the country. i want us to be even better than that. it's up to us. it's up to us to change our behavior. it's up to us especially because when you think about it, sadly, what we see in terms of businesses not being able to open. some of our favorite restaurants and retail shops and places where we get our hair and nails done, they may never return. people who need to send their kids to school because we, regardless of the achievement gaps and equipment we're providing for low income students we're still seeing problems and increase in the achievement gaps. we have work to do. i'm asking people in san francisco to just really change their behavior. i know it's not easy.

i know we want to enjoy ourselves. but it's up to us to make a difference. today, i want to really talk about our budget and the proposed budget that's working it's way through the legislative process as we speak. part of why we are investing $446 million in response to covid has everything to do with the understanding that we're going to be living with this for some time. that's money that i wish we could divert to other things. but unfortunately this is the reality of today. i hope that's not the reality of our next budget cycle. we're committing about $93 million directly from the general fund. again, that's money that i wish we could be diverting to other places and the fact is, it's

going to be important that we're prepared and doing what's necessary to keep the public safe. today, i want to get into our slides and talk a little about our investments so you have a clear understanding of why and what's being invested based on our response based on our budg budget. so let's look at exactly what it is that our response is this year in the budget. it includes 16 point five million for operations. health response. 62 million for food distributions and housing and shelter programs. it's important to remember that this funding really assumes that we don't see any major surges. if that happens, we will need to

divert even more resources. that's why it is so critical that everybody does their part to stop the spread. it assumes that we'll continue to be reimbursed by fema. we all know how the federal government has been. this is only through june of 2021 for the next year. if this stretches beyond june there's even more of a drain on our budget next year. the funding for communications and operations is critical to not only staffing our covid command center but also providing communication in the many different languages and cultures in san francisco in different ways.

50% of our cases in san francisco have been in our latino community. visitation valley have the highest rates of cases in the city. communication is key in a public health response. thankfully we have an incredible team of people doing this work every single day. one hundred eighty five million for health operations is a lot of money. it's important to understand in the context of all the things that we're doing as a city. we're talking about testing, ppe, surge capacity, preparations, contact tracing, community out reach, out break mitigations and everything else required to fight this virus and keep our re residents safe.

we have massively expanded our food distribution to people in the si city and will continue to this for as long as needed. keep people fed and increase sanitation conditions on the streets. pit stops we chose to expand city wide for an additional $16 million. as you can see from the slide, this is a significant investment. in short term options to keep people off the street. continuing to fund hotel rooms and shelter in place. we also know we need more housing for people which is why this all feeds into our homeless recovery plan to create six

thousand replacements for our homeless residents. these are absolutely critical for our plan to work. building on some of our existing programs as well including our waste replacement, meantle healtmental health programs. educational efforts to support our schools. mobile testing for neighborhoods that are disproportionately hit. these investments in our budget this year as we know, are absolutely critical in order to get us through the very challenging time and i can't

reiterate enough the need to make changes to our behavior. i don't know about you, but as i said before in some of these press conferences, i was a very challenging kid to deal with for my grandmother who raised me. i can remember time and time again, when you tell someone to do something over and over and over again. don't touch that fire, don't touch that fire. you're like, i wonder what the fire feels like. you touch it the fire and you're like, i'll never do that again. that's the kind of kid i was. it feels like i'm a parent telling people in san francisco over and over again wear your mask, socially distance, do this, do this that. really, this is about protecting public health. this is about getting us back on

track. this is not just a problem in san francisco, it's a problem all over world. when you think about it there's some countries in the world that have reduced the virus and gone back to normal. that's where we want to be. the only way we're going to get there. the only way we're going to be able to open the gyms and nail salons and visit our parents and grandparents in senior homes and places they are housed, is if we change our behavior. we listen to our public health expert. especially in places like dolores park. especially in places where people continue to gather and not socially distance. from our contact tracers, we

know that many people who are contracting the virus are contracting the virus because they are having gatherings. they are having family gatherings and birthday parties and other events. you know what? today is my birthday. i'm going to socially distance myself and talk to people op opn zoom. if we all did our part rkts wher, where wewould be today. i know you're tired of hearing it from me. i say it time and time again. i can't reiterate enough that we need to do our part.

we can be a leader and crush this virus if we all do our part. with that, i want to ask the director of the department of public health dr. grant kol fa x fax to please come forward now. >> good morning.

i'm dr. grant colfax director of public health. happy birthday and thank you for your commitment when it comes to covid response. when it comes to shelter in place, a surge of covid 19 cases. our investments in testing, contact tracing and food security among other items have helped san francisco manage to slow the spread of the virus. thank you again for your ladership anleadership and dire.

here is an update of where we are with the virus. as of this morning. six thousand forty two have been diagnosed and sadly sixty seven of them have died. we're currently caring for 88 in our local hospitals. that's a slight drop from last week. it's a 20% reduction from our peak in july. because of our efforts. because of your efforts such as face coverings and social distancing, we have lowered the effective reproductive rate to just below one. the effective reproductive rate or re is a key measure of how fast the virus is spreading. it's the average number of

people who become infected by an infectious before. if it's above one, the virus will spread and it will spread quickly. when the re factor is below one, it's slowing. our best estimate is that re has been just below one, between point nine eight and point nine five. we continue to exceed our daily testing goals and lead the state and nation it testing. in this next phase of our testing strategy, we'll be more targeted in our testing even as we expand testing capacity in the city. last week, we brought mobile testing to communities with

highest infection rates of covid 19. including in the bay view, sunny dale, mission and omi. we are indeed following the day awe to identify the communities where testing can have the greatest impact to identify and slow the spread of covid 19. as you saw in the budget presentation, the mayor is proposing a nearly 56 million-dollar budget in testing next year. that number has started to drop from the high point a few weeks ago. it's a cause for great concern and could easily go up again. this is one of our key health

indicators. anything above 15 new cases per day puts us in the red zone on our highest alert level. we're been there for the past few weeks. we've seen our numbers improving. let's stay vigilant. we've seen issues with the state reporting system that may have caused issues with cases. we see many many san franciscans covering their faces. recent research indicates if 80% of a population is regularly using face coverings we can prevent out breaks of covid 19. please, be one of those 80%.

thank you to everyone who is doing their part to reach that critical mat. why don't we make it ninety. why don't we make it 100% of people wearing face coverings in our city. we know unfortunately some people are not covering their faces complicitily. i see some people trying but maybe they don't know both their nose and mouth need to be covering. maybe they don't know that face could havings are required in san francisco for everyone age ten years and up. if you have any questions or doubts, wear a facial covering. it's right thing. it's the safe thimg t ting to t.

it's like remembering your wallet or keys. it's a habit we're going to need to develop and have with us for some time. my mask protects you. your mask protects me. this is something we can all do and indeed we must do for each other. we must keep up our momentum and stand our ground and sustain our gains and continue to make progress. we're seeing some hopeful signs. as we've seen before this virus is persistent. we cannot let our guard down. please, again, continue to do your part. continue to take caution and care. take care of yourself. call your friends and family. we are all in this together.

we will get through this together. together we have the power to save lives and again, crush that curve. thank you. >> thank you dr. colfax and madam mayor for your time. we'll begin our q and a portion. first we have health care related questions for dr. colfax. what specifically is the city doing to shorten the time it takes to get test results and boboaster contact tracing. >> the turn around times have averaged general 48 to 72 hours.

we did fall behind because of the great surge in testing. we have caught up on that. we're increasing looking to expand our city test sf capacity. those times will hopefully continue to be shorter than a few weeks ago. we've trained three hundred people in contact tracing. we're try to go catcing to catcm the flood of cases. making great progress on that. we continue to expand our capacity and contact tracing. as you see in the budget there's investments to strengthen that work going forward. >> thank you doctor. have any out breaks been traced to a gathering in dolores park. where are the out breaks

happening. >> we know that out breaks occur when people gather. indoor gatherings are more at risk than outdoor gatherin gathering-people doing essential work and need to work in close proximity, we need to have that happen. let's not gather for things that could otherwise be delayed or be done on zoom or in other virtual ways. with regard to specific out breaks, i can't comment on drawing conclusions from the gathering at dolores park except to say that's behavior that we're very concerned about it. our message continue continues o

not gather unless absolutely essential. do not gather out side your immediate household. if you do, wear those face masks and use good hygiene and socially distance when possible. look, when i walk or drive around the city, we know this is still not happening to the degree it needs to be. we need to hit that 80% mark. let's go for 90% or one hundred. we need to crush this curve. >> thank you. the next set of questions are from the associated press. how have the state's problems with cal ready effected san francisco effective reproductive rate. >> it's based on the number of

hospitalizations. our data is not part of that calculation. we're confident in our ability to estimate based on the hospitalization rates in the city. >> how can we be sure cases are going down if there is under reporting by the state's system. >> the number of hospitalled cases are going down in our city. that's what we base the reproductive rate on. it's on those numbers sm the nu. the number of cases diagnosed with covid 19, that number could change based on the correction from the state. we hope to have tha that tha th. >> thank you, doctor.

what are the major factors contributing to the numbers leveling off? >> what we-we can't draw any one action with regard to cause and effect with regard to the decline in the number of cases. i do think a few weeks ago our recognition that we were in the midst of another surge and the reproductive rate was going up rapidly. we worked with comeupit communiy members, key stake holders and people in neighborhoods most effected to work to really get the message out that everyone needed to be aware of this. access testing. if you were in an area experiencing out breaks to wear

those facial coverings and not gather. i hope people heard this and people are doing their part to flatten and hopefully crush the curve. i will say that the reproductive number is just about at one now. we need to see that trend continue so we get much much lower. i'm hopeful that we continue to go in the right direction. >> thank you, doctor. have you considered further restrictions or enforcement measuremeasures foreplaysesmea .

>> we need to give people- >> thank you, doctor.

the next question comes from sf examiner. business owners from the small industry and other personal services have been frustrated that they cannot fully reopen even after sanitation guidelines. what is your level of concerns. >> right now we are on the state watch list and have been since late july. no further reopenings can happen until we're off that watch list and receive updated guidance from the state. and what might be plausible going forward. >> thank you. our next question. if the reproductive rate is not below is only based on

hospitalization and not positive tests it does not include asymptomatic people. how is that viable. >> it's an estimate. it's an estimate that we have been working with u c berkeley and u c sf and cal san francisco researchers with regard to developing a model that takes exactly that into account. uses the hospitalization number and extrapolates that to the broader population at large to come up with an estimate of the reproductive rate. it's publicly available with regard to what the reproductive rate estimate is. you can dig deeper into that on the website which we can certainly provide to you.

>> thank you, dr. colfax. there no further questions at this time. this concludes today's press conference. thank you madam mayor and dr. colfax for your time. >> staff and members of the public who are joining us for the san francisco health commission meeting for tuesday august 18th. we will call this meeting to order. will you please call the roll. >> yes, commissioner bernal.

[roll call] commissioner chow is supposed to be here. i thought he was on but he is not. mikaela, can you share that slide right now? i'm going to pop up the public comments slide so that everyone on can see how to make public comment. there's a few people on and i want to make sure everyone knows. give me one second and i'll pass you to ball.

so, the phone number for public comment is (415)655-0003. the access code is (133)190-2636 and press pound twice to get on the line. when you are on, if you would like to raise your hand for a specific item, please press star 3. when you get on the line, you press pound twice and then star 3 if you would like to raise your hand for an item and we'll talk about the comments for each item. commissioner bernal, would you like to move forward with the approval of the minutes or wait for commissioner chow? >> commissioner ball: do we have a quorum? >> we do.