we can work together if it got to that. , whether that would be something that would fall under the hospital or elsewhere. there's other resources we might know about that they may not. >> we're looking at all of those option. i was thinking more of a massive icu means, which, i think we would have to look at hospitals in the bay or something like that. so again, i don't want to create an alarming scenario, but in terms of looking at other places where people who are not acutely ill but are symptomatic and stay, that's something we're looking at, not only with other hospitals but other key participanteners in the city. ps in the city. there was a question around testing. so the testing capacity is a key

issue for us. it's a key issue, as you know, across the country right now within our public health lab under the direction of dr. susan philip and they've done an amazing job of implementing testing. our capacity is relatively small and they're having to prioritize testing the people who are most in need of testing, requirementy symptoms in the hospital, at high risk for first-degree exposures and then healthcare workers. so we're really focusing on those flee populations '03 thre. to give you an idea of how our day-to-day is going right now, we're injecting a capacity of a day's worth of test or at the best, a week's worth. and so we're getting tests delivered to us by the cdc in

the very challenging fashion because we're simply not able to be assure ed this either w assuh tests to last for months or to expand our capacity to run 24 hours a day. so that's within the dph side. within our public health lab side. we're also working with private labs including quest diagnostics in our health network and that, again, is a dynamic in challenging. quest lab turn-around is three to four days and we're working to ensure that we get people tested who need to be tested. other test companies are telling us they don't have the capacity to except other tests and so

forth. another part of this that we're working on are the partners with the ucsf, they're developing their own tests and it's exciting and i think it's a key part of the puzzle. they're working with global limitations with reagents. so, for example, on friday, i was informed that ucsf was going to be able to perform hundreds of tests a day, not just for gph, but through the ucsf system but then today, i'm told they can't get started because they don't have sufficient reagents. so they have the tools. so there are multiple different strains of testing and each strain has its own inherent challenges. we have such a national shortage of supplies and i have to say

that we were short of things like swabs. we're short of things like swabs. so i have asked not only within the health department but assistants from the controller's office. we brought ito develop a city-wa city-wide approach so that we're actually able to have a full visibility in terms of what tests are available, who they're available to, that we have a shared tracking mechanism and we know how many tests are done, not just the number of positives and we move forward in a coordinated way and there's still support from the city to ensure that we're moving forward

in any fashion that helps us all to do better for the people of san francisco. so that's our fourth priority which i added to our list this morning. >> is the city-wide testing plan you're trying to develop, would that include the private sector hospitals, as well, or just the county and ucsf? >> no, we're trying to -- so right now we're doing a rapid assessment of what is happening across the city because what happened was, some tests became available. there's activity and different groups are doing different things and everyone is trying to solve the problem, or how they're trying to solve it and we're doing a whole needs assessment across the city of all institutions. we're looking at privates. we're doing an assessment of

whatfwhat philanthropy can inved we're trying to decide is it scaling something up or is it because they don't have basic supplies in order do the testing and so on and so forth. if we can, we're trying to get to a point we're trying to determine who gets tested and that's a real challenge, right? but we know that if we could test everybody, that would be -- in a way that's meaningful and systematic, i think that would be the ideal setting and that's what i'm calling the south korea model, right, because they've just rolled out testing in a huge way. we are the city that essentially has done so much of that with hiv. so that's our model. i've brought in a key global health expert and her first day was today who has worked with the clinton foundation and w.h.o. on pediatric testing in

africa and this is her full focus and she's working not only with gph again because i knew the gph people on the ground doing the work, but she's working with other city departments. she would bring in analysts and managers, project managers and people go out and find this information. >> dr. green. >> thank you so much, grant. do you have any sense of timing on this? because a lot of patients have heard about the kaiser drive-through and think there's something else or they can go to kaiser and i think there's a similar programme that you know better than i. but at this point, cpmc has been vocal, they're not in the outpatient business and some of their physician's staff are not employed and they don't know where to get tests.

we're getting really deluged with questions and some, perhaps, do deserve to be tested. in general, think, the primary care people who aren't in a system like kaiser could really use some advice and some directives from the dph, because the systems have been very nonspecific in the recommendations and even in their guidance. all of people are showing up in emergency rooms, at least in ours, and the mixes with people may be positive which makes you worry about spreading the disease further. i know that was a lot of question comments. but what do you see and how would you recommend that practitioners get information and talk to the patients as they see the numbers mounting?

>> so as we're working to get full visibility and who they're testing across the city right now. evacuee been very clear at dph that if people have questions about -- have symptoms or questions about getting tested for covid-19, they should call their healthcare provider. those healthcare providers have act eaccess to information abouw to get tested. how to find out information about testing. the healthcare providers will get counseled whether the patient their calling for, whether that patient qualifies for dph testing. they would have to fit into the three categories because we have to prioritize who gets tested. that is the reason we're developing this broader testing

plan, is in order to address the questions that you have. i'm concerned about people going to emergency rooms or urgent care centers who are not sick to get tested. the other message we keep putting out, please do not go to emergency room or urgent care unless you have an illness and need to go. evacuee been pushing that out ad we're committed to working with our partners to make sure they have that message pushed out, as well. >> in keeping with dr. erogon's advice, i would like to ask we wrap up with the last one or two questions here. is there a commissioner who has not posed a question that would like to ask something? >> i have one question and this is commissioner gerato.

if any of thin any of the figure there been children or adolescents who have tested as positive? >> i have not heard of that case in pediatric and i don't have numbers in terms of young adults but we can provide that for you. >> director kolfax, speaking of children, for parents with children who are out of school and may have questions about the safety of child-care settings or, also, whether or not it's advisable for them to schedule play dates and anything like that, is there specific guidance we're offering? >> yeah, there's specific guidance on our website around that. >> dr. chow, you had one more question briefly? >> yes. it was more -- actually a

compliment to the department and website and to reemphasize that dr. kolfax's point that the department has a great deal of information and evacuee been wen making use in our medical group and we've been encouraging that patients be able to look it up and i want to compliment the department for having put out clear directives and keeping it very up to date. so those that may be watching and listening, that those are important resources and to, again, emphasize as it does, that you don't rush off to the emergency room and you don't necessarily have to get tested and there's some really good documents on that website about the issues of how to care for people on the provider's side and then how to actually be cared for on the consumer's side. and so i want to thank the department for that, too. it's been very useful.

>> thank you. i think we all associate ourselves with dr. chow's remarks. dr. kolfax, anything to add before we move on to the next item? >> there was a question before the homeless population. i want to emphasize that that is a big concern of the department. we are working with our partners at hsa and hsh at the department of homelessness in support of housing to do everything that we can to best protect and care for the homeless population. they obviousl are part of the ve population to covid-19. i'm in th not aware of any experiencing homelessness. we know from data from dr. margo and others that the physical -- that the medical age of people

who are chronically homeless is 20 years older than their chron logical age. we are establishing places for people who are experiencing homelessness who are under investigation or covid-19 positive i just wanted to go back to commissioner green about

the providers. i wanted to assure you all that we have a liaison to the san francisco medical society ensuring that private providers are getting the information they need about testing and how to manage their patients and work with their patients going forward. we're also issuing a health order this afternoon that will ensure that only people who need the most urgent or emergent care will be seen in offices going forward. >> is there specific guidance we're offering to people who are

hiv positive in terms of their being a part of a vulnerable population that needs to take specific measures? >> so we don't know how covid-19 interacts with hiv and whether it's additional risk factor, especially for people living with hiv who are suppressed versus people living with hiv who are immunosuppressed. we're following cdc guidance gus and fits into the vulnerable population going for other chronic diseases. >> thank you, director colfax. >> commissioners, if we could

move on to the next item, which is the joint conference committee that occurred today. >> we met before this meeting and we got an update from the administrator on the situation and status around the coronavirus orders and things that are being taken that seemed quite comprehensive and very

well put in place. so we were glad to hear about that. and i believe that can be shared. if others are looking for that information, particularly the information. (pause) we asked for a flex status which asked for the reclassifications of some of the beds to accommodate the population needs there.

there were rehab beds and dismiss beds and the rest of the time we spent on reviewing the regulatory report which included the recertification survey that happened recently at laguna honda and other facility-reported incident events that have been surveyed. i wouldn't necessarily go into the detail but that information is available to the other commissioners.

>> any questions for the commissioner filiarmo. >> i skipped the item 6, which is the health commissioner elections which are important to your leadership. so let's go to that, please. >> to the office of president, do we have nominations? dr. ch o chow? >> i would move dr. dan grenell. >> i second that. >> mark, would you like to call a role call? (role call).

>> and that's it. >> movinmoving on to the electif vice president, a mo nominationf vice president? >> i would like to nominate dr. laurie green. >> i'll second it. >> second. >> ok, i will need a role call. (role call).

>> thank you to my fellow commissioners for your support and the faith you placed in dr. green and myself as your officers. these are extraordinary times that we hadn't foreseen and i am certainly grateful for your leadership and the expertise you bring to the commission. also, i would like to thank mayor breed for her decisive leadership to keep us ahead of the curve to the extent possible, certainly calling on our city's experience with many other public health challenges, very proud of the decisive actions that san francisco has taken to help stem this crisis. also, very grateful for the leadership of director colfax, dr. etcand others we've been heg from and want to provide whatever support they need to do their jobs to confront this challenge and then, also, a

special thank you to our excellent commission secretary, mark moorewitz for his leadership and work to keep our commission operating, as well as working with our technological team. thank you to you for making this meeting possible to be virtual. and finally, just thank you to our commissioners for, of course, modeling good public health citizen behaviour and joining here virtually and also thank you to the people of san francisco for your abiding by the orders being put out by the city to ensure we all ban together to keep san francisco as safe and healthy as we can. dr. green, is there anything you would like to say? >> well, you said that so eloquently. of course, it's a huge honor to be a part of the executive group and i would echo all of the thanks. i just can't imagine what it's like to be in the shoes or

population health division. i know people are being redeployed in areas that they haven't been working in. everyone is being so diligent and i think we will be an example for the nation of how to do this right and hopefully, we will save many, many lives and continue to respect our entire population, the equity of san francisco and really be the shining example for the country and we may be under-resourced in items, but overly abundantly resourced in still of our individuals and the people part of this department expect citizens of this city. it's a real honor to be a part of this and i'm so grateful. >> thank you, dr. green. >> i look forward to working with both of you. item 9 is a consideration for a closed session. >> second. >> thank you. i will go through a role call vote for the closed session.

role call (. (role call). >> because this is the first time we're doing this, we will not be coming back to say goodbye, but after the closed session, we will simply ajourn and in the future, we'll have this worked out better but thank you for your patience. so everyone online, please push n and commissioners, you are invited to the closed session meeting and you can use that phone number to call in to that and the code. text me if you have any questions. thank you all. >> thank you, mark.

>> i am the director of the department of emergency management here in san francisco. thank you for being here. i just want to remind everyone about the priorities of san francisco. our priorities are to protect the health and safety of those in san francisco. that is our most important responsibility. this is a constantly and rapidly

changing situation we are working hard to flatten the curve the disrupt the spread of covid-19 and protect community health. finally, we call on all those in san francisco to do their part to help protect our most vulnerable residents by staying at home, practicing good hygiene, checking on people by phone if possible who might be isolated. what w we are doing at our emergency operations center is we are working closely with all city agencies, many represented here to support the direction of the department of public health. we are also supporting essential city services that need to remain open. this includes supporting essential personnel, making sure they have the resources to

maintain regular cleaning and helping understand how to implement social distancing. finally, the eoc will continue to support efforts to shelter and care for people impacted by covid-19 and vulnerable populations. before we move on, again, i think the most important thing to share with folks is that this is evolving, that we may not have all of the answers to questions, but we want be to hear the questions so we can work those and turn those out to folks. we know there are a lot. i will turn it over to director jeffrey tumlin from s.f.m.t.a. >> good evening. i am jeffrey tumlin, director of transportation for san francisco. as you know, public transportation is an essential

government service. it is how our nurses and firefighters get to work, it is how our residents get groceries and prescription drugs. we will be working hard to ensure that public transit continues throughout this public health emergency to ensure that people can get to work and get the services and supplies that they need. we are working to rearrange services to decrease the amount of financial district express service in order to reallocate service to neighborhood lines and to lines that serve our critical healthcare facilities so passengers can better maintain social distance while on the bus. for the health emergency, we will eliminate service on the cable cars and f and e lines to protect the health of our operators, ensuring that on all lines that we are operating our operators have a partition

between their operating cabin and the rest of the transit vehicle. muni vehicles are thoroughly cleaned every night and stations are wiped down four times each day for areas experiencing a high amount of touch. our car cleaners are dedicated throughout the process and will continue to be so and operators continue to show up at work. today despite the closure of schools we had a higher than average a attendance of bus and rail operators. we will work on changing parking enforcement, tow, citation and fee policies to accommodate the health emergency. we understand that many of our public will be affected by this emergency. we are immediately suspending all late penalties for failure to pay citations as well as

stopping sending any late citations to dmv or to collections. we are temporarily stopping enforcement of

sfgovtv

>> mayor breed: good morning. are we still in the morning? good morning, everyone. thank you all for joining us today. i am san francisco mayor, london breed. i am joined by a member of the board of supervisors, supervisor aaron peskin as well as doctor grant coa colfax, police chief t and fire chief nicholson as well as other officials. we are definitely practicing

social distancing by having at least six feet apart from one another in this location, but also this virtual press conference is an opportunity to demonstrate the kind of behavior we want to see happening all over the city. we want to thank members of the press for their patience and for accommodating the change in order to help protect and keep them safe as well. we also want to thank members of the public because we know for the most part so many in san francisco have really stepped up and really focused on social distancing and also helping to support and educate neighbors and other people as to what is most appropriate to do during this time. i know that we often times refer to social distancing as saving lives.

i want to be clear that it will save lives. if we continue to practice social distancing every single day during this stay at home order, we will get to a better place. as doctor colfax has said it is a challenging time. the numbers are increasing as we do more testing. we know as we said in the last press conference that we will need more beds and more ventilators ashmore support. what you are doing by socially distancing and staying at home and only going out for essential services you are reducing the number of people infected. thank you all for everything that you have done to help us get this far. i know it hasn't been easy.

we still have a lot more time ahead of us than we do behind us. your patience during this very challenging time is definitely appreciated. i want to start by providing an update on some real positive information that we just received because, sadly, we know testing is very limited in san francisco. the department of public health have been able to administer now 150 tests each day. that did not include the private hospitals, and this is information we will receive sooner rather than later. we expect to increase the number significantly. doctor colfax will provide an update on testing and how we expect to extend our testing efforts more significantly than we have in the past. the good news on that front is

now thanks to kaiser and blue shield, we will be able to provide testing for the healthcare workers on the front line working with patients who have been infected as well as many public safety officials, firefighters and police officers and those on the front line. we will prioritize them for testing. we know so many of them are very concerned they are doing the work in the community. they are trying their best to save lives. they live in fear if they have the virus and they are concerned with going home to spread that virus to the family. getting the ease of knowing if they have the virus is critical to protecting public health and safety. we will prioritize public health and safety officials for

testing. the doctor will talk about that more as well. i want to just also mention to the public that although we want to be tested. i know everyone wants to be tested to know and think that could put an end to what we are experiencing, and i want to be clear that in light of having sufficient testing for all san franciscans, social distances is the key. i keep mentioning it, but i can't mention it enough because regardless of how many tests or who we are able to test, that at the end of the day is going to make the most impact. please continue to practice social distancing. i want to talk about, since this is friday and the weekend is approaching. we know what happened last weekend. what happened last weekend, you

did see people out, of course, enjoying the fresh air, walking dogs, walking with families, and kids and practicing social distancing. sadly, we saw a number of areas in the city just jam-packed. we also saw people who were playing things like volleyball and basketball and other sports together that are not thinks that we are able to do at this time as a result of the order. just to make it clear, we are going to have to make some changes. the last thing i want to do, as i said on monday, is to basically close parks. we need to shift our behavior and make adjustments so that people are not doing the kinds of things that are going to lead to the spread. as we go into this weekend, i

just want to appreciate the fact that we have been able to close places like acataz, four point and lands end look at. the federal government announced parking closures including baker and ocean beach. if you are going to try to go to baker beach or ocean beach, the parking will not be available. we will monitor the neighborhood to make sure there isn't an influx of vehicles that are impacting the parking in those particular neighborhoods. we don't want people to get in their cars and drive to ocean beach. we want people to stay at home. when they need air, walk outside, go to a park within the proximity of your neighborhood. don't get in your cars and drive

to ocean beach or other places. we are going to be closing parking lots in chrissy field and the lots in the marina and ocean beach and specifically near the beach chalet. we hope by closing the area to cars, people will get the message why we are pushing folks to really try to stay, get your fresh air, walk your dogs, but don't get in cars to drive to specific locations to play volleyball with friends, have picnics, wine parties, zoom is a great tool for parties and connections with friends and family. i discovered that as a great tool for socializing. the last thing we want to do, as i said, is to start to close the last bit of fresh air that we

are able to get during this very difficult time. parks, we know, are essential. other places have chosen to just close parks and other places down. we don't want to get to that place. if we see more people placing in basketball courts or playing volleyball and baseball and the sports more team related, we will have no other choice. it is still okay to go out and walk and okay to ride your bike and run. i just want to give a message to the runners. i had an experience walking yesterday in a narrow area. the runners decided to run close next to me. it would have taken three seconds for the runner to wait until i crossed the bridge area to get by so we could maintain six feet. i am asking people to be considerate of one another. i am not asking you to get in

the street and risk getting hit by a car. wait a minute or two to allow people to pass within a safe distance. we all can play a role in making sure that social distances is practiced by everyone. the fact is we are in this for the long haul. there is no need for us to be in a hurry. i want to also talk a little bit about what is happening with our homeless population. because we know that there are so many people that are very concerned what this could mean not just for the people sadly sleeping outdoors. what does this mean in people in settings like single room occupancy hotels and other places? we have been working on a number of things. i want to talk a little bit what we have done and what we will

continue to do. hopefully, this will give people an update on where we actually need to get to as well. starting next week, moscone west will open up and supplies are delivered this weekend. we are going to use that as a place to thin out shelters so we can start to have places so that people who are living in congregate settings like shelters can be spread out. moscone west will play an important role. i want to talk about hotel rooms. we put out an r.f.p. for hotel rooms to be used for people who are