Is he dialing in now . I will call. And i apologize. No problem. Well give him 30 more seconds. Thank you to dph staff and everyone making this meeting possible by webex. Commissioner bernal thank you. Before we move onto the approval of of the minutes, i want to share with the commission, with dph staff and all those watching as members of the public, that as you know, we are under an excess i have heat advisory and there may be rolling blackouts in San Francisco, the beginning as early as now 4 00 p. M. In San Francisco with an anticipated restoration of power around 7 00 p. M. We dont know exactly when this will happen or if it will happen or what areas of San Francisco will be affected, we do know about 103,000 customers accounts will be impacted by this. I know director colfax will talk about dphs response to the heat advisory during his remarks and i want to assure the commission and members of the public the Health Department will be monitoring the heat situation and take all appropriate actions to prevent and protect vulnerable populations. So, hopefully well make it through the whole meeting but if we do suddenly go dark, we know why. Apologies in advance if that happens. Lets move on to the next item. Approval of the minutes. The commissioners, you have the minutes before you if you have had a chance to review them. If would you like to make Public Comment on this item press star 3. This is for the minutes, item 2. And commissioner, i think we can move forward. O. Do we have a motion to approve the minutes . So moved. Is there a second. All those mark, call the roll. [roll call] yes. Thank you. All right, well move it to the covid19 update. From director colfax. And actually sir, im sorry, its the directors report first. Item 3. I jumped ahead. Directors report first. So, we will go into the directors report, thank you, mark. Hello dr. Colfax. Thank you secretary morewitz. Just a few things to highlight in the directors report, what you have before you. Mayor breed presented her covid19 budget for the next fiscal year, which is over 400 million, 446. 1 million to be exact with significant portions allocated to help operations, including of course most of that to the department of publichealth and focusing also on housing and shelter programs and Food Security and Human Services in Emergency Communications and operations. This budget is being presented in various components by different departments to the board of supervisors. We presented the covid19 dph portion of the budget to the board last week and there were a few questions and well go before the board for our fourth hearing on the budget on friday. I will give an update on covid19 in more detail in the next agenda item. Just to say that as some of you may have been reading in the paper, there were reporting delays and charges with regards to the state cal ready system that impacted our ability to better to optimize our understanding of the status of the deposi epidemic in san frano and partner notification. The state is telling us that those data are fixed and we are improving our ability to monitor the epidemic as a result and as we look at the data coming in, there may be some adjustments with regard to the data that has been posted on our website. Weve received a large bonus of thousands of tests, reports that were previously not calculated into our Positivity Rates. The good news is those were for the most part negative results so we were counting for the positive and of course, even with, not of course but just to highlight that with the cal ready system challenges people were still getting their positive test results from their provider. In terms of the few pieces on the Behavioral Health side, the mayor announced last week that a collaboration between the Health Department and the Fire Department ems6 in terms of creating a Street Crisis Response Team that will pair First Responders with Behavioral Health workers on the streets and ensuring that people get the Behavioral Health services that they need in real time when they are engaging with First Responders and this is a Pilot Program and we expect to have it up and running in the fall and lastly per president bern allies discussion around the heat, we have been working with our communitybased organizations and with our team to make sure that people understand the precautions necessary if given the heat advisory, and combining that messaging with covid19 prevention messages, so drink water and stay cool, wear face recovering, avoid strenuous activity and wear light clothing and weve been coordinating with office of Emergency Management to consideration of opening cooling centers if and when we meet the criteria to open them in this age of covid19. That completes my directors report and im happy to take questions. And so, if the commissioners have any questions about those articles or what i went through im happy to answer them. Thank you. Im sorry you are muted. Commissioner bernal sorry about that. Before we hear from commissioners, mark, do we have any Public Comment. Anyone would like to make Public Comment press star 3 and im not seeing hands right now. Lets check. Star 3. Looks like we can move forward. Commissioner grown. Commissioner green. Unmute yourself. Sorry, i didnt have the question. Im sorry. If i raised my hand it was in error. You are just waving at me. We dont see questions from commissioners. If we dont have any questions or comments, from commissioners or someone is having difficulty raising their hands in the system if you would like to just speak up. Commissioner giraudo. My question is when do you think the state crisis team, which is wonderful, will be able to launch . Some time in the fall and im happy to provide updates as we get a sense of the capacity to resource the project and also to hire people. This is claire. I just wanted to say that we were working pulling together and a team to just really delve down as the next step for everything we need to do for that project to make sure that were in close communication with hr and the existing stakeholders to move forward with that. Im looking forward to it and i think its going to be great. Im hoping so as well. Its a department of the department and commissioner. Any other questions or comments, commissioners. If not, well move on to the covid19 update. I was just going to ask i was going to ask when it does start, if we can be notified and then get an update because this is an Exciting Program and one that we would like to track and im sure the public will too. We would be happy to coordinate with the commission and provide an update on that. Absolutely. If there are no further questions well move onto the covid19 update. Director colfax. Can you hear me . We cannot hear you. Now we can. You are good. You can hear me . Now we can. Sorry about that. Well, again, commissioners, director of Health Providing you with an update on covid19. I have a series of data points to review with you and then of course happy to answer any additional questions. As you can see, were at 842,700 cases of covid19 diagnosed in San Francisco. Approximately in the last two weeks and under cal ready system has created challenges and we have estimated about 1,400 people who have been diagnosed in the last two weeks of this would be considered active infection and we have a total unfortunately of 70 total deaths among San Francisco residents. Next slide. This is our test team numbers and we far exceeded our goal of 1,800 tests today and were now almost at 3,900 tests on a seven day rolling average and you recall that we set a new goal for september of doing 5,000 tests a day across the city and were making Good Progress towards that goal and demonstrated by the seven day rolling average on the curve. Our over all seven day Positivity Rate is 2. 97 and we have started our adaptive testing strategy that i talked to you two weeks ago with mobile teams providing testing particularly in the southeastern part of the city and where we have high Positivity Rates and we currently have two test sf mobile sites going into neighborhoods with highest prevalence rate with a capacity to do a total of 500 additional test as i day compared to where we were just a couple of weeks ago. With regard to cases of Race Ethnicity and continuing to see high preportion in the Latin X Community and we are working with key stakeholders, Community Leaders and providing the supports services and the cultural Economy Services and with regards to addressing the covid epidemic in the last inex population. With Sexual Identity data i did want to share this data with the commission looking at cases, cases diagnosed and you can see here that we have under Sexual Orientation, and this is again, a data that doesnt include all our cases. You can see this was for cases interviewed and after april 27th of 2020 you can see the distribution by Sexual Orientation and by gender and next slide. I also wanted provide covid19 case and deaths by age group just to emphasize to the commission that we have, in terms of distribution of cases, this is a pandemic people who are under 50 over all and we have seen a shift as we seen across the nation to a younger population that weve had an increase in cases among people younger than 18 and particularly in the last few months and you can see our distribution here as currently stands and then that is by age group. You can see that we continue to reflect with over half of our case, our debt screen among people over the age of 81 and you can see 3 of our cases where people over 81 or over with regard to the deaths 90 of deaths that weve had in San Francisco of the 70 deaths, 90 have a known whoa more bid condition about the disease and being particularly deadly among older adults and the people with comorbid conditions. So a quick county cove covid comparison. Our case rate is low compared to similar jurisdictions across the country. Death rate significantly lower than other communities and our testing rate is higher with the exception of the testing rate in baltimore and you can see where data are available and we are in excessive including new york city which has done a lot of work to stale of testing were at 3. 61 and theyre at 2. 59 per 1,000 residents. So this is our current hospitalization rate its the farright is our current hospitalization rate and this is our hospitalization rate through the pandemic that peak that we saw in april and may going down to a low of 26 hoppizations in late june and we see the city climb to 111. You can see that weve had some variation in august where were currently most recent data shows a total of 84 hospitalizations and the dark blue lines are the number of people in the icu and the light blue lines are people in our medicine surge that is so were watching it carefully and it is to note the peak and the decline is quite similar and so far to what we saw in april and may with a 94 hoppization and another increase and in late april and early may so were wait to go see if we see a similar pattern here so far it looks like it may be marrying that. We dont have conclusive evidence why theres this by model distribution but its something that were observing and determining why we get this distribution again. Next slide, please. These are data on our key health caters and we have the slope of covid19 hospitalization thats rate of increase shown here at the 1 level is now green and that is alert just a few weeks ago commence rat with that indication we are in a surge. Our hospitalization Capacity Remains in the green with 25 and of our acute care bed facilities and our icu bed capacity is in green and we are high levels of case positivity and this is going on for a number of weeks now and were at 11 and for 11 cases, per 1,000 over seven day rolling average and we, again, to stay at that high level. The testing numbers are ability to succeed our goals and now going to that goal 5,000 in september and our Contact Tracing and partner notifications those numbers are in the orange and lower than we would our goals and again, part of this we attribute to that backlog of testing that happened a couple of weeks ago that was very challenging for our team and we hope coming in, we will correct that and we caught up with our test teams window in terms of turn around times we hope the Contract Tracing numbers will improve. Weve made expansions in our Contact Tracing capacity and are staffing and anticipating the potential for 200 new cases a day. Expect those numbers to improve. Over the next few weeks and then our ppe within n. D. P. H are good and were in a 30 day ply of dpe. This is update on our reproductive rate of the virus again is how quickly or slowly the virus is reading through the population and its less than one and the virus is slowing down because fewer than one person is getting infected and its basically neutral and one person infected infects one new person and a reproductive rate means for each person infected more than one person gets infected and you will see the solid blueline demonstrates the estimate the row productive rate based on models and this is not a number that we can precisely measure and this model at uc and uc berkeley is something weve been using on from early on in the epidemic. We were at a rate as low as. 8 in may and june and it was 1. 34 a number of weeks ago and were down to. 93 on the farright of the curve. Confidence are still wide so we could still be above one but over all the trend is the favorable direction but i would just add we want to continue to see that number go down so that completes my covid update for the commissioners. It doesnt complete it because i did want to add one other component to this which is we were added to the state watch list because of our covid19 hospitalizations. We remain on the state watch list due to our high case rate which means for now we are on pause on our reopening and we are working with the state to determine what the next steps would be when we are off the watch list and the state is we are hoping the state will issue more detailed guidelines about what accounting the may be able to reopen after coming off a watch list and i asked our Health Officer to create a detailed plan in terms of when our reopening face may look like Going Forward given weve been on pause for most of the summer and we are in this pandemic and he will be in a serious situation for a number of months so he is now working on that in terms of what gates we may use to consider reopening and business and other entities Going Forward as we enter the fall into flu season and other challenge thats may lie ahead so thats my update for the commission. Do we have my Public Comment. I dont see hands. If you would like to make Public Comment on this item, press star 3. Lets give it a moment to make sure we dont miss anyone. Star three we have one caller. Give me one second. Just for you to know, i have a timer and everyone can speak for two minutes per item and i will start in the order i see raised hands. We have several. All right, caller, you are on. Caller hello. Hi. My name is know he will and im a hairstylist in San Francisco. The salon i work at has been closed for five months and that is seeing salons reopen safely. Its baffling we are unable to work in San Francisco. We have been waiting watching neighbors and close theres door permanently and were still unable to pay our rent as you know employment insurance have run out and the situation is dire. Hair salons are controlled environment we we practice safely since we are licensed and regulated by the state and we focus on disinfection and client protection. I firmly believe and as evidence shows that by allowing salons to reopen will not spread the covid. Please let us reopen. Hi my name is sha ray a and im the ex tough cultural district and one of the questions that i have was about the rates and ethnicity and how its tracked on the presentation that you presented. Specifically does that. 4 include those who indicated both native american and other ethnicity . And also, on those Health Funding related to the mayors most recent budget announcement, im curious if theres still proposed cuts to major native American Health programs. Thank you. Just a reminder and that the commission will not answer questions thaw may ask but they are hearing you and noting them and passing them on so you are being heard. Lets see, next caller. You are on, caller. Hello, caller. All right, theres no one there. There we go, im sorry. Caller you have me now. Go ahead. I apologize, i have so many mute buttons i had to find the right one. I want to thank the commission for its time first of all, my name is craig and my wife owns a hair salon in San Francisco and i want to join with the womens voice who said you know, theyve been closed for so long now and its absolutely brutal and i would urge that these hair salons should be open and to ask the commission to do whatever it can to row think the policy of the city and county and urge the st