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 brain health related, Behavioral Health and issues related to the same 815, 566, if here and available on the 14th. Literally, we will get a sense of where we prioritize the county and the 60 bed build out and talk about that in a moment. Northern california, the beds we are focused on and other general facility needs. 566 is expected to be here in california. Some are coming from outside the state, it just depends. We are confident in the 800 number 566, we are very confident will be here within a week and help support staffing important and critical facilities both in response to and in anticipation of an increase search. As it relates to additional requests, a number of people asked the federal government, the answer is yes. We have requested the icu strike teams against emphasis on our icus at the moment. Always preparing for within the Healthcare Delivery system and outside we will get to that alternative care. The teams which you will have followed us the last number of months, these are disciplinary staff and expert staff, strike teams together. They been in the Central Valley in the past, these combat teams are extraordinary. These will continue to push for more personnel and medical response and the language of these services to advance. We have limited staff in this, i just want to provide you with a little information. These individuals will limiting their an infection control, Critical Care and the like. Strike teams in multidisciplinary, federal, state and local, private. Making sure we avail ourselves to the largest degrees weekend. There are also things we are doing as well that i thought i would highlight will get to a few more here briefly and some questions. There are some interesting protocols we put into place. Riverside county, expanding products rates of growth. Riverside specifically 60 saturday. San bernardino feeling pressure and icu capacity. We are trying to provide opportunities to get people back at home, paramedic support. We have capacity to pull 100 patients out within the system, get them back home. And riverside and san bernardino. You have matured as we have understood more of the nuances, more effective treatments, caring people and securing to health these are examples of things we werent able to do it is roughly 2000 beds outside Healthcare Delivery system for studies in warm status, here you can see Imperial Valley we have patience in the bed capacity to provide hundred beds down and Imperial Valley. Also detrimental, in Northern California not immediately sacramento but the proximity of the facility, 224 beds just in a couple of days, we will get that facility prepared and up and running as needed. These are prelocated areas we feel they may need in the future. San diego and even San Francisco medical stations, these are bed capacities that we can turn on as needed. Most of these will not be in any immediate sense but they are available and they are warm status because we are not just leaving them in the corner, we are starting to contact these things, not necessarily the one status, most of these can turn over and be with him was 96 hours. Within 48 to 72 hours. Keeping this in providing information to make sure in terms of the preparedness of resources, speaking of availability resources, here is our current inventory. I will remind everybody we just committed 600 million units, ppe and that is just surgical procedure masks n95 100 billion hundreds of millions more across the spectrum, gowns and gloves and the like but we still have over half a billion units of surgical fast n95 masks in our inventory, we have mass and other ppp and other ventilators. It is important, 7000 ventilators available ventilators, 7020 but the state has been active over the last number of months to secure drop them availability for ventilators and we have now over 14000 in our state inventory. The others together, 21000. We are in a completely different place and we were the beginning of this pandemic goes on ppe and ventilators in our capacity to start of these locations in a moments notice, 96 hours in our sophistication in terms of accessing limited scope and use as well as surging staff as part of our all of our strategy of preparedness to get through this winter, work our way through what looks to be a tough and challenging january to february as we build that bridge to vaccination. It is on the horizon, with the vaccination we continue to accelerate our planning and preparedness for vaccine distribution. This is, safe and equitable vaccine dissolution have been highlighting the next couple of weeks, progress on vaccinations will update you on the progress. We are working off a plan that is 327,000 doses that come from pfizer directly, it will be as early as 15 of this month. For planning purposes, its been around the 12th to the 15th. The purposes of this around mid december. We have successfully had submitted from our partners, first orders houston last friday orders on the last friday we put up plan for 218, if you want to take the vaccination plan, and details, we focused on planes last friday laid out this population, go to covid19. C. Ca. Gov website to learn more about that. First orders, first submitted in first doses will be made available primary for highrisk healthcare workers we have the plans at the facility in place for the actual distribution, not just what they referred to as pizza boxes, they look like pizza boxes should be vaccines, those plans are not just in the state plans but locals and their partners. Here is the next planning process with illumination on potential availability of additional phase one a, we have a Vaccine Advisory CommitteePower Distribution advisor that plays one is on the website. The next public, we want them available to the meetings are open to the public wednesday, i encourage you to look at the website when these meetings or get realtime information as quick as any of us get. Theyve done a magnificent job as committee, and the next phase 1b where we are going, fda approval vaccine that we expect this week as early as the tenth and we expect the moderna approval question around that two of her or so later. We are getting into december n now, first week of december and we will start, i believe good news, continue to significantly improve, just months in terms of availability of vaccinations. Planning assumptions the state and 327,000 doses for pfizers first distribution you moderna and all the other distributors and manufacturers of vaccines, we are working on an assumption of 2. 16 million doses of the vaccine within the month of december. 327,000 xp, or within the next week number of 2 million five two vaccinations, each one shot. So cut that number in half in terms of availing themselves vaccine process, i dont need to review, for those of you following, no we have been doing in terms of providers getting prioritization guidance with the Advisory Committee how we allocate in an equitable. That is all plans one day. Lets look at the next slide, the icon on the right is the next the next Health Department orders the orders came in frid friday. Theyre coming in as we speak. Reviewing the orders and then we submit them to the we receive and review those orders and then submit those orders. Orders will be processed, this is the first phase. Pfizer is doing their own distribution. Moderna is working not directly pfizer, it is a different process between pfizer and moderna. Moderna is working with a californiabased one. There an intermediary in terms of their planning we are working directly with them on the moderna vaccination. Again, 200 Pfizer Vaccines, both requiring two doses. One is older cold storage, one is just cold storage. Both require different approaches, pfizer doesnt directly, they ship Distribution Centers throughout california based on everyone improving. Transportation is pretty easy and selfevident. Ups. Fedex and others to the providers and plan for state. They maintain throughout the requirements for transportation. The vaccines are received, there is one other group of sites will get to your question. The receive by pfizer on site and then they start the ministration. Based upon the first 327,000, we are confident in our capacity with the cold chain requirements met by our providers. As you recall, and ill repeat it again today, we have secured, we already procure and expect delivery end of this month in early january supplementary ultra cold storage and cold storage that we would distribute throughout california just as the redundancy major to provide more confidence depending on where the vaccines go in our capacity to deliver them, to augment what our providers arty have. Mind you, providing vaccinations in american history, there was a sense of overwhelm. We havent yet for no other reason than this, the scale and scope of the 19 million vaccines will provide on an annual basis and how sophisticated our network is. Theres always how well it is distributed, we have regional gaps so that is the existing network, existing resources in that network and so far, i imagine the next headlines people will see, as we administer vaccines, some will have the cold chain requirements and some will be able to be utilized, we have to work with all of those no one is naive about these in this process but so far, its been a very active process relationships are very well established and supplementary on these Advisory Committees for safety Advisory Committee to help people do things right in. That is the update, i want to close with photos so you can stand, some of the Pfizer Vaccine pallet shippers. Here are some purchased on the cold storage, healthy ultra cold storage. Some people say what do they look like . Ill put it up on the slide monday. There you have it. This give you a sense of what it looks like. Not pizza boxes with moderna. Forgive me for bringing that up. They also are distinct, distinctions are important and how we can avoid the extent possible in terms of the old chain connection. That said, i wanted to more to the cause of education and update you on some of the work. 80 million in direct support for Public Education. Over 80 million in servicing the words, over 1000 going up you may have seen some of these already. Caesar the new iconic heads we are putting out. You can see this mockup of to the you will physically see, not just on slide, about the apartment, your friends safer and you can see we are being smash mouth, forgive the phrase, and how we get your attention. Advertisements, we want to put these images out of the billboards themselves, the people to pay a little more attention. The Education Campaign youve already seen the last few weeks, he will see a lot more in the next few weeks including not just images like you just saw in the last slide, some more creative images you see dogs, just trying to get your attention. I just thought i would bring to your attention what we are working on and what you will start to see. Thousands of the billboards and any other languages, at least of which of course always spanish and english, etc. I want to show you the california firefighters foundation, inc. The following a fire foundation, the Grocers Association as well, providing a lot of support and in storage support, grocers specifically to connect with people in a culturally competent way and i hope you will enjoy a brief example of the Firefighter Foundation putting out in terms of everyday life on the line. Somebody other workers are having to do the same. Protect our selves, wear a mask, wash hands, they succeed apart. During this type. Slow the spread. I say trust messages because more and more trust others along the same, i just want to thank our firefighters. A reminder, fire season, into december still battling fires in california. Partnerships at the local level but also credible cal fire team, thank you to all the men and women working so hard, working into december as well. In the office in the healthcare professional is what we are asking more for them than we ever have in the next six to eight weeks. I want to introduce you to someone whos very familiar, thomas, the new Public Health director now in the state of california just announced, i am just announcing his ascendancy. My formal role of capacity as mayor there and the Health Department, extraordinary Health Department. One of the most well resourced, both financial perspective to eliminate this pandemic the spread of the virus but a replicated all across the state we are very enthusiastic continues to supplement our efforts as we move into this next and challenging days. Im happy now to answer any questions. Thank you for taking lesson. We want to ask about the Technology Available using Similar Technology using it right do you think california is going to make sure people downloaded, and what is the plan to reach people reluctant to comply with asking ourselves for a number of months in the presentation, and wanted to advance the pilot, we had advance it on a number of campuses. We are very pleased with the results and effectiveness. The pilot went from one to seven use use. Why is it a little different . Also noted, youre absolutely right in my initial remarks that is only as good as peoples adaptation, its an opt in, not opt out. You make the decision. Its not Contact Tracing, and his notifications if you choose to use it, we can leverage more utilization which will take us more effective meaningful and i think the answer to your question is, this is california. Adaptation, willingness to be on the cutting edge of new technology, adaptation, not just creation, discovery and the fact that we have to algona based companies, apple and google partnering with us, we will be providing this in the state and the state of california, the largest state in the United States i think gives us the capacity with the experience weve had of these apps that we can see patients. Again, i am very sober about these rates and i dont expect tens of millions, quite the contrary. We are hoping there will be enough to make this meaningful but apple and google will be helping in that motion and you can do the same. I appreciate your inquiry. Hi there. I wanted to ask about the timing of the state home quarters. As the discussion about a broader stayathome order before thanksgiving instead of a curfew . You give a sense on how the discussions went . Talk about what you think gathering during thanksgiving is achieving search now . The vast majority, overwhelming majority of californians are now in this state home order protocol. So just because of the regions that somehow we are neglecting a significant number of individuals, we certainly have two other regions not in this order the vast majority, overwhelming the state as it relates to the conversations we had, we had many conversations based upon the facts determined, the wind, the facts will determine on local Health Officers on the how. I would stand aside to allow doctor galli talk about this question you have asked about thanksgiving. Thank you for the question. Since the beginning, we are constantly working not just regionally but statewide and as we move through this current search, and asking about, what are the right actions . Looking at the data, as the governor mentioned throughout, to determine what we would do. These various restrictions are a hardship for people. It is not what we expected at this time of year but we know some of them are required to make sure we get through the surge as quickly as possible and save as many lives and preventing as many infections as we possibly can. Certainly through october and november, discussing with local partners the right actions to take, the timing of the actions, moving through, adding areas restrictions and then looking at the icu capacity, our ability not just to care for covered but all emergencies and critical Health Issues in our Hospital System, the decisions with the Regional State home order. Your question is a very important one as it regards to thanksgiving transmission. We know those cases have occurred around potentially dinner tables or activities, plans of travel throughout thanksgiving will show up right around now. He beat the last couple of days we are seeing but for many days to come, not that this is just the beginning but we believe transmission we have been reporting so far will likely continue to go up some because of the activities around thanksgiving so all of these are coming together, these actions signals in our data that cause us to do the state home orders the way that we did. Thank you. I wanted to direct this to the governor, the attorney general of the year to lead hhs potentially. I want to ask you specifically, you got healthcare plans, some of which i think we will hear about in the next month but even beyond, what to talk about the healthcare plans california has those who require federal approval and money, medicaid, i am thinking about homelessness, some want to go even figure on healthcare mansion so what kind of healthcare you think attorney general brings of the federal california homes more with their potential effects it is a game changer for us. Normalcy versus pressure, described in terms of relationship with the federal government, and now our own attorney general. I had a conversation with the internal attorney general, we can assure you we have been doing previous to his announcement and help expectation would have strong personal relationship with the secretary at the fact that it is our own javier is a game changer for the state california. All the issues related and if i have lost most of you, it is for on it as we speak this afternoon. Every day, ive been working on preparing the budget, i say this over and over again recently local, state healthcare budget serious budget conversation unless youre talking about healthcare we have had our eye on some big reforms we have been looking for a great partner you have found a Great Administration and even better partner in our attorney general so i am enthusiastic about it, it couldnt be more pleased. Not just for the attorney general but for the state and our healthcare future as the state so we are going to hit the ground running and take advantage of this moment of these relations. Everybody needs to be treated equally and fairly but california is the largest state was more at stake in terms of these reforms. We want to make sure we are right there in the beginning doing everything we can to accelerate these reforms that you are well aware of and will be made more of in the coming months as i release the january budget in just a number of wee weeks. Kevin. Hi, governor. I have a couple of education questions. First, can you explain allowing schools to stay open after you shut them down in march . Second, the pandemic has exacerbated an equity with low income families, was access to education. A lot of people are wondering why you havent intervened directly. Not intervening directly, weve provided 5. 000000000 dollars, we took cares act money money that could have been spent in any category. We worked with the legislature with that 5. 4 billion focus on support. The overwhelming majority of that was money set aside specifically for equity. You may recall there was some dispute with the legislature, they didnt want to go as far as i did in terms of the equity and we were different about it we have a focus and were able to work with the legislative to land where we had hoped. Weve provided two months of p ppe, we worked on establishing protocols and procedures based upon data and facts, based upon epidemiology and the reality around the world looking at best practices. Look at cohorts, look specifically at high needs population, special needs and the like and look at strategies to cohort individuals and provide process and protocol through waivers at the local level. We put up a tiered status and you dont need to be in the orange or yellow tear, even red. You can be and purple and still access waivers. Weve been working with our local directors, ltas, local education administrators across the spectrum and we continue to engage in a proactive way to provide support. Particularly on the issue of testing. One reason we worked aggressively and did something no other state in america did for testing facilities, to help support schools to reopen and be in a position where these tests in particular, were we support testing needs, not just as the state but specifically for our Public Schools. One reason we are more aggressive than any other state in our country and going after ppe and procuring our own, he may recall we had a peak 40 million more mask thing the entire National Inventory in our state providing support in our schools and our district. So we have been very focused and results, as of i is a father of four, someone who believes in the social emotional side of learning will address the concerns and anxieties. Have. Can have a conversation about equity unless youre talking about issues and struggles distance learning. On multiple occasions, we have communicated to you and others our efforts, we have highlighted them and report of over three and a half billion dollars of support just in the last year end a half that we have been able to bring into the state. Tens of millions of dollars specifically for from books to address the Digital Divide and amplify the efforts and support the work we did with the legislature in terms of that 5. 4 billion earnings lost money, being used more strategically to address the issue of equity. None of us are naive about the background rates, Community Spread creating stress on the entire Healthcare Delivery system, School System and entire economy. Those stresses are real and very visible, with the action and announcement made just in the last 24 hours at the l. A. Unified school district. The engagement and the state approach in terms of addressing the issues of equity supporting the district but i also hope youre familiar with that work being an ongoing commitment and thats why our budget, which we will submit in a few weeks, ill lay out in mark detail and specificity, more support for our systems including the critical issue of testing of which we are fully resolved to commit addressing head on so i hope you will support the information in the space as i am fully engaged in working with the incredible leadership to advance this safely and get our kids back to school while at the same time protecting teachers and professionals support it off is making sure our kids are safe and that. Los angeles times. I just want to followup kevin, you and your administration, they have not hesitated to exercise your authority to see what mandates and restrictions on everything from stopping at the grocery store, getting a haircut you have advocated that authority when it comes to School Reopening to allowing School Districts to decide. I want to know why that is. What you say to parents who feel that private schools are wealthy families get to stay open and Public Schools do not, in many cases. I dont think i have advocated executive orders. As it relates to the issue of our default being in prison education, we have been crystal clear. I think most folks are familiar with the thousand plus School Districts in the state, Public Education that is unique and distinctive and how it is a real process not a command and control structure. Perhaps nowhere more as it relates to Public Education in the state of california. Perhaps you know about the formula brown had advanced, meaning the focus on local Decision Making and local conditions and english as a single language. So we can avoid when youre dealing with over 6 million Public School children we had 21 counties in the state of california, 21 counties just a few weeks ago, we announced old parttime schools operating in person of hybrid, just online, obviously those receiving waivers and others conducting in prison education, that was a few weeks ago. Thirty days ago, three and a half Positivity Rate. Positivity rate has exploded. I dont know one should be particularly critical when the Positivity Rate in Riverside County was just that 16 and a half Positivity Rate even more than that. Other parts of the state, there is no concern by teachers, concerns by parents, i am a parent. Ive got four young kids. Four to 11 years old. When you have rates that are exploding, icus and hospital rates putting tremendous strain and pressure, it is not inappropriate for these parents and professionals to express concern and anxiety about the safety of the children and in prison instruction. We are working relatively to get people back into school. I want to see them back in the classroom but it must be done safely and i can assure you we are working to advance the cause and you will hear a lot more in the upcoming days specifically about our testing strategies in particular to address that very issue in order to get our Public Schools back in operational as soon as possible. Thank you, governor. Theres been a lot of confusion over the order as it relates to the lodging industry. You see a lot of Different Things on what it means. On your order, otherwise required by law, the state reservation. You think people cant stay in a hotel people but those who are horrible can. On the website it says the Regional State home order offering covid19 mitigation and containment measures only for essential workers, etc. State lodging Association Says theyre not sure what it means because there is victory information. Im hoping to set the record straight. Nobody can stay in a hotel right now, the only essential workers whether youre from arizona to newport beach, it is confusing. Its not confusing with the order we just put out. In these regions in the state, if you fall below the 15 capacity or in a region like the bay area where we support local Decision Making based on the commissions on the ground where they are now in these new protocols. The protocols the state put out, essential only. Lodging can be open for essential workers only. Not for tourists or leisure in those areas have fallen into the categories. Specific regions in the state, two reasons that remain subject to preexisting roles. That said, i will have doctor ghaly come up and perhaps he can talk about that more. More important, you should expect my team to reach out directly to you provide more clarity see you can see that in more specific terms. Thank you, government. Thank you for the question. We are working to be clear on that in the upcoming posts on this question and others as it relates to the regional stay at home order. Top line of the regional stay at home order, we look in those areas where icu capacity has dropped below a specific level, we require people it is not essential for you to leave your home, you arent doing one of the outdoor activities, stay home during this critical time to bring transmission rates do down, to help us get it under control so our hospitals can do what they have done for so long which is provide highquality to all those californians who need it. As it relates to travel pacifically, if youre in one of the two regions currently under the regional stay at home order, we ask you not to travel or leisure. If you need to travel and must stay overnight in a hotel, as a result of your work, that is permitted and we know it needs to continue to keep our infrastructure moving and critical sectors operating. The other area is isolation. Some communities have brought hotel rooms, we encourage to allow people who cant be isolated in their homes or accommodations to help the hotel to be able to do that effectively so we can reduce transmission we know hotels and travel industry will function as it has been in those areas and other limitations will be clarified with additional written posted guidance around the regional stay at home order that will be up there. Thank you. Alex michelson, fox 11 news. Thank you. An informational question and a more broad question. I wonder if you could get contest context aware icus would be normally this time of year. Also, any thoughts on trying to bring back the uss mercy ship. The broader question, with so many people whose businesses are being shut down by these orders were really frustrated that they feel they have not seen enough evidence for outdoor restaurant spreading covid in a major way, hair salons and nail salons spreading covid in major way, im wondering what you say to these people who say ive done everything you asked, ive followed the rules, i spent money on ppp, my staff is on the brink of losing their jobs and losing businesses. Its the holiday season, what you say to these people who are really desperate and confused and angry right now . I said it monday and ill say it again today, i am deeply empathetic and committed to advancing the cause of supporting Small Businesses during this tried and challenging time. You saw this last week, half a billion dollars, 25000 grant not just for Small Businesses but cultural institutions nonprofit. The dollars are now going out the door. If youre small restaurant or barber shop or nail salon, go to the covid19. The website. Avail yourselves information about the half billion dollars support and that is just interim support. January, we are working with the legislature to get affirmative action to provide even further support. With 100 million of additional money we put up in hiring tax credit for those that can hold the line, bring parttime or fulltime employees back. The dollars were just made available starting last week. We are waiting sales tax from the collected and distributed back to the state, allowing people have elected sales tax, an additional 90 days without penalty or any fees associated to utilize those dollars to help support their business operation. Those are three specific actions that have just been taken in the state and those are just three, among many actions as it relates to Small Business moment for people falling through the crooks dont have traditional relationships with Credit Unions are banks that we are providing. It is a Novel Program that janet yellen, working on behalf of our Economic Advisory task force, she created this program by the legislature. 100 million we have put in to leverage resources not just direct resources from 125 million just in that program. I am a Small Business owner, i started right out of college and then opened a Small Business with one parttime employee. I deeply recognize peoples pain and suffering in this moment. Their dreams being shattered because of the pandemic. You asked me how i feel, it devastates me to know because i intimately understand what it means when you put everything on the line, you leverage everything. Through no fault of your own, then a blow Global Pandemic hits and create constructs that are devastating to your life and prospects for the future. We need the federal government to recognize and they are not doing their job to provide Additional Support at the scale required in this moment but extending the ppp program Small Business loans and grants to help support folks in this time of need. What california is doing is not unique in the nation, quite the contrary but it is unique as we will be proactive, we tend to believe in many respects and i recognize the consequence and struggle all i am asking folks this is the third wave. We dont vaccines are on the w way. The pacific vaccines to be disputed by the year. We will, or resilient and capable. We will provide more support for the legislature on commercial to do the same on rental evictions the lot of work to do across the spectrum including Public Schools so people can go back to work. They need the support they need to get the kids educated is evident and profound. Forgive me for being longwind longwinded, i know the work you do, its not anything you can use but this is not an intellectual thing for me as someone literally is here because of my entrepreneurial background i got me engaged in local government initially, that led me to San Francisco and what to start running for mayor. I have reverence for Small Businesses. Reverence for entrepreneurs and it breaks my heart to see videos and reports and others, peoples lives being poured because of this pandemic and we are trying to do our best. I recognize it is never good enough but we are not going to give up and we will continue to do our best to provide more support during this very challenging time. Let me talk to doctor kelly to internet more specifically. Thank you, governor. Right now, hospitals usually prepare for the upcoming season. They start to put together their plans and how it will moderate the plan for icu beds because they anticipate additional business, flu, it isnt an illness that lands you in the icu, they might need an inpatient bed but not icus said. Different facilities across the state might be halffull in the icus, some might be on the being entirely full but we look at this regionally as beds that are available to treat people in this emergency for covid. At the peak of the summer, some of the regions dealing with roughly 35 of their icu capacity filled up with covid positive patients we think about that as an over workload that wasnt there before. Fifty or 60 capacity before covid, you might be running close to 90 99 . They are more impacted. That is why the partnership with the Hospital Partners have made decisions about how to control demand for icu beds, increasing staffing as much as they can, working to cut down demand for a period of time. Some procedures and scheduled surgeries safely delayed but there are limits. You can only staff up so much because icus, the staff is in such demand across the nation. You can only put in dialysis for all these procedures that are scheduled, sometimes elective procedures but they can be delayed for a day or two but not months. We see utility things other than covid very quickly. Our state is not just around covid health. We want capacity to be there for you when there is a car accident or a heart attack or stroke. We talked about this together to assure you are looking at this issue is not just because of the demand, not only because of the covid demand broad demand. With vaccines, the 2. 16 million doses we see coming in december, those are first doses. It is not to be cut in half or save this second half for januarys doses, we have a commitment to get the second doses three weeks afterward so we have enough to get the second dose so we can continue to build up the number of people, the additional benefit of a vaccine to protect them from covid all of these decisions are happening now today because there at a certain time in our response, i love sports, i think of it half the time as an important moment but coming to this. Where there is a light at the end of the tunnel, there is some hope with vaccines, quite a bit of hope and we are actively working that is why the government is so committed to sharing where we are with vaccinations so we can combine efforts today to reduce transmission and get another set of hardships personally others businesses or individuals, all of these aspects in our lives being impacted with the hope of vaccines coming to really get us through this third search. The icus are an important metric for us, preserving it will help us save lives. Preserving it will help us create the room we need in our Healthcare Delivery system to serve you all at home if god for bid, you need to back in the days and weeks ahead. With that, i want to