them safe as well as support the patients that were here to serve. We estimate that we will need more. Its not a question, and were grateful to the governor for the work that he is continuing to do, but we will need more. We estimate that we will need about 5,000 more beds and about 1500 more ventilators to address this significant challenge. We know that its important to make sure that were ready, that were prepared, and we also know that if people continue to kocongregate on th streets, continue to meet with each other, we will not have enough beds, enough ventilators to support the people that we know are going to need them. Thats what this is about. Thats why youre hearing from all over the world to stay at home, to stay within your respective home with your respective relatives so that we can do everything we can to prevent the spread of this virus. We are going to do everything we can to get our Hospital Community ready, and it definitely has not been easy. We are doing everything we can to acquire a number of hotel rooms to help house those who are unsheltered and to help those who live in congregate settings, so they dont have to share bathrooms and they can shelter separately. We are setting up a system so that we can keep people apart from one another to prevent the spread, and this has been a real challenge, especially with our homeless population, and we will continue to have updates on our efforts going forward. I have continue to make requests to our state and federal officials. I sent a letter today to governor gavin newsom, as well as Vice President mike pence, the head of this task force effort, making clear what we need. This is not the first time weve made clear there is a significant need in our Health Care System, and i hope it will be the last; that they will significantly deliver for the people of this country. We need to be prepared to save lives. We need to be prepared to take patients right away, and we need to be prepared with the capacity necessary in order to help people. So i want to thank the Hospital Council and our great partners for continuing to work with us in the Hospital Community, the provide sector, the public sector. We are working collaboratively around the challenges that we face with testing, with p. P. E. , the challenges that we know will continue to get to a point where we are going to have to keep working together at this supporting one another because we know that, clearly, at this point, the numbers will continue to rise, there will be people who continue to need to be hospitalized. And i want us to keep in mind that we dont want to turn anyone away. Think about when youre out there, and youre socializing, and youre not social distancing from one another. Think about the reactions that could result from your actions that you or a loved one could go to the hospital and they couldnt get a bed at that point. So i ask the public to continue to cooperate, to exercise social distancing, to continue to be responsible for one another because we are in this together. We are all responsible for one another and whether or not this virus spreads more than what we are seeing. We can see a difference by doing our part. So i want to express my thanks to san franciscans who are enforcing the order. Were trying to do everything we can to outreach to individuals and businesses about what this means. The police chief and members of the San FranciscoPolice Department are out there, doing their very best to address challenges with crime and to educate the public as to why this is important. Everyone has a role to play in keeping our city safe and healthy, and i appreciate everything that you all have done and will continue to do to get us to that point. And so with that, i want to take this opportunity to introduce dr. Grant colfax with the department of Public Health to provide us with an update and the collaborative efforts between the San Francisco department of Public Health and our Public Hospitals and the hospitals that exist here in sfrichk. San francisco. Thank you, mayor. Good afternoon. I am dr. Grant colfax, director of Public Health for San Francisco. Over the last few weeks, mayor breed and several bay area counties announced an unprecedented order, requiring residents to stay at home in order to slow down the spread of the coronavirus. Since then, many other counties and the state of california have issued the same instructions, as have multiple places across the country. I want to take this opportunity to thank everyone who are taking this order seriously, and as seriously as this situation calls for. Your efforts to stay home and maintain social distance is and will save lives. I want to emphasize that. Social distancing is and will save lives. I know there are people out there who would lead you to believe that our efforts are too aggressive, but i cannot stress enough just how vital they are. As of this morning, San Francisco has over 170 confirmed cases of coronavirus. Just three weeks ago, we had two. We expect these numbers to continue to rise rapidly, and sadly, we have now reported our first death from this disease. On behalf of the department of Public Health, i extend my condolences to this mans loved ones, and i am sorry to say that the worst is yet to come. And yet, we are preparing, as we have since the very beginning of this emergency. The hospitals in our city have tried to empty as many hospital beds as possible to make room for the patients that are coming. Currently, there are about 1300 staffed regular beds across all San Francisco hospitals, and about 200 staffed i. C. U. Intensive care unit beds. These beds have appropriate staffing and supplies today to care for all patients who need that level of care, including coronavirus patients. This number of beds could handle an initial surge of coronavirus patients, as well. In less than two weeks, we expect a surge of people needing hospitalization, so our goal now is to, again, flatten the curve so fewer people get sick at once. This will reduce the likelihood this will reduce the likelihood that our Health Care System gets overwhelmed. The last thing i want, we want, is for those who need care to not be able to access it. Every hospital in the city wants to care for everyone who needs help. Thats why we must recommit ourselves to staying vigilant and only leave our house for essential reasons. Again, the community depends on it. Now, as we are preparing for the surge of coronavirus patients, i want you to know that San Francisco is working hard on an unprecedented and unified response. Our work is being predicted and modelled on the potential disease spread and our interventions. It will help us develop scenarios based on information, science, and facts from San Francisco, the nation, and bay area. We are working with some of the worlds top experts, scientists, and epidemiologists, including those at the university of california berkeley and ucsf. We are lowering the number of patients in our Health Care System and admit to hospitals. We need to continue to make room for a surge of sicker patients. As ive said, and the mayor emphasized, we have ordered all san francis san franciscans and bay area residents to stay home. We have restricted visitors to hospitals, longterm care facilities, and residential facilities to protect the health of vulnerable populations. These are by health order. We have cancelled or postponed elective surgeries and routine medical appointments and moved services to telephone and video conference. These are being done under a health order. We have provided places other than hospitals for people with suspected or confirmed cases of coronavirus to remain safe and isolated to free up hospital beds and hospital staff. We have ordered enhanced cleaning of s. R. O. S, expanded shelter hours, and more meals served to shelters and Navigation Centers to improve the health and safety of vulnerable populations in an effort to further reduce hospitalizations. The second effort in getting ready for a surge of coronavirus cases is the work that all san franciscans are doing together to increase capacity. A new floor just for coronavirus patients is being readied at st. Francis Memorial Hospital that is being staffed and equipped through contributions from st. Francis, zuckerberg San Francisco general, and ucsf. Weve made the hiring of d. P. H. , department of Public Health nurses faster and easier, and this has already resulted in adding over 80 new nurses to this collective effort. We are obtaining more supplies and effort when we need it most, including personal protective equipment or p. P. E. And we are growing our capacity to test. We are now processing dozens of tests a day and waiting only an hour for results. Our top priority is our patients, our community, and the people who care for them. I want everybody in our community to know we are doing the very best we can to be the very prepared we can be in fighting this disease. But i must look across the nation to new york city, and i continue to be concerned. It is plausible that despite all these efforts, we could have a scenario similar to the one that is playing out in new york this very day. If that happens, our capacity, our Surge Capacity will be far exceeded. Look at what is happening in new york. An excellent medical system, superb scientists, frontline brave courageous nurses and doctors, and even the ability to respond to normal activities is being overwhelmed. In that situation, we estimate we will require over 1500 ventilators and 5,000 additional medical hospitals, and chair of the Hospital Commission for San Francisco and hospital counsel of San Francisco. Thank you. Good afternoon, and mayor breed and dr. Colfax, thank you so much for your leadership. As chair of the hospital, id first like to thank all of our caregivers in the city who keep our city safe. These are unprecedented times that we are experiencing together, and it has never been more of a time for our hospitals to work together, and i am grateful to be here in San Francisco where many of our hospitals have a long history of partnering together to keep our citizens healthily. Like many other states, cities, and hospitals around the world, we have shifted our focus to care for those with covid19. St. Francis is proud to devote an entire unit to that. We, too, are supporting social distancing. We are encouraging our employees to work from home whenever possible. Were supporting social distancing as much we can within the hospital and encouraging our patients to see physicians through virtual visits instead of in person when thats possible. A Public Health issue of this magnitude must be addressed with creative solutions. The hospital has been working to identify these solutions since the very beginning of this crisis. No one hospital can do this alone. The only response is a collective response, and im grateful that this collaborative effort to create a dedicated center for covid19 patients will help ensure hospital cares available to anyone who needs it. It applaud the care of the city and county of San Francisco, zuckerberg health, and the mayor has the necessary foresight to prepare for whatevers coming our way. Working together, we will beat this pandemic. Its my pleasure now to introduce mark lehrer, the president and c. E. O. Of San FranciscoPublic Health. Thank you. Thank you, dr. Cline, 20 seconds, but i wont take the full 20 without talking. Mayor breed, i want to thank you for your courage and your leadership, setting an example for this nation in getting in front of this virus and taking actions that will hopefully help us flatten the curve. And dr. Cline, i want to similarly thank you for your actions, to be aware of the issues that were facing and helping us through that. One of the greatest strengths of San Francisco is our sense of community. When theres an issue, when theres a problem, we all step up together to face it. We have a long history of doing this across all sectors, and today i want to talk about particularly how the Hospital Community has stepped forward to address the issues that dr. Colfax just outlined. We know we need vastly more hospital beds. We know we need vastly more testing capablity. We know we need Testing Health visits, and over the last few weeks, hospitals have dramatically increased the number of tele physicians have dramatically increased the number of telehealth visits. Today, for the first time at ucsf, we took more patients in telehealth than we did in person, a true moment of recognition of an important change. Every hospital in San Francisco is doing its part. Kaiser was the first to have a drive through testing center. Sutter health, cpmc, is looking at ways to expand their capacity. Chinese hospital, the v. A. , everybody is looking to see how we can further address the needs of our particular community. At ucsf, we are planning to reopen our mt. Zion hospital to expand our capacity by at least another 50 to 60 beds, but i particularly want to talk about st. Francis medical center, because dr. Cline showed extraordinary leadership to say, we will make space available. We dont have staff, we dont have administration, we may not have the supplies to make this happen in time, but thats where all the other hospitals in San Francisco stepped forward. And led by dr. Susan ehrlich, led by the president and c. E. O. Of San Francisco general, we all got together and talked about how we can contribute. Weve made a 1 million contribution dedicated to that unit. Sutter health and Chinese Hospital are all stepping up and trying to help in any way they can to help make this unit a success because as we all succeed together, it benefits us all, but we all have to come together in order to achieve that. Let me just say, too, that ive spent a lot of time talking about, thinking about silver linings. I mentioned that were doing more telehealth appointments than ever before. But members of the Health Community in San Francisco are working closer together than maybe they ever have. Theyre all working together to figure out how we can work together, share resources and services to provide wellbeing to all of the members of the community. As dr. Cline mentioned and dr. Colfax, weve been tapping into resources that we didnt even know we would ever need. The brilliant people at u. C. Berkeley, working with our scientists at ucsf on modelling, the Chanzuckerberg Biohub initiative has been an enormous help in making equipment and expertise available in improving our testing. Scientists at ucsf working on not only new testing approaches but also new treatments. And most of all, i want to acknowledge our Strong Community of supporters. People interested in making sure that San Francisco is always a Community People who stepped forward with contacts, people who have stepped forward, taking their n95s and depositing them in a place where they can be used by health care workers, and people who have made financial contributions to get us through this difficult time. We must flatten the curve. We must get in front of this epidemic. We are going to face very hard times in the coming weeks, but if we do the basic things that dr. Colfax talked about wash washing our hands, keeping our distance, and staying home, we can do our part to help this community succeed. So thank you, and ill turn it back now to mayor breed. The hon. London breed so thank you, everyone, again, for your partnership and support and everything that youre doing to get through this crisis. At this time, we want to open it up to questions, and i want to acknowledge that we have here with us, as well, the department of Emergency Management director, mary Ellen Carroll. We have the police chief, bill scott, is here, and the director of the department of Human Resources i mean, human services, trent rhorer, is here. Okay. Im going to go ahead and call on you. Dominick, San Francisco chronicle, question and followup. Can someone talk about the mechanics of the unified plan, and whos calling the shots as these resources come in. Thank you. The hon. London breed so i think either dr. Mary Ellen Carroll or dr. Colfax, either one of you want to address that . Okay. Thank you. Mary Ellen Carroll, department of Emergency Management. So we are centralizing resource acquisition and purchasing and distribution. We are working hand in hand with the department of Public Health to identify the resources that are needed and to make the appropriate purchases and also request for aid through the state and the federal government. The Public Health department will be our link to our partners here to determine the overall city needs. All of that will be centralized here through the Emergency Operations center, and we will work through our existing system in order to ensure that we both are aware of what our needs are, what our burn rates are, as we use it, and where we need to come in where our gaps are. Dominick, do you have a followup . Yes. Just a question about the modelling. With new york sort of being the test case, if you will, or something thats fed into how San Franciscos plan came together, can someone just speak a little bit about how the modelling works or how much input would be needed if San Francisco starts to look more like new york state. Thank you. So thank you. This is grant colfax. So the model has been developed by