Live coverage on cspan2. Celebration is always december 7, in a year where we have new members of the california legislature. I will jump right in the tightest briefest possible and get to a number of the issues of the day. Particularly as relates to some of the regional orders that now are in effect in california but also wanted just to provide some context and some information about some new technology that will bring to bear. To slow the spread of covid19. Its been a lot of discussion around apps, a lot of discussion about how technology can advance our efforts to notify individuals can mitigate the spread of covid19 and address this pandemic headon. Two of californias bestknown headquarter technology companies, google and apple, have joined together in an effort to provide for exposure notification. Not Contact Tracing, right exposure notification. I want to provide you with a bit of information about what california is doing today to help support their efforts come a little bit about the work weve been doing with google and apple over the course of the last number of months with a Pilot Program particularly at our use these. You can see here that the california notified out we were putting out is about an opt in opportunity for individuals to participate in a notification protocol, an opt in. Not an opt out, privacy protected. This is not Contact Tracing this is notification technology. You can choose to participate in leveraging this technology to allow people that you have been in contact with or have been in contact with you to be notified of potential exposure related to the transmission of this disease. I remind you its 100 private, 100 , 100 secure, 100 voluntary. You opt in or you choose not to, and theres no tracking data, no location data that is shared as part and parcel of california notified whatsoever. These are foundational principles. The reason why is we value privacy. California has long been a leader in terms of advancing the cause and we dont want to do anything to set that cost back and thats what weve been frankly a little stubborn and kept her eyes wide open in terms of this technology. We dont want to jump in ready fire aim. We wanted to take time, reflect on this technology to be secure in our confidence that what were promoting, what we are stating here today is indeed accurate and thats exactly what we have been doing. Lets talk about the technology specifically. Technology will be available this thursday. You two platforms, apple and Google Android platform. The Google Android platform requires that you download california notify from the google place door. You opened up the outcome turn on the covid19 exposure notification. Its a very, i was a relatively. It is indeed a simple process. Go if you have Google Android, download the notification app from google play and you open the app and you turn on the notification. Ill tell you what it does in just one moment but i will remind you it is available this thursday. The apple iphone, writer, simple thing. Its already in the phone. You open up settings, scroll down to find the notification you can see on the slide specifically what is required in terms of the property you tap the turn on notification for exposures and you follow the prompts here it allows fundamentally bluetooth access and with these technologies, just except the terms. You tap turn on and thats it. Your phone now is prepared for notification. Lets talk about what this is. Heres how it works. Lets assume you are alice and bob, chatting, youre very close. You are not social distance, not physically distance. You are chatting for a number of minutes and your cell phones, because you opted into this technology, are automatically because of bluetooth exchanging what we refer to in technological terms as anonymous keys. You have a few days later, you determine, if you discover if you are alice that you tested positive for covid and you receive a code via text from the California Department of Public Health for the california notify. What does this mean for bob . If alice can sense for california notify to anonymously alert other users, that she has likely been exposed in the last 14 days, then bob gets notified and is directed to information with an alert that looks like the one you see up on the screen. You have recently been exposed to some test tested positive for covid19, that this prompt for more information. That more information will lead you to information thats been provided by the California Department of Public Health on what you can do next. So fully automated, often technology, not Contact Tracing, does not any way, shape, or form provide any of your personal information in any part of the process and protocol. And this is a pilot that now we are bringing to the state as a statewide opportunity that we have been engaged in september, specifically the pilot began with a ucs and we officially started with california, well, university of San Francisco and then expanded to more california uc campuses. Now seven different uc campuses. We expanded them to those campuses in november, over a quarter million users now and just in the last number of weeks, eight weeks, more than 60 positive test verification codes have been issued, giving 60 individuals have notified positive tests and been verified through the code process and been connected to the folks in the cloud come in the circle, people than they have come in contact with. Its confusing. Really isnt that confusing. Just encourage you to go to covid19. Ca. Gov website that covid19. Ca. Gov website to learn more about california notify and whether not its something that you want to add just additional tool in the toolkit in terms of your safety protocols. Thats what a store that slide of a physical distancing, wearing masks. This is a technological opportunity for you to add to those tools again available this thursday december 10. Opt in, not opt out. You will receive similar to what you see writer on the screen and exposure notification. This will likely go out on wednesday before the thursday application of this new available technology, this will just prompt remind you that you have the ability to utilize this technology if you choose. Washington state governor inslee just a few days ago i think last week offered a similar strategy. A number of other states have been the same way here in california the scale and scope, number of individuals obviously i can make themselves available themselves to this technology, this holds a lot of promise. I dont want to overstate it because you need to get to an application level that is significant for it to have kind of impact that would be profound. But nonetheless as as a you hae seen from the pilot at the ucs it has been effective, and even if we dont have tens of millions of people participating in this program, the more people that participate in it, the more that opt in, the more effective this program can be. Again, another tool in our toolkit in terms of impacting the spread and transmission rate of this virus. Now lets talk about new case numbers, 24,735 is what we reporting over the last 24 hours. You can see 70 average now moving up just shy of 22,000 cases a day. This is substantially greater than what we have seen in the past. Just over the last three days we have average roughly 25,000 cases, seven pages shy of 22,000 cases just in the last 72 hours averaging about 25,000 new cases a day. You can see here on the 14 day test Positivity Rate at 8. 4 . You can. You can see that rate beginning to rise. Just looking at the last seven days of testing you can also see our testing on a daily basis is also rising. 48 hours ago weve recorded almost 300,000 test over 24 hours come testing on a daily average over seven days. Nadja shy of 210,000 210,000 t. Would want to get those numbers up over 25 negative close to 26 million tests have been conducted in the state. Thats the highs number of any state in the country but not on a per capita basis and thats why those data test numbers continue to need to grow and thats why we encumbered, rather committed ourselves to opening state lab down in Southern California which is very timely, particularly now youre seeing what we experienced a number of months ago, starting to see Testing Backlog s. N. A. P. Across the country start to increase in terms of time to test results begin to increase, number of days beginning to grow. We of course in anticipation of that open our own state lab to get to 150,000 tests over 24 hours every day. That number continues to grow, as a set in the past more of a flywheel. Fly with if we dont wrap up overnight, 2000 test the first week 15,000 plus, a month to get up to 150,000 tests in the First Quarter of next year. Positivity rate just to put this in perspective at 8. 4 compares the 14 day. You can see would work just two weeks ago at 5. 6 positivity now 8. 4 . You can see that rate of growth is very, very acute. Decided to provide compares a 30 day look back when we were just a month ago, 3. 4 positivity pick you may recall that i sort of a magic number from a global perspective for the want to see rates below 5 to create some semblance of stability of course california we want to sit below 1 . We want to see this virus eliminated, but nonetheless we were 3. 4 just 30 days ago and how quickly and thats with this chart represents how quickly we can see these numbers climb, 10. 5 is the seven day Positivity Rate. That is an indication of where we are going. 14 days more modest at 18. 4. Thats a nice receipt received a 14 day since we started recording when we got into those summer months. Those early days he may recall, ill go back, the 40. 8 was back in april that was on the basis of a very small number of average daily test. You can see believe the stability throughout the summer with a little peak in july, a little bit in august and we started to come down september, october and that every go back up in november, 8. 4 Positivity Rate now in the state of california. Hospitalizations we are now over 10,000 patients in our hospitals, 72 increase over the last 14 days. You can skip quickly this grows on 1123 come just a few weeks ago we had shot of 6000 covid19 positive patients in a Hospital System. Now over 10,000 just like that. 72 increase in just working days. You carry that forward and you understand why we made the recommendations we did, making us that we did rather, last week as it relates to further controls, further rather protocols in terms of movement and behavior in the state. I want to put the hospital healthcare system, capacity overall into perspective. You can see here a slight very smooth for those unwatched these presentations, close to 74,000 hospital beds in our hospital care system. This is the healthCare Capacity, not our capacity outside the Hospital System itself. You can see 14 14 of our hosl beds, just 14 are covid19 positive, but 63 of all of the beds are being utilized for other purposes. As you recall, we stated this on multiple occasions in the past, these with a protocols wellestablished in the beginning of this pandemic, ability for the Hospital System to surge to provide access and capacity above and beyond those 74,000 beds, and also reduce by decompressing the existing hospital census of admitted patients by reducing elective surgery. You are seeing system by system, region by region doing just that. No mandate from above. Weve been working very, very collaboratively with the hospital association, a True Partnership with our system, and we have the ability realtime dashboard to monitor and engage to get a sense of where people are pulling back in terms of the elective surgeries, peoples capacity is approaching and need and concern to surge either within the existing footprint of a hospital site or more regionally in terms of mutual aid system that is welldefined in this state. So hospital bed capacity has always been a concern. We have raised that as a legitimate concern, particularly region by region, hospital by hospital, system by system within the aggregate we are currently in a position where we can absorb additional growth. Again its about icus and thats been our primary focus and thats why we highlighted icus last week. We highlighted in the week before and they were certainly highlighted in the last 24 hours for a number of new requirements went into effect in two regions in the state and then the voluntary requirements that were put into place any third region of the state. More on that in a moment. Lets take a look specifically at icu admissions in the state, now over 2000. Just at about 1402 weeks ago. 2360 2360 individuals have been admitted icus. Youve seen a 69 increase in icu capacity, rather icu beds being utilized just in the last 14 days. Lets put this in perspective. I have a chart that is very familiar but i wanted to provide a different lens on this chart. What weve done is you can see in the blue portion of this, thats patients already in our icu system. Heres our total capacity, the circle of icu beds come medical Care Capacity in the state of california. You can see now as the state, this is again in the aggregate, we dont live in the aggregate but this is in the aggregate. Icu capacity, whats available in our icu critical Care Capacity system is just 14. 2 of beds. Good news is you can see in the lower right ventilators available if the highest number weve ever seen. We have busily been procuring more ventilators to ocular specifics in a moment and thats important because the end of the day the and staffing become foundational engines our ability to deliver Critical Care. But you get a sense of why. If youre asking why did the state of california move forward with the trigger at 15 of iq and could icu capacity, while the focus of icus disproportionally. I hope this chart delays in anxiety as to the why and substitutes i hope with more optimism a frame that we are not only being proactive but we are also preparing, and i want to talk about that in the second but first lets update you on the regional stadium or that when it effect after regions fell below 18 of the remaining icu capacity to remember, california size size and scope of the state is with a population of 21 states combined. That so often is a case of the talk about other states, National Media and others, california issues considered like another state when, in fact, california in so many ways is unique and distinctive because of the scale and scope, the size notches the diversity but the Regional Diversity of california in particular, and in each region are different resources, different capacity and as as a consequence we have looked at five regions and not just one state, five regions where there is a connective tissue between literally and figuratively between the Hospital System and Critical Care system in terms of relationships and mutual aid protocols and a framework of proximity that advantages our Critical Care delivery. The regional stayathome order now because two region San Joaquin Valley and the Southern California region, the largest region, which in and of itself is unique you a sort of these regions have fallen under the 15 icu capacity. Lets take a look, look under the hood with those look like specifically. Heres your current ic capacity at least as of late last night. Each region again reflected in the map that i just showed and when we go back to the mac you can see Northern California, the area around sacramento where a i currently am, the bay area more concentrated, Larger Population center San Joaquin Valley, Central Valley, Southern California. Again bay area, current icu capacity is about 25. 7 . The bay area voluntarily and again remember the way we frame our approach to californias response to this pandemic is to allow localism to ultimately be determinative in terms of their approach and their engagement. No one better positioned than local health offices, local leaders to understand the conditions on the ground, trendlines they can mitigate an address before they become headlines. So the bay area moved but not pursuant to state orders, pursuant to their own local health orders. Greater sacramento has not moved at 20. 3 by pursuant to state orders to getting closer to 50 capacity to Northern California california a little bit better in terms of their current capacity based upon transmission rates and the Community Spread of covid19 at 28. 2 but you can see they can san joaquin San Joaquin Valley down the 6. 3 . Most populous part of the state, 10. 9 current capacity. Thats where we are as of this moment that we will be updating these slides later, the cd, early tomorrow consistently updating this information. But the issue that remains in terms of her focus and our attention is staffing, fundamentally staffing is going to be human resources, are going to be the most challenging well, most challenging for not just california but for every state to address, is how we get enough people that are not fatigued, that are not exhaustive, that we have asked too much from, theyre healthy and ready and available regionally, the right location with the right skills that Company Match the skill sets and we staff all of these beds. You have 150 albion and cnas to help with our skilled nursing, staff and Residential Care facility. Various needs including bra