Issue for us. Its a key issue, as you know, across the country right now within our Public Health lab under the direction of dr. Susan philip and theyve done an amazing job of implementing testing. Our capacity is relatively small and theyre having to prioritize testing the people who are most in need of testing, requirementy symptoms in the hospital, at high risk for firstdegree exposures and then healthcare workers. So were really focusing on those flee populations 03 thre. To give you an idea of how our daytoday is going right now, were injecting a capacity of a days worth of test or at the best, a weeks worth. And so were getting tests delivered to us by the cdc in the very challenging fashion because were simply not able to be assure ed this either w assuh tests to last for months or to expand our capacity to run 24 hours a day. So thats within the dph side. Within our Public Health lab side. Were also working with private labs including Quest Diagnostics in our Health Network and that, again, is a dynamic in challenging. Quest lab turnaround is three to four days and were working to ensure that we get people tested who need to be tested. Other Test Companies are telling us they dont have the capacity to except other tests and so forth. Another part of this that were working on are the partners with the ucsf, theyre developing their own tests and its exciting and i think its a key part of the puzzle. Theyre working with global limitations with reagents. So, for example, on friday, i was informed that ucsf was going to be able to perform hundreds of tests a day, not just for gph, but through the ucsf system but then today, im told they cant get started because they dont have sufficient reagents. So they have the tools. So there are multiple different strains of testing and each strain has its own inherent challenges. We have such a National Shortage of supplies and i have to say that we were short of things like swabs. Were short of things like swabs. So i have asked not only within the Health Department but assistants from the controllers office. We brought ito develop a citywa citywide approach so that were actually able to have a full visibility in terms of what tests are available, who theyre available to, that we have a shared tracking mechanism and we know how many tests are done, not just the number of positives and we move forward in a coordinated way and theres still support from the city to ensure that were moving forward in any fashion that helps us all to do better for the people of San Francisco. So thats our fourth priority which i added to our list this morning. Is the citywide testing plan youre trying to develop, would that include the private sector hospitals, as well, or just the county and ucsf . No, were trying to so right now were doing a Rapid Assessment of what is happening across the city because what happened was, some tests became available. Theres activity and different groups are doing Different Things and everyone is trying to solve the problem, or how theyre trying to solve it and were doing a whole Needs Assessment across the city of all institutions. Were looking at privates. Were doing an assessment of whatfwhat philanthropy can inved were trying to decide is it scaling something up or is it because they dont have basic supplies in order do the testing and so on and so forth. If we can, were trying to get to a point were trying to determine who gets tested and thats a real challenge, right . But we know that if we could test everybody, that would be in a way thats meaningful and systematic, i think that would be the ideal setting and thats what im calling the south korea model, right, because theyve just rolled out testing in a huge way. We are the city that essentially has done so much of that with hiv. So thats our model. Ive brought in a Key Global Health expert and her first day was today who has worked with the Clinton Foundation and w. H. O. On pediatric testing in africa and this is her full focus and shes working not only with gph again because i knew the gph people on the ground doing the work, but shes working with other city departments. She would bring in analysts and managers, project managers and people go out and find this information. Dr. Green. Thank you so much, grant. Do you have any sense of timing on this . Because a lot of patients have heard about the kaiser drivethrough and think theres Something Else or they can go to kaiser and i think theres a Similar Programme that you know better than i. But at this point, cpmc has been vocal, theyre not in the outpatient business and some of their physicians staff are not employed and they dont know where to get tests. Were getting really deluged with questions and some, perhaps, do deserve to be tested. In general, think, the primary care people who arent in a system like kaiser could really use some advice and some directives from the dph, because the systems have been very nonspecific in the recommendations and even in their guidance. All of people are showing up in Emergency Rooms, at least in ours, and the mixes with people may be positive which makes you worry about spreading the disease further. I know that was a lot of question comments. But what do you see and how would you recommend that practitioners get information and talk to the patients as they see the numbers mounting . So as were working to get full visibility and who theyre testing across the city right now. Evacuee been very clear at dph that if people have questions about have symptoms or questions about getting tested for covid19, they should call their healthcare provider. Those Healthcare Providers have act eaccess to information abouw to get tested. How to find out information about testing. The Healthcare Providers will get counseled whether the patient their calling for, whether that patient qualifies for dph testing. They would have to fit into the three categories because we have to prioritize who gets tested. That is the reason were developing this broader testing plan, is in order to address the questions that you have. Im concerned about people going to Emergency Rooms or Urgent Care Centers who are not sick to get tested. The other message we keep putting out, please do not go to emergency room or urgent care unless you have an illness and need to go. Evacuee been pushing that out ad were committed to working with our partners to make sure they have that message pushed out, as well. In keeping with dr. Erogons advice, i would like to ask we wrap up with the last one or two questions here. Is there a commissioner who has not posed a question that would like to ask something . I have one question and this is commissioner gerato. If any of thin any of the figure there been children or adolescents who have tested as positive . I have not heard of that case in pediatric and i dont have numbers in terms of young adults but we can provide that for you. Director kolfax, speaking of children, for parents with children who are out of school and may have questions about the safety of childcare settings or, also, whether or not its advisable for them to schedule play dates and anything like that, is there specific guidance were offering . Yeah, theres specific guidance on our website around that. Dr. Chow, you had one more question briefly . Yes. It was more actually a compliment to the department and website and to reemphasize that dr. Kolfaxs point that the department has a great deal of information and evacuee been wen making use in our medical group and weve been encouraging that patients be able to look it up and i want to compliment the department for having put out clear directives and keeping it very up to date. So those that may be watching and listening, that those are important resources and to, again, emphasize as it does, that you dont rush off to the emergency room and you dont necessarily have to get tested and theres some really good documents on that website about the issues of how to care for people on the providers side and then how to actually be cared for on the consumers side. And so i want to thank the department for that, too. Its been very useful. Thank you. I think we all associate ourselves with dr. Chows remarks. Dr. Kolfax, anything to add before we move on to the next item . There was a question before the homeless population. I want to emphasize that that is a big concern of the department. We are working with our partners at hsa and hsh at the department of homelessness in support of housing to do everything that we can to best protect and care for the homeless population. They obviousl are part of the ve population to covid19. Im in th not aware of any experiencing homelessness. We know from data from dr. Margo and others that the physical that the medical age of people who are chronically homeless is 20 years older than their chron logical age. We are establishing places for people who are experiencing homelessness who are under investigation or covid19 positive i just wanted to go back to commissioner green about the providers. I wanted to assure you all that we have a liaison to the San Francisco medical society ensuring that private providers are getting the information they need about testing and how to manage their patients and work with their patients going forward. Were also issuing a health order this afternoon that will ensure that only people who need the most urgent or Emergent Care will be seen in offices going forward. Is there specific guidance were offering to people who are hiv positive in terms of their being a part of a vulnerable population that needs to take specific measures . So we dont know how covid19 interacts with hiv and whether its additional risk factor, especially for People Living with hiv who are suppressed versus People Living with hiv who are immunosuppressed. Were following cdc guidance gus and fits into the vulnerable population going for other chronic diseases. Thank you, director colfax. Commissioners, if we could move on to the next item, which is the joint Conference Committee that occurred today. We met before this meeting and we got an update from the administrator on the situation and status around the coronavirus orders and things that are being taken that seemed quite comprehensive and very well put in place. So we were glad to hear about that. And i believe that can be shared. If others are looking for that information, particularly the information. pause we asked for a flex status which asked for the reclassifications of some of the beds to accommodate the population needs there. There were rehab beds and dismiss beds and the rest of the time we spent on reviewing the regulatory report which included the recertification survey that happened recently at laguna honda and other facilityreported incident events that have been surveyed. I wouldnt necessarily go into the detail but that information is available to the other commissioners. Any questions for the commissioner filiarmo. I skipped the item 6, which is the Health Commissioner elections which are important to your leadership. So lets go to that, please. To the office of president , do we have nominations . Dr. Ch o chow . I would move dr. Dan grenell. I second that. Mark, would you like to call a role call . role call . And thats it. Movinmoving on to the electif Vice President , a mo nominationf Vice President . I would like to nominate dr. Laurie green. Ill second it. Second. Ok, i will need a role call. role call . Thank you to my fellow commissioners for your support and the faith you placed in dr. Green and myself as your officers. These are extraordinary times that we hadnt foreseen and i am certainly grateful for your leadership and the expertise you bring to the commission. Also, i would like to thank mayor breed for her decisive leadership to keep us ahead of the curve to the extent possible, certainly calling on our citys experience with many other Public Health challenges, very proud of the decisive actions that San Francisco has taken to help stem this crisis. Also, very grateful for the leadership of director colfax, dr. Etcand others weve been heg from and want to provide whatever support they need to do their jobs to confront this challenge and then, also, a special thank you to our Excellent Commission secretary, mark moorewitz for his leadership and work to keep our commission operating, as well as working with our technological team. Thank you to you for making this meeting possible to be virtual. And finally, just thank you to our commissioners for, of course, modeling good Public Health citizen behaviour and joining here virtually and also thank you to the people of San Francisco for your abiding by the orders being put out by the city to ensure we all ban together to keep San Francisco as safe and healthy as we can. Dr. Green, is there anything you would like to say . Well, you said that so eloquently. Of course, its a huge honor to be a part of the executive group and i would echo all of the thanks. I just cant imagine what its like to be in the shoes or Population Health division. I know people are being redeployed in areas that they havent been working in. Everyone is being so diligent and i think we will be an example for the nation of how to do this right and hopefully, we will save many, many lives and continue to respect our entire population, the equity of San Francisco and really be the shining example for the country and we may be underresourced in items, but overly abundantly resourced in still of our individuals and the people part of this department expect citizens of this city. Its a real honor to be a part of this and im so grateful. Thank you, dr. Green. I look forward to working with both of you. Item 9 is a consideration for a closed session. Second. Thank you. I will go through a role call vote for the closed session. Role call . role call . Because this is the first time were doing this, we will not be coming back to say goodbye, but after the closed session, we will simply ajourn and in the future, well have this worked out better but thank you for your patience. So everyone online, please push n and commissioners, you are invited to the closed session meeting and you can use that phone number to call in to that and the code. Text me if you have any questions. Thank you all. Thank you, mark. I am the director of the department of Emergency Management here in San Francisco. Thank you for being here. I just want to remind everyone about the priorities of San Francisco. Our priorities are to protect the health and safety of those in San Francisco. That is our most important responsibility. This is a constantly and rapidly changing situation we are working hard to flatten the curve the disrupt the spread of covid19 and protect community health. Finally, we call on all those in San Francisco to do their part to help protect our most vulnerable residents by staying at home, practicing good hygiene, checking on people by phone if possible who might be isolated. What w we are doing at our Emergency Operations center is we are working closely with all city agencies, many represented here to support the direction of the department of Public Health. We are also supporting essential City Services that need to remain open. This includes supporting essential personnel, making sure they have the resources to maintain regular cleaning and helping understand how to implement social distancing. Finally, the eoc will continue to support efforts to shelter and care for people impacted by covid19 and vulnerable populations. Before we move on, again, i think the most important thing to share with folks is that this is evolving, that we may not have all of the answers to questions, but we want be to hear the questions so we can work those and turn those out to folks. We know there are a lot. I will turn it over to director Jeffrey Tumlin from s. F. M. T. A. Good evening. I am Jeffrey Tumlin, director of transportation for San Francisco. As you know, Public Transportation is an essential government service. It is how our nurses and firefighters get to work, it is how our residents get groceries and prescription drugs. We will be working hard to ensure that Public Transit continues throughout this Public Health emergency to ensure that people can get to work and get the services and supplies that they need. We are working to rearrange services to decrease the amount of financial district express service in order to reallocate service to neighborhood lines and to lines that serve our Critical Healthcare facilities so passengers can better maintain social distance while on the bus. For the health emergency, we will eliminate service on the cable cars and f and e lines to protect the health of our operators, ensuring that on all lines that we are operating our operators have a partition between their operating cabin and the rest o