That the public is aware of what is going on and the decisions that were making and what to expect. Theres so much uncertainty. This has been a very fluid situation and at any given time information can change. So we believe that it is critical that you understand how were making those decisions. And some of the experts who are leading these efforts are important people that i think that everyone should know and should hear directly from them. So today were going to dive into the statistics are and the criteria our Public Health officials are looking at and what they need to see for us to continue to reopen and advance our recovery efforts. Here in San Francisco, you all have been doing an amazing job. And as a result of following this order, and i would say maybe not everyone but for the most part a lot of folks are, because you have been following these social distancing requirements, you have made it possible for us to just move further into the stages that have been outlined for our reopening purposes. So we need to continue to do that. We have heard from many of you that this is one of your biggest questions. And so today to talk specifically about just whats happening in San Francisco with the curve and everything and how well we are doing, although that could change at any given moment, is dr. Grant colfax, the director of the department of Public Health. And dr. Colfax was a Public Health leader during the h. I. V. aids crisis and has been leading us through this pandemic. So we appreciate his leadership. Were also joined by dr. Susan philip, the director of the Disease Control and Prevention Branch in the department of Public Health. Shes been leading our testing and Contact Tracing efforts in response to the coronavirus. So what we want to do today is to talk specifically about the criteria related to ill start with the information related to where we are in terms of testing and hospitalizations and other information. And the criteria. Where do we need to be to begin to open up safely. And then also an outline of those phases. Phase one, phase two, a and b and so on and so forth as to what is possible if we continue to follow the social distancing requirements. It is possible that we can get things to a better place, sooner rather than later. So the goal is to also to go into depth with dr. Susan phillips around testing and where we are with testing as well as Contact Tracing and how those things are going to play such a Critical Role in helping us to get open sooner rather than later. So with that, i want to just start with dr. Colfax, just to talk a little bit, you know, about where we are in terms of the numbers. And then how fast the numbers can shift. But, more importantly, if we continue to follow the requirements that are put in place, what can we expect for the possibility to open up sooner rather than later . So dr. Colfax, i know that is a lot, but lets get started. Well, okay, thank you, thank you for your leadership during this really challenging time. And i just want to reiterate that what youre saying this is a really changing dynamic. A changing situation as we learn more about the virus and how the virus spreads. And i also want to extend my gratitude to San Franciscoians for their support of our shelterinplace order. The orders are one thing, but it really takes the community to come together and to support each other in doing this. And its been remarkable. Its about Public Health, but its more about community and how Community Supports one another. Our families and our neighborhoods, to to do our best during this really difficult time. And i think that everyone is doing their best right now. And its really been remarkable over the past few months. You know, it was just in february, mayor, where you declared a state of emergency before we even had a single case. We then went forward with a shelterinplace order and things have really evolved. Theres been scary moments when we were worried about having a situation like we saw on the east coast in new york where the Hospital System got overwhelmed. And where so many people got terribly sick. And, unfortunately, many passed. We have avoided that worstcase scenario in San Francisco and the bay area and im just grateful for your leadership and the support of the public in this work. I think that a couple of things. One is that we as we work to enter this new phase of a gradual reopening, its really important to emphasize while were hopeful that the situation can change quickly. When this virus takes off, it takes off really fast, right . And thats what we have seen, again, in jurisdictions. Thats what we saw in china, thats what we saw in italy, thats what we saw in new york. So we have to be cautious as well as optimistic and hopeful that the work that were doing now in terms of Wearing Masks, in terms of the social distancing, that that really needs to continue for us to be able to live together and also to live with the fact that the virus is in our community and will continue to be in the community for the foreseeable future. So far we are the gain is going relatively well but were only in the second inning of a long game. This is a situation that is going to last for probably 18 to 24 months. A vaccine is still a ways off. We saw hopeful news today but even the most optimistic experts think that vaccines will probably be at least 12 to 18 months off. So maybe i could just mayor, could i just show some of the i want to show a curve because we have talked a lot about flattening the curve. And i just want us to id like to show the curve that i look at when were talking about that. So this is this is our slide of people with the hospitalizations of people diagnosed with covid19 in the city. So its a bit of a complicated graph. So im going to explain it, take a little bit of time to explain it. So this is looking from april 13th to may 16th. The vertical bars are the total number of people across our hospitals, across our nine hospitals in San Francisco, who have been diagnosed with covid19 on any given day. So you can see that on april 14th, on the far left of the slide, that there were a total of 88 people diagnosed with covid19 in our Hospital System. There were 63 people in acute care. And 25 people in the intensive care unit. So those are the people in our city who were sick enough with covid19 to need hospitalization. And we really want to follow also the numbers of people in the intensive care unit because those are the people that are sickest. And we want to make sure that were able to support them to the best of our ability in the medical setting. So this curve is important because it represents the sickest people. You can see over time that that curve this graph has been relatively been flat. If you just look over time between april 14th to about lets say may 5th. That if you drew a line across those bars on the top, that would be a flat it would be a flat curve. Right . So we have really flattened the curve in San Francisco, which means that we are having the situation of many people getting sick and many more people dying because of covid19. So the news also gets a little better right now, which is that if you look from may 5th, so look at that 80 number, may 5th to may 16th. You can see that those numbers have actually dropped. So whats really fantastic about this is that for right now that our curve is not only flat but its actually decreasing in terms of the number of hospitalizations in San Francisco. So this is very hopeful and its really good news. And as we go into these next stages of reopening we have to be very careful that we maintain our masking and our social distancing and our hygiene efforts in conjunction with the shelterinplace, because these numbers can change very, very quickly. So as we go into the next stage of the Curbside Pickup, we increase our commerce in the city, which is good news, and we have to make sure that as we move around that the virus doesnt move around more and actually get more people sick. And thats why were watching this curve very carefully. So if this curve starts going back up, and gets back to where we were at the end of april, you know, 90 or even above, that you would have to look at that very carefully and not only consider whether we dont go to the next stage, but whether we we are more conservative in actually closing things down to some extent again. So thats where, mayor, youre exactly right, this is a changing situation and we need to look at the data on a daily basis. Im hopeful that with the collaboration of San Franciscoians that we will continue to move forward to the next stages. But, again, this could change relatively quickly and were going to need to be watching these numbers so that we ensure that were protecting the health of San Franciscoians as possible. So how are we going to do that . Mayor london breed lets give the criteria of what youre going to be specifically looking at and how youre going to be making decisions to move . Because, i mean, we get questions people want to know when are we opening schools . When are we opening hair salons . When are we opening places where people will have direct contact with one another . So thats because we cant give people specific dates, this is what youre saying, that everything is contingent on what happens with these numbers. So i know that you want to talk about the criteria. And then you want to go into the phases and what we can expect in terms of a general timeline around these phases . Thats right. So im going to go to what were going to be watching Going Forward. To determine how soon and how quickly we can move on those stages that youre asking for, mayor. And then dr. Philip will talk in more detail about our scales of testing and the context. Does that make sense . Mayor london breed yes, lets do it. All right. Can we have the next slide up, please . So these are the basic five indicators that we will be looking at to assess our progress in reopening. Mayor london breed can we just show that slide on the screen, this one slide . I think that it is. Oh, i think that it was being shown. Mayor london breed it was shown but it was some other stuff on there too. I think theyre trying to mayor london breed there we go, all right. Yes. So we are looking these are the five areas that we will be looking at across the city. A number of cases of covid19. The Hospital Capacity across the city to take care of people who are the sickest from covid19. And our testing efforts to scale up our testing. We know that theyre so important for people that have access to timely testing for covid19. And our Contact Tracing. And the need for personal protective equipment. So, mayor, id like to talk a little more in detail about each of these before we get to the phases. Is that mayor london breed yeah, we want to do a brief overview and get into the phases because i think that we want to have dr. Philip talk about the Contact Tracing. So in the number of cases well watch that hospital curve, because those are the sickest people. And were also going to be looking at the case rates as we scale up testing. So this can be a little confusing because as we test more people we will find more pieces. So then the total number of cases are going to go up. But what were really looking at in that situation is the rate of positives. So are 10 of those testing positive . Or is it 5 , 1 . So as long as that rate is going down, well be comfortable with that number. The Hospital Capacity is really ensuring that we have enough capacity in the hospitals in the event that our numbers start to go up really quickly. And ill just give you a concrete example. Right now our covid19 cases are occupying about 6 of our Hospital Capacity right now. Which is really remarkable. 94 of our other hospital beds are filled with people who have other conditions. So we want to make sure that Hospital Capacity doesnt the People Living the people in the hospital who have covid19, that that Hospital Capacity which is currently at 6 , doesnt go above 20 . With regard to testing, dr. Philip will talk about this in more detail. We have scaled up testing dramatically in the last few weeks and over 1,000 tests a day and aiming to get to about 1,800 tests a day in San Francisco on a regular basis. Contact tracing, we want to make sure that were investigating the cases and supporting People Living with covid19. And also making sure that if theyve been in contact with people, that those people know that theyre supported and they get tested. Again, dr. Philip will talk about that. And then personal protective equipment, for us to do our work as medical advisors and First Responders we want to make sure that theres adequate personal protective equipment across the city, including masks and other facial coverings to protect ourselves and others from the virus. So, mayor, unless you have questions about this. Id like to go to the stages. Mayor london breed lets go to the stages. Thats what were here for. Okay. So this is the governors framework for reopening. So phase one we have completed. And right now for phase two today with the Curbside Pickup were now in phase 2a, where we are its exciting because of that curve. Were on Curbside Pickup. And also allowing manufacturing and logistics to support those businesses with Curbside Pickup. And in the next few weeks as we watch those data, we would hope to be able to relax restrictions in phase 2b. To adapt retail, and to reopen schools, offices and child care. Mayor, theres also were working hard to ensure that theres guidance and potential for camp, summer camps for kids. So this would be during that phase 2. Mayor london breed so you think that as long as for example, that the numbers either are stable or decline, that the possibility to maybe have summer camp is possible . I think that its a real possibility. Its going to be a little different than it was before because we have to be cautious about social distancing. So its going to be different. But i am cautiously optimistic that if these numbers hold up that we will be able to to go in that direction. Again, as you said, the situation could change. Mayor london breed can we pull that slide back up, the phase because i think that what is helpful is to just kind of getting a feel for the timing of these phases. So, for example, today we are in the 2a, right . Thats right. Mayor london breed so in order to get to 2b, the five criteria need to be met, number one. And then, number two, how like, if the five criteria are met and then were able to maintain them over a certain period of time, whether d time k that 2b would be able to go into effect, you know, based on just an estimate . I want to be clear this is not the city saying this is going to happen, but based on the trend and what we have seen happening based on the numbers, theres a possibility that we could get into 2b at what point . Or phase three at what point . Yeah. So i think that for phase 2b, and we wouldnt just open up all of 2b up at once, but i think that generally we would anticipate another two to four weeks of watching the data, learning from what we have learned in 2a, and ensuring that people are able to continue to follow the social distancing, the hygiene and the masking guidelines. But that generally in the next two weeks we would then be able to adapt to move to 2b if the data holds up. So somewhere in that two to fourweek window. Mayor london breed which means even longer for like hair salons and nail salons and churches . Thats right. So thats phase 3, yes. Mayor london breed so that were talking about, again, maintaining whatever these numbers are at a flat or a lower rate. And were still talking about those places even a month away . Oh, at least, yes. Mayor london breed i think that part of what is helpful in the course of this conversation is to also to provide people with some guidance so they know what to expect. So i think that and we wont get into it in this conversation, but get into it in a later conversation, you know, just the specifics of how we get people back to work. Because it has been i know very stressful for so many of our businesses and so many of our religious community and folks who are just desperate to come together. And also those who are struggling financially, which as you know as a doctor that this creates a whole other Health Challenge around Mental Health and a number of other issues. So we definitely got to make sure that we keep that in mind, although we know that this is one of the most important things that we need to focus on to prevent the rapid spread of the coronavirus, which even though our numbers may look good today that the fact is that those numbers can change at any given time and we could, sadly, be in a situation similar to how new york or italy or other places have experienced. I think that ultimately the goal is to get people used to the new normal as well, to get used to the masks and the social distancing and all of those other things that are going to help to get us through this. Not just today or tomorrow. But long term. So lets lets talk a little bit about, you know, dr. Colfax, can you tell us again, i know that we cant provide people with specifics. And i want to get to dr. Philip. We cant provide people with specifics as to when, but, you know, i guess how are we going to how do you propose that we make this adjustment . You know, this has been hard already and its been, you know, like over two months. And it is a struggle for just the average person, but especially those who are dealing with