Our very best, and we ask for your patience as were learning this new way to Work Together. Commissioners and presenters, if you have not already done so, please mute your microphones to minimize the background noise. When you speak, youll have to unmute yourselves. And the commissioners, raise your hand to ask a question. And we can switch presentation indescernable . And well ask everyone to please be patient as we make these adjustments. Lastly, we would like to thank all of the people who have been working very long hours to make this meeting possible. Starting, of course, with mr. Mark moore, and jeff burton, and d. P. H. Directors office staff, and s. F. Gov. Tv, and the board of supervisors, which drafted the best remote meeting practices. The commission is truly grateful for all of your great work. So thank you very much. Thank you, commissioner. This meeting is being televised this meeting is being televised by s. F. Gov. Tv, and for those of you watching live stream, please be aware there is a 30second to twominute delay. If youre watching the video at s. F. Gov. Tv, and youre interested in making a Public Comment, make sure that you call in at the beginning of the item called. For instance, if you were making general Public Comment, as soon as the item is called, call in so that youre sure to get in line for that. Let me post the number, so you can see it again. Give me one second. So the number is on the screen right now, for you all to call in. It will be in about three seconds. Here we go. The number to call in is 8883634734, and the access code is 2241310. If you would like to make compliPublic Comment any time during this meeting, call in any time. And you can listen to the meeting live without any delay, as we move forward. A couple of points about the Public Comment, since this is a new technology for us, every individual is able to make comments once per item. Even though technologically you could get back in line, if i recognize your number or hear your voice, i will disallow you from commenting more than once. Each individual can speak up to two minutes, as is our normal rule, and after two minutes, we will have to cut you off so we can take the next call. If youre on the phone line, using the number that i just gave you, you will press 10 to actually get in line for an item. 10 activates you to stand in line to be in for Public Comment, otherwise youre just listening into the meeting. If youre making Public Comment, make sure everything around you is muted and quiet, especially if youre watching on the computer because it will reverberate, and it is very difficult for us to hear you. I hope that information is helpful. And then i will repeat this information throughout the meeting, in case folks come in late for the meeting, i want to pacsure thamake sure that the pc understands how to make Public Comment. [indescernable] commissioners, i think we can move on to item 2. Let me get there. Thank you, mark. We have some Unfinished Business from our last meeting, a motion to disclose or not enclosed session in our march 24th, 2020, meeting. Do we have a motion to disclose or not to disclose . Motion to disclose. Second. Mr. Mar, would you do roll call . Yes. Actually, before we do that, i want to just note that the issues that the item that you all actually discussed and considered enclosed session was the s. F. G. Credentially support. Commissioner chung . Yes. [roll call] all right. Thank you very much. Item 3is the approval of the minutes of the march 24th, 2020, meeting. Upon reviewing the minutes, do commissioners have the amendments . I ask that you speak to the meeting being at 101 grove, is that correct, or are we supposed to put virtual or what . Commissioners, the meeting at a time was at 101 grove, and it felt thats fine. No problem. Motion to approve . So moved. Second. All right. So ill do roll call. [roll call] great. Thank you. The next item on the agenda is the directs report, and i am not sure if director kofax is with us . I am here. Oh, great. Can you see me . I can see me. I can see you. Okay. You have the commissioner indescernable . Do you have the directors report . [indescernable] the next item is going to focus on our covid19 response. I am not going to go into the detail, as described in the report, but i did want to mention that im very pleased that we have our new c. E. O. , who is in honda hospital, michael thorps. He has joined the v. P. H. Team in this unprecedented time, and has come up from southern california, and has lots of outstanding experience in Skilled Nursing facilities and other types of hospitals. He has jumped right in, and im very pleased that he has joined the team. He will continue to be working with actin the acting director, as he becomes on board and becomes familiar with the issues at hand with regards to honda, and the institution itself, and the amazing committee of residents and staff that work there. Great. Welcome. Commissioners, any questions . I believe, mr. Cofax, if there is any other else youre going to say . I was going to go into more detail of the directors report, in the next agenda item. As know, there have been a number of across the accounts and other information historically just for the commission that has been added to this report, but i dont have any additional details, unless the commission has questions from me. Commissioners, if you would like to ask any questions, could you raise your hand so we can recognize you . Commissioner chow. Thank you, dr. Cofax. I can see i was going to ask, on mr. Phillips, who is coming, to look in on honda. And you mentioned he would have it sounded like a transition period. About what period of time would you think that was, that we would have maggie still as our acting director, and are you looking at several weeks our months . What would be the thinking yes, commissioner. Sorry to interrupt. The im sorry, were you finished with your question . Yes. Okay. So the plan at this time is for them to act as a team, as michael gets up to speed on the complexities of the situation, and the full transition would be completed by june 1st. Okay. Very good. A second question would we be picking up during the discussion on the covid, the way of triaging and moving patients . And therefore i would save my questions for that. Okay. And i believe they are in attendance at this meeting. Mark, can you confirm that . Yes. Theyll actually be joining later. I thought they would be on here. Maggie, are you here . Yes. Both michael and i are present. Oh, great. So theyre available to answer more detailed questions as we go through the presentation. And commissioner chu, it seems that your questions might fit in with question five, which is the coronavirus update. That would be fine with me, to discuss the triaging and the outboarding of patients as we move them away from the acute hospital. Thank you. Thank you. Commissioners, any other questions . If youre not on video, please speak up. All right. Thank you very much, and thank you, maggie, for your help with the transition, and welcome to michael phillips. Your conference is now in question and answer mode. To summon each question, press one and then zero. Moderate, go ahead and put the first call through. Caller, are you on the line . Is there a caller on the line . You have two questions remaining. Caller, please start speaking. Caller yes, hi. This is michael petrellous calling in and im watching on your microsoft screen, but it doesnt tell me what agenda item were discussing. Yes. I verbally announced. Were on the directors report. Okay. On the directors report. Here are my two minutes of comment. I want to salute the department of Public Health for doing an excellent job of slowly and methodically rolling out the quarantine that we are living under. I also want to take this occasion to thank all San Francisco citizens, who are practicing physical distancing. I think it is terrific that we have flattened the curve, and that we are seeing the infection rates are not alarmingly high. I think it is very important that we, the citizens, who are observing physical distancing, continue to do this and continue to receive praise from the Health Department. And, finally, i want to say, i would have liked in dr. Cofaxs report here, a little bit more information about current coordination with other regional Public Health departments. Thank you. All right. Thank you. Next caller, please. Caller you have one questn remaining. Hi, welcome. Please say your name and your two minutes will begin. Caller hi, my name is Teresa Palmer, im a physician and a geri geriatrition. I feel like the lack of testing of asymptomatic contact at the nursing home is a form of rationing. It is a statement that nursing home patients lives are not worthwhile, and the lives of the is staff are not worthwhile. I would like some answers as to why were not ramping up testing at Nursing Homes, as we know we should in all congregate settings. Were setting ourselves up for a second wave, and were going to have massive dieoffs in Nursing Homes. Thank you. You have zero questions remaining. All right. Thank you. Those who made Public Comment. I think we can go on to the next item, item 5, the Coronavirus Preparedness update. Dr. Cofax, i cant see you. Can other folks see dr. Cofax . I can hear him he seems to have disappeared off the scene here. You can hear me, right . I can hear you. My video is on, and i can see oh oh, there we go. Hi, everyone. We can see you now. Hello. I had to share. Okay. Im sorry, im not able to see you. But just continue. Ill figure this stuff out later. Thank you. Okay. So good afternoon, commissioners, again, and secretary morris. Thank you for joining with regard to this report. Before we go to the slide, i just wanted to express my gratitude for the residents of San Francisco with regard to their collective response in addressing this unprecedented pandemic. From the beginning, we knew that our ability as a community to mitigate the spread of the virus was really dependent on our collective response. And thanks to the leadership of mayor breed and the aggressive actions that she supported, both locally and i think regionally as well, they continue to certainly mitigate the affects of this pandemic in San Francisco. So just to reinforce the gratitude, and also to acknowledge the tremendous effort and strength that this pandemic has put on the Health Department and the incredible work and efforts of people across the department with regard to particularly the last eight weeks in ensuring that we listen, are responsive based on data, science, and facts. And if we are flexible in our response, as more information comes in, and we do the right thing for our community. So this collective response is really focused on the priorities that i spoke to you about, which seems long ago, a very different time now, in february, with regard to slowing the spread of the coronavirus in communities, and that really is around flattening the curve. And i have provided some slides here for you just to remind us about where we have been and where we are going. But with regard to fightinflattening the curve, i think two things stand out. One is the declaration of a local Health Emergency after the mayor, in february, declared a city emergency. That really allowed us to prepare a city emergency declaration, which was done in february, which really helped us to harness our resources across the department, and, frankly, across the city, to be as prepared as possible. The shelterinplace order, which was put into affect march 16th, that initial order was key in terms of developing social distancing reinforcing the social distancing intervention, which was so key to slowing the spread of the virus. Other key things that we have done that i think remind you indescernable , just the emphasis on hygiene, with regard to washing ones hands, avoiding touching ones face. I think we all remember perhaps we remember the day or the person where we didnt shake hands for the first time, and we started practicing more triple hygiene with regard to reducing the spread of the risk of the virus. And then most recently, just the recommendations around facial coverings and the order that was just released last friday, that increased the requirement with regards to wearing fascial masks facial. I think they were all key, these socalled nonpharmaceutical interventions. You can see that we did it within the context of the broader population context, as well as, as you can see, from several of these orders, there is much focus being on vulnerable populations. And thats our second key priority, that, again, we started articulately months ago, really ensuring that were doing everything we can to protect the most vulnerable to this disease. We know, unfortunately, people over the age of 60, people with morbid health conditions, are more likely to die from this disease. We saw that happening internationally. Unfortunately, those patterns held in the u. S. , including here in San Francisco. So i will get into more details around that, but that certainly has been one of our key priorities Going Forward. As well as protecting Health Care Workers and first responders. The people on the frontlines, the people whos focus is on caring for people most at risk for covid19, making sure that they were able to protect themselves, so they are better protected and can help others. As well as protecting their families and their loved ones as much as possible. The First Priority is really around medical surge, ensuring that we brought forward capacity in order to meet, in essence, a surge. It is still very possible that a surge will be seen in San Francisco. So we remain vigilant in our focus on ensuring that there is Hospital Capacity to meet not only what were managing today, but in the event of a moderate surge, that we do have that capacity. And then also being clear, unfortunately, as happened in new york city, that there are scenarios where there were no there would not be plausible ways that a local response would be adequate. And we would need to be clear with state and federal partners that more help would be needed. I think the other key piece of our focus has been on testing and Contact Tracing. And the fundamental principle in Public Health, and something that has really come to the forefront as we have confronted this pandemic. And the testing pieces have been very challenging. But i think were making steady progress now. And then ill talk a bit about the Contact Tracing that we anticipate to be able to be affective in a relatively short future. Before we go on to the next slide, i want to also emphasize the help, the support, the collaboration with other City Departments and community partners. This is a truly citywide responsresponse. Not only do we have hundreds of d. P. H. Staff working on this, the department of operations center, the Emergency Operations center, which is headed by director Mary Ellen Carroll has been a remarkable partner, and has ensured that our response is more than just a department of Public Health response, it is truly a city response. The controllers office, the homeless department, housing department, and others really are coming together and working handinhand, and in many cases 2 24 7, to ensure were doing everything we can and to meet the needs of our citizens. Can we go to the next slide, please . Sure. Im sorry, i just got you on camera. Go to the beginning, dr. Cofax . On my drean th screen, the Health Orders are coming up. Would you like to go to the test cases . Yes. Give me one second. Sorry. Sorry, everybody. Im a little slow on the uptake on that. Okay, here we go. All right. Mark, may i just ask a process question . I have a i dont know if anyone can answer this question. Im having some challenges with this program whats wrong . The video is the bar that shows the microphone and the camera is super imposed on the eye, so i cant see the slide. I dont know if the other commissioners are having that problem. Jeff burton is on, who is an i. T. Guy. Jeff, is there any response you have to that to help dr. Kofax . Im not sure exactly what is happening, but it seems like something technical. Yeah. Mark, it appears that the control bar is obstructing the view of the dates along the bottom of the charts. Is that happening for other people, too . Well, on my screen, it doesnt. And then the control bar, you can actually it sort of disappears if youre not using it. And it would otherwise so i guess it depends on how it is being viewed. Because it sounds like for dr. C cofax, the control bar is in his way, and for me, it is below the slide. Mr. Kelly, if you move your mouse curse ser so curser y from the control bar, give it a second and it will disappear. You need to move your cursor off the control bar. Does that work, dr. Cofax . Im following the instructions, and it is not working all of the time. But i will as part yes, i will be flexible and work with what weve got, how is that . Okay. Sorry about that. Can everyone see the slide . Yes. Commissioner be careful to mute yourself because were hearing the conversation. Mr. Cofax, do you want to continue . Yes. Commissioners, i wanted to provide you with information about where weve been and where we are going. And just review data so that there is sort of an understanding of what things stand. This is our total number of diagnosed cases in San Francisco, 1231 total cases. And it represents the people who are positive who have been tested. So it doesnt represent all the cases because we know many people havent been tested. But of the people tested, weve had 1231 cases. Weve, unfortunately, have had 20 deaths. And you can see from ear