>> good morning, everyone and thank you all for being here today. my name is london breed, the

mayor of san francisco and i'm joined by the president of board of supervisors, norman yee, as well as the department of public health, dr. grant colfax and we are joined by police chief bill scott, the director of emergency management, mary ellen carol and thank you to the press for accommodating this virtual rest conference in order to maintain social distancing during this very challenging time. i also want to take the opportunity to thank the people of san francisco. this weekend, things looked like somewhat of a success in terms of social distancing for the most part and definitely an improvement from last weekend. the streets are pretty clear and there were some definite hot spot areas that we'll be focusing on, but the beaches and some of the parks and other

places, people were practicing social distancing and we very much appreciate your cooperation. it will make a world of difference and, in fact, we already have made a difference in really saving lives. we may not realize the impacts this until this is all over, but eventually, we will learn, i'm sure, that because of what we have done and how we all have participated in complying with social distancing, it truly has saved lives. as of today, we have 374 confirmed cases with six deaths and that is six people who have passed away because of the coronavirus. and my heart goes out to the family members expect friends e have lost in san francisco. one person is too much of a loss and as we have said before, this is a very deadly virus, as you

are seeing, not just in san francisco but throughout the country. and the reason we have taken significant steps has everything to do with saving lives and protecting public health. because we know that there will be challenges on our healthcare system and we know that people are anxious to know about the stay-at-home order and whether that will be extended. i know that our county health officers will be making an announcement tomorrow to talk about the specifics of extending the stay-at-home order until mar the sake of planning and everyone can begin to know this continue to have an impact, you should definitely plan to stay at home and this process and

what we're doing here will continue until at least may 1st. if anything changes, we will definitely notify the public. so i want to just talk a little bit about some of the challenges that we have having and will continue to have and what we're doing to prepare for those challenges. we've said from the very beginning we knew that our vulnerable populations, not only consisting of our ederly but those living in congregate settings and sadly those on our streets would be a part of that vulnerable population and so we would have to move quickly to make sure that in places where we have single-room occupancy hotels, where our shelter systems are and places like ga laguna honda, we had a plan and would keep people safe.

from the very beginning, we knew this would be a challenge. we have learn ed this nine employees at laguna honda hospital have tested positive, as well as two patients, and we are still testing people a at at laguna hospital and we'll have more information once that comes in. we knew the situation would be challenging and so immediately last week, i sent a letter to the federal department of human services asking for significant

support so that we could not only focus on making sure we provide the resources and support to this hospital and we don't continue to drain other services, but we have the expertise and the testing on side and other things needed in order to prevent something from happening that we know has happened in other places throughout the country, including in washington, that house hav a significant populatn of ederly patients. laguna ha honda is one of the largest hospitals of its kind in the country, housing over 750 very, very vulnerable residents who cannot take care of themselves. and this is basically their home and this is where they eat. this is where they live. this is where they're cared for. and so we have been taken immediate steps in order to help support this hospital and

support the people and the staff who are part of it. we were fortunate in that the cdc on friday, after sending that urgent request to the u.s. department of health and human services, the cdc has sent two infectious disease doctors and two epidemiologists and the department of health has sent two prevention nurses to help assess the situation at laguna honda and make recommendations and we also have a dedicated staff member at the cdc in atlanta to help monitor and facilitate the situation specifically at l laguna honda because we know that, again, this is a very vulnerable population and more testing needs to be done and it's going to be important that we have the resources and we have the support necessary to protect and save lives. it's just a start and i'm grateful for what we've

received, but i want to be clear, it's not nearly enough to get us to a better place specifically concentrating on la golaguna honda hospital. we'll definitely be reaching out to federal and state partners to ask for additional support for the residents and the staff at laguna honda hospital. i also want to be clear that the situation will escalate at laguna honda and it will escalate here in san francisco. the fact that we are taking such drastic steps to, in essence, pretty much shut down san francisco has everything to do with how serious this is. i can't reiterate enough how important it is for all of us to continue to comply, for all of us to continue to be good citizens, to continue to cooperate. this weekend, i received a note

from one of my neighbors. the note basically had the email address expect phone number of one of my neighbors on the block who said they were the block captain. so if i needed anything, whether its grocery shopping or pharmacy pick-ups or what have you, or even someone to take to, they were available. and i got really emotional when i received that note because it made me think about how amazing people are in this city and how i've heard so many stories about people reaching out to their neighbors, people identifying ederly people that they know need help and just dropping off groceries, folks just stepping up and being there for one another. because we know that it's not just about the physical health and what we need to do to combat the coronavirus. we also understand that as human beings, there's an emotional toll that this will take on so

many of us. so it's so important that we continue to uplift one another and be there for one another as much as we possibly can. my thoughts and prayers go out to the team at laguna honda. i want to thank them for all they continue to do to give dignity to so many elderly patients who may not have family visits or support and resources to do anything just to be there and to know the nurses and those doctors and those social workers continue to put a smile on the face of those patients. they show up everyday and they just really deserve our respect, our support and we will do everything we can to continue to do just that. so at this time, i would like to introduce dr. grant colfax to

provide us with more detail specifically what's happening at laguna honda, what we're doing to prepare for the inevitable and how, together, we will do everything we can to save and change lives and get through this. so thank you all so much. and let me wipe this mic down.

>> good afternoon, i'm gra grant colfax, director of health. thank you, mayor. today i'm saddened to report to the san francisco community that laguna honda hospital has a growing outbreak of coronavirus. we've prepared for since the start of the pandemic and we will continue to do everything we can to protect laguna honda hospital and staff. i want the community and all of the families to know how much i care, we care about them and they are our top priority. we are intensely focused on doing everything we can to protect everyone at laguna honda from harm, but i also need to be realistic and forthright.

as we look at the data and the patterns around the world and in our country, we know that long-term care facilities are at most risk for coronavirus outbreaks. therefore, we expect the situation to, unfortunately, get worse. across the united states, many long-term care facilities have been hit hard by the coronavirus, including in california, washington, colorado, minnesota, new york and many other states. no local community is equipped to manage this escalating crisis alone. and that is why we have asked for help from the state and federal government and, i am thankful that some of our requests are starting to be answered. as of today, infection control nurses from the california department of health and infectious disease physicians

and e epidemiologists from the c are on la go laguna honda exper. they will make decisions for management that is expected to escalate and will work with leaders at the department of public health to develop a prospective response plan for long-term care facilities in addition to l laguna honda. i am grateful for this help and we need more. from the beginning of the global outbreak, efforts by the city to prepare for the coronavirus have prepared the most vulnerable population. residents who are over 60 years old and those with certain underlying health conditions and chronic diseases. the residents of laguna honda

hospital are in the most vulnerable of these groups. laguna honda has a total of 11 confirmed cases of coronavirus. nine are amongst staff and two are among residents. all are in good condition. since march 26th, 158 staff and 54 residents were tested for the virus. among residents, two have tested positive and 51 negative and one result is still pending. among staff, 156 have tested negative and 25 more tests are underway. and i expect more cases of coronavirus in the laguna honda community among both staff and residents because it is now spreading throughout the bay area. we are drawing on all of the resources we can muster at the

local state and federal level to strengthen our response. laguna honda has been and remains a top priority in the city's preparation and response to coronavirus. the first health officer order after declaring a local health emergency in early march was to restrict visitors from laguna honda to protect the institution's residents. laguna honda leadership has worked actively and diligently to train staff on coronavirus including the use of personal protective equipment, ppe, for all cleaning of common spaces of resident rooms and other prevention technique. here is what is happening on campus right now to respond to the outbreak. first, the hospital incident command system is activated to manage the crisis and the incident commander, troy

williams, is here to answer further details about that process. the state infection control nurses are creating expanded protocols on environmental cleaning, ppe, and staff safety. the cdc is intensifying the information to look for sources of infection and the pathway of spread and this will prevent a plan that taking the coronavirus situation fully into account. the two units where the cases have been diagnosed, south 4 and south 5, are under an extensive quarantine order. each of these units houses approximately 60 residents. within these units, doors have been secured, sheriffs are at the doors preventing residents from leaving and only allowing appropriate staff to enter and residents are being assessed for

symptoms on every shift and staff are being screened twice for symptoms at every shift. testing of all staff on south 4 and south 5 where staff cases have been found is almost complete. to date, nine positive cases have been confirmed. and testing of all patients on south 5 where patient cases have been found is complete and results are pending. to date, two positive cases have been confirmed. all nonessential personnel are restricted from entering the facility. all essential visitors, staff and residents are medically screened and all laguna honda staff are screened at the start of each shift. in addition, laguna honda is setting up a field care clinic on its grounds as a precaution in case there is a need to separate groups of patients.

we are continuing to assess the situation and adapt our response accordingly. working with our state and federal partners. however, even best efforts are no guarantee against the spread of the virus. there are currently 374 cases and six deaths due to coronavirus in san francisco. in addition to our focused, rapid response efforts at laguna honda hospital, they are preparing for the expected surge of hospital patients. i remind all of sanfrancisco to do your part in slowing down the virus. by decreasing community spread, you will help protect vulnerable groups like the very residents of laguna honda and other long-term care facility residents across the country,

other ederly people and those with underlying he health conditions. this is the time to come together as a community while we stay home whenever possible. i cannot stress that enough. unfortunately, we will be seeing more cases and deaths in the coming days and weeks. please do your part to keep those numbers as low as possible. thank you. and i would like to introduce mr. yee, board of supervisors.

>> good morning. i'm t norman yee, president of e board of supervisors and i'm in district 7 in which laguna honda is located. i want to thank dr. colfax and mayor breed in taking a stand with these vulnerable populations we're dealing with. we knew that at some point somebody was going to be infected.

so as tough as it's been to say no visitors coming to laguna honda, it's something we had to do. think about it. the people that are there in the hospital are now not with their families, not with their friends visiting. and the love that the family and the friends want to provide for them, they can't. so a tough decision, it was very difficult to make, but think it was the right decision. problem, in fact, it delayed any infection there. it probably, in fact, reduced the numbers that we're seeing today. what i'm saying is probably reiterating what dr. colfax was saying, that we need to take an aggressive stance. we need to attack this aggressively and do everything we can to slow it down, to

minimize how many people are going to be infected, whether it's staff or the seniors themselves. one thing that we could do even more aggressively if we have the tools is to start testing everybody there, everybody. we can't be working in a vacuum. we can't be guessing oh, where is the next person that will be positive? we have to get ahead of that. so as dr. colfax and mayor breed were saying, we're reaching out to the state and federal government and please respond because we need your help. that's all i have to say today and thank you very much to the residents who are behaving the right way, social distancing, stay at home as much as you can and enjoy whatever you can at home and if you have to go out,

make sure you are staying away from people, at least six feet and to continue washing your hands. thank you very much. >> we'll open it up to some question. >> madam mayor, this is a question from abc7. what is the city doing to help small businesses during this crisis. >> so one of the first things that we announced early on, because we knew there would be

some real challenges with our small business community, is a fund to provide a million dollars in grants right away and that money has dried up and we provided a delay in business taxes until 2021 so that businesses here can hold off on paying taxes until next year. we put a delay on a number of fees that businesses get charged and we also provided a $10 million fund for employees where you have businesses who have sick leave and, for example, if an employee only has two weeks of sick leave, we could provide an additional week of sick leave through a fund that is available and we've tried to make sure that we provided all of these options to small businesses. they can check out the website

oewd.com for more information on how they can get additional assistance. the governor added additional -- there are others other actually before did not qualify for unemployment insurance that now qualify for unemployment insurance. and so state unemployment insurance is available to a lot more people than it hav ever has before. so it's important that people apply because you may not think you're qualified, but you are. i'm working to develop a no-interest loan fund where we've partnered with a number of nonprofit agencies -- excuse me, folks in the private sector to contribute money along with public dollars and we're hoping to make that fund available to

businesses sooner rather than later. we understand that businesses are suffering and there's some real challenges with paying bills, but i think our commercial moratoriums on convictions and a number of other things we're doing to really slow down or hold off on extreme responses to the lack of our business community and their inability to pay bills because of the resources that they're no longer able to regenerate, i think that some of the measures we put in place will be helpful. i know they won't be enough so we'll continue to add a number of resources to help support our small business community and i just want to be clear, there's a lot of folks who are hurting out there and we'r we're going to do everything we can but this is a problem that doesn't exist in san francisco. it's all over the country, all over the world and it will be

difficult to help every single person, but we'll do our very best. >> question from sin singh tao. for affordable housing, but what about luxury home building? >> the fact is in san francisco, costle building anything is so expensive, the fact we don't build is a problem. it doesn't matter what sort of housing gets built. the fact is, when this is all over, people are going to need places to live and so i'm not going to pit between one housing versus another. housing is essential, period. and what we don't want to happen is what happened, especially when we started to focus on job opportunities between 2010 and 2015 during the time when we were attracting a number of tech companies and other businesses

to sanfrancisco. for every eight jobs we created, we created only one unit of housing. you had people lining you in the western housing community where i grew up, where you would never see anything like this for one apartment, which i think drives up prices. so the fact is, all housing is essential. and we don't need to pick one over the other. the fact is, when this is all over, just think about it, we have thousandscs of people on streets. you think we'll able to afford thousands of units to house them? this will require every single unit that we can get on the market, no matter what kind of unit it is. >> thank you, madam mayor. the next questions are for dr. colfax.

this is from reedasm lbergati from the washington "washington? what date are you used to make your posts positive? what's the view of using modeling to predict what will happen with the virus and are you relying on any models? >> thank you. we have some of the best people in the help department helping us pull in data from all sources, both locally, nationally and internationally to make an informed response. some of the key things we're

looking at, obviously, are the number of cases and very importantly, the number of people who are hospitalized, including people in the intensive care unit, following numbers carefully, and using other data from china, italy and now new york t of what to be prepared for in worse case scenarios and updating the numbers to see where we stand. so in terms of what we're missing, you know that there's clear testing deficiencies across the country and we're working to expand our testing capacity in san francisco. we still do not have an accurate prevalence number and, in other words, we not know overall per thousand people in san francisco what the rate of the virus infection is and we are working, again, with the uc berkley and ucsf colleagues to determine that number as quickly as

possible to get the estimates and those will be very important in informing our models. with regard to whether models are helpful, yes, i think they are very helpful and they provide a number of plausible scenarios and they certainly do not provide certainty about where we're headed but provide plausible scenarios to help us plan our response going forward. >> the next question is from jamie harr of the associated press. the department of public health is sending health inspectors to conduct inspections at sros. how many are checking and what are you looking for or not looking for? >> so we are focus on a number of things, but particularly with regard to hygiene, making sure that the procedures are being followed and making sure that we're doing outreach and education to the community, around the social distancing order and making sure that people have the information they need and, also, making sure that people have the information they need in the event they need

care. they know who to call, when to call and to get the help from the public health department, their community and other healthcare providers and systems across the city. >> and this is a followup, if there are unsafe conditions, what will you do? will you move people out? >> we're looking at focusing on the conditions are as safe as possible and if peopl symptoms, they are protected and that they're provided with resources and physical spaces that allows them to self-quarantine from their community and other people that they may come into close contact with. >> and the next question is from shannon lim of kqed. there's a question and followup. what are san francisco's plans to start testing hopeless people for the coronavirus? do they have a protocol for who they will be testing and when this will begin. >> so i appreciate the question

and i'm emphasized that we are expanding our testing and it's a key priority of the department's. i just want to be transparent, though, what we're doing. to give you an example, when we send our request up to state with regard to asking for more help and responding to the laguna honda situation, part of that request was the request for more swabs, testing swabs. therthis is not just limited ton francisco but a national shortage and we are struggling to get swabs in order to test and so along the supply chain for testing, there are severe limitations. while we are working to expand testing capacity, my public health lab is expected to triple its potential capacity starting today and we are still struggling along that supply chain to ramp up testing as long as possible. so anything from the specimen collection you need for swabs, from the processing reagents that are needed, our supply

chains are episodic and hard to determine. so with regard to testing people who are tendernessin experiencig homelessness, we will focus on people who are symptomatic and people with high-risk exposures. >> miss lin's followup and similar to question from dan simon from cnn. the medical director of the er at ucsf believes there's a flattening of the curve and credits the state-at-home order and not seeing a surge of expected of patients. do you believe this is so? >> i haven't spoken to the er directly. i think it's still too early to tell. we are monitoring the numbers. the thing is when this disease takes off, if it takes off, it takes of rapidly in communities just like new york, the

escalation, the curve is very upsloping very quickly. it's what we call a logrythmic increase. we need people to stay at home and we are expanding the stay-at-home order and more details will follow. we are watching the data very carefully and i do not know whether the aggressive actions early on have had the tentative effect but we need data to confirm that. >> from the l.a. times, a similar question, asking to clarify how many people with the virus are hospitalized in san francisco right now. and the sheltered place in terms of flatten the curve, if that's not happening now, when do you think we might see that happening? >> so to answer the first question with regard to

hospitalizations from the latest data i have from the city systems, we have 58 people hospitalized with confirmed covid-19 in the hospital systems across san francisco. again, that number could rapidly change. and it's too early for me to speculate whether we're succeeding in flattening the curve. >> the next question, may i ask if san francisco or dr. colfax are coordinating with any other bay area counties in the city -- excuse me counties, cities or the state of california on how long to extend the stay-at-home order? >> yes. certainly i am in regular contact with health directors across the region, as well as direct contact with state health leaders and the response to this pandemic and confrontatio yard e

healthhealth order. this is far more effective from a regional approach. the order that will be released tomorrow will be another regional approach going forward and it is essential that we collaborate, share information and react to reduce the pandemic spread. >> and the final question is from dominick vercasa of the chronicle. will any activities currently permitted, like housing construction be prohibited under the extended order? >> so the order will be released tomorrow and those details will follow. >> thank you. >> that concludes our press conference. thank you.

>> chairman heinicke: all right. good morning -- good afternoon, ladies and gentlemen. i will call this meeting of the san francisco m.t.a. to arrested. i will read some preliminary rules after the roll is called. call the roll. [roll call] >> clerk: thank you. you have a qu.