And the commissioner knows our i will say baseline Behavioral Health challenges within the city. Those are only reinforced again by covid19. We are looking to use the hotels now and then we are also working with h. S. And h. S. H. To set people up in a shelter with broader support and more capacity to take care of people who are covid positive who are also lean towards developing capacity and facilities to care for people who are covid recovered. And once people move through the covid positive recovery and it is important to emphasize 80 of people do okay. So in the congregate setting, this percentage will vary depending on the population. The bottom line is we need to also support people who are in the covid19 recovery past the infectious period. And that is something that we have been keeping hard on with the Housing Agency and those are support questions and those questions. I have two questions with the manpower of the Contact Tracing and when you stated that you are hoping to get up to a capacity of 150 people of being able to do the Contact Tracing and when do you see that might be possible . Is question one. Question two, one of my concerns as we are Going Forward is you had just mentioned Behavioral Health issues not only during the crisis and as things ease up and longterm in the aftermath. With relooking at increasing xas within the Department Training . What are the is there planning now going on to be able to address these needs which are rather significant across all age groups . Thank you, commissioner. And we do have people identified to the City Attorneys Office has made available scores of investigators who will be training this with a way that is culturally appropriate and we have had remarkable interest in this program with scores of emails who want to join this effort. We will meet the 150 threshold fairly quickly. The other City Department wills go back to their other work. And we are doing aggressive recruitment and will fill that out. I meant to say in the presentation we are this pandemic has forced us to do things in new ways and build new teams and capacity faster than was even imaginable. And one of the things to acknowledge with the department of Human Resources and our new h. R. Director is we hire as many as 200 nurses in the last four weeks to strengthen the medical approach and applying it to the Contact Tracing, staffing and thinking that through. And also with regard to Behavioral Health, the acting director are the leads and thinking through not only what we need now and with the shelter in place which is, lets face it,s treatmently challenging and also what do we need to think through what is the intersection of the Pandemic Response so that should be part of one of the key colors that we build out. Thank you. I am most interested in the Behavioral Health because in my work the need is increasing significantly. Commissioners, any other questions . Hi. I had actually one or two questions and first, of course, i want to thank dr. Colfax who and with the show he does with the Mayors Office and the press conferences which he handles so very well. And thank you. I think you help show a very thoughtful and very compassionate department. Obviously also grounded as you continue to say. And the chronicle notes that you always have science right there and that is the type of image we all want in this type of crisis, so i appreciate that. I understood when there was a request of the jewish home that this was going to be a fairly selfcontained unit, so that might just be a simple yes, no, or thats not the way it works. And the new guidelines have seemed to come down also from the president ial task force and seem to ls a talk about as you are moving towards having, lets say, less Surge Capacity, would there be the opportunity to then other areas in an acute hospital that would be sort of selfcontained . Or perhaps certainly covid that is selfcontained. And second question since we are all giving two questions actually does relate to the sros and i wont get into the article that you i am sure have seen in the examiner that discussed the issue of a particular family in china town that was trying to reach some sort of accommodation by way of also the sro and all and that clearly operational level becomes sometimes very problematic with regards to how we would like to do things. I would like to know if what you mentioned and to help try to answer some of the questions with the patient privacy which is true on p. H. I. A with patients permission and it may well relate to how a patient then relates late we are their being discharged and needing to go home, or the patients relatives can certainly be some sort of way in which there is a dialogue because those patients would be interested in that. And the approach being taken and made it appear our department was not working together to protect those sros along with the availability of the housing that you have put together so well. So i didnt know if you would be able to give some comments on those. And i wanted to certainly have you have enough time to give us an insight into the future, whatever that may be. The information that i have is that the state, again, the state came out and visited the home. Did an assessment. And from my understanding from my understanding made the assessment that the home was meeting infection Disease Control guidelines and so forth for the state. And they authorized i want to be cautious with the words i am using but my understanding is they basically authorized the jewish homes plan and thought it was adequate to protect residents. Im sorry. I am running out of the battery. And in any case, thats the information i have with regard to the jewish home and the state with regard to their plans for covid positive. With regard to the sros, we have been very active as i iterated in my review with the community [inaudible] can you hear me okay . I think your wifi was going in and out, so like the last minute we didnt hear you. It was going in and out. Now we see and hear you. Director colfax, perhaps where you were standing earlier had better reception if you would like to move your plug. Well, also you can take off video to use less bandwidth if you want to do that. Is that better . Yes. We can hear you. Thank you. I was going back to i was responding to commissioner chows second question with regard to the sro work. Again, we have from te beginning identified sros as a key vulnerable population with regard to ensuring they get their resources to help mitigate the spread of the virus. We have an sro task force which is not only made up of Public Health teams and also other City Departments. We have been with the health order and with inspections and we have been effectively enforcing the sro order. And we reached out to the residents in multiple languages and offer people hotel rooms where they can stay and be supported with food and other basic necessity if they so choose to go into the hotel rooms. So were doing everything that we can as a system. And as quickly as we learn about that, we iterate the system and that can improve. And there are specific examples. I am sorry for that, and we will continue that those are rare. And they get the services to take care of themselves and mid gait the spread of the virus to mitigate the spread of the virus. I think that is a reasonable response that these occurred within about, oh, two weeks ago and obviously everything was still moving and trying to get that under control. But i appreciate your last response there that if such did occur or had occurred, it is not our routine and we are looking to try to ensure they are all accommodated. Thank you. And to give you an opportunity to talk about there is no need to go back to the slide, but the data and number of covid positive patients who are both in who are in intensive care versus nonintensive care, do we know what percentage are currently on ventilators . And my second question regarding that data is, to what do you attribute the redubs in the number of p. U. I. S . That expanded testing or is it something happening in the hospital setting . Can you hear me okay . I am getting an echo. In general, the i. C. U. Patients, about 3 4 of those are on ventilators. Its challenging to update that data on a regular basis because the ventilator status can change rapidly and this is from nine different hospitals. But just on sort of a monitoring level, the real question is whats our i. C. U. Capacity . And in those i. C. U. S, most of those represent beds with more capacity. We expanhandled the i. C. U. And Ventilator Capacity as part of the surge planning by 91 , so we almost doubled the capacity there. And that was a key concern as we looked at the situation in new york. And again, people really responded tremendously to that. Commissioner, im sorry, i forgot your second question. The reduction in the number of p. U. I. The p. U. I. Number is one that i watch with caution in terms of interpretation about what will happen in the next coup of days. And likely that will depend on things like a neighborhood in laguna honda is all being tested and it is when the c. D. C. Was here or if there is specific things that certain hospitals are doing where they may be testing a large number of people for a very specific reason. There are so many heterogenuous reasons why the p. U. I. Can go up and down that i have been focused on the hospitalizations of confirmed positives. Unless i start seeing a consistent trend in the p. U. I. And i think you can see as from that graphic it is hard to see that yet. Director colfax, would you like to go into possible future steps or defer that to another meeting . I know you do have a hard stop. Well, i think that i just as we think through where we would go from this stage, and i think its important, one, to emphasize the importance of physical distancing, wearing the mask, the shelter in place, compared to where we started march, there is more covid19 circulating in the community. So even though to some extent while its been a month, over a month, and it is challenging, but i want to emphasize that those pharmaceutical, Public Health interventions remain really key in addition to basic hygiene. But as were looking at our approach Going Forward, we really need to think about what are the key and we are starting to think about with other partners across the region and the state and what are the key things we need to be looking at for potential relaxation of some of the social distancing protocols. Where would that be most necessary . What is the balance in terms of the risk and benefits of that . And i think there are real Health Questions as well that need to be considered because we know the aggressive shelter in place that we have done while its been the right thing, there are certainly Health Consequences including of that. And what are the key things we need to be looking at in terms of expansion of our Contact Tracing capabilities, a change in not just a flattening of the curve but a potential decrease in the curve, and then how do we develop a system that is flexibility so that if there are outbreaks that we are able to turn certain switches on and off. That is a general answer to a complex question and the Health Commission and may want to add a few words to this because hes been thinking a lot about this with some of the other health officers. I dont know if you have anything else to add from my general interview and i know we only have a few more minutes. Thank you very much. Can everyone hear me . Yes. Yes, so let me just summarize it and just really quickly the big ideas. Dr. Colfax covered most of it. There are basically three phases the way this is being thought about in the country. We are currently in phase one which is slow down the infectionened, prevent hospital surge, and start preparing for the next phase. The next phase is when we begin to open up and pull back on the shelter in place. To do that we have to have all the systems in place that dr. Colfax mentioned. We need to have a good testing system, case investigations, Contact Tracing, being able to deal with all our vulnerable populations. Having all that in place. The third phase is far off and that is going to be when we have good therapeutics and we have a vaccine. So that is probably were not going to have a vaccine for probably a year and a half, so thats at the highest level, that is how were thinking about it. And were also waiting for the state. The state has given us some initial guidance in how they are thinking about it, but we need more specifics because we want to align as much as possible to the state so that were able to focus on the Public Health role and less about the challenges of picking and doing the sheltering in place the sheltering in place which affects so many different businesses. Thank you. Move on to the next item on the agenda. A give me one second to put a slide up, if you wouldnt mind. Certainly. Were going to move on to item 6 which is general Public Comment. Before we begin, i want to put the slide up so people have the information. Just give me a second to get there. I will work on it, but moderator, we can start the Public Comment. Do we have any calls on general Public Comment, item six . Moderator . Are you still with us . Oh, i see. No calls. There is nothing on this for item six. We can move on to item seven which is an action item and resolution honoring the San Francisco department of Public Health for its ongoing response to the covid19 health crisis. And commissioner, i will read the draft resolution and i will include and note the clause that commissioner chow is going to suggest through an amendment. And excuse me if this is long. Those of you who are in the d. P. H. Executive team, take this in because this is a time of gratitude. Whereas dr. Grant colfax, San Francisco department of health, director of health, initiating d. H. P. Planning efforts to respond to covid19 in late january 2020 and began reporting to Health Commission on covid19 related activities at that time. And whereas, on february 25, 2020, ma mayor breed with input from dr. Colfax and dr. Aragon was one of the first cities in the United States to declare a local emergency due to the threat posed by covid19. The San Francisco board of supervisors concluded and in the mayors emergency proclamation on. And whereas, march 4, 2020, the california Governor Newsom declared a state of emergency due to covid19. And whereas, march 6, 2020, dr. Aragon declared a local emergency and board of supervisors con curd. And whereas, on march 6t city issued Public Health guidance to encourage social distancing to disrupt the spread of covid19. And whereas, march 7, 2020, dr. Aragon ordered city facilities to cancel nonessential group events of more than 50 people and prohibited visitors z lagun hospital. And whereas on march 11, an order was issued of 1,000 people or more in public gatherings. March 13, 2020, he issued and order prohibiting gathering of 100 people or more. And whereas dr. Colfax and dr. Arrgon worked closely with several counties to align the area in a uniquely coordinated covid19 prevention and response effort. And whereas, on march 16, 2020, dr. Aragon issued an order coordinated with five other bay area counties for residents to stay at home through april 7, 2020. And on march 31, 2020, dr. Aragon expended to may 3, 2020. And whereas on march 19, 2020, Governor Newsom following the leadership of San Francisco and five other bay areas counties issued an executive orreder to require californians to stay at home and whereas, dr. Aragon continued to put forth a series of Innovative Health orders to outline necessary measures to protect the health and well being of all San Francisco residents and to focus on the most Vulnerable Health population. And whereas dr. Colfax and other d. H. P. Leadership have worked closely with state and local leaders in the complex procurement to expand the hospital and medical shelter capacity and purchasing personal protective equipment and testing supplies. And whereas, dr. Colfax, dr. Aragon and other d. P. H. Leadership has coordinated with nonprofit organizations and businesses to develop the San Francisco community of care including sharing of medical staff and precious resources to increase medical Surge Capacity and resources devoted to the covid19 responses. And whereas the effort to provide transparency and keep the public informed, dr. Colfax and dr. Aragon and others continue to lead the pace to coordinate important covid19 case data, testing data and give updates on the Public Health response. Now, therefore, be it resolved that the San FranciscoHealth Commission commends dr. Grant colfax for his steadfast and compassionate leadership during the covid19 pandemic. He continues to lead the d. P. H. Through the ultimate challenge of temporarily repurposing 2 billion department to respond to the Ongoing