reach out and share your stories and experiences with us. i still believe it is important for us to vote on this resolution today to place , to in the official record, and to commit ourselves to helping small businesses. i want to thank supervisors mandelman, preston, and safai for their cosponsoring of this resolution. okay. so madam clerk, can you call the roll on this? >> clerk: on item 24 -- [roll call]

>> clerk: there are 11 ayes. >> president yee: okay. without objection, this resolution is adopted unanimously. madam clerk, let's go to item 26. >> clerk: item 26, motion to concur and actions taken by the mayor in the 9th and 10th supplement to the proclamation on april 10, 2020 and april 14, 2020, to meet the ongoing local emergency related to the novel coronavirus covid-19 pandemic.

>> president yee: thank you. supervisor peskin? >> supervisor peskin: thank you, colleagues. first, i wanted to start with a house keeping issue. it is my belief that in at least one, if not two, of the mayor's declarations, it was accompanied by legal advice. we all received -- >> president yee: supervisor peskin? i don't know if your video is on or not. i don't see you anywhere. >> supervisor peskin: hold on one second. wait one second. yeah, my video is on. >> president yee: okay. my bad. >> supervisor peskin: okay. so as i was saying, my understanding is that in at least one, if not two instances, the mayor has received privileged legal advice as to these supplemental

declarations. yesterday, the board of supervisors received, for the first time, an attorney-client privileged memorandum with regard to one of those supplemental declarations, so the housekeeping item is, i just want to be clear, as with attorney-client privilege advice, that the board gets, as we craft legislation, that is ultimately shared with the chief executive, that during this emergency period, the converse happens, and i think we are still waiting on one other attorney-client privileged memorandum that has yet to be given to us on an earlier supplemental. but i just want to confirm through the president with our deputy city attorney, miss pearson, that that is now going to be the policy of the city attorney's office.

>> mr. givner: this is deputy city attorney jon givner. can you hear me? >> supervisor peskin: yes. >> mr. givner: my colleague had to unexpectedly leave the meeting, so i'm jumping in, but only on audio, not video. that is currently our office's policy to provide confidential written advice to the board whenever we provide confidential written advice to the mayor regarding one of her proclamations. >> supervisor peskin: okay. so i think there may be one outstanding piece of advice that we did not receive, and we should probably receive those timely, but i will speak to you, mr. givner, offline about that. with regard to the 10th supplemental, this is a question through the president to the representative of the

mayor, and i'm trying to understand what precipitated this order, and i have a number of questions, and i'll start with the fifth supplemental declaration. my understanding is that is expiring and that is about to be renewed, so through the president to miss kitler, is the fifth declaration with regard to he vacatioevictions e renewed today or tomorrow? >> through the president to the member, we expect to extend the eviction moratorium tomorrow. >> supervisor peskin: thank you. and with regard to the 10th, which is premised -- it says that it shall be unlawful for a

tourist hole will to remove any touriany -- tourist hotel to remove any tourist staying in a unit, what was this trying to address? >> through the chair, our office was made aware of a number of individuals who had been sheltering in place at a private hotel, a tourist hotel not in kind of the number of hotels that the city has been bringing on-line but kind of a private hotel that they had booked a -- at a private hotel,

not a number of hotels that the city has been bringing on-line, but kind of a private hotel that they had -- not in kind of the number of hotels that the city has been bringing on-line, but kind of a private hotel that they had booked a room through their own means and had

test -- a -- [no audio]

>> clerk [roll call] >> clerk: there are 11 ayes. >> president yee: okay. so this motion is approved unanimously. so madam clerk, please read the in memoriams. >> clerk: this meeting will be adjourned in memory of the following beloved individuals. on behalf of supervisor safai, in memory of the late luis echegorrian, and on behalf of supervisor stefani, kathy yoshigochi. >> president yee: okay.

madam clerk, do we have any further business? >> clerk: there is no further business today. >> president yee: okay. members of the public, you are also welcome to continue watching. this meeting is occurring under the governor's policy, discussing any business that is within the subject matter jurisdiction of the body. this will allow the board to be fully briefed by the health officer and ask questions of him as long as we do not

discuss among ourselves or take any -- any of these -- action on any of these. members of the board, please stay on the line, and if we can give ourselves about 30 seconds, we can ask our health officer, dr. tomas aragon, to be on the line. >> clerk: mr. president, dr. aragon is on the line currently when you're ready. >> can you hear me? >> president yee: yes. so dr. aragon, are you ready? >> yes, i'm -- i'm ready. >> president yee: okay. thanks for joining us today to

provide the board a briefing on the latest updated on the health emergency. before we get started, madam clerk, can you please take the roll and call the attendance of any staff so we understand who is present for this update? >> clerk: yes, mr. president. [roll call]

>> clerk: mr. president, everyone is present. >> supervisor ronen: okay. i've got a question before we begin. >> president yee: let me finish this part first. so let's continue to use the roster so we are able to speak one at a time. please indicate if you would like to speak, and i will call on you. if there is no current speakers, i will turn it over to dr. aragon to share his briefing with us. supervisor ronen? >> supervisor ronen: yeah. i just find this all very odd. i didn't know about this part of our -- this addendum to our meeting that wasn't noticed to the public. can -- can you explain -- so --

so we can just call a meeting with all 11 supervisors without informing the members of the board of supervisors and without informing the public ahead of time on a major policy issue as long as we don't have cross discussions? it just seems very odd to me. i don't know how this happened and why we weren't informed. >> president yee: sure, and i'll take a shot at that. basically, this is for information only and to clarify the information, and, i guess, this is, you know, one where we won't do it every week, but it's good to know. no, we're going to do some of these updates informally through our monday through friday briefings, and to give the public some good information. as i mentioned earlier, the governor's sort of executive

order that allows public bodies to receive information, and it allows us to do it without setting an agenda. so deputy city attorney givner, are you still there? >> mr. givner: i am. >> president yee: okay. is that sort of along the right line? >> mr. givner: that's right. your description was accurate. the governor issued an executive order on march 21 that allowed legislative bodies like the board to receive briefings from state and local officials regarding the government's response to covid-19 and allowed the board members to ask questions during those briefings as long as the board members don't discuss among themselves or take any action. the governor's order doesn't require the board to receive these briefings in a televised

setting, but i understand you've chosen to do that today. and as i said, there's no requirement for agenda notice for this type of briefing. >> president yee: supervisor ronen. >> supervisor ronen: as a matter of courtesy, if one of these meetings are going to be planned, if we could be advised ahead of time so we could plan our schedules. we attend the monday, wednesday, friday briefings, and this would have been nice to have known before it was introduced at introduction. >> president yee: so supervisor ronen, i agree with you, and this was requested of me pretty close to starting time at 2:00, so supervisor peskin, would you like to weigh-in because this is your request. >> supervisor peskin: thank you, mr. president, and thank you for your accommodation. to supervisor ronen, through

the president, and through to my colleagues, i actually wanted to put this on the agenda as an imperative item, but i was advised that could not happen. i do want this to happen in a regular form, in a way that the public has access to this, in this very rapidly evolving situation. i hope that we can actually have a regular item on the agenda where we can hear from somebody who is actually our appointee of the board of supervisors, the public health officer, and the public can hear it, as well. this is our first time out, and -- but i appreciate everybody's indulgence and just wanted not only for the 11 of us to hear, but the public to be able to hear.

this is an imperfect start, but it is a start, and you and i and my colleagues have been banging the drums for more transactions, and that was the spirit which i brought this to today's meeting. thank you, president yee, for accommodating my request, and thank you, city attorney's office for making this, as well, and i hope that this information can be available to the public, as well. >> president yee: okay. so dr. aragon, would you like to get started? >> yes. thank you, everyone, for giving me time this afternoon to go ahead and give you an update. what i want to do is give you a little bit of context from a regional perspective. so san francisco, we have been very fortunate in that we were able to dodge a bullet in terms

of the sheltering in place, social distancing, all of the interventions that were implemented prevented a large hospital surge, and we are not seeing in the bay area what is happening in new york city and what happened in italy, so that's one good thing i want to reassure people. what -- but one of the challenges is that even though we dodged a bullet, we're still very vulnerable, and we can easily tip into a new york scenario, and i'll try to explain why that is. so we know from data that's coming out of santa clara and los angeles counties that there are some serology studies to get an idea of how many people in the population has been infected. we know that santa clara, even though it wasn't a perfect study, about 2% of the population was infected. if you look at the number of

surveillances they have in their system, it's a large underestimate of cases or people that were infected. so whatever cases we're aware of was actually a large undercount of the number of infections. that's the first thing. the second thing to realize is a large population is still vulnerable. uninfected and still susceptible. in santa clara, it's close to 98%, and san francisco is probably going to be closer to santa clara. the way this virus works, it's so contagious, it's being verified by the modelers, the hospital regions across california and also the bay area, that we could -- we could -- we could, if reinfection were to occur, we

could tip into a new york scenario. that's the first thing i want to say. the next thing i want to say is if you look at when we started our shelter in place and where we are today, we're -- even though we were able to slow down the growth, the iceberg of infection, that we're now seeing movements of those infections into our most vulnerable infections. the s.r.o.s, the homeless, long-term care facilities. the people who are not only the most vulnerable, but who have the most difficult time doing shelter in place and all the interventions that we would want. some of our advanced staff are doing calculations, and because that population is big, if it moves really fast through that population, we can still end up with a surge in san francisco, so that's one of our vulnerabilities. the next thing i want to summarize is how the thinking is nationally on how we're

going to move forward. the good news is that san francisco really is in a better place than pretty much anyplace in the country because we've been able to prevent the surge, so that's great. so the question is, how do we move to the next phase. we are in what is called nationally phase one, which is slowing the spread and preparing our infrastructure for the next phase. phase two is about how do we begin to roll back these dramatic interventions like shelter in place that has a humungous economic impact and is also going to have an impact on the community, especially those that are most vulnerable, as you know, the low-income people of color, undocumented. and so how do we begin to roll -- how do we begin to open up the economy in a way that doesn't create a surge that happened in new york city.

that's phase two. phase three is we're not even close to phase three. phase three is where we have good therapeutics, and we have a good vaccine, and we can treat the population. so i want to come back to phase one, and where we are now, and what we're trying to do in the city. the way to think -- i'll give you a way of remembering the key pillars of phase one, and they all begin with the letter t. transmission, testing, tracing, and treatment. under the category of transmission is where we know most of our activities have been. sheltering in place, social distancing, universal face coverings, hand washing, all of these interventions -- environmental disinfection are

critical to interrupting transmission. we want to keep those in place until we can pull back on shelter in place. the second is testing. fortunately, testing is improving. back east are using saliva test. i understand there's a home test that may be approved or just got approved recently, so the testing capacity is going to increase dramatically, and that's going to help a lot in terms of our case finding strategy. as our testing capacity increases, we're going to see more and more testing. with case finding, we have case management and contact tracing. that's the third phase, the tracing component. we have to build a public workforce that can do all this

public health management and tracing. we have a component with ucsf, and we've implemented an complication that allows us to hire people who can work from home and do contact tracing on -- to call up and do contact tracing on-line, the whole work flow of contact tracing. that works fine for an average person that you can contact and get that information and work with that. the other component is the people on the ground. we need to build up strike ste teams, not just for our population, our homeless, our s.r.o.s. currently, we have core expertise and core capacity. we now need to replicate that -- [no audio]

>> again, we can begin to roll back shelter in place. and then, the last of phase one is treatment capacity to make sure that we have both the surge for hospital beds, i.c.u. beds, and ventilators. we were fortunate in san francisco that we didn't have to use our surge capacity, but we need to have it if we see a surge in infections. so that's where we're at in phase one. i do want to mention that the bay area, we're part -- because we're part of california, ultimately, the legal authority of how this plays out in california comes from the state, so we're really waiting for more state guidance on how

they're going to anchor their intervention because to the extent that we can align closer to what the state is doing, and that everybody feels comfortable that that is a responsible way to move forward, then that's going to make it a little easier for us to sort of being focusing on those public health components and not getting into these other components where people are asking me, you should open this up, you should open that up, and it's really hard to know, in my current role, to be focusing on that. we're trying to move to how do we focus on the core public health interventions and align to what the state is doing? so that's where we're at right now. again, and i think -- like i said, we dodged a bullet, but we're not -- we've damaged one bullet, and we want to make sure, as we move forward, that we have everything in place so that we can begin to open up in

a way that makes sense for everybody. so let me -- let me stop there, and i'm happy to answer questions -- you may have questions about other components, and i'll try to answer those other questions to the best i can. for example, the map of cases across san francisco, i can answer questions to things that have already been released publicly. >> president yee: supervisor peskin? >> supervisor peskin: thank you, mr. president, and thank you, dr. aragon for making yourself available this afternoon. i think what you said was helpful for all of us to hear. you did speak to the vulnerable populations and vulnerable sites that we are all painfully aware of, whether they're nursing homes, shelters, or

single-room occupancy hotels -- and jails, for that matter. can you show us what our plan is for each of those types of sites? >> so in that -- and that's an area where we absolutely need to build -- we need to build capacity. so let me start off in the long-term care facility. we're learning how to manage different situations. so the long-term care facility, i would say that's where our biggest chance is for mortality. laguna honda was our first focus because we have 800 residents at laguna honda. we have a workforce of 1500, and it was just a big

vulnerability. we had a few cases at laguna honda. we brought in the c.d.c. and the state health department, and they really helped us how to figure out -- how to manage -- how to manage a long-term care facility as big and as complex as laguna honda, so we learned a big part how to do that. how to confine big parts of the hospital and to do mass testing of the hospital staff and residents. we learned a lot from that, and what we need to do is replicate that across a lot of long-term care facilities throughout san francisco. other long-term care facilities don't have the training, experience, and capacity that laguna honda has, and so our long-term care facilities need a tremendous amount of support not only in p.p.e., in helping them develop a task of testing,

components, screening, that component. we need to build out -- i'm just going to call it a strike team -- teams that can be deployed to help the long-term care if a similarities. and we're learning at our hotels and our s.r.o.s. it's the same situation, especially as testing becomes more available, how we're going to do surveillance in s.r.o.s, how we're going to do targeted testing should any cases appear, and how we're going to do targeted availability. so when have a room, and a person goes ahead, how we're going to be able to place that person into both isolation and quarantine. the shelters -- we're in the same situation in that we're better learning how to manage that, as well. you'll be hearing -- some of

this has been in the news, but you'll be hearing more about how we're learning how to shelter in place homeless people who are covid positive, who are recovering or recovered, where they can be all in one location where we have the staff, the personal protective equipment, the training, we have everything in place so that can happen safely. and we have -- we still have more -- we have more capacity that we have to build up so that we can do that better, more efficiently, and so that we can do that quickly. >> president yee: dr. aragon, particularly in regards to this strike team that you're talking about that would be available if something happens, if this

strike team is there, why wouldn't we send them to these nursing homes now and maybe have some prevention instead of waiting until something happens? >> yeah. what i'm calling a strike team is more than responding to an outbreak, it's focused on inspection. we want them to be inspecting the long-term care facilities before and when and if an outbreak occurs. so we're calling them an outbreak prevention and response team. so we sort of realize the way communicable disease control capacity started is it started with a team of people who were trained to focus on a specific communicable diseases in the community, and now, we realize is that not only do we take

that team, and now, they have to be specialized in long-term care facilities, s.r.o.s, homeless, and now jails. each one of those requires a different strategy, so now, we have to replicate -- we have to build out more teams, and so within that, we have to build more capacity. so right now, we don't have that capacity, so we're looking to -- we're looking to hire more staff. right now, we're working with san francisco state, u.s.f., u.c. berkeley. we're trying to bring in staff, working with c.b.o.s so that we can hire staff to do all of this work that can extend the expertise that we have at the health department. >> president yee: thank you. supervisor haney?

>> supervisor haney: thank you. thank you, president yee. dr. aragon, i wonder if you could speak to testing capacity. we spoke if we have enough tests in san francisco. it seems like we have a lot of priority populations that we should be testing that we aren't testing. there's been some announcements from ucsf that they're able to help with testing for a period of time. how much testing are we doing citywide, and what are the limitations for us to do more? >> yeah. i don't have the statistics on me right now. if you go to the website, it tells us the testing capacity that we're doing, and the testing capacity is finally beginning to open up and finally beginning to increase. the one thing that held up testing was the supply chain of things like swabs. initially, it was reagents. all of that is beginning to

improve, and p.p.e., personal protective equipment. it was not really the labs, but all of that is improving, so we're beginning to gear up so that we can do more -- we can take the public health capacity and focus on the most vulnerable populations. and then, the public sector, we're going to hope that they're going to take care of more of the general population so that collectively, we should be able to do more testing. so you're -- you're going to see -- you'll see dramatic improvements in the testing. it's taken a while to get to this capacity, and also, in the technology of testing. so there are the development of rapid tests that can now, within an hour, tell you whether you're positive -- positive or not. as i mentioned before, there's a saliva test, and there's a home test that will be available soon if it hasn't already been approved. >> supervisor haney: when there was the cases at m.s.c. south,

they tested that entire shelter, and it seemed like there was good reason to assume that there may be other shelters that have, you know, large outbreaks, as well. >> right. right. >> supervisor haney: but the policy of the navigation centers and the s.r.o.s and people on the street is the symptomatic get tested, but if you're none symptomatic, you don't -- nonsymptomatic, you don't get tested, even if you're in this highly dangerous environment. what is your stance on that? >> so i would say we're moving towards developing a deal testing people who are asymptomatic. i think there's going to be a

number of people that are asymptomatic, probably like 25%. that's resulted in a real change and shift. we're trying to figure out what would be the appropriate interval, and what is the appropriate setting for it to be most effective, and that's one of the reasons why we went to universal face coverings is because we know that there are people who are asymptomatic, and so that's an important part of that strategy. and so we're -- we're learning how to do this together with the state. the state just recently, two days ago, published guidelines for testing, and we can make sure that you'll have those guidelines for testing. it includes both symptomatic and asymptomatic testing. >> supervisor haney: yeah, because it seems there could be a need for asymptomatic testing

in places where it seems like it would spread quickly. just last thing, when you were in front of us, i think about five weeks ago, just a month ago, we asked a number of questions about homeless individuals in different environments, and five weeks later, for the most part, as far as i can tell, not much at all has changed for people who are currently on the streets. they are still largely out there in environments where they're not receiving services or not in a safe place, and i know there's a lot that's been said about people who are in shelters and navigation centers, and the very slow pace in moving them into hotels. but for people on the streets, what is your view of what we should be doing right now to prevent the spread in light of the fact that it's been over a month, and as far as i can

tell, in my district at least, not much has changed at all in terms of what their reality is and the potential for spread of people that are currently on the streets? >> yeah. you're asking a really good question. i believe most people in general -- the c.d.c. guidelines are pretty good about what they recommend in terms of guidelines around shelters, homeless, housing. observing just how much work it takes to just do that logistically -- and i have the opportunity to do that because i get to interact with people around other parts of the state. i believe that san francisco is doing more than other parts of the state, and of course, there's more that we can do. what i see as the biggest barrier is just having all the components in place. just the rapid response and all the things that we need to make

that successful, as well as having options -- options for sometimes either a -- a -- a person is unable to go to a hotel room for self-care for personal reasons or otherwise they don't want to go there, so we need to have many options that will accommodate the needs of the option. i' i'm -- needs of the population. i'm sorry. i'm getting a text here. >> supervisor haney: i'm sorry. i'll let other people ask questions here. i know we're getting data regarding other populations, but if our goal is to get people into a place where they can isolate or shelter in place or not have contact with other people in that, it's not

happening. and the small movement of people we've seen in shelters and navigation centers, i haven't seen any improvement in people who are homeless, so i just want to flag that as something that needs your attention. >> president yee: supervisor ronen? >> supervisor ronen: thank you. i just wanted to follow up on a little bit of the same topics that supervisor haney brought up. in terms of testing right now, i have been trying to get the entire division circle navigation center, residents and staff, tests for about three weeks now, ever since the first person tested positive. and it's just been one excuse after another, and they haven't been tested. and this morning, i learned in another congregate -- well, in

an s.r.o.-like housing unit in my district, that 25 people tested right, and those individuals have separate rooms, so they do share bathrooms, but not living space, unlike division circle. why haven't all of the residents in shelters and navigation centers been tested? i just haven't received a satisfactory answer from anyone about that yet. >> you're asking a really good question. i can tell you from -- from where i sit, i haven't been involved in those specific decisions. what i can share with you is our approach continues to evolve, and casa quesada is a

good example. we're learning that mass detection and targeted screening is a good approach, and you'll see more of that as we move forward? i think what you're describing is a direction that we're moving in, and as more testing becomes available, we're trying to figure out what is the best way to do that. so i think stay tuned. you'll see changes as testing becomes more available and as our strategy becomes more liberal in terms of testing. >> supervisor ronen: okay. it's impossible to get -- i have so much respect for you, dr. aragon, but i have yet to get a satisfactory answer. everyone says oh, you'll wait and see, we don't feel it's necessary. hopefully, it'll move in that direction, but it's been weeks now, and the staff and residents are terrified. and in other congregate living facilities, we've found that it's very widespread, and i

just can't get a clear answer from anyone. i'm just wondering if you're willing to issue an order -- i think there should be testing of every congregate living facility completely. i do not -- it's not a resource issue at this point. we have the materials so why wouldn't we do that? i'm just really confused and just looking for a clear answer. is it just that we don't want to find out that so many people are testing positive because then we don't have the resources to deal with it? i mean, what is the real reason that we're not testing people in congregate settings? >> yeah. it's a real good question. i'll just tell you the way that i see it. i just -- the way that i see it is one, we have the band width of all of the things that we're trying to do, and as we're

prioritizing our activities, at this moment, we haven't been able to do as much as we would like to do? what i can tell you is that as testing improves -- as testing improves -- and i think you will see changing because we're really getting a better handle on how to deal with the congregate living situations and asymptomatic infections. and i -- i -- i understand -- understand your frustration and concern and perspective, which is very valid, and i will personally communicate. and i know you haven't -- you haven't -- you haven't gotten the answers you desire, but i'll try and find that out for you. >> supervisor ronen: i asked the question to the mayor's assistant, and he said he would

get back to me, and he hasn't got back to me. i'm asking our chief health officer, the chief of staff for the city and county of san francisco and i cannot get a clear answer. meanwhile, the residents of the division circle navigation center live in fear. it sounds to me like what you're saying it's an equipment and staff issue. i just have to get an answer. it's really the most frustrating thing. >> yeah, yeah, yeah. i understand what you're saying, and i think you'll see as our -- our practice of how we're dealing with this epidemic is evolving, and what

you're describing is something that everybody is moving towards. for example, in the jail, we're screening everybody that comes into the jail, and they found two persons that were positive, so that's the direction that we're moving into is this focus on asymptomatic screening. so you're absolutely right to ask that question, and i would say that in general, that's where everybody is moving towards. i think, as i said, as testing becomes more available, p.p.e. becomes more available, we have more staff, you'll see more testing. >> supervisor ronen: okay. so moving on, the second question is almost the same as supervisor haney asked about the people on the streets. the situation on the streets, it's getting worse, not better.

in encampments that we've had for years on the streets, we have more people. we sort of encourage those encampments by putting por porta potties by them. this is a population that we've tried for years to get them indoors, so you can imagine the frustration of individuals that don't feel safe going outside their front door and the situation of people on the streets? we hear that slowly but sure you're getting to people on the streets, but none of us have seen it. all over the east side of the city, there are massive tent encampments all over again. they're not small, like they used to be, they're massive, and those were incredibly dangerous prior to covid-19. now, they're just out of

control, and -- and -- and -- and it's -- it's -- it's just not that things are getting better, they're getting worse. so can you talk a little bit more about timelines and strategies and moving people off the street or a different strategy for the street? >> you know, i think possibly the best thing is that -- i'm not working in that specific area. as you know, our emergency operation center is very large. i'm not working specifically in that area, but what i can do is i can work with dr. colfax and to bring -- maybe we'll use one of these briefings to answer those questions directly so they can get you the information directly. that's probably the best way to get you the information you deserve. >> supervisor ronen: okay. thank you.

>> president yee: supervisor walton? >> supervisor walton: thank you, dr. aragon, for taking the time to answer questions this afternoon. just a couple of, like my previous colleagues' questions. people told us they would be pulling people off the streets and placing them into hotels? >> yeah. i do not have this information. just to let you know, i learned about this meeting yesterday, and it all got arranged today, but what i can do, i will follow up with these specific questions and work with dr. colfax to make sure that we have the information that you're requesting. >> supervisor walton: well, i know that you've been mentioning some of the conversation that has been

happening at the state level, and the scientific response to what's happening. i know you've seen the latest numbers in terms of who's been contracting the virus kbi zby code. half of the cases are in my district, and the other half are in areas where we have the most vulnerable populations. do you believe that mass testing in these zip codes should be taking place immediately? >> i think what's going to happen is -- is that you will see, we're -- we're -- right now, we're adopting the guidelines from the state on testing, and there is a component -- what i will do this evening is i will send you the guidelines, and there's definitely a component around asymptomatic testing. i think we're going to have to do more in the areas that are

impacted. i think the challenge is -- you know about some of these challenges. in some ways, it's easier to focus on the congregate living situations. we know, for example, in the bayview, the mission, we have a lot of families that live in really crowded conditions, so we have to figure out how we work with that -- those people that are exposed to crowded living conditions, as well as the people who are exposed to crowding and in congregate conditions. we're it tending to focus on those that are in congregate because we know that more people can get exposed, so i think the longer term strategy that you'll see evolving is we want to have low barrier testing. we want to improve our surveillance system, and then, we're going to be extending -- we're going to be starting by testing asymptomatic persons who are close contacts because that's where the biggest risk

is. so that whole strategy is really developing around that testing and containment. >> supervisor walton: well, as san francisco chief medical officer, i want to ask you is it your opinion that we should begin mass testing in areas where we see a disproportionate amount of covid-19 cases? >> that's a very interesting question. i spent a lot of time thinking about this issue. i think we need to come back

with the state guidelines and our impact in those areas and how it impacts the testing. >> supervisor walton: i wouldn't belabor the point, but i will get with you offline regarding that because we are suffering in disproportionate areas, and we need to step up in areas that we can and prevent the spread of the virus. i know that asymptomatic testing is one way we can do that so we can address some of these disproportionalities. also, by chance, do you have an update on the number of covid deaths by district? do you have the zip codes? >> no, i don't have those. i don't have those with me, no. but i -- i -- i was listening in early on, and i know that's of interest. >> supervisor walton: and so my

last question, just -- and i sent an e-mail to dr. colfax, leadership of some of our key city departments, h.s.a., h.s.h., to know the key things that are happening since we know that a large number of contracted covid cases exists in our homeless population areas, i will be following up with you to figure out what you think we need to do to combat these disparities. you know how much we've been struggling in getting people out of these places and get people safe. i can't understand how we haven't done a better job of getting that done, and i just want to make sure that you understand that this comes from a place of trying to actually

save lives and to stop the spread versus trying to perpetrate a bigger problem in our vulnerable communities. i thank you for your time, and i hope you can bring back some of your colleagues so we can get some concrete responses. >> yeah. i want to thank everybody for your time. we -- there's always ways that we can improve. we're commit -- we're commit -- we're committed to improving, and part of that commitment is going to be -- is going to be sailing up so we can deliver on our shared goals of saving lives. >> president yee: supervisor safai? >> supervisor safai: thank you, mr. president. thank you, dr. aragon, for your time today. my question revolves around is your presentation over? because i do have a question, but you're kind of focused on

phase one. were you going to get into phase two and talk about what's some of the things that you're going to do in terms of in your next health order and what guidance you might have because i have a specific question about phase one, but i also wanted to know if you were going to talk about phase two and some of the next steps. >> yeah. what's happening at the regional level is we've been reviewing some of the publicly available documents and reviewing frameworks for how to think about these different phrases. in the bay area, we haven't started talking about the specifics of phase two. there are some people nationally who began to restratify the different risks of opening up the economy.

this is from johns hopkins, so you can begin to have access to the same information that we have. basically, i think it's going to be really important for the state to really step up and provide some leadership and guidance. we want to take advantage of the best science, the best available information as opposed to each count sort of doing it on their own without really taking advantage of all the expertise that's available in the state. so yeah, i don't have anything specific around phase two, but we can share with you the documents around what we're doing that revolves around what we should be doing in phase two. >> supervisor safai: okay. my questions have to do with phase one. this has to do with s.n.f. facilities. i have a s.n.f. facility in

district one. they've doing that as a way to continue to, as you talked about in terms of our treatment phase, ensuring that we have i.c.u.s, acute care, hospital space, in case that there was a surge, so i understand the thinking behind that. the only thing is that it doesn't necessarily -- if that is an area that you're concerned about additional outbreaks, and then, you're moving covid-positive patients into that facility, can you talk about the thinking kind of behind that. and then, the other thing, on the point of asymptomatic testing, you know, why wait until there could potentially be an outbreak in this facility? because right now, the guidelines are only test people who show symptoms, but you've only had one case in that

facility, and it would be good to, you know, in many peoples' opinion to defendatest -- even it's just a snapshot, you might get an idea of someone and intervene in advance before there could potentially be an outbreak in that facility? so i know that's a lot of things, but we're going to have a town hall in the jewish community thursday night. they're trying to do everything they can to be as safe as they could be, but i know there's a lot of discussion around how they can have testing on-site when there's covid positive cases. >> yeah. in long-term care facilities, you're going to begin to see a lot more testing, especially of staff, because what happens is staff bring the infections into the facilities. >> supervisor safai: right, and i think that's what happened in the case of the person that

tested positive. >> yeah. you're going to be -- like i said, the strategy's really evolving for all of these different populations. long-term care facilities is -- tend to be a closed ecosystem with the exception of staff that come in and out. >> supervisor safai: yeah. >> so you're right, you're going to see more testing. what happens is when a facility or part of a facility commits to testing patients who are covid positive, what they do is they cohort those patients, they put them all together, and that way, they're able to dedicate the service with the best p.p.e. the other thing that's beginning to happen is you'll begin to see people, staff, who have recovered from covid or tested positive, they'll begin to take care of that unit. so you'll begin to see the specialization, and you'll begin to see facilities

specialize in taking care or part-time taking care of patients. so relying on symptoms is not sufficient. if you relied on symptoms, you will miss most of the patients. >> supervisor safai: so when -- so when will we see -- i mean, you're saying you're going to see -- there is a case already, they've tested that individual. so when are we going to see an increase in the testing, because this is the only licensed long-term care in the city. there's a lot of family and patients of existing people that are concerned about this. as i said, we're going to have this in two days. it would be wonderful if we can get increased testing in that facility as soon as possible. >> yeah. let me -- one thing we can do is, we do have a team that focused on long-term care facilities, and it would be good to have one of the people that focuses in these area explain how they're focusing on

long-term care facilities. so i can make sure that you're connected with our key person because i think it would be good -- basically, they're spending all their time on this topic. >> supervisor safai: okay. >> actually, i'm being called by the health commission right now because i'm supposed to be there to report to the health commission. is that going to be okay? >> president yee: well, if you have to -- i mean, if you have to do that, we can't hold you here, and this was, as you said, fairly last minute. we'll try to -- moving forward, i mean, i think this is useful, and thank you, supervisor peskin, for making this happen. i'll try and figure out a way in which we can have something more regular so we can sort of anticipate, and i'll speak to you in terms of what's a better

time during meeting, after the meeting, that type of thing. >> yeah. let me know sort of ahead of time, so if there's -- if there's a subject matter expert, i can get the information that you're asking for, so that way, you'll get more complete answers. >> president yee: so if you have to leave, then, i'm sorry, supervisor preston and supervisor stefani, i'm going to skip you, but when we do this again, you'll be first in line. supervisor peskin, would you like to wrap it up? >> supervisor peskin: thank you, mr. president. i would like to wrap it up, and i would like to agendaize this as another briefing that the public can watch after next tuesday's board meeting or have this be an item on next tuesday's board meeting, whatever the council prefers. i think this has been

incredibly productive. i'm sorry. i had additional questions, as i know supervisor preston and stefani did, as well. this has been highly helpful, and i would like us to continue to have these discussions publicly, and would like to do so next tuesday with your indulgence, mr. president. >> president yee: yes, we'll figure it out. >> supervisor peskin: okay. thank you, sir. >> okay. thank you, everyone. good luck. >> president yee: okay. thank you very much. colleagues and anybody else that's listening, thanks for staying tuned, and as i mentioned, we will figure out a way to do this. so i'm going to go ahead and end this portion at this time, so i will -- if you want to get off now, that would be fine. since this is not a

meeting-meeting, i'm not going to hammer down, but say thank you for getting the work done. >> clerk: thank you, mr. president. >> supervisor haney: thank you, everyone.

>> welcome to the april 13, 2020 meeting. i am joined by video conference with vice chair supervisor stephanie and supervisor gordon mar and i'd like to thank sf gov tv for staffing this meeting. any announcements? >> to protect members, city employees and the public, the legislative chamber and k committee rooms are closed. however, members will be participating remotely at the same extent as if they were present. public comment will be available for each item on this agenda, both the channel 26 and sfgov.org are streaming

across the screen. call (888)204-5504. when you are connected, dial 1 and then 0 to be added to the key. you will be lined up in the system that you dial 1 and 0. while you're waiting, the system will be silent and notify you when you're in line and waiting. all will remain online. everyone must account for the time delay between live coverage and streaming. alternatively, you may submit public comment in either of the following ways, email me at victor young. if you submit public comment via

email, it will be included as part of the matter. written comments may be sent to city hall 1, doctor carlton b. goodlet place, san francisco, california, 94102. that completes my announcements. >> thank you so much, and can you please read item number one? >> an emergency ordinance to temporarily require private employers with 500 or more employees to provide emergency leave during the public health emergency related to covid-19. >> thank you. any opening comments? >> thank you, chair ronen. colleagues, as you may recall, this item is to move forward one amendment that was made to the public health emergency league ordinance at last week's roll

committee meeting. the amendments that we're considering to the public health emergency leave ordinance applies to section 5 and it pertains to allowable uses of emergency leads and only applies to employees who are healthcare providers and this amendment was crafted to balance the need for healthcare providers and similarly are healthcare workers to be able to take time off when they're sick or need to quarantine and balance that need with the urgent need of maintaining our healthcare wor workforce. to thithis provides leave whose employers can opt out of the leave expansion.

and it goes without saying that healthcare providers should gott go to work when sick or quarantined. this ordinance will give them expanded pay leave to use if they're sick or quarantined. we know that pfizer sent a letter asking for an exemption but we disagree that healthcare providers should be exempt. there's been discussion with the hospital council and northeast medical services, a major nonprofit healthcare clinic that has a significant place in my district. if healthcare employers are offering paid leave, it will count towards the additional 80 hours and to ensure we don't short staff this ordinance. its uses are incredibly narrow and only apply in cases where it's in the interest of public

health for healthcare providers not to go to work. and it does not allow uses of public health emergency leaves by healthcare providers for a border range of uses that are allowed for workers at businesses with more than 500 employees that are covered by the public health emergency leave ordinance. so colleagues, i thank you for your support in the public health emergency leave ordinance last week and also that the full board last week and without your support, i'm moving this further amendment that would provide additional leave for healthcare providers in a more similar range of uses. >> thank you, supervisor mar.

supervisor stephanie, my comments? >> no, i don't, thank you. >> why don't we open this item up for public comment. mr. clerk, is there any members of the public who wish to speak on this item? >> members of the public who wish to provide public comment should call the number and present 1 and 0 to line up to speak. >> please allow me to check the cue. >> no problem. >> no callers wishing to speak. >> with that, public comment is closed. i'm happy to make a motion to put this to the full board to

the committee with full recommendation. can we take a role call on that motion. >> on that motion, supervisor stephanie. >> aye. >> supervisor mar. >> aye. >> chair ronen. >> aye. >> the motion passes and in matter will be recommended as the committee reports to april 14th board meeting. >> thank you so much, mr. clerk. is there any other items? >> that completes the agenda for today. >> fantastic. fastest meeting of all time. the meeting is adjourned. have a good day everyone.

(role call). >> directors, you have a quorum. there will be no such announcement with sound devices today. item 4, approval of the minutes from april 7th regular meeting. >> very good, board members. we've been supplied with the minutes and i will ask first, is there anyone from the public who wishes to comment on our april 7th minutes? >> for members of the public who are watching this meeting via sfg tv from april 7th, please call (888)808-6929 and then code