Clerk mr. President , all members are present. President yee okay. Thank you. Will you please join me in the pledge of allegiance. [pledge of allegiance] so id like to acknowledge the staff of sfgtv, karina and michael, who record each of our meetings and make the transcripts of the meetings available online. Madam clerk, is there any communications . Clerk yes, mr. President. On march 7, 2020, a Citywide Health order was issued by the health order, issuing aggressive recommendations to slow down or reduce the spread of the covid19 virus and protect the health of general populations. During the call for general Public Comment, i will provide more comment on how the department of Public Health is encouraging more participation remotely. Thank you, mr. President. President yee thank you, madam clerk. Colleagues, as you know, we are not operating on a routine process in the state of california and San Francisco. I want to remind everyone that the board of supervisors is an eventual government function and will be open for business. We will prioritize the scheduling of business and items that have statutory deadlines, but well also be placing protocols to adhere to the safety guidelines. Im going to do something a little different today. Lets start off with an imperative agenda item. We have here dr. Tomas aragon, who i would like to invite to speak on this Health Emergency and the health order itself, so dr. Aragon, are you here . Hes not here, so i wont take it out of order. Hopefully, hes not at an emergency. Okay. Lets move on. Colleagues, today, we are approving the minutes from the february 4, 2020 regular board meeting. Are there any changes to these Meeting Minutes . Seeing none, can i have a motion to approve the minutes as presented . Made by supervisor peskin, seconded by supervisor row anyone, and then, without objection, these minutes will be approved after Public Comment as presented. [gavel]. President yee dr. Aragon . So basically, were asking you to explain what this order is about and what these requirements are so my colleagues know that this is basically not a duplication. Okay. Im sorry for being late. This is item 33, and i was across the street watching television and i heard my name called, so i rushed over here. So one of the challenges that we have in Public Health as a Health Officer, when there is an immediate emergency, sometimes a Health Officer needs to declare a Health Emergency, and this law was written around the type of situation where if for example, if there was a hazardous spill, and theres no time to get approval, and i need to declare an emergency right there immediately, and so this law was only written to work for seven days, and then, it would have to have approval. So thats the basis of how this law was initially was designed, if something needed to be done immediately. Specifically, in addition, it provides additional things that allow let me read this to you. Grants immunity to Certain Health providers, doctors, nurses, health and respiratory therapists, including nongovernmental employees and hospitals for following the directives of the Health Officer, authorizes disclosure b by the Health Officer to any information of local agencies and to anyone provide treatment. It also has here that it allows us to really focus on everything that has to be done really has to be focused to health. It has to be justified. So the decisions that weve made long Mass Gatherings along Mass Gatherings, prohibiting anyone from coming into longterm care, local Health Emergency is very narrow in scope. Its not like a local emergency, which is much broader in scope, so this is very specific to health issues. President yee okay. Is that it . Supervisor peskin . Supervisor peskin supervisor yee, and dr. Aragon, if you want to catch your breath, please do so. Oh, thank you. No, im okay now. Supervisor peskin insofar as we are in uncharted waters, you, we all know, are not the chief of d. P. H. , but you are the Health Officer. Correct. Supervisor peskin i assume youre n youre what youre reading to us is not local law, but state law. Theres 58 jurisdictions but 16 health jurisdictions. Supervisor peskin and can you just tell us in addition to what you ju us, in addition what you just read us, what the scope of your Emergency Powers are . What can you do, what cant you do, what requires the mayors concurrence, what requires the boards concurrence, and under what time frames . So under the authority of the Health Officer, it occurs at the county level, and its only its state were unique because this would be for the unincorporated areas, and then, they would determine whether they want it effective for the cities. Under the Health Department, theres a lot of brought authority. The statement is something you can do whatevers necessary to control a Communicable Disease. Obviously, in the world, you cant do everything. Were going to did the least restrictive to do the least restrictive measure thats going to control a Communicable Disease that restricts individuals and protects the community. Supervisor peskin so youre telling me that or us, during the duration of this crisis, we will have to renew this on a weekly basis, is that correct . No, it can be renewed similar to the local emergency for a 30day period. Supervisor peskin got it. And i dont want to put you on the spot, and but i think it is important to put on the record mayor breed issued a declared a state of emergency, which this board concurred and ratified. Is there a reason that the Public Health emergency did not follow until 6 march 2020 . So heres my understanding as a nonlawyer, and in speaking to other Health Departments and ive written what has been read for other nonlawyers when you have something thats this big, you might have something thats very local where you need to focus on a specific site. But Something Like this is so broad sweeping, it affects so many different sectors of our whole county, you do need a different emergency to mobilize all of the assets and cut through all of the bureaucracy that you would need to deal with the covid19 epidemic like what we had. As the epidemic continued, we really needed to step up and we realized that we needed to cancel Mass Gatherings. In consultation with the City Attorneys, we have to be very specific in terms of why were doing something, and that would help be the foundation for these other Health Officer orders that come after this. As far as i know, this is the first time that ive been involved in this big of a process, so im learning along with everyone else. Supervisor peskin you and me both. So and by the way, i dont know the answers to the question that im asking you. I think were all asking the same questions, and im not trying to put you on the spot, but the order that you issued the next day, on 7 march, did your emergency did you have to issue the Emergency Declaration before you could issue the order as it relates to social distancing and other orders that you may be issuing in the days and orders ahead . The way i think about it it was guidance that we have from the City Attorney . I do Health Orders all the time around individuals, around tuberculosis, things that are very specific . But all of a sudden with longterm care facilities, to keep visitors out of longterm care facilities that, by law, they have rights to, it was good to issue an emergency and follow up the local Health Emergency would be the foundation that gives you the rationale for everything, and then, the orders are specific. So thats my understanding. Supervisor peskin got it. So it sounds like you have the power to issue orders, but given the Emergency Declaration, you can tier off of that declaration in the orders that one of which you have ordered and others that are being issued or being contemplated. As to that order that was signed by you on saturday, 7 march that preceded us cancelling a large scale event in this building and Everybody Knows about this. Its in the media. So is there a reason inured to the chief Health Officer of the city and county that you have not made orders governing large venues that are not under the jurisdiction of the city and county . So youve asked a good question . This is where cities around the country are adapting to a growing situation . We know from evidence in china and everything going on there, if you pull if you do everything the more aggressive you are, the more impact youre going to have. And the question is how do we do it in a way where were going to have impact but minimize any unintended consequences, and i think thats the challenge. And i think in the United States, were adapting and learning how to do that. So for example, 12 midnight, santa clara county, theyve decided to even be more aggressive than San Francisco, so they have cancelled all public and private events for 1,000 or more. And of course, were now having those conversations, thinking is this the strategy that we need to be to do regionally . And so these are the types of discussions that were beginning to have now because theres no play book that tells us what to do for this situation. Supervisor peskin so doctor, we have a few lawyers on this board. And im so grateful for the lawyers. Supervisor peskin as mayor breed and i have discussed, we as elected officials who are not medical professionals defer to you and your colleagues if there theres epidemiologists. Im really not trying to put you on the spot, but when youre in a situation like this, and youre elected to this job, we have a profound responsibility. So when you give the medical you are urgence to this situation. If we had a 1,000person event in this building on saturday night that are much more pertinent than things that are happening tonight, how do you reconcile that, and what is your best advice, sir . Youre asking me a question thats a very good question. What were doing is that were looking at the evidence that exists, and were taking core Public Health measures . We know what the core Public Health measures are, and were activating those that we think are going to make a difference without if we dont have to activate everything, that would be the best scenario. In general, i can sort of give you the big concept. The big concept is we know were in the midst of an epidemic, and these Community Strategies that exist exist because theres no treatment or no vaccine. What were trying to do is were trying to push the epidemic curve over, and were trying to lower the epidemic curve. Its not just to lower the illness, disease, and death, but it also gives our time to purge our medical system you see whats happening in other countries to be prepared for the surge of people that are going to be coming in. The question is how much of these triggers do you pull to do this . It can be and theres this whole spectrum from what youre seeing in china, is they not only pulled whats every single trigger, but they closed off a whole region from travel. No one can thank you very muco can come out. So we look at that, and we use the tools that we think are going to work continwithin the context of our county. Supervisor peskin okay. Doctor, i will yield the floor. I do not want to be argumentative, but the thing with china is they did too little too late. What im trying to get you to say i want you to be aggressive, but at the same time, we dont have a whole lot of hours or days left to talk about this. So you still havent fundamentally answered the question why were cancelling city gatherings, but were not using the power of your office for one specific thing, and that is Communicable Diseases. Before the City Attorney gets too excited well, it is kind of a scheduled item, because it is an imperative item, and shes not getting too excited yet, to exercise that power when it comes to consistent power, as well. You need to be aggressive and at least speaking on behalf of one member of this board, ive got your back, sir. And i truly appreciate your support. Whenever we do anything like this, we try to bring everybody along . And sometimes we move a little bit, and sometimes we move farther, and your support means a lot to us . I think were learning from other counties that are being impacted, and we will take this into consideration and your position means everything to me. Supervisor peskin time means everything. I dont want this community to become seattle, much less wuhan. And i want to thank everyone on the board because all of you have been wonderful. Ive been so impressed with the amount of support we have been receiving. President yee so i see that theres other supervisors that want to chime in at this point. This just wasnt meant to be a section where we are going to prolong this. We do have this item at the end of the meeting, and i want to give a reason why i did this up front, because dr. Aragon, like most of the medical folks in our city, are very busy at this point, and i didnt want him to just sit here and wait around. If we can and the mayor has to leave, also, and i know she has a bunch of comments that i would love for everybody to hear. Real quickly, im not going to call the rest of the people in the roster. Im sorry, and i just want to say that, like supervisor peskin, you know, that i also personally will have your back if you make those declarations, okay . Thank you very much, dr. Aragon. Thank you again. President yee okay. Colleagues, madam clerk, lets go to our 2 00 p. M. Special order. Clerk item number 1. We welcome the honorable mayor london breed present in the chamber today in a policy discussion with members of the board from district 5 and 6. Two minutes are allotted for each question and its answer. There will be no Public Comment, and the mayor may address the board for up to five minutes. President yee okay. Madam mayor, do you have any opening remarks . By the way, im aware of some comments that the mayor was going to address today. She was going to cut them off at five minutes, and i told her no because of the importance of them, so i used my power as president of the board to extend this. The hon. London breed thank you, president yee and members of the board. I want to take this time to update the board on the steps were taking against covid19. The decisions that were made were based on the recommendation from our Public Health experts, who we know are among the best in the country. We declared a state of emergency and activated our emergency center. Theyre working around the clock to reach vulnerable communities and prepare the public. Just yesterday, supervisor peskin and i announced Additional Resources to support our residents that rely on shelters, resource centers, and singleroom occupancy hotels. Increasing cleaning and accessing additional meals to keep individuals safe and to limit the spread of the virus. Today, i announced additional steps to provide new spaces such as r. V. S for people without homes to quarantine themselves should the virus become active. We are working with our hospitals and medical staff to make sure we can take care of people in need of medical attention. Events are being cancelled throughout the city to contain the sprayead of coronavirus. And i appreciate supervisor peskins comments to go further. I know these steps are a serious disruption to our economy and way of life. While it will have a major impact on our Small Businesses, our workers and the tourism industry, its important that we work with all of our departments to create a plan, in addition to addressing what we know are real challenging Public Health concerns, we also have to deal with the Economic Impacts of this virus. I have been working with the Controllers Office, the Business Community, and nonprofit partners, to make sure that low wage workers impacted by our guidelines can be supported to cover the cost and the loss of wages. This goes beyond our Public Sector workers, and people like our hotel workers, our nonprofit workers, will be impacted, so we need to be prepared. Were looking out for our Small Businesses and the workers they reply to figure out how we can sustain them throughout this uncertainty, especially for people who may not have sick leave or the ability to provide daycare for their child. Were examining everything from tax extensions and Penalty Relief for our Small Businesses to working with our state to expand unemployment and disability benefits, to partners with our large businesses, our Financial Services and our Philanthropic Services to provide low interest loans and