To account for over half of cases. And i just want to emphasize that we are strategically evaluating our efforts specifically in the Latino Community. Im happy to come back to the commission to report back on those efforts. Weve done a lot, and its clear that we need to continue to do more. This inequity has been with us since the beginning of the pandemic. We are focusing more testing and more testing resources and working more with the Latino Community providing lowbarrier testing. Our Contact Tracing and Case Investigation teams have expanded dramatically, and including providing culturally appropriate services and also providing Wraparound Services in Broader Health care needs and Behavioral Health needs, and youll be happy to know that we continue to offer isolation and quarantine options for people who are not able to safely quarantine at home. But theres certainly more to invest there, and im happy to return to the commission to report specifically on our efforts in the Latino Community going forward. Next slide, please. In terms of age distribution, you can see that we have a relatively young our cases are concentrated in a cohort of basically young adults, with nearly half of our cases between the ages of 18 and 40, and you can see that is very different in terms of mortality, where nearly threequarters of our cases are in people who have been diagnosed with covid19 over 70, and over half have been 81 years or older age. Next slide. So these are data compared to the other jurisdictions. Again, youre familiar with this information, but thankfully, our death per 1,000 is much lower compared to other jurisdictions, and weve been fortunate in that regard. Our testing rate is quite high, exceeded only by a few other jurisdictions across the county across the country, excuse me, and our case rate is also relatively low compared to other jurisdictions. And again, i think this is in a city that is seven by seven i believe that San Francisco is the second densest city in the country, after new york city. And we know that in denser settings and more crowded, where theres more opportunity for more crowded conditions, unfortunately, covid19 does spread more easily. Next slide. So this is our hospitalization rate, and we have been in a surgery since july, where we started to see that increase in hospitalizations. Were down to 26 total cases in the hospital. At the end of june, we started to see that incline. Were now down to a slight decline, down to 72 total hospitalizations in San Francisco. You can see the i. C. U. Bed the people in i. C. U. Beds, the white lines represent the patients in the medical surgery beds. So in this slide, it shows that things are moving in a more positive direction i believe than the last time i reported back to the commission. So in terms of our key Health Indicators, this is the these are the indicators where were assessing the status of covid19 across the city. Our hospitalization our Health Care System indicators, which are really indicators of our hospitals, are in the green zone. Growth of covid19 cases are in the negative zone, so thats good. You can see here that acute hospital bed capacity and our i. C. U. Bed capacity here across San Francisco remains in relatively good shape with 27 and 35 respectively. Whats been up for sometime now and is concerning is our case rate. The running sevenday average at this time is 8. 5. That has come down substantially over the past few weeks, but we are still at the high rate, indicating a relatively high burden of disease in the city. Our testing numbers i referred to, over 3500 a day. Progress has been made on Case Investigation and Contact Tracing, these numbers became particularly concerns as there was a lag in our testing and followup time. Just want to acknowledge the Contact Tracing and Case Investigation team expanding capacity, doing this work every day in a culturally appropriate manner, meeting people where they are. Were now at 87 of cases reached, and making progress. Mean goal, in yellow, and moving toward our goal of 89 . And p. P. E. , 30 , 100day supply for our health care staff. We require next slide. [inaudible] every one person infected new person infected is less than one. For every new person, less than one gets infected. Greater than one, more than one person gets infected at baseline. Youll recall that in july, we started to see an increase in june, we started to see an increase, and we our reproductive rate got up to as high as 1. 35, as you can see by that solid blue line, after being about. 85 in the spring. Im happy to say thanks to the great efforts of San Francisco, we are down to 0. 91 and trending down. We are have been moving in the right direction for a number of weeks now, and hopefully with the em if a seu emphasizing, social distancing, limiting crowds and interactions with large numbers of people, we will, as a city, will continue our success in slowing the spread of covid19. So im going to stop there and turn it over to dr. Tomas aragon who will now talk a little bit around the states announcement of reopening and the steps that we are taking to gradually reopen lowrisk activities over the next couple of weeks. Dr. Aragon . Good afternoon. So last friday, the state came out with a new framework for how theyre going to both measure the disease and also to categorize different counties. Prior, they used to have what was called the watch list, and it was basically two categories. And theres several ways you can get on the watch list. Case rates, hospitalization, as well as some other metrics, and if you got on the watch list, you were on it for a period of time. You had to close down activities and thats what happened to us in late june, where we had to close down nonessential offices, malls, and we had to postpone our openings of personal services. So the new framework now is only using two metrics. Theyre using the case rate, and then, theyre using the test person positivity. And based on those two metrics, theyre classifying people into counties into four tiers. Tier one, or the purple the purple tier, is is the highest, and whatever whatever number is worse, you end up in that you end up in that category. The second tier is called red, and the word theyre using to describe that is substantial. The third tier is orange, and the last tier is yellow, minimal. So if youre in purple, its very similar to have been on the old watch list. If you end up in one of the lower tiers, as you move into the different tiers, you can open up more. One of the things the other things they did was they wanted to discourage counties from undertesting, and so counties that were doing more testing had their case rate downweighted. So for San Francisco, because we do a significant amount of testing, they downweighted our case rate, and so we were classified into the red category. And so basically, that means that we had more things available for us to open, and that was really the basis of a of the plan that was announced today by the mayor and dr. Colfax. And there was between friday and today, there was a tremendous amount of work. People really working like crazy to get all of this in time to be able to move forward. And ill give you just the general themes. Im not going to go into the details or specifics unless you have some questions. And basically, what were doing we sort of approaches it this way. We looked at our Health Indicators. Can we move forward . Are hospitalizations flat or moving down . Are our case rates flot or going down, and is our testing in the appropriate range . And dr. Colfax indicated that were moving in the right direction. And the next question is what does the state permit us to do, and then, we apply a riskbased framework, and we move forward in those areas that we feel is going to be safe. And the other thing thats right around the corner, youre going to be hearing about them, and thats going to be schools. So the first body of activity really focuses on allowing activities to happen outdoors. So personal Services Like hair salons, outdoor gyms. Other Recreational Activities to happen outdoors, one, thats safer, but it also allows a business to adapt to serving outdoors. Just to give you an example, so today, my wife, the first thing she did was she washed her hair, and she went and got her haircut outdoors. She was very happy that she got her first haircut since the pandemic started. She did it outdoors not too far from our house, and the person who cut it was very excited to cut her hair, so that was outdoors. Just a couple of things that were going to be addressing. Outdoor worshipping, increasing the amount of outdoor worship and some other categories. The other big area is this next body of activity which is really schools and education. Its very big. Anas going to talk to you shortly about it. Shell give you an update in this area and how important it is that we succeed in this area. And the other area is lowerrisk indoor activities, and thats looking at those activities that really involve oneonone services, where if somebody were to be infected, the risk of a lot of people being infected were much lower. These services are going to be primarily personal services, and well be looking at other areas, but thatll be the primary focus. So im going to go ahead and stop there because youre going to get a lot from ana, because youre going to get schools, which is going to be a big category. That said, do you have any questions . Are there any questions from commissioners or should we continue . It looks like commissioner dorado has a question. I do have one question. When you had mentioned noncontact outside activities, i thought you were referring to sports activities. Can you maybe explain that. Does that mean that the kids cant have practices, no competitive games . Ive been asked this question multiple times. Yeah. They they yeah. Theres two ways of thinking about it. What can be asked it how can be done with is what can be done with schools opening up, and then no contact. When you think of activities that we dont want people to do, you can just think theres close physical contact between people is what we dont want. If theres nonphysical contact, shared equipment, thats okay, as well as people really are careful, but we kept that category nonspecific because theres activities such as pickle ball i did not know about pickle ball but adults let us know about all these activities, so theres guidance for all these activities, i should say. Welthank you. Its just that i get soccer practice, can we have, you know, hockey . Its just these sort of things, and thats where we need eventually probably clear guidelines so that we dont have, you know, confused people would be yeah. It is a little complex. Ill tell you, so soccer is a contact sport, and it really depends on how its designed. So and ana will go into this. One of the ways we try to minimize risks is to have cohorts. So if you have kids that stay in that cohort for an extended period of time, then, we allow riskier activities because theyre in the cohort. But what we dont want is people from all parts of the city coming together to play Something Like soccer because they can get it and bring it back to the households and affect Community Transmission. Thats part of the challenge, and thats part of the complexity. When you get to the schools, its going to be highly regulated to the extent we can because we can design it to lower the risk. Okay. Thank you. Any other questions, commissioners . Yes. I had two questions about the presentation and also about the information that the Mayors Office released. One was in regards to the outdoor activities, playgrounds were not listed, and the second question is theres no mention about [inaudible]. Im sorry, what . [inaudible] in other words maybe im missing it. Indoor dining or Outdoor Dining well, Outdoor Dining is permitted now. Correct. But theres no mention of your goals here of Indoor Dining in restaurants. And i guess my other question, which is much more broad, as were declining numbers of people that can get around into any of these, whether they be in pods or at schools or churches, are we then using the states guidelines or each county seems to decide whether or not at the moment up to this point can be [inaudible] and i think thats whats confusing to people, too, is whats the science of a pod being 10, 12, or 15 . Whos writing these numbers that we abide by . Yeah, let me take them in order. The first one is Indoor Dining. And we know so much more now about how the virus is transmitted than we knew even a few weeks ago. And a big issue with this coronavirus is going to be the aerosolization of the virus. Just raising your voice or singing raises the a aerosolization of the virus. In terms of our trace rate, we are in we have whats called widespread transmission, so we have quite a bit of Community Transmissions, as dr. Colfax pointed out. So the probability of somebody walking into your dining, into your restaurant, is incredibly high. Its probably youre going to have an infected person eating in that restaurant, its going to be a high possibility. If you sort of multiply that probability in the city. So highrisk activity is something were going to look at as the numbers of infection go down. The other thing you mentioned is pod size, and the general rule is the smaller the pod size, the better. Its a general rule, and its like a household. This is one of the challenges that we have in the latino household, the number of people that will live in a household can get very large, so when the infection gets into their household, a good proportion of them become infected. So the smaller is better. The state has given us guidelines. Theyre only allowing 14, so thats the number that were focusing on around the children activities. And then playgrounds, playgrounds is always a tough one. The problem is you can have multiple households, younger households, multiple kids, and then, they can transmit to each other. Kids in general have mild symptoms or no symptoms, but then, they can go back and infect their entire household. So were trying to mitigate that risk while the Community Transmission rate is high, especially at the time were trying to open up schools. So were focusing on how do we keep transmission rates low when were trying to open up schools . So were keeping an eye on certain things, and playgrounds is one of the things that were keeping close. Dr. Aragon, i know its tremendous effort, as you see, for you and the city to have put out a whole list within two or three days after the new state guidelines i think is tremendous. And i appreciate personally, and i think the public does, the explanation that youve given in order for us to understand why certain things dont open yet. I think its an explanation that we continue to try to get out there so that its not just the rule but the rationale behind it for these controversial subjects, and i really appreciate your response today. It was really very helpful. Thank you. Thank you so much. I would echo that. Any other comments or questions from the commissioners . I guess i have just one, dr. Aragon. Is there a place on our website where members of the public can find the information youve articulated, especially as youre updating these things. I know we can find it in the news media, but is there a website thats easy to read that details some of the what youve presented but also some of the details of the Health Orders because sometimes it can be so complex, and i wonder if you can make a reference for people that they can check from time to time. Yeah. So youre bringing up a gap area thats been identified, and i know the city is going to be focusing on improving their communication strategy. So including updating the website. The website is out of daofdad we need to make it more friendly, in addition to the air quality update, as was mentioned, to make it more friendly. So thats an update that we can hopefully bring back to you in the near future. Well, youve informed us greatly. I guess we still just have another part of the presentation. Yes. If i can introduce ana [inaudible], she is going to update our approach on the schools and education, and i just want to say, while we while the departments been working incredibly hard for so many months now, but one of the things that i think is a positive for the department is were working more collaboratively than i think ever before, and there are key leaders who have emerged in this covid19 pandemic, and ana has been one of them. Shes been leading the team just with regard to education and schools, and just collecting information [inaudible] as part of our covid19 response. Thank you so much, and thank you for the opportunity to present all the work that were moving forward in the Education Field and in schools, and i must admit, i am having a bit of a hard timesharing my slides, so mark, if you could talk me through how im able to do that. Sure. And i also want to let everyone know those on the Public Comment line, i see you, and when this is over, well get to you. Ana, at the bottom of the screen, take your cursor down, and theres seven buttons. Two buttons from the left, theres a scroll and an arrow. I do not see any buttons at all. Do you see any buttons . No. Taking your cursor down to the bottom of the screen . No. [inaudible]. You have to click first on the screen and then you see the buttons. Oh, thank you. Oh, thats helpful. Thank you. And then i see so sorry to put everybody through this. I i see i have the screen view, where i see everybody, and i have the tool bar, but i do not see any buttons per se in order to share my slides. Okay. Let me see if i can give me one second. I can talk through them if thats necessary. Ill try to share on my end so we can get this going. Give me one second. Sorry. Okay. I wasnt prepared, so give me mark . Yes. Can you make