Transcripts For SFGTV Small Business Commission 20240712 : v

Sf gov for televising and it can be viewed channel 578 or livestream. Members of the public who will be calling in, 408 4189388 and the access code is 146 7727791. Press found and pound again to enter the meeting. When connected, youll hear the meeting discussions, but you will be muted and in listening mode only. When your item of interest comes up, dial star 3 to be added to the speaker line. Best practises are to call from a quiet location and speak clearly and slowly and turn down your television or other devices that you were listening to the meeting on. If you dial star 3 before the Public Comment is called, youll be added to the queue. An alarm will sound once the time has finished. Speakers are required but not requested. Again, the number is 408 4189388 and the access code is 146 7727791. Press pound and then pound again and to queue for Public Comment, press star 3. Sf gov tv, please show the Small Business slide. This is the public forum to voice opinions and concerns about policies that affect the public vitality of Small Businesses in San Francisco. The office of Small Business is the best place to get answers about doing business in San Francisco during the local emergency. If you need assistance with Small Business matters, particularly at this time, find us online or via telephone. As always, our services are free of charge. Before item one is called, i would like to start by thanking Media Services for coordinating the virtual hearing and the livestream and a special thanks to arch frius. Please call item number one. Call to order in role call. role call . Commissioner adams is having trouble getting into the meeting. role call . Mr. President , you have a quorum. Please call item number 2. Discussion on Small Business reopening during the covid19 pandemic. The Small Business Commission Seeks to understand the current dynamic of the virus, testing and what Small Businesses can expect over the six to 12 months. Discuss item presenter is dr. Tomas aragon, Health Officer of the city and county of San Francisco and doctor, when youre ready for me to pull up your presentation, just let me know. Welcome, doctor, and thank you for making yourself available. You have a challenging job, to say the least. And we have very grateful that you are the one doing it. So thank you for coming and making time for us today. With that, we would like to give you the floor. Thank you very much. Can you hear me . Yes, we can. Fantastic. Ive five put together ten slides. Lets put up the slides. If youre sharing your slides, you have to have the ball and if not, i can pass it to whoever is sharing it with you. Last time i shared slides, my computer crashed. Weve all been there. Are you pulling that up, dominca . Yes. Perfect. So lets go to the next slide. I want to start off by letting you know how San Francisco did to other comparable areas across the United States and so, if you look especially at the number of deaths, the death rate, you see San Francisco is 6. 1 and you compare it to new york city, which is almost about 275 per 100,000. And the reason why this contrast is important is that it really gives you an idea of how devastating this virus can really be to community. We are the second densest city in the country and we were at risk of having a new york style event. From the researchers that looked at San Francisco, they estimated that we prevented over from the shutdown, we prevented over 38,000 hospitalizations and over 4,000 deaths and you can see other cities, as well, that have had higher death rates and higher case rates. And so thats really just to give you an idea of the challenge we have faced. And so in general, the bay area has continued to do better than other parts of the country, other parts of california and im going to go over where we are now and some of the challenges that we face. And the other thing i want to mention is that sometimes people pose this as a choice between the economy and containing the virus. The areas that have tried to open up the economy first have not succeeded. You have to contain the virus. The parts of the world that are opening up their economy are the parts of the world that have successfully contained the virus first. This virus is so infectious, its unforgiving and its relentless. And its pretty much impossible to do any type of higher risk activity higherrisk activity would be, for example, Indoor Dining and thats impossible unless you control this virus. Its that infectious. We cannot do any highrisk activity until we have the level of active infection so small, the risk is so shawl, were able to put up the fires that show up. The mistake that california made, georgia, alabama, florida, all of them is that they tried to open up the economy before having the virus under control and what you see is that it actually makes things worse and takes longer to open up the economy. Next slide. And so the things that we look at and ill mention these briefly. I do want to point out is that in june, in june, across california, people seem to think it started with memorial day weekend, that we really had a spike in cases. We were actually getting ready to open up personal services. We noticed that our cases were going up, hospitalizations were going up and then we ended up on what the state calls the watch list and that is when several indicators are moving in the wrong direction. When you end up on the watch list, we had to shut down the state required us to shut down nonessential offices, malls, to not open Indoor Personal Services and to put a pause on everything. And were still on the watch list and were moving in the right direction and well come off the watchlist theyve been having issues with their data, it should be happening this week and it will put us in a better position to come off the watch list. I think whats happening, the state is reevaluating their framework of how theyll open up california and all of california is in the same position. Right now 38 counties out of 58 counties ro are on the watch lit and they represent 75 of the population in california. So this has been a real challenge. The state was focusing on southern california. Its now focusing on Central California and trying to calm things down. As i said, the bay area in general has been doing better than other places. The things that we look at, the hospital trends, caserate trends, test positivity and ill show you the effective reproductive numbers. When you look at all of this, it gives you an idea of whats happening. We look to make sure the healthcare is ready. We look at testing, our Surveillance System and our ability to do Case Investigation, Contact Tracing and outbreak management and then all of the prevention activities that we need to do. And one of the challenges with a pandemic is that because we have a surge across the whole country, it has slowed down testing dramatically across the whole country. And thats been a real challenge because if you cant get tested or dont get test results back in a quick way, it makes it different to do actually, impossible do Case Investigation and Contact Tracing and outbreak management. And then the next level is level of Business Readiness and ill go over some of the core concepts. We know a lot more about the virus today than we did each jusevenjust a few weeks ago. Were able to really nail down key concepts that if we all focus on these concepts, collectively, well be able to reduce the level of infection and when we do that, were going to be able to move forward. Next slide. So in San Francisco, we have over 7,600 reported cases, and over 67 deaths and we have done close to 300,000 tests. Next slide. If you look on the lefthand side, is the epidemic curve of cases. So we shut down in march. When we shut down in march, we had this first wave here, and back there you see that in april. Had we not shut down, we would have gotten a big new york citystyle spike and so we were able to people classically describe this as flattening the curve. So we were able to flatten the curve and we were doing fine until june. And so, it started in june where we started to see a rise in cases and then this was followed by rises in hospitalizations. So here on the righthand side is that youll sigh the hospitalization rise and so we had up to 114 people in San Francisco. You can see here in august and this is where we were until just recently and we did a lot of education of asking people to please, please, please, wear your face mask, physical distancing, avoid social gatherings. We did this peak over the past severaunfortunately, the caseins high and were hoping that will continue to go down. Next slide. And so, what happens is that we have mathematical modelers at uc berkley that take the hospitalization data. What we know about the population biology of the virus and then do projections. Were much better than two weeks ago. Two weeks ago, we were projected to go up to 1,000 cases if we did not get things under control. This is an example where i say were much better off today than we were back then. Back during the first wave, we did not know about the utility of Face Coverings. Now we know about Face Coverings. Were able to give people concrete advice and thats why we were able to make a difference here. We can see that its getting much better. Next slide. And so, this is whats called the effective reproductive number and that is the average number of secondary cases produced by an infectious case and so an infectious case produces more than one. The epidemic grows and if it produces more than one, the epidemic decreases. This is a positive Feedback Group and it grows exponentially and when its below one, its a negative feedback and so, the epidemic is doing smaller and smaller and smaller, and thats exactly what we want. We want the negativetive Feedback Group, get the infection level as low as possible and do riskier activities. To give you an example, parts of the world in taiwan, they go to the opera. In the opera, everybody wears Face Coverings and the level is so low that even as something as risky as the opera being open, theyre able to do. Thats where we want to get to, but were not going to get there unless we all work together. You can see in june, you can see this dramatic spike and you can see it went up to about 1. 31. That level right there, even though it doesnt sound like a lot, that would have lead to over 1,000 hospitalizations and would have lead to many deaths over time. With the changes in behaviour, we can see its just below one and so were moving in the right direction and thats great news and hopefully, well continue to go there. Next slide. Just to give you an idea, here is most of our infection or half of the infections are in latin x populations and primarily in the younger groups. So here you see the ages between 18 and 40. You see the biggest infection that group and i would say thats probably the biggest change weve seen. Weve always seen a concentration in the latin x. In june, we saw it moving beyond latin x, moving to younger age groups and to other ethnic groups, as well, and also more infections across the city. So a lot more Community Transmission is what we saw. We expect it was primarily because of people doing social gatherings. Next slide. And then here is where the geographic intensity is in terms of cases and the intensity of transmission, although its citywide, we have much more infection going on in areas where theres low income, crowded and primarily, again, in the latin x and primarily you see here on the east side of the city is where we see the most intense infections. One question that people ask me is, why are we having this surge, why is the state closing down malls and why is the state not allowing personal services to go down and if we dont know if that may or may not be associated with the current surge. And i think thats been one of the challenges thats happened, is that we think the state can do a better job. They can do a better job of really trying to understand the underlying drivers of the surge. There are certain things that do seem to be holding up, is activities have happened indoors, where people talk off Face Coverings is high risk. When you have an indoor gathering is a large amount of trainingtrainingstransmission. The next slide. And so one of the big ideas thats coming out, its much safer to do things outdoors than it is to indoors. So the extent we can move activities outdoors, it reduces the risk dramatically. But it doesnt mean its riskfree. So we know, for example, that just talking actually, just breathing, just breathing if youre infected and even if you have no symptoms, just breathing puts out virus into the air. If youre talking, more virus. If you elevate your voice, more virus. If you sing, its even worse. You get tiny, tiny ai aerosols t stay in the year for extended periods of time. While wearing a face mask reduces that by 80 , even if everybody is wearing a Face Covering indoors, it doesnt prevent 100 because that means that each person if someone is infected, the level of virus has been put into the air is reduced by 80 and if you have an indoor space, a Single Person can infect a lot of people. And thats one of the big takehome messages. Indoor activities is very, very dangerous. It will be better when we get the level of infection really low so that even the indoor activity will be less risky. So while we have so much Community Transmission, theres some parts the city that have over 10 of tests that are positive, which is really, really high. And so, when you sort of do the mathematics, its the cumulative risk of having someone walk if Community Transmission is high and youre in an indoor restaurant, the risk of having an infected person in your restaurant everyday, if youre serving over 60 people a day, youll have over 50 probability that an infected person without a mask is inside your restaurant. Thats why its so incredibly dangerous. Its important not to think about just the individual per capita risk or individual risk. What it really is, the cumulative risk that matters and thats why day after day after day, it just spreads so dramatically. Next slide. So there is my last slide. So what i want to leave with you before we open it up for questions is to say that the state has been going through a surge. Different parts of the state are in different part of the surge. Southern california seems to be cooling down. Their hospitalizations are going down and they have had a lot of deaths. Central valley is very impact. What we saw by looking at maps, we saw all of california was involved, including the bay area. San francisco made it on to the watch list and all of the bay areas on the watch list, were all in the same boat, so to speak. Were all in the same boat. And we suspect what the state will do as it reevaluating the framework going forward, it will probably break up sections in california into regions because were so connected economically that it will treat us as a region that when they decide to reopen things up. I cant tell you how theyre going to do that. They havent communicated to us and ill give you some advice later on that i think its important to communicate moving forward. In terms of Community Mitigations, theres really four areas to really focus on. And that is mobility and mixing. Every time you leave outside the home and you mix with people outside your household, that starts increasing risk. Wherever you arrive to that location where you may be meeting somebody outside of your household, it could be outdoor restaurant. It could be indoor retail, whatever it is, ventilation matters. And so outdoor is much better than indoors and if somebody has to happen indoors, ventilation, ventilation, ventilation. Open up those windows. And then you have closeness of contact. How many contact . How much contact are you having with people . How close are you and what is the duration of contact . So any time theres crowds or if you have, for example lets say youre a grocery clerk, that grocery clerk is seeing customer after customer after customer and that cumulative risk to that grocery worker over a day will be larger than an individual person that works into the store. You can see individuals that have that frequency of contact will have the highest risk and this is why workers, bus drivers and anybody thats seen a lot of customers, their cumulative risk will be higher. Waiters, for example, and so as youre designing things, its important to take that into account. The last thing im pointing out, we have control over individuals and workplaces which is Face Coverings, handwashing and an environmental disinfection. These four are the pillars not only to design things to be safe, but now know enough about the biology of this virus that if we all practise this, it can make a big difference. Our big goal just to let you know what the big goal is, we have to get the prevalence so low that not only can we open up businesses but can get kids back in school. This is really, really critical. We have to get kids back in school because the impact the lifelong impacts having kids out of school is very, very, very big. And so, im trying to get all of the adults motivated, that we want the risk to be low, not just so we can open businesses but that we can get our kids back if school because our kids are really the future. So theyre the things were focusing on. Youll hear about h