There are two callers. First speaker, please. So, again, commissioners, this pandemic, as you can see, very few people want to participate in any of these major projects. So we leave it to you, our representatives, to do Due Diligence based on third street, which is a mess, the central subway, we are waiting for the opening, the van ness bus rapid transit, the businesses that needed to be helped have gone. And we havent learned anything what happened on Market Street before. We always dont seem to learn something from the past projects and we dont seem to have a checklist. We just live it to become project managers, who are not really project managers, because they cant do a needs assessment. And then we love to have our fire chats, the Public Comment period, where we allow them a couple of minutes and you dont seem to be paying attention to us. Its going to come to bite you all in the back. Supervisor peskin next speaker, please. Thank you, caller. Your two minutes begins now. Thank you. Supervisors. I apologize, what im going to say. The first thing i would like to do is thank you about some of the downtown [inaudible] from the meeting and the new improved [inaudible] classification is appreciated. The thing i do want to bring to your attention. On the one hand, we have the c. A. C. Moving along and potentially a general Engineering Services contractor meeting for the proposed. You have a parallel track between caltrain and high speed rail on this alignment. I would like to bring to your attention, there is a high probability that this analysis will essentially make it impossible for caltrain to rail yard potentially however. So i would suggest moving forward, you do something to delay the award of the contract, because [inaudible] problems and capacity, thats we can have on the line fort person have to take it from there. Thank you very much. Thank you, caller. Supervisor peskin any other members of the public for general Public Comment for todays meeting . Seeing none, Public Comment is closed and were adjourned. Thank you, chair. Please remember to remain on team. Sfgovtv and producers, getting ready for timm hi, im chris mattis and youre watching coping with covid19. Today im going to the dentist. [ ] when you confirm your appointment with your dentist, ask about the safety protocols they put in place to make sure you are comfortable visiting. My dentist has been very proactive letting patients know exactly what to expect when they arrive, explaining their safety procedures and setting up a detail emailed reminder shortly before appointments. Before i left i put on a mask and took the smallest number of items i would need including my insurance card. Generally i try to book medical appointments earlier in the day. It seemed like i have less weight time and im in and out of the office faster. One of the protocols my dentist has implemented is for patients to call the office from their car to let them know they have arrived. They argue they are in their waiting room right now. If they are not ready, they will call you back to let you know when you can enter the practice. As i walked into the office, the receptionist asked me to use a Hand Sanitizer. I was taken back into the room where i would receive my treatment. Everyone in the office was using p. P. E. Gowns, masks, gloves, and face shields. After entered the treatment room , i gargled with sanitizing mouth mouthwash and we reviewed my chart and xrays. Then we would talk about what steps i would make in my visit. We started my treatment. The procedure was fast and painless. After everything was complete, i was able to make a followup appointment without having to interact with reception. I replaced my mask, was taken back through the office where i used more Hand Sanitizer before going back to my car as i drove home, i was careful not to touch my face. As soon as i got through the front door, i washed my hands for over 20 seconds. Heres a quick recap. [ ] i have seen anecdotal reports that suggest some people are forgoing important medical or dental care because theyre worried about catching the virus even during normal times, offices are extremely hygienic and sanitary and during the pandemic, they are taking extra precautions to make sure everyone is safe. Go ahead and make that appointment and visit your dentist and get the care you need to. Thanks for great. Commissioner chung is here too. Yes . Mr. Chung commissioner chung thank you, i thought it was a statement. Clerk so all were doing is waiting for commissioner christian but i spoke to her and shes on her way. So lets move on. Move to item 2, commissioner . President bernal yes, you have the minutes from the tuesday september 1st meeting in front of you, thanks again to dr. Lloyd green for chairing that meeting in my absense be. And, commissioners, Public Comment . Clerk those of you on the Public Comment line press star, 3, to make a comment on the minutes. Star, 3. All right, no hands raised. So we can move on. President bernal upon review of the minutes, commissioners, a motion to approve. So moved. Second. Clerk i will do roll call vote. [roll call] great, the item passes. Next is the report. Im sorry . Is it okay if i call out . President bernal yes. On the minutes. Clerk okay. So the next item, number 3, the directors report. Good afternoon, commissioners. The director of health, and i will summarize and take any additional questions. Theres a lot going on in the world of Public Health. Some good news, september 9th the Supreme Court upheld proposition c, which will free up hundreds of millions of dollars for funding for homeless services, including a significant amount that will be dedicated to the Behavioral Health services for homeless individuals. So we are looking forward to hearing more on the legal opinion of that. But good news in terms of more resources for Behavioral Health issues where they intersect with people who are experiencing homelessness. And we are currently gathering more information to determine how quickly those funds, if and how quickly those funds will be available. And im happy to report that to the commission when we have that information. With regard to 19, we are continuing on our gradual safer reopening based on the latest data and science. For instance, as of today, we have after opening up a number of places earlier this month, as of today we have indoor activities, including personal grooming services, very limited indoor gym and personal trainer activities, and then we museums may open potentially as soon as september 21st, obviously, with safety guidelines in place. We are also moving forward with school reopenings. Schools that were submitting safety plans and well start with a ksixth grade and a move to middle school and then high school and a gradual reopening. And the team has been working very hard on that. Well cover more covid19 issues in detail further on in the agenda. Good news on the front with regard to h. I. V. We released our h. I. V. Report in 2019, and we achieved a record low of 166 cases of h. I. V. In the city. This is a 19 decrease in new diagnosis since the Previous Year and declines were seen across almost all groups, including among black african americans, people who are on drugs and people experiencing homelessness. There continue to be inequities with in a spike of crimes and of our goal of getting to zero with other h. I. V. Programs. In regard to work in the covid19 pandemic with regard to research, we also were able to collaborate with with u. C. San francisco, the Latino Task Force on covid19, and d. P. H. , and with supervisor Hillary Ronen and the biohub, which conducted testing in a transit hub, at 24th Street Mission plaza, found very high rates of positivity among the latino population at that at that site. Consistent with the findings that we continue to see high inequities of covid19 diagnoses among latinos who constitute 51 of current cases. We are focusing to looking at our prevention and care response, including through increased access to testing. As i previously described we now have mobile popup sites with testing expanding to multiple neighborhoods with high rates of covid19 infection, including the mission, and visitation valley. And i just wanted to share the data that with regard to Contact Tracing and case investigation, 89 of latino cases have been interviewed with more than 90 of contacts interviewed since june. This is actually higher than the overall average. And then in keeping with our isolation and quarantine availability and ensuring that people have opportunities to isolate and quarantine if they cannot do so at home, up 46 of the residents in isolation at home or in hotels have identified as latino. I will stop there and well, actually, theres one other key issue that i do want to highlight in the directors report, which is that we have been working very diligently and in partnership at covid command with our partners at the department of Emergency Management with regard to air quality. And the intersection, obviously, of air quality and hit health, d ensuring that we are sending the messages that communities are being supported where necessary with facial coverings and that staff have the support they need in order to deal with what has been a very challenging couple weeks with regard to air quality. And also as of labor day with heat, unfortunately, given the effects of climate change, this is not the first time that weve had this, and because of covid command were more coordinated in our response than ever before. And other things in the directors report that i dont have time to read through today. Theres a number of press links, that im happy to answer any questions about. Thank you, commissioners. President bernal any comments . Yes, i have folks on the comment line. If you would like to make comment on this line, raise your hand by pressing star, 3, so well know. Give you a few seconds. All right, it looks like theres no comments to this item. President bernal all right. Commissioners, any questions or comments . I dont see any hands raised, but does anyone want to chime in. Clerk commissioner christian raised her hand. Commissioner christian thank you. Director, i wanted to ask very quickly if theres in an ongoing way, if theres any guidance that you can give the department can give to san franciscans about how to protect ourselves from the smoke and chemicals in the air, from the wildfires when we are not able to use the medical grade res re. And were not using them for smoke. Theres so much toxicity in the air and even when we dont smell smoke or when we see smoke, and that, obviously, as the Department Tells us, weakens the pulmonary systems, makes people more vulnerable to covid and to flu and to everything else. So, you know, obviously theres a correlation but we dont have the protective measures that we would like to in order to protect ourselves from that. Given that we cant use the medicalgrade rerespirators, is any guidance that you could give to us how we can fortify our masks, or our cloth masks, anything that we could do traveling to and from work or out by necessity to protect ourselves . Thanks. Thank you, commissioner. We do have guidance, its somewhat complex given the air quality and different populations that are at risk, depending on the air quality. But i can certainly provide you with that link and we can make sure that we get it before this meeting is concluded to share with the commission in terms of exactly what youre asking for. So ill make sure that we get that before the end of this meeting. Commissioner christian thank you. And also just continuing the great work that youre doing about getting information out to the Community Every day. So, thank you so much. Absolutely, thank you, commissioner. President bernal commissioner chow. Commissioner chow yes, i just wanted to make a comment to commend the department and dr. Colfax on the h. I. V. Report. And i understand that were going to hear it in our next meeting, but i didnt think that we should let that go without commending the work thats been done there. Its tremendous. And even though we havent quite gotten to zero, at least for some of us who have been around for a while, this continues to be an amazing trend. And in the face of it getting harder as we get smaller and smaller numbers. So, again, kudos to the department and we really look forward to seeing the report next meeting. Thank you. President bernal commissioners, any other questions or comments . I just have two quickly. Director colfax, first of all, i wanted to second what commissioner chow had said about the h. I. V. Report, its a very Promising Development as we continue to see decreases yearoveryear. And its a testament to the excellent work that the commission and the department has been doing on an ongoing basis. Seeing dr. Buckbinder, Susan Buchbinder on the agenda to speak about our vaccine work reminds me not only of the wonderful work that the department across all areas does, but the additional burdens and the additional stress thats placed both on staff from the executive staff throughout all of our programs to our frontline workers. Can you just sort of characterize how the staff is doing, are they experiencing, you know, fatigue . Are there resources that the commission or support that the commission can offer in order to support them personally as they do their critical work and network . Well, thank you, commissioner bernal and i appreciate the question. I think that as you said this is a marathon. And i think that were in a stage now where were, i dont know, the 10th or 15th mile. And this is where, you know, some of the adrenalin, institution adrenalin, is starting to wear off and people are really, you know, i think that some people are dog tired, to be totally candid. Were digging deep. I think that theres resilience among the d. P. H. Team, and as importantly, and more importantly, the Community Partnerships are in this response. And we are looking at im looking at what can we continue to do and what are some things that may need to be potentially delayed in the Department Just because we have so many Different Things going on. And covid19 is, obviously, paramount in our need to respond. So i think were looking at that. And that hearing that if there are certain components not so much service delivery, because you know, with the board support we are not cutting any services, even though its a challenging budget environment. But other things that can be delayed in response to our covid19 needs. We have hundreds of people working at covid command. All those people have very very busy jobs before they were put into covid command. And they are very busy there as well. But, certainly, i think that the capacity for the department to do everything at the same time is really challenging right now. Again, we are used to working in a scarce in an environment of scarcity and thats sort of where Public Health has been for many decades. So i think that we can be responsive and continue. But we really do need to be taking a look at other things that if they dont have to be done this week or this month, can we delay them without, obviously, harming the Public Health. Ill just give you a concrete example. As we enter the fall, in addition to the smoke, were really looking at how do we ensure that we have a comprehensive response to the flu, right, you know, whether the flu vaccine and education efforts and outreach efforts. Those efforts have always been incredibly important, but more important now than ever because we dont want a twindemic of covid19 and flu. So were pulling staff from other areas and actually working across other city departments through our Emergency Response to see if we can provide bring in more essentially more bodies with the right background, of course, but more capacity in order to address this very important issue. So, yeah, i think that as we saw with h. I. V. And i appreciate, obviously, dr. Buchbinder is an International Leader in this work and i think that our h. I. V. Response is building into the institutions memory, which helped to respond to covid19 in the way that we did, we can and we will get through this, but its a long way to go. And i would just ask for the commissions support. Obviously, you know, guidance, and also just ensuring that that people on the frontlines hear that what you care for you support, and most importantly that you understand. Thank you. President bernal and dr. Colfax, i believe that i speak on behalf of the entire commission in expressing our gratitude and support to all of the d. P. H. Staff who have not only taken on dual roles during the pandemic, but keeping the Department Going in the midst of the pandemic. Wed like to make this an ongoing discussion, so please be sure to bring to us anything that we might need to know in how they might be supported in ways they can ensure that they know how grateful we are to them and how much were cheering for them. And thank you, and thank you to everyone at d. P. H. Dr. Colfax, one more question, and you mentioned during your report the disparities that the latino communities are experiencing in the pandemic, certainly, in terms of our transmission in the community. We know that there are a lot of different factors that lead into it, whether its being an essential worker, someone who cannot work at home, People Living in congregate settings, can you tell us about the engagement thats been happening with the community in order to address this and how were moving forward with this . Yes, so as the commission knows since the beginning of the pandemic, we have been focused on the communities most affected by covid19 and we identified early on that the communities at greater risk for covid19 would include the communities at greater risk for other poor health outcomes. And, of course, the stigma, the discrimination and the xenophobia and the environment in which were living in, particularly