Transcripts For SFGTV Health Commission 20240711 : compareme

I also want to thank the commissioners. We have a fairly full agenda, but everyone submitted questions on many of the presentations, and weve gotten very thorough and thoughtful answers from staff, so hopefully that means we can go through our agenda in a very efficient way and we can go to our different activities of the evening. First item is the minutes. Are there any additions or corrections on the part of the commissioners . Okay. Any comments from the public . Clerk if youre on the Public Comment line, please press star, three if youd like to make a comment on the minutes. No comments, commissioners. Okay. So is there a motion to approve the october 20, 2020, minutes of the commission . So moved. Second. Can we have a roll call vote . Clerk yes. [roll call] clerk just for everyone to know, if the if youre not speaking, then please mute yourselves, and commissioners, if youre making rustling noises, and youre not muted, i am going to mute you. So i apologize, but we want to keep the sound quality good. So well move onto item 3, the directors report. Hi, commissioners. Grant colfax, director of health. You have the report in front of you. Since i am going to give an extensive covid update, and in keeping with commissioner green, so we can move through this meeting, i stand to answer any questions. Any questions on the directors report . Yes. [inaudible] has a very robust lab Testing Program for kids, and i didnt know where we were today or how well that program was doing, which i thought might be nice to let our commission know in terms of being that we just closed out lead poisoning presentation week. Yes, commissioner, we with provide you with an update on that. Ill reach out to the team and ensure we have some things for the commission. Sure. And if i may, commissioner chow, i just sent you a few things. I can summarize to the commission that the d. P. H. Children healths initiative currently serves over 2,000 children a year. Theres 21 million in the sellman funds. They did get that to us. Being ookay. Anything you wanted to, dr. Colfax, to highlight in the report or did you want to move onto the update . Commissioners, all of my update would be covid, so i thought we should launch into that unless commissioners have questions on the directors report. All right. Hearing none, lets do our covid19 update, then. Okay. I believe we have slides coming up. Right now, we have 12,554 cases of covid that have been diagnosed in the city and county of San Francisco. Weve unfortunately had 149 deaths. Weve continued to strengthen work, meeting with Community Groups and making investments going forward. As weve seen across the rest of the country, theres a predominance of male versus female cases. We continue to have relatively few cases among the Homeless Population. Only 3 of our current cases are homeless, and at this time, you can see that the majority of our cases are community contact, and then, you see the distribution of cases by sexual orientation. Next slide. We continue to do well compared to other jurisdictions or similar size or density in San Francisco. You see that our death rate is often half of the next lowest death rate, which is king county, seattle. Our death rate is, again, less than half, with the only exception of miami at 1. 98 , and then, our testing numbers are higher than any other jurisdiction for which these data are available. Things have changed since ive last presented to the commission. We are seeing increase, again, in cases. Our rate of increase in total covid hospitalizations is high in the red alert at 20 increase. Now though this number is i increasing, the speed is important. The good news is our Health System Capacity Remains robust. You can see that at the 21 and 45 . Our case level is creeping back up again. It was 3. 5 last week, and its back up to 4. 2 . Contact tracing, partner notification numbers, while not at quite that 90 and above that wed like to be, we are holding in the mid80s. I would mention to the commissioners that there was a very nice paper published in the journal of the american medical association, thabout d. P. H. Leaders. Its been well received about our work with the ucsf partners. Next slide. And then, our Health Care Workers remain at 100 . This is a hard graph for me to look at every morning, but we need to look at it and better understand how fast the disease is accelerating. Were at 9. 3 million cases. A 44 increase over the last two weeks, and deaths over 225,000 and increasing significantly. Next slide. So i mentioned these are data looking at the various case trends, and you can see here that our cases these [inaudible] so the virus is really spreading very rapidly in the midwest. I bring these up because, you know, even though were doing very well in San Francisco and the bay area, we see what happens or can happen and what is happening in other parts of the country. Hopefully, we will not get to this point, but certainly it remains a possibility. Next slide. So these are our numbers in terms of hospitalizations. In San Francisco, remember, the blue lines are people that are in the medical surge, noni. C. U. Beds, and the other line is people in i. C. U. We had two surges we beat back. In august, we got up to 21 people in the hospital, and were back up to 34, which is why were in the red zones in terms of hospitalizations, so well continue to watch this carefully. Next slide. And our reproductive rates has crept up a bit. It got up to. 79 last week. Were now at. 83, so were obviously watching that very, very carefully. This reproductive rate and the hospitalization is really calculated based on the hospitalization rate. And remember, the hospitalization rate is about two weeks behind the case rate, so that case rate increasing, that overall Positivity Rate increasing, we expect to see the hospitalizations increasing commenceately in the next two weeks. So we made a decision on friday to pause further reopening plans. We had planned for further reopening on november 3, greater capacity with regard to indoor capacities, including indoor dining, worship, and church services. Were concerned about travel for the holiday and the national picture, weve made a decision to put a pause in order to, you know, hopefully ensure that San Francisco can continue to reopen safely. This is also an effort to ensure that we didnt overshoot and have to reverse openings, which we feel is more disruptive and difficult for businesses in the community, and well continue to follow our Health Indicators going for the record. Finally, i just want to say, in terms of our success, just cant emphasize enough the gratitude for all san franciscans taking this very seriously and walking in the streets or driving, its really remarkable to see the masking prevalence, which we show sakns lives, and i just want to thank San Francisco for their support as we continue to work to slow the spread of the virus and look with grave concern at the national situation, but hopefully, we can, again, provide a good example and also avoid some of the situations that this that this pandemic has created in other communities. Thank you. Thank you, director colfax. And i think the whole commission would offer our gratitude to the government, to the mayors office, to your department because the progress that weve shown has been remarkable compared to some areas of the country, and the team has led in such a diligent way, that were all grateful for the collaboration of everyone in this endeavor and how much, sadly, contact is going on in other parts of the country. We have another presentation on the flu vaccine, but we have an opportuni opportunity, before Public Comment, for commissioners to ask questions about dr. Colfaxs report. Anyone . Yeah. May i ask, dr. Colfax, the numbers are certainly remarkable, but is there any indication that the opening of some of the activity might have caused an increase the numbers are so small, i would hope that youre going to actually say no, that weve opened up indoor dining, and weve opened up indoor shopping. So is there anything measurable that would worry you . And i fully agree withholding the line here, that makes a lot of sense. But im just wondering, in your tracing and contact type of work, whether weve seen any of that, or even as certain schools have opened. Thank you, commissioner. So we dont have any indication with the level of specificity that i think we all wish we had, that this increase is due to one or two or three of these activities. I think the bottom line is, since september 1, when weve been taken off the state watch list, that weve been opening up Outdoor Activities to, you know, lower indoor activities, to what would be considered high risk activities indoor dining, in which people cannot even eat inside with a mask on. We expect, and we continue to expect as we continue to open up more virus spreading because its basic biology, and theres not a way to completely prevent the spread. Our goal is to try to continue to get the balance right so that we open, we ensure that people are doing everything they can to stay safe. We anticipate what might be increased risks on halloween, but were getting reports that it wasnt an increased risk. Were trying not to, in a sense, overshoot with our reopening because as you know, by the time the virus takes off, and you know you have a lot, its too late, and it takes a long time to push down, but were looking at the data both locally and then looking at the science to see if there are ways that, as we work to slow the spread of the virus, we may be more surgical with the work in terms of better getting a better understanding of, you know, on the surface, these all might look like equal, what we understand the virus better, these things will rank it up at a higher level. Right now, normally, based on outdoor versus indoor, masking versus nonmasking, good ventilation versus poor ventilation, and obviously, the number of people congregating in these activities. Commissioner guillermo, you had your hand up . Yes. Its a related question, but i know theres some new data nationally that shows that infections among children are at upwards of 60,000, but its probably a way undercount, and so im just wondering, does our Contact Tracing indicate anything demographically with regard to an increase in children either being in contact or being increasing the caseload . Yeah. The virus did shift to a younger population to some degree in the early to late summer. We havent had another big shift in that regard. Obviously, with schools reopening, we expect to probably see more children diagnosed, but were following that very carefully at this poi point. But we havent had a major shift in that direction at this time as far as i m aware. Any other comment dos or questions from the commissioners . So i guess we can have the presentation about the flu vaccine. And i just opened up the presenter wall, so julie should be able to do that in about one second. There we go. Thank you for the opportunity to present about and provide information about this years influenza season. My name is julie, and im the director of Communicable Diseases control and prevention here in the department of Public Health. Our section includes the Communicable Disease prevention unit along with the immunization and travel clinic in addition to responsibilities for surveillance [inaudible]. So this slide shows last years disease estimates for the flu season in the united states, and you can see that there were an estimated 40 to 65 million flu illnesses, 18 to 26 million medical visits, hundreds of thousands of flu hospitalizations, and tens of thousands of [inaudible]. So looking ahead to this season [inaudible] but also to minimize surge in outpatient clinics, e. M. S. , hospitals, and due to flu illness, and also to mitigate increased testing demands due to undiagnosed influenzalike illness. So what is the flu season going to be like this year . Are there any takes we can derive from the Southern Hemisphere, which as you know, their flu season peaks during our summer, so theyve already been through a flu season during covid19. So while [inaudible] in australia [inaudible] on the right side of this graph, australia was doing plenty of influenza testing, which is indicated by the blue line, and finding very few positives of influenza disease, and those are indicated in this graph by the colored the colored bar lines, and you can see it was nearly flat in their flu season during our summer. Australia saw only 350 flu cases, which is down 99. 8 of their flu season [inaudible] and this is thought to be related to the measures that were taken in response to the covid19 pandemic, including social distancing, masking, border closures, and also an increase in flu vaccination. Theres lots of unknowns about the upcoming flu season every year for us. This year, and every year. Flu seasons are predictably unpredictable. We dont know the exact season timing, such as when it will arrive, how long it will last, and this year, on top of that, theres the impact of social distancing and the possibility of a twindemic [inaudible] while covid was circulating. However, even though the Southern Hemisphere did experience a mild flu season, we cannot count on that happening here, and we need to do everything we can to prevent a severe flu season which starts with ensuring widespread flu vaccinations. So where does d. P. H. And the San Francisco command center fit in . So this year, much of the d. P. H. Is [inaudible] in the command center so [inaudible]. Every year and this year, the majority of san franciscans will get their flu shot through their primary care provider or pharmacies, but the flu Vaccination Team is focused on filling in gaps and focusing on the homelessness. So this slide shows our flu vaccine strategies. Our strategies are to clbt with existing City Partners and pharmacies. Number two, modify our supply to encourage document, develop information and guidance for clinicians, standup Community Flu vaccination clinics, to ensure sustainable staffing, and across, all of this, efforts to help inform our plans for covid vaccine. During sept, we connected an age assessment of partner flu Vaccination Efforts in San Francisco to understand the plans for the upcoming flu season. We heard back from 93 flu vaccination sites, and 96 of them anticipated vaccinating either the same percentage of their Patient Population of last year or a greater percent of their population of last year. One of our focuses has been understanding vaccine inventory across covid demand. Its continuing to be distributed incrementally. Manufacturers have indicated no significant delays, but the measure of distribution has gone on longer than usually because of this Record Number of doses that have been produced. Were seeing doses come in now from this federal supply. One of the things that the team has done to monitor the flu vaccine supply is to create an inventory across d. P. H. That gives us a weekly snapshot of the flew vaccines that we have available and have administered. Through the public and community engagement, our goals had to provide the public with are to provide the public with reliable information, including providing information to san franciscans on where to get their vaccine, covered by insurance or not covered by insurance. Thereve been Public Outreach and social media campaigns. For information and guidance, we we sent out our San Francisco Health Officer order that dr. Aragon signed. [please stand by] that we learned about through our Health Care Partner survey. The green bars indicate the sites that are stirred up by the San Francisco Health Network. [inaudible]. And the yellow stars are Community Flu vaccination sites that were working to [inaudible] up. To ensure that there is a low barrier to access to flu vaccine in San Francisco, our strategies have included leveraging existing Health Facilities [inaudible], supplementing gaps by creating these communitybased flu vaccination sites in collaboration with our community partners. These are staffed by b. P. H. Staff and by lab core which is contracted through the California Department of Public Health. [inaudible] will start later this week. Amazon had its first [inaudible] yesterday and there were 59 flu shots given and we anticipate increases. And additionally, the San Francisco Health Network has worked to stand up flu vaccination critics but are colocated with the covid19 testing sites. These a snapshot of our website where we list the flu shot locations publicly available and include locations where people without insurance can [inaudible] or walking in. And last, we plan to learn from our experience with influenza vaccination this year to [inaudible] vaccination buffer. We are building our command centre team, which is working with flu vaccine and will transfer over the covid19 Vaccination Efforts once flu vaccination scales down. We are learning [inaudible] associate distancing and vaccination clinics while covid19 is cocirculating and we plan to adopt flu vaccinations where appropriate for covid19. That is my presentation. Thank you very much. [inaudible] extensive work. I believe this is a time