Sorry about that. Hello, everyone. Thank you for joining us today. Just a friendly reminder for those who are joining us for the first time. This platform is only for members of the press. If you are member of the public, watch the live stream on sfgov tv on the youtube channel. Keep yourselves on mute and also keep your videos off as well so we dont distract from the remarks. If you have any questions at the end, i do want to let everyone know we do have a hard stop at 11 30 to be mineful of the directors to be mindful of the directors time. If you have any questions, please submit them to us by chat and well receive those questions and try to submit as much as we can with the time that we have. Please remember to give your full name and outlet and no more than two questions. And depending on time and the type of question we might take it offline as well. Thank you, all, if for your patience, and i will pass its on to you director colfax. Well, good morning, everyone. Im dr. Grant colfax, director of health for the city and county of county. Tos today im going to provide an update on the covid19 pandemic in San Francisco looking at health ind kaytors and other data. Unfortunately, we are experiencing a surge in covid19 infections that is affecting our communitys health and our reopening plans. As a result, we are forced to continue to pause our reopening plans until conditions improve. We are, we have been, and we continue to be in a period of uncertainty, and i want to acknowledge that is a really hard place to be. We all need to continue to do what we know works. We can flatten the curve and we can do it again, but if we do not, the consequences could be dire. In terms of where we stand today, both locally, regionally, and nationally, in San Francisco we have 4,696 cases diagnosed of covid19 and sadly, 50 deaths. In the bay area region, approximately 37,500 cases and 667 deaths. Across the state, 346,000 cases and over 7,000 deaths, and across the nation, cases and deaths continue to rise. 3. 4 million cases and nearly 137,000 deaths. The virus is not only still out there, it is out there more than ever before. It continues to spread locally in our community and throughout the bay area region. We are working with researchers who are seeing the reproductive rate of the virus continue to claim above 1. Right now we estimate that that number is now approximately 1. 3. That means that each person who is infected with covid19 is passing the virus on, transmitting the virus on on average to more than one person. It is key that we get that reproductive number to 1 or lower. It is key for us to move forward. Now, 1. 3 doesnt seem that different from 1, that far from 1, but if we do not do better, we are looking at major problems by late august and september with an average peak an average peak of 900 hospitalized patients by early october. And just to put this in some frame of reference on the last surge in april, we peaked at 94 cases. This average scenario of 900 cases is nearly 10 times worse and it is certainly not the worst Case Scenario that we have by that time. Models show that we could have thousands of hospitalized cases by then. Todays tracker show that there are 92 covid positive patients in San Francisco hospitals. That includes 76 San Francisco residents and 16 transfers. Lets look at the Health Indicators we are using to monitor our covid19 response in the city. These are available on the San Francisco data tracker, and you can reach them from our departments website. They are scored by color. Green, yellow, orange, and red to make it easier to see at a glance where we stand and theres detailed Data Available for people who want to dig a little deeper. Right now the indicators show that we have reason to be concerned. Our cases per 100,000 and the case rate has increased to 7. 7. That is in the red zone. Our goal is to keep the case rate around 1. 8. We are red. In terms of our Hospital System, the rate of covid19 infections which really represents the slope of that curve that we work sod hard and successfully early on to flatten, that rate is now increasing at a 33 rate. That is red. That is cause for grave concern. Our goal is to keep that curve increasing by less than 10 . Our other hospital indicators are thankfully still green. Black is our capacity to take care of people across the nine Hospital Systems in the city. Right now we have 27 of the acute care beds available and 28 of the intensive care units available. With regard to testing, our testing indicator is green. We are coveraging 2,950 test day across the city. With our that is far exceeding our goal of 1800 tests. Certainly as we are seeing across the region, across the state and nationally, our testing system is experiencing delays in access and getting results both within our city system and with private providers. Our numbers are high at 20,950 in the green range. With regard to Contact Tracing, we are at level yellow reaching 85 of cases and 85 of contacts. We expect that that indicator to turn orange this week due to delayed test results reporting and our increases in cases. The Contact Tracing team is working hard to catch up and will continue to expand staffing of that program. In terms of our personal protective equipment or ppe, we are on level orange with 78 of the Health Department having a 30day supply of ppe. Im sorry, let me rephrase that. Across the Health Department, we have our ppe supply is 78 . Our goal is 100 . We are experiencing some issues in terms of obtaining ppe likely due to the increased National Demand for ppe supplies. San francisco and the challenges across california the virus is spreading at Dangerous Levels and this week the state announced a roll back with additional restrictions for counties on the states watch list. Approximately 30 counties are on the monitoring list as of today including several in the bay area. We know the bay area region is an interdependent region where they live, work, and play across and covid19 knows no county lines. If any county in the region is in trouble, we are all in trouble. That is why a regional approach has been key ever since this pandemic started, and we continue to be in touch with the hub area officers sharing data and solutions to keep all the communities as safe as possible. And it is certainly possible if our conditions do not improve, a roll back may be necessary in San Francisco in other parts of the bay area as well. Whether thats a roll back through local action or through state determined access rules will continue to be watched. But this is a tool to control the situation and we have always known that this is the possibility given the unprecedented situation in the uncertain situation we continue to face. No one wants to be in the situation were in. And as we look at the rise in cases, many of them are because the people have started to gather with friends and family and others to socialize. And i realize how hard these months have been for us and the sacrifice that all of us have made. These visits are really hard to resist but the truth is that they are spreading to covid. The birthday parties and visits with parents or grandparents, cousins, the barbecues, they are contributing to a delay or rollback in reopening of businesses or even the first day of school. Another key behavior that we all need to do is cover our faces indoors and outdoors when people are around you who are not part of your immediate household. This is critical. Research shows that masking significantly lowers the rate of transmission and 80 of people wear them. Adherence to facial coverings and masking is so key. One cannot tell by looking at someone if someone has covid19. We know that people are asymptomatic at some stage of their disease and they can transmit it when they are asymptomatic and being safe and wearing facial coverings and social distancing and using good hygiene is key to our success. And the simple act of wearing a mask will slow the spread of the virus and lead to lifting shelter in place restrictions. For those who are wearing masks, we are truly saving lives and those who are not taking precautions, you are not helping. The situation is becoming more serious every day. Please wear a mask and do not gather. Stay 6 feet apart. And wash your hands. These basic acts will make a huge difference if we do this together. We have flattened and we even crushed the curve before and that curve is now escalating and we all need to do better. And until then, our real thing is on pause. And until then, our reopening is on pause. We are not able to open up personal services, indoor museums, aquariums, outdoor swimming pools, Indoor Dining, outdoor bars without food, real estate open houses, and other activities that encourage people to gather and make it harder to wear a mask and social distance. And while it is hard to slow down the reopening and that we all want so badly and the price we pay for moving too quickly is very high. Remember, this virus has no timeline. That is why it is up to us and now is the time despite very curious numbers that i reported to you in terms of our hospitalization. We have a window to make a difference. We can still drive that number to one or lower that reproductive number by the interventions i just went through. We have a window to do this and it will make a huge difference in our hospitalization rates and the number of lives saved. We have shown that we can join together to make a difference, and we need to do it again. Truly, the power is in our hands. And even in the Uncertain Times we know for certainty what are the right steps that we need to take. We can have a thriving city with the healthy population and a renewed economy if we work together. Thank you. Thank you, dr. Colfax. This should be better. The first question and i do just want to say to everyone joining us today that we did receive another question and we will take them in the order they were received. And any others that we cant take in time we will simply take offline. Thank you for your patience. Dr. Colfax, the first question is from christian captain. Can we please explain the role schools could play in the state of covid19 infection rate . The School District announced that students will be Distance Learning when School Resumes august 17. Theres been a lot of talk on federal and local level about local kids getting back on campus. What will it take to get San Francisco kids back. One thing it will take is for us to be confident to reopen schools safely for the buildings to reopen, and certainly we are going to need to see a decrease in that reproductive rate and continue to follow the data and science to ensure that the support systems are in place and that people are able to physically distance and that the most vulnerable are protected in the settings and emphasizes the need to have the safety protocols in place and followed using the best evidence we have in terms of transmission. So we will make the decision about whether it is safe to reopen the physical spaces depending on where we stand with the virus and where with our surge in the city when the time comes. Thank you, doctor. Next question, the governor issued new order this is week to try to wrestle the california surge back under control. The order includes statewide closures of bars, Indoor Dining and other activity but those werent happening in San Francisco anyway. What places or events are currently the main source of infection and how are you in addressing the sources . We think it is a combination of factors and increasing the number of cases in the city. And there is clearly increased activity in terms of social gatherings that people are having and we really need to insure that people are taking the precautions and not making those and not having those birthday parties and barbecues moving forward as much as possible. And focussing on the prevention, education, and neighborhood by neighborhood and street by street and going to be so critical. And we are reinforcing the work with Community Partners to insure Community Champions that people have the resources and the knowledge they need to be safer. The other key components of this are that we continue to see infections among essential workers and we think that may be do to certain work place conditions that safety precautions are not being followed. We will be looking at that and enforcing and increasing our oversight and enforcement required precautions and the Health Orders that have been established and we will also be looking at the existing businesses and looking back at the data and potentially what is on the table for that. And i will also add that we have known since the beginning of the pandemic that crowded conditions that promote the spread of the virus and really again working with Community Members and multigenerational households to ensure and getting people tested and taking precautions to protect themselves as well as their family members. Thank you, doctor. Is the country considering the Outdoor Dining and reverting to takeout only as a way to reduce gatherings . Are there plans to cite businesses for Health Order Violations in your counties . We are taking one thing that is clear from the data is indoor activities are riskier than Outdoor Activities overall. We know that the virus spreads more easily and more quickly in indoors than outdoors. And we are taking a look to determine whether this increase in cases is driven by some of the Outdoor Dining and Outdoor Dining and we think this is more due to the noninsurance of some of the businesses rather than rather than the risk thats taken and the relatively smaller risk that is there and if the proper precautions are taken. And outdoors and dining and drinkings and not adhering to the masking and social distancing rules and is at a higher risk. And looking at increase in enforcement and in businesses and institutions and focussing on individual enforcement and enforcement of individuals but really looking at the potential enforcement of institutions and businesses that are not complying and doing the enforcement and the institution and right and Small Businesses are not able to necessarily comply at baseline and what can they do to improve their compliance and support and workers to be more safe during the challenging time. Thank you. Next question, doctor, are you ordering residents to stop gathering outside with masks if groups are keeping to under 10 or 12 people . So at this time we are encouraging people to minimize gatherings as much as possible, to wear a mask if you are in close contact with others and to socially distance whenever possible and certainly if people do better in these small groups that they gather outside is much, much safer. So those are the key components to this right now. And we know theres a lot of need to improve that appearance to the facial coverings of the social distancing. I think we know and we have seen particularly when people know each other and good friend or family members but not members of the immediate household, it is ward to wear a mask and keep socially distant. We want to hug people and we want to engage. We dont want to think a loved one who is not a part of the immediate household or good friend may be infected with covid19 which is why we really need to get the messages out and support the communities most affected by covid19 to drop this reproductive rate below 1. Thank you. Next question. How will the Current Situation effect decision to reopen indoor pools for summer camp . So we have put a pause on any additional and include outdoor pools at this time. Thank you. Next question, and what surge sites are ready to be set up and the Hospital System reaches capacity and when will that be done . Right now we have Hospital Capacity per indicators and again you can go to our website and see that capacity across the nine Hospital Systems and we are in the process as we have been a number of weeks preparing for a greater surge and i want to be clear here. We all need to do our part so that we dont get to that point. We have seen when this virus overwhelms Health Care Systems such as in new york city as it is now doing in arizona, florida, and the southern part of this state the outcomes are poor. Theyre much poorer while we have had 50 people die in San Francisco of covid19 and that is too many and one death is too many and our death rate is significantly and bend the curve here again and not overwhelming the Health Care Systems to move forward. Thank you, doctor. How will the city enforce the latest orders . Im sorry. I missed the first part of the question. Last question from San Francisco chronicle. How will the city enforce the latest orders . So we are working across the city to strengthen our enforcement capacity, and that will be a culmination across different cities and Department Agencies including the Health Department and the city attorney. If people see violations the violation of the health order and businesses and call 311 and make a report and send people out to investigate. Thank you, dr. Colfax. This concludes todays press conference. For all of you joining us today, we took the questions in order and the number that they were received and all other questions will be taken offline in the interest of answering them. Thank you for joining us today. Thank you. Hi, im chris manners and youre watching can the coping with covid19. Today im going to talk about some of the steps that you can take to stay safe as we slowly lift our restrictions. Keep wearing your mask when youre outside your home. Theres a board consensus among medical professionals that wearing a mask will help to contain the virus. And in california youre now required to wear a mask in public or in highrisk settings such as when youre shopping or taking Public Transit or seeking medical care. Not being able to see your friends or family is hard, even if you are Video Conferencing with them. Limited socializing is now okay, but keep the number of people to a minimum to be safe. And try to only spend time with the same folks. Getting together with people indoors is much riskier. So meet up outside, instead of in your home. If you dont have a backyard, choose a park thats nearby. Many of the parks in San Francisco now have social distancing areas on the grass so you can maintain a safe space. And take disinfecting wipes to sanitize anything that others may have touched. Unfortunately, shaking hands and hugging are still out with the virus. And these days a thumbs up are much safer ways of acknowledging somebody else. Some restaurants are now allowed to serve food outside. If you do choose to dine outdoors its safest to only sit with people from your own household. Make reservations at the restaurant and arrive on time so you dont have to wait too long. Many restaurants cant serve food outside because they dont have the space. So dont stop ordering food for pickup or delivery you if you can afford it. Purchase multiple items each time that you go to the supermarket. Its probably the place that youre visiting that has the most people, so minimizing the number of trips that you take is a sensible choice. Remain in a minimum of six feet apart from people not within your house hol household is very important. Maintain a safe distance from others. Finally, keep watching your hands. Moving the virus from your hands to your face is one way that you can get sick. Fortunately, soap and water kills the virus. So regular handwashing will help to keep you healthy. Heres a quick recap in response to the pandemic and our current restrictions are changing quickly, go to sfgovtv to review the most uptodate guidelines. Thats it for this episode. Remember that the virus is still with us. So be careful and stay safe. You have been watching coping with covid19, for sfgovtv,