Often focusing on test positive, accurately so. We have seen this number come up from what ha been below 3 just weeks ago to now a 14 positive o14 positive of 5 and a 7 day up to 5. 6 . We have a goal to keep this as low as possible, continue to test the communities to find cases to wrap around the cases, avoid one case becoming many. This number is one of caution and one that intense identifies our inintensifies our role. We knew we were at 3. 3 a few weeks ago. It has risen nearly 52 increase in the past two weeks. I know it feels like its just a small difference between 3. 3 to 5 but its a significant difference in the increase which is when we focus open not justin creases in rates but this idea of rate of rise in two weeks to have a 52 increase is quite concerning to us across the state. Hospitals, we talked to you about hospitals all the time that we know that 12 of todays cases will be in the hospital in two to three weeks. That helps put these numbers in context. We have seen a 63. 6 increase in hospitalizations for coronavirus over the past 14 days, just days ago reporting we were just climbing over 3,000 cases in the hospital across the state today. Over 4500. Our icu capacity, one of our most precious resources. That shows not just the bed in a specialized unit but specialized staff trained to use the equipment and take care of very sick individuals and ventilators and all the medications and tools that help us support ones system. Those beds have soon an increase of 40. 5 in the last 14 days and have climbed to just over 1100 individuals in those areas. Just a reminder that if we look day over day, week over week we have seen a climb not just in the number of individuals who are in the hospital but really in the number of new admissions coming through the front doors of Emergency Rooms and hospitals across the state. Even though that number slowly rises on hospitals, much faster are the number of new admissions because what i said earlier. Roughly 12 of those individuals, those cases today that test positive. We expect will be in our hospitals in two to three weeks. We talked about not just the rise but the steep rise. That rate of rise. You look at what we experience during the first significant surge early on. Okay. You have been listening to dr. Galley. We apologize but this was an old press conference from we believe last week. We are continuing to watch for his News Conference today to start. Once that does we will bring you that information and go to that live. To our bay area weather right now. Clear skies as we look live across the region. We are going to go to darron with a look at our weather. Hey. Hey michelle. Considering its the tuesday before thanksgiving. Lets start off with that. I will give you the forecast for daytime highs on thursday. Across the bay area. Inland on top, bayh cross the middle and the coast on the bottom. Now, those numbers should look familiar because this is what we have been doing. Its not a lot of change here in terms of daytime highs, bay area wide. Speaking of which lets take a look outside. Thats the scene from the top of the Sales Force Tower looking over north beach. It is a lot better than it was when we were on during the newscast from 4 30 to 7 00 a. M. Where we sue many temperatures down in the upper 30s. utemperatures now in the mid 60ss and we are close today time highs at this point already. I will have more on the seven day forecast coming up a little bit later. Thank you. We now have the new News Conference. Lets listen into that. 12 of todays cases end up in the hospital about two to three weeks later. Remember this number, 81. 3 increase over the last 14 days, 5,844 in the hospital. These are based on case numbers from two weeks ago. What was the case number . I will remind you it was around 7,000 case. This tells us that we are more than double today, that the pressure on the hospitals will continue. Its not just on our regular hospital beds. Its on one of the most precious resources we have in Health Care Delivery and intensive care unit bed we have seen a 57 increase over the last 14 days. Currently just under 1400 california residents in the intensive care unit because of coronavirus. Next slide, please. So, Hospital Systems are stretched. We know that. I talked to Hospital System leaders many times a day to hear how things are going on the ground. This number has some nuance to it. Remember on the 1st of november, just over 2500 people in the hospital, 708 in the intensive care units. Plenty of room. We have prepared for this certainly thats still the case but when you see the numbers more than double in just under three weeks we are concerned. Intensive care unit, nearly doubling in that same period of time. I will remind you that people are first often admitted to the hospital in a general ward bed and then as they potentially progressively get worse they need intensive care unit care so they are moved from that general ward bed to the intensive care unit so we are talk to you about lagging indications. Usually hospitalizations follow case numbers and then intensive care unit stays follow regular hospital stays in some predictable way somewhere about a week later. I want to tell you that something we track is hospitals asking us for waivers. Some permission to be able to operate with some additional patients being seen with existing staff and today we have 175 hospitals across the state operating with a waiver. Some of these intensive care units in those hospitals are already being pressed to a significant degree. Next slide, please. This is a slide i used last week. I wanted to bring it out again it. Was a slide actually that i created after having a nuts and bolts conversation with my own mother about how she can think about her own risk of getting infected and i said, look. You have to think about it. It is sort of like a simple math problem. Your potential likelihood of getting exposed so today we know theres just more coronavirus mill around the communities. Its its more prevalent as we say. You are more likely to get infected with coronavirus just because its more available and more around the communities. Even if you behave exactly like you did a month ago. Just more prevalent in our community. That duration of exposure so we often talk to you about having short exposures, short periods of mixing that those two things come together and cause you to have increased risk when you have Long Duration exposures and you are doing things in our communities where we are likely to mix more than usual. What are some of the protective factors in how do we reduce that overall risk . Its wearing your mask, keeping your face covered as much as you can, especially when you are with people who you are not used to mixing with, that isnt just people that you dont know. Strangers and the Grocery Store or on the bus but even with people that you are familiar with, that you are close to, you know friends and family from afar. Its very important to keep your mask on. Then this is why we focus on keeping at least six feet of distance because that distance can reduce the likelihood of getting infected even when together for a period of time. Just wanted to use this as another reminder that there are different elements here that we can control. We can reduce our risk and a reminder that some of the activities that you did a month ago if you said whats the big deal . I just keep doing them this way in the truth is that even those activities which felt low risk, felt safer a month ago today are higher risk than many of us realize. Next slide, please. So, onto the conversation about ti. Announcer r movement. We did last monday. We had abhijit unprecedented number of counties move into from less restrictive to more restrictive tiers. We had large number, 41 counties in purpose as of last monday. On friday we reported that we didnt have any additional county Tier Movement but today its a different story. We have had some counties move from red to purple. Others moved from orange to red. The two that had been in yellow have moved to orange and so, in the next five you will see exactly those counties next slide. Counties moving back to purple, colusia down north, humbolt and lassen. Counties moving back to red are calaveras and moving back to orange are alpine and mariposa. Some may wonder are any Holding Steady and making some progress . We have some counties that actually have met the threshold to move to a less restrictive tier. Its just a couple. They have only met that threshold for one week so there is no reported Forward Movement this week but just as we have said that we pulled the emergency brake. We are looking closely at counties across the state. We are still using the full compliment of our blueprint and looking at if there are any county that continue to do because of their collective actions, and their own impacts with transmission, to be able to move forward and if any of those counties emerge we will certainly update that as part of our tier announcement the next time we do it. Next slide, please. Theres been a lot of conversation about thanksgiving and holidays and what to do and how seriously we hope all of you take it. I will start by saying, you know i like many of you are disappointed about how this thanksgiving will look different from years past. It is my kids will say they often quiz whats your favorite holiday and why . Thanksgiving is it for me. The fun of gathering with loved ones, food is always great and then football for me, watching tons of Football Games throughout the day is a real treat. This year itll look different for me and my family and im hoping will look different for you and yours as well. Think its necessary to modify or pause our usual traditions to stop the surge this year. We are focusing that the safest way to celebrate this year is at home with members of your household or virtually. Next slide, please. We like other states have really thought hard about how do we communicate to all of you different strategies to have what are frankly hard conversations . Im a doctor part time and when i did see patients i enjoyed giving young people and parents guidance about how to have hard conversations. This is familiar territory. We know its not easy to say no and its not easy to say no to loved ones. As we kind of dig deeper in to the pandemic and our response, there is never more important time than now to use this as an opportunity to let your friends and family know that you are making a decision to reduce transmission and not gather. We know that, you no he, this is one of the first steps that you and others can take to reduce risk and keep your families and communities healthy and i think that its important to know that its hard to do this on your own. That many of you will likely need some partners in crime if you will to talk to other members or people that will likely be turning down a gathering invitation as well and communicating together to stay that this is the right decision for us and our family and our community. Next slide, please. Strategies and i think that its really important to be clear, say no, effectively starts with just, say no. Its simple, its direct. Its clear. It often helps close the door for further negotiations. It shows that you are serious and thought about this in a considerable way and that its an important decision. Think its important to offer alternatives. I was just having this conversation with my 7yearold son eli. He was asking me after we told him again for the 5th or 10th time i cant remember which. My mom, his grandma wont be able to join us. He said but, dad, she is part of our family. How does this make sense . I thought you said we just have to keep our masks on we are outside with people we dont know and i had a chance to explain to him what i tell many people that its not just about being careful around those who you dont know. Because so many times spread happens without sum hams, that people are presymptoms and people are mixing and its as important to say no even when it comes to the closest people in our families, it took a few times to explain it but i think he did get it and he understands that part of our strategy is some short term pain declining invitations to grandmas excellent cooking for some confident that the next ten, thanksgivings will include her at our table in our house. Its important to be honest. Excuses are helmeting but they can back fire. Dont feel pressured to keep the conversation going. I know that my mom can convince me to talk about the same subject a few different ways and just being really clear that the no is a no and its important. I will just say that i know that you may say i wish i had this a week ago or two weeks ago because people are already coming or we have plans. Its not too late to make the change. Game time decisions happen all the time. I think this is an important one for you to consider. Call that audible. Make a decision to do something a little different and decide not to gather with as big a group as before and consider doing it with just your household. Next slide please. Some thanksgiving dues. These are really repetition for many of the messages we have made. Celebrate with members of your own household. Respectfully say no to anything that makes you uncomfortable, that causes you to gather even if in fun and exciting ways, in ways that you know may contribute to transmission with in that gathering. Take advantage of creative ways to experience remotely. I know we are working to set up a zoom at my house so that my mom can pop in and out as they wishes. The kids can yell through the computer to have her come and see something they are working on or enjoy desert and dinner together as well. Make sure to drop off thanksgiving meals for older loved ones or those with underlying conditions so they can stay home. Think its important that we look out for this, lets not forget that part of the joy is not just sharing the meal but having the meal and making sure that our loved ones and those we know may be alone have a meal, that they can enjoy. Then its important just to make sure that these precautions remind yourself, remind others around you that these are the things we have to do to protect our family and friends because we love them. Next slide. You know the other truth is that california enjoys really warm weather. This year i wouldnt say its really warm but never different think i would get to be a weather forecaster or weather person but here you go. It looks in california that weather thursday is certainly going to be mild and even kind of warm about some of the temperatures Southern California where i am will be in the mid70s with sun throughout most the southern part of the state and that gives us an opportunity to really think about being more creative with our thanksgiving fans. I know that some friends have asked me what they can do and i have suggested hey, have thanksgiving lunch instead of dinner. May be fun. May allow to you add a few other courses or menu items to your meal. Also it allows you to do it outside and may low allow to you involve other activity that you dont normally do. I know it breaks some of our traditions but often people have thanksgiving dinner, somewhat early so, maybe its not a stretch to move it up a couple of hours to two or three. Do it outside. You know, if you are in i apart of the state where a heat lamp or some other ability to keep warm lets you be outside, sweaters, coats, scarves. All a different way to have a different thanksgiving. To stop the surge, nonetheless. Look at the weather, decide today to do things slightly differently than you planned before. Next slide. Want to remind you of our travel advisory. Remember we put this out just a bit ago to remind people that if you do travel into the state or you travel out of the state and then back in that there is a strong recommendation that you should self quarantine for 14 days. You may ask why i didnt spend any time with anyone else. I was in and out of home of some friends that i trust but this is exactly the point. We know that roughly 40 of people who are infected today in california, across the nation and the globe are without symptoms. That means that without knowing, that you have coronavirus you could transmit it. Doesnt mean you will we come sick, doesnt mean you will need the hospital but it does mean that you become an important protector of those around you. Keep your mask on and quarantine if you do come back after any period of time outside of the state. So that we can assure you dont spread it to others around. Next slide. So, as we close to the end of this presentation i just want to remind you of these important things that we have talked and continue to talk and talk and talk about wearing your mark, make sure that its with you at all times. You may have that quick Grocery Store run. Get to the car, realize you dont have your mask. Take the extra minute, go get it. Do the right thing to protect yourself. Those other customers, and in many ways and mainly the people that work at your Grocery Store or any place you will frequent. Maintain that physical distance six feet or more. Wash your hands, important with the kid whose will be mixing and touching things, many kids even if you are staying at home you may have the full week off of school, important to remind kids to wash their hands, cover their cough, all of those things make a difference. Minimize your mixing. We have talked about this quite a bit today. Then never pass up a chance to remind you to get your flu shot if you havent. I know clinics and Hospital Systems in your Providers Office near you is able to willing and excited in fact to get you that flu shot if you havent gotten it already. Next slide. So, you know, by way of watching up, together we can stop the surge. There is no doubt we have done it before. We have the tools. As i look at our data, day in and day out. I know that we have the tools to make that turn around. Even though that todays changes will take a little while to take effect. They will take effect in every day we wait to make the changes means that we will have another day of high cases, another day of pressure on our hospitals this is something that we all have Agency Responsibility to change. As these rates of transmission continue to get stronger, i know california will too. With that i will turn it become over and take any questions. Thank you. San jose mercury news. H. Hey, john. Could you talk a little bit about i noticed that in the bay area, San Francisco, marin and san mateo, no movement there on your tiers and wondering, i think San Francisco actu