the meeting is being called to order at 5:36 p.m. the meeting is televised on sf gov tv 2 or live streamed on the website. members of the public who will be calling in, the number is

415-5 415-655-0001, and then the number is 415-655-0001. the access code is 1466093005, pound and then pound again to connect. again, the number -- the access code is 146-609-3005, press pound and then pound again to connect. you will hear the meeting in discussion, but you will be muted and in listening mode only when your item is addressed called dial star 3 to be added to the speaker line. best practices are to call from a quiet location, speak clearly and slowly and turn down your television or radio.

if when you dial star 3 before public comment is called, you'll be added to the queue. when you are called through public comment, please mute the device you are listening to the meeting on when it's your time to speak you will be prompted to do so. public comment during the meeting is limited to three minutes per speaker unless otherwise established by the presiding officer of the meeting. speakers are requested but not required to state their names. s.f. gov tv, please show the small business office slide. >> today we will begin with the reminder that the small business commission is the official public forum to voice your opinions and concerns about policies that affect the economic vitality of small businesses in san francisco. the office of small business is the best place to get answers about doing business in san francisco during the local emergency. if you need assistance with small business matters, particularly at this time, you can find us online or via telephone. as always, our services are free

of charge. before item no. 1 is called, i'd like to start by thanking media services and sf gov tv for coordinating this virtual hearing and livestream and special thanks to jim smith for assisting with the public comment line. please call item no. 1. >> item one, call to order and roll call. [roll call]. we have a quorum. >> great, next time, please. >> update and report on the san francisco's reopening plan, strategy and local public health indicators, discuss in items. the presenter is dr. thomas aradon, chief health officer of the city and county of san

francisco. >> great. dr. aragon, welcome. we're so happy to have you back. appreciate you spending some time with us. my goodness, a lot has happened since we last saw you, and it's good to get the update. so we're going to begin this item with your presentation, and then that will be followed by any questions we have and then any public comment and perhaps there may be a last round of discussion among the commissioners after that. >> okay, great. >> thank you for your time and please, you have the floor. >> okay, thank you. i'm assuming everybody can hear me fine. >> we can hear you just perfectly, thank you. >> okay, great. so why don't we go ahead and go to the next slide.

yeah, if you can move it forward one. >> madam clerk, are you in charge of the slides? >> i am, and it should be up. i don't know if my service is slow and that's why it's not going. >> right now it's on the title card. i think he's looking to go to the next slide. >> i am on san francisco covid-19 data and report. so i think that my internet is slow. >> hmm. >> and it might not be caught up. >> do you want to give me access to -- can i have access to the -- >> yes, absolutely. >> i can just share from here. okay, oh, great, i will try it.

>> sorry about that, dr. aragon. i am a simple civil servant with simple internet access noo can you see it? >> it's kind of small. >> okay, great. let's see if this works. how's that? okay, so i'm going to cover four areas. i understand that i have up to 15, 20 minutes. i'll try to go through this insightfully, so i'm going to cover health indicators, talk about how health orders are done. i'm going to mention some emerging health risks because i think it's really important for everybody to really be up to date on the types of things we should be thinking about in

terms of keeping things safe, and then i'm going to go ahead and address some of the questions that people send me. let's just go quickly into health indicators. right now we have almost 11,000 reported cases. we've had 99 deaths, and we've done over 465,000 tests for covid. the types of things that we look at are going to be -- and i'm going to go into this a little bit later, is going to be the case rates, and then the tests percent positivity. those two is what the state is using for its blueprint for a safer economy, which i'm going to cover, which is the new four-tiered system. you look at hospital trends, and then the other one we look at is going to be the effective reproductive number. we are -- and there's two areas of preparedness that we're always concerned about, which is

the public health and health care system readiness, and then of course businesses and school readiness to be able to open up safely. so this slide here is a summary slide that compares san francisco to other cities across the united states that are relatively comparable, and what you'll see here for frisk is the case rate cases per thousand and then the other one is going to be death per thousand. so if you take the cumulative number of deaths, for example, and you divide by the total population, you get those metrics. and you can see that compared to other areas of the country, especially when you look at deaths per 100,000, that we've done better than other areas, and i may have mentioned last time that, you know, that our interventions prevented over 38,000 hospitalizations and close to 4,000 deaths.

and so this is another way of looking at this historically. so the effective reproductive number is the average number of secondary cases that's produced by an infectious person. any number greater than one means an epidemic is going to grow. any number less than one means an epidemic is going to shrink. and so we'd like to get it down to below one. early on, early in march, you see that it was above 3.5, which is a very high reproductive number which means that during an infectious period every case was producing between three to four additional cases, and you could just imagine that this iceberg was growing rapidly. you'll see that that started going down. we had started canceling large gatherings. the shelter-in-place was initiated on march 17, and then you can see that continued to

climb. and then you'll see the other interventions that were done. after memorial day, you can see a few weeks later, san francisco, like other parts of the country, and in california, had an increase in cases, and now we're down over here in august, and see we've got our reproductive number less than one. we want to get it lower, but it's -- right now it's less than one, and that's good news. and then just a summary on the left-hand side is our epidemic curve of cases. so you see on the left-hand side we flattened the curve, and then you see there the increase in cases in july, started in mid june and then july, and you can see that it has been going down. so right now we have about 56 cases per day, and on the right-hand side you see our hospitalization curve, the dark blue is the i.c.u. admissions, and you can see our second surge

that we have that peaked there at 114. the key difference between both of these curves is that we know a lot more about the virus now. we were able to manage the second hospitalization curve without shutting down the economy again, and that's the big difference. on the left-hand side, we didn't know how to control the virus. we learned how to manage it without shutting down. that's important information. so now what the state has done, they used to have what they call the watch list, but they now have changed it and they're looking at the case rate which is then adjusted, which i'll say in a second, and then the percent positivity for the tests. so if the case rate after adjustment is greater than

seven, or if the percent positivity is greater than eight, you will be in tier one, which is the purple tier. and that tier is basically the equivalent of the prior watch list. if you have metrics that are lower than that, you get assigned to three potential other tiers. one thing the state has done is that a case rate is we have our actual case rate, which i just call our epidemiologic case rate, and the state adjusts that down if you're doing a lot of testing. however, the actual risk in the community is really based on our actual rate. the reason why they had this adjustment is they wanted to discourage other counties from under-testing, because you can imagine some other counties may say, well, if i test less, i'm going to detect less cases and my case rate have going to be

lower and they're going to put me in a better tier. so they wanted to discourage that. so it turns out what they're doing is that if your case rate is -- if you're testing -- i'm sorry, if you're doing a high testing, they will weight it down, and if you're doing low testing, they will rate it up. so in other words, you will stay in a higher tier if you're not doing sufficient testing, and that's an incentive to get counties to do more testing. so we were classified -- epidemiologically, we were in the purple tier, but we were assigned the red tier, tier two, because we were doing extra testing. so when you look at -- this is now the current map. you'll see the current map is here that we're red. even though epidemiologically we're purple, and that's been really part of our strategy. i'll show that in the coming slides. so given that we're

epidemiologically purple but assigned to red, it means that we have more things available to us to open up. and what we did was that we looked to the purple tier and we said we're just going to open up everything in the purple tier, and then within the red tier we're going to be more selective by focusing on lower-risk activities first and the higher-risk activities we're going to push down to one tier, one tier, so we opened those up when it's going to be safer. so we started out with outdoor activities, low-risk indoor activities, which is a lot of the personal services. we have a high-risk indoor activities, which is going to be indoor dining that i'm going to get into some detail. i'm going to focus on indoor dining, but conceptually the things i'm going to talk about really apply to other high-risk areas, with the exception of the need to remove a facial covering to eat or drink. and then we have the highest-risk indoor activities that right now nobody's really -- for example, the

symphony, the opera, sort of these big events with mass gatherings. there are things that are so high risk right now that we don't see it really happening until things either change dramatically, we have a vaccine or we have much better cheaper tests where we can mitigate that ri risk. so i will briefly cover health officer orders and then i will get back into the indoor dining. i'm putting that under the category of emerging health risk. so how the health officer -- here's how it works. so the federal government can collect taxes, wage wars and regulate interstate commerce. all other powers are vested in the states, and the state police powers are used for public health authority. so what happens in california is state police powers for health are dedicated down to the counties. we have 58 counties and some cities also have decided to

become health jurisdictions and operate health departments. so we have 61 health jurisdictions. by law, every county -- or health jurisdiction must have a physician health officer to implement local health authority, and that's me. so the bottom line is you can look at the second bullet point here, is health officers are authorized to control contagious, infectious or communicable diseases and may take measures as may be necessary to prevent and control the spread of disease within the territory under their jurisdiction. health officers have the broad authority to give us the flexibility to do what we think might be necessary to control a communicable disease. of course the power is not unlimited, and this is why we work with a city attorney to make sure that what we're doing can be -- is -- we're doing the least restrictive that we think

can get the job done but still be within our larger legal framework of the constitution. we want to minimize doing anything that goes against the broader laws of the land and that can be defended legal ly. so the way we do the health orders is first we start with the california blueprint for a safer economy, and we start with what the state allows us. ultimate authority is at the state level. so the state health officer can actually overturn anything that's done locally. it rarely happens, but they have the ultimate authority. we consult with subject matter experts and nail down what are the key public health principles that we're going to be using. we work with the city attorney

to make sure that we have -- we can do -- we have the appropriate legal framework to implement our intent, and the legal attorneys will draft an order, and then we have directives. and think of directives as guidance but with legal authority. and the directives are more flexible because those get updated as new science becomes available, but the orders tend to be constant and points to the directive. and then we work with information and guidance where we have more subject matter experts that focus on developing guidance and tip sheets. it's really the combination of all these levels working together is how it all functions, and in general we tend to be more health protective than other counties. some counties will just say, okay, the state has come up with guidance. go for it. just implement that guidance. we take the extra step of reviewing that guidance, looking at other guidances from across the country and really making

sure that we're implementing the most up-to-date science, and then we translate that into directive. emerging health risk. so this table here has risk factors for transmission of the coronavirus. i want you to focus on really column two. you'll see 14 different risks that are itemized: mobility, network, contacts, and we're thinking about people having close contact, so you're thinking about not just the number of people but the rate of contact, the distance, the duration, what activity is happening, eating, drinking, talking, singing, whether a face covering needs to be removed, handwashing. indoor setting and then -- and then ventilation if you're in an indoor setting, and fomites are just inanimate objects. i went ahead and just itemized

in the third column those things that are very specific to indoor dining. and so you'll see that out of 14, nine of them apply to indoor dining. so mixing -- number of persons and frequency of contact. we now know that aerosols, whenever we actually just breathe, it creates aerosols. and the way to think about aerosols is that if you can smell smoke, if somebody's smoking and they are exhaling the smoke and you can smell it, you're breathing what they just exhaled. that's how far aerosols can travel, and you know that you can smell smoke from quite a distance. prolonged duration, as i've just mentioned, aerosol generation. the face covering prevents 75 to 85% of aerosols from being released. it really decreases it. that's why it's important for everybody to have face coverings on, and even then it's not 100%

that it prevents all aerosols. so even if everybody in the room is wearing a face covering, you still have aerosols as being generated and put into the air, so ventilation is really, really critical. and that's why doing things outdoor is very important. and if we think about who's going to be most at risk, it's truly going to be the workers indoors who are seeing multiple customers over the day, day in and day out. thinking about ventilation, air exchange and filtration is really critical. indoor dining, indoor setting with possible poor ventilation, mixing with persons outside the household, face covering removal to eat and drink, physical distancing less than six feet when you're sitting at a table with people who may be outside your household, and then the duration of close contacts.

so in one of the challenges that we have in the science of coronaviruses, we have been with this pandemic for six months, so there's still a lot of things we don't know. so study what the drivers of infection are really requires specialized studies, and basically the type of specialized study that's done in an epidemic setting is comparing people who became cases and people who did not become cases, and then identifying what risk factors are associated with becoming a case versus not becoming a case. and so -- and this is one of the first case control studies that has been done, done by the cdc, and if you can see there on the third, the third item where you see restaurants -- oops. sorry about that. i will go forward here. you see there you'll see here that restaurants is -- restaurants is associated with becoming the case of covid.

so this really verifies what we've been seeing, which is outbreaks associated with restaurants and especially bars. and you can see here, for example, under bars you can see bars and coffee shops you can see here they are both elevated. so this is really the first hard scientific evidence that we have of restaurants being a causal factor. we have had that intuition because of outbreaks, but this is the first study to verify that. so even though i've been talking about indoor dining, the concepts really apply to any indoor space. as we start opening up churches and people start coming together, everybody really needs to think about -- you see at the very bottom it says their personal protective equipment, so people tend to focus on face

coverings, which are really, really important, but the truth is that you have to focus on all four levels. if you really want to reduce risk, you have to think about -- you have to think about all of them. and so i'm going to just spend a couple of minutes really on engineering controls. so on the left-hand side, it's just a reminder of what happens. so a person can be asymptomatic, have no symptoms, feel perfectly fine but be very infectious. so they are putting out aerosols. aerosols are tiny, tiny droplets that float away, can travel farther than six feet, and can infect persons even who are at a distance. so this is a really critical thing when you're indoors and there's poor ventilation and the concentration of those aerosols are building up. if everybody's wearing a face covering, it's going to reduce the amount of aerosols that are there. so you see there on the

left-hand side, on the bottom depiction, you'll see that the person on the left now has a face covering on, but it doesn't prevent all the aerosols from coming out, but it really decreases them, and so this is where ventilation comes in. so ventilation is really critical to really -- we want to dilute that even more, and it's really -- it's a really basic concept. i want to dilute the aerosols, and there's only really two ways of diluting, which is ventilation and filtration. what's the easiest way to handle ventilation? move the activity outdoors. if you're indoors, you have to think about, okay, how do i dilute it? i open up windows or i use a filtration system that's going to remove those virus particles from the air. if you have a filtration system, let's say you have recirculated air, in general you don't want to have recirculated air, but if you did have recirculated air

you're going to want to have the appropriate type of filter to filter out the air so the air coming back into the room has now been cleaned. and so you will see, for example, that there are areas that use portable filtration systems. you can go online and buy these. they are made for the home. people are using them right now because of the poor air quality, but you can buy those that are sort of stronger and built really for business purposes, and so for example at the tuberculosis clinic, we have portable filters that we use to keep the -- to keep the patient rooms, to keep the -- because people have tuberculosis, they are being in clinic, we want to make sure that we minimize the risk, so we use those portable air cleaners. so the big items that we think about, again, is mixing with persons outside the household, ventilation, contacts, face coverings and activities.

and the supplies to everybody, anything that's happening indoors -- and this applies to everybody, anything that's happening indoors. i'm going to jump into some questions that i received. so some of the questions i received have to do with reporting requirements. you'll see there at the very bottom is a pdf file. that one has the nitty-gritty details. the bottom line is that if you have had three or more cases within two weeks, you absolutely need to report to the health department. you need to say -- if you become aware that three of your employees have come down with covid, you need to let us know because that's -- that's a requirement. but even if you had one case or two cases and you need more guidance or you're having challenges really understanding what's in that document, there's a telephone number you can call to help -- so that we can help you manage it.

one thing to think about is that most infections have no symptoms or they have mild symptoms, so the truth is that if you have one case, you probably have more cases that are not even detected. so it really depends on the size of your business and how many people you have. think of a case as either that person may be introducing it into my work site or it's a tip of the iceberg. and so you don't always know, and it's really hard to sort that out unless, of course, everybody were tested. and that's why it's really critical, the face coverings is very important. we have a lot of community transmission happening now. so it's the cumulative risk of somebody coming into your work site, whether it's an employee or a customer, being infected is very high, and so that's why you want to have universal face coverings. and it's hard to achieve because when people don't have symptoms

and they feel well, they don't realize that they are infected. people let their guard down. one of the things that we notice is that workers really tend to infect each other. oftentimes we're worried about the customer, but actually it's the workers who are in the break room eating something, removing their face coverings, and they are exposing each other. so you really want to think -- you really want to think about that. can it be forced to close if i report? so the whole idea, we in general, we're not in the -- we don't look to close down businesses. usually if a business gets closed down, it's usually because there are egregious violations of health standards, and it's probably not related to covid. so we do -- for example, we do close down restaurants when there's other issues happening that are -- that have to do with serving food safely, but it's rarely going to be because of covid. you may -- you may decide to

close down just to clean -- just to clean the environment, and that's -- it's good for the workers. it's good for customers and it increases customer confidence if you do them. what is the impact of ab685 covid-19 imminent hazard to employees exposure notification and serious violations? so the state of the assembly bill does have new requirements based on osha regulations, and what i'm going to do is our person who's in charge for occupational safety and health for the health department is reviewing this bill and we'll develop some summaries just to let you know how that's going to apply, but there will be the ability based on osha standards to close a business for having egregious violations related to covid. this is going to be more specific to covid. i haven't had a chance to read this more carefully. i did give this to our person, our expert who is going to go

ahead and read it and summarize it because we actually have to be aware of this as well too, so we'll develop a summary so you have a better idea about that. so what is required for san francisco to move to orange? so we were assigned to the red tier. you cannot move out of a tier until you've been in it for at least three weeks. so move out of a tier you have to be in the next tier for at least two weeks, so we're close to -- we're right now we have been assigned to the orange tier in terms of officially we're in red, but our metrics after adjustments, remember that adjustment that i mentioned earlier, has put us into the orange tier, and it's very possible that if things do not change that by next week we will be officially in the orange

tier. and what we've done is those higher-risk activities like indoor dining that we've pushed down into the orange tier, that means that indoor dining will be able to open up. and what we're going to do with indoor dining, we're going to develop a directive. so remember i mentioned about the directive. it has legal authority, guidelines have legal authority. we're going to want restaurants to self-certify that they are meeting minimum standards and thinking through all of these things so they can really reduce risk as much as possible indoor for their workers and their customers. so for example we want them to think about ventilation. we want them to have a plan of how to increase ventilation indoors. i think that's going to be really important. did labor day weekend lead to a surge in infections? right now we're seeing a slight increase. we're crossing our fingers and

hoping that it doesn't increase anymore. it usually takes two to three weeks after. it was a really hot day, so lots of people stayed indoors because it was too hot to be outside, and i'm trying to remember if the air quality was bad that day. if it was, it means less people spent time outdoors. we don't seem to be having the type of surge that we had with memorial day. how can we work with dph to understand industry-specific risk? that's a really great question, and we're happy to work with any of you to figure out how we can make your businesses safe. the key principles, i think we now know the key principles, and it's the ones that i just mentioned on the slide, and what i would say, the last comment i want to make sha i think is really important, not just for you, your family, your workers and your customers, but in public health we try to come up with guidelines that will reduce the average risk in the population to control an

epidemic. but we know that actual individual risk may really vary. so you might be in an environment where there's poor ventilation. you might be in an environment where you're predisposed to have a severe complication because you're older, you have a chronic medical condition, and you may decide, i really want to reduce my individual risk even more. and so we're going to be coming out with more specific information on how people can reduce their individual risk even further. an example would be people know about n-95s. the general public, if they had to be outside with very poor air quality, an n-95 is an option to reduce breathing in air that has poor air quality. well, that same n-95 can actually reduce your risk of becoming infected with the sars coronavirus if you were in an indoor higher-risk setting. and so things like respirators,

n-95 are options that will reduce individual risk even more when you're in an indoor setting, and we're going to make that -- we want to make that information available, because people may want to take additional steps that go beyond our general requirements. at the back i went ahead and just put some -- a bibliography of recent citations that addressed the issues that i brought up. and so that's it. i hope i didn't take too much time and that we have plenty of time left over for questions. >> i think we will have plenty of time, and that's great, and appreciate this excellent presentation, so thank you. so with that, i'm going to turn it over to our fellow commissioners, and first up is commissioner adams. >> thank you, president laguana, and thank you, dr. aragon. this is an excellent, excellent presentation, and it explained a lot and helped me out a lot.

my questions for you is about office buildings. and i'm not talking about the big corporations. i'm talking about the office buildings where windows can be opened and that, like your older office buildings, where you do have a lot of small businesses in these, like attorney offices, accountants, c.p.a.s. right now we can't even find anything on the city website other than only essential workers can go into the office. is there going to come out with any directives on those soon? and i mean, i appreciate -- i know it's only essential workers who cannot work from home, but i have tenants who are like individual office attorneys and c.p.a.s and stuff that want to come down, and i don't know what to tell them. >> yeah, so i -- there is -- if

you go to covid19.ca.gov -- you know what, we're going to have to send you this link. there is a matrix, a pdf that has a matrix basically how the state has everything, including offices. and pretty much we're following that matrix, except for high-risk things that i mentioned, the high-risk things we're pushing down the level, but you can go -- you can find your -- there is a row there on offices, and you can just look right across, look at the color, and you'll get an idea of exactly what we're going to be permitted. so we're just following with the state for those. we're following our assigned tier for everything except high-risk things, and high-risk things right now are movies and indoor dining and religious worship is one of the areas. so they are all going to be sort of open -- they are all going to be opening up together, but we

pushed everything down by one tier. >> okay. thank you. >> you're welcome. >> the chair: okay, who else i got? any other questions here from commissioners? >> my presentation was so clear that there are no questions. [laughter] >> the chair: commissioner ortiz-cartagena. >> [speaking spanish]. [indiscernible] to help small businesses. you mentioned all the stuff you've been doing, so i want to thank you for that. we all appreciate you, especially in the restaurant community. one of the questions, and it's not even a question, it's more of a how can we partner and

disseminate information in real time in spanish. all this stuff is great, but sometimes we don't get the directives [indiscernible] and sometimes the spanish is a little too technical for restaurant employees. what are your thoughts on that, disseminating? [indiscernible] that would be great [indiscernible] telling people that, i don't know, like, [indiscernible] or something. >> okay. well, can you do me a big favor? can i assign you to bug me about this one? this is a really big one. i absolutely agree with you. it's -- we have to figure out how to get to the latino workforce in a way that's going to culturally resonate, and i'm glad you're bringing this up. i'm definitely going to follow up on that, but also i want to

follow up with you to make sure that, you know, whatever we do is connected to the small business commission. because it's really -- it's not just the food industry. it's a lot of different industries where we have essential workers who are working behind the scenes, and we need to get the word out to them in multiple languages, so thank you for bringing that up. >> thank you, doctor. >> the chair: wonderful. commissioner yekutiel. >> thank you very much, dr. aragon, for your second presentation. i watched your presentation for the health commission and i really appreciate that you kind of tailored this one specifically for us. i'm sure that must have taken lots of time also. so i just had a couple of questions. one is regarding the framework in terms of for information dissemination. you know, this is very kind of similar, i guess, to what we were just talking about in terms

of getting information out to people. one thing that i noticed when we were handing out p.p.e. is that a lot of businesses just are not connected via email, and so people were, you know, giving me phone numbers or, like, you know, just this name of a person. it was just very difficult to kind of, you know, have a very streamlined method of communication. so i'm kind of curious as to what your understanding of how your health ordinances are pushed out and then disseminated? >> so i will tell you what i know, and i'm sure all of this can be improved. so you know, i work primarily with the office of economic and workforce development and their communication network to get information out, and so my assumption is that the small business commission and oewd are -- my assumption is that you're communicating closely, but that's been sort of the way that i've been -- that we -- we

have let them sort of figure out how to communicate that out. i don't know if you know joaquin torres. if you have suggestions for improvement, if there are gaps, please let him know, and i'm sure they'll really work on improving the communications. >> okay, because i do get the sense that, you know, when we're listening to your presentation, you know, it makes a whole lot of sense. like everything, i get it, i can see the health ordinances. i'm able to go online and i can find what i need, but then when i talk to small business owners, there's mass confusion as to what's happening, when is this happening, who said what. and so i am just kind of understand, i guess, where -- you know, where that gap is and who we can really work with to close that gap for everybody. >> i know that in the mayor's office they've assigned a

dedicated person -- i don't know who the person is, but in the mayor's office. so andres power might be the person who knows who was assigned, or sean elseburg is going to know the chief of staff. so a dedicated person to focus on communications just for the reopening. and so i think that's going to be -- because you're absolutely -- you're completely correct. it's just -- you know, i'm in this every single day, and i get confused, so i can't even imagine what it's like for somebody who's not doing this. you're absolutely right. and the mayor's office has recognized that communication is a really critical element. >> i think -- and then one of the questions that was in your health commission meeting last time i felt like i would love some maybe deeper understanding about it. they talked a lot about, again, the language, the legalese, and

i think you had mentioned kind of like tip sheets, and i saw some of the tip sheets, and they still feel kind of like complex for a business owner who has, like, 20,000 things. do you think there are opportunities to still be able to, you know, simplify those further and then be able to really tailor it to the workers as well? >> yeah, this is sort of -- this goes along with the earlier one, which is we have to figure out -- and i will definitely follow up with the communications person because i think we have to figure out really how to take it to that next level. yeah, because i -- even myself, i sort of tend to focus on how do i just get this done accurate, and then i hope that somebody else takes it and translates it into other language. i will ask, when we start interacting with the new communications person, i will

follow up with this because it's reaching the essential workers, both in written and -- we have to have written and non-written ways of communicating, and it's a big area. i agree with you, and i promised to follow up and hopefully that i'll -- you know, that communications person will mobilize resources in this direction. >> thank you. i mean, i think having your support on that would be, you know, one of the big key things because knowing that you're putting so much effort and thought into tailoring something for san francisco and then making -- and ensuring that that then is executed, you know, to the best of all our communities' abilities, i think both of those things would be a really nice complement for us to be able to work on this together. >> and the other thing i tried to do in my slides, if you remember one of the last slides that i had that had the picture with the mask, and then the other one, i put those on purpose together in one slide so it's almost as if you have to

just take that material and translate it into what works for you. and there's a few key points there that if everybody can just really figure -- stay focused on those points, we will make a big difference. so that slide is an important slide because a lot of the content for preventing transmission is on that slide. >> perfect. thank you so much. >> mm-hm. >> the chair: okay. >> and keeping your family safe as well. because everything that i tell you, i apply with my family. >> the chair: wonderful. commission commissioner yekutiel? >> i want to say thank you so much for coming to a place where you could create a timeline for my community to reopen their businesses indoors. i have not been able to have anyone set foot in my business and to serve them for over six

months. and you know, it's emotional. it's -- we have talked about this before, but this is what we're here to do. this is, you know, for many of the people in my community, this is our -- this is the fruition of, you know, a dream at times. so to have our business shudders indoors for so long is really, really difficult. i know you know that. i just want to first say thank you so much for coming to a place where you're giving us the ability to reopen our spaces inside, for trusting us. i just want to say on the outset of this that restaurant owners really want to do this right. they are begging, they are begging for the trust of you, thomas, and your team and the city and the entire public health committee to give us the opportunity to do this properly, and so i know that about my community. i know we're just looking for an opportunity to do this right. my first question is about requiring filtration systems with indoor restaurants. is that something that you're

thinking about requiring restaurant owners to provide, indoor filtration systems? >> well, we're not requiring them to do a or b. we're saying -- we're requiring them to address, to have a plan for how they're going to improve ventilation. >> but are, like, are regular fans and windows enough or professional filtration systems do you think are what's going to be needed to create ventilation? >> yeah, of course you could always do -- you could always -- there's a whole spectrum. you could always do more, of course. and we realize that -- and this is also true of schools. there's a lot of old schools, and so that's why you want to sort of start with the obvious, which is can we open the windows? can we open the doors? you start with that. >> right. >> and then there are guidelines and we're going to have to make sure these guidelines are available to you. and for example, in old schools you can get -- you can get

portable air purifiers that will get the air exchange in the room, several air exchanges, and purify the air, and so you want to have those available to you because you may have a part of the restaurant where there isn't a good window and a door and you want to do something further. >> right. >> we want everybody to think about it and to plan for it. there's no way that we could go -- there's too many restaurants for us to know what everybody is doing, so we want to make sure that part of the self-certification is that you've thought about this and you can explain to somebody else -- if somebody were to come to you and say what are you doing to improve ventilation, you can say we're doing a, b and c. >> right. so i just looked up in the [indiscernible] of this conversation what would it take for me to have a professional purification system for my business, and minimum 5k, but probably closer to 15k, just for the size of my restaurant. and so of course there's a

balance here, right? we want to do this right, but the whole point of giving my industry the opportunity to open doors is to save them from financial ruin. if requiring them to spend tens of thousands of dollars on air purifiers is what's required for them to open indoors, it doesn't really make sense. i'm glad to hear that the self-certification, there's some flexibility. just to be able to figure out a way to be safe and requiring ventilation. commissioner dooley, i think you're unmuted, by the way. i heard you mention n-95 masks earlier as being better at preventing spread. do you think you're going to be requiring guests of restaurants to be wearing n-95 masks for entry? >> no, no, no. we're not requiring people to wear n-95 -- we're not requiring folks to wear n-95. what we want to do is we want to make people aware of, you know, again, in public health we focus on here are requirements to reduce the average risk. we want also to empower people

with additional information. if they want to lower their own individual risk for whatever reason, because they find themselves in a location where they feel i need to protect myself, or they may be medically vulnerable and they want to take some extra protection. so that will be additional information people can use, but there won't be a requirement. >> i'm just trying to make sure that there's going to need to be a rush on something for restaurant owners to open their businesses that we can start getting ready now to provide the things we need to do this right. the third question i have is about hours. i know it's actually -- i know we've been flexible in changing up what all the requirements and the guidelines have been, but i think what's resulted from it now is i think a lot of people in my community of restaurant owners are confused about when they are allowed to open and close. are you thinking for the inclusion of indoor dining that there will be a restriction on how late restaurants can be open? >> not that i'm aware of. i'm not aware of any

restrictions around hours. >> okay, and my final question around the reopening of indoor dining is about capacity limitations. i've heard in different parts of the state there are capacity limitations from 10% to 25% to 50% and a cap on a total number. i know this is a process you guys are working through right now, but are you thinking about a particular -- the orange zone is 50%. red is 25. so are you thinking 25% capacity? >> yes, when we move into orange for restaurants, it will be -- it will be -- let's see here. it will be 25% capacity or 100 people, whichever is fewer. >> got it. okay, so those are my questions on indoor dining. i just have a couple more. this is -- i'm also a religious jew, and i know you've heard a lot from the community, so restaurant hat off, religious jew hat on. deeply religious. of course high holidays are coming up. they have happened. we had rosh hashanah, happy new year to you, thomas. this is the most important time of the year for my community and my people. and people are really nervous

and sad and scared about not being able to be in e-koemanical organizations or synagogues. i'm hearing confusion around why large retail establishments like malls and places -- you know, large department stores are acceptable for people to come into but not large synagogues or churches. i imagine your answer is going to be because in churches you sing and you aseparate -- aspirate a lot, but i'm wondering what the reason is for the difference? >> yeah, so if you remember, remember one of the slides i started with is that we start with what the state allows us to do. >> right. >> and when we came on the watch list, the state closed all indoor restaurants and all indoor worship. and so that's -- that happened outside of our control. and now we're giving -- we're being given the opportunity to

open things up, and so we're using the state framework again. so the places -- i have been talking about indoor dining, but the places of worship, they -- when we mauve to orange -- when we move to orange, they will be moving to 25% of capacity or 100 people, whichever is fewer. we are going to be opening up that significantly for indoor, and we're also going to increase outdoor as well. >> i understand that. i just -- it seems like your department is comfortable conforming with the state's guidelines on some things, but also coming up with own guidelines in other ways, and so i'm wondering kind of your personal opinion, what do you think is the reasoning between allowing for certain uses for indoor as acceptable but not religious? >> yeah, i think -- you know, you're asking a really good question. i'll give you sort of my take on it from an epidemiologic perspective. >> thank you. >> until we're able to do these case control studies, like the

one i showed you, it's really hard to identify what drivers of infection are. okay? >> mm-hm. >> so when you ask people, you go to the cdc and you say what are the drivers of infection, they will tell you what their intuition tells them, and their intuition has really been driven by outbreaks, and so the outbreaks that we know about are primarily related to restaurants, religious services, bars, and so that's what people -- that's what people know, and so we don't have the evidence base -- we don't have the evidence base to be able to say, oh, you know what, this really well-designed case control study showed that churches are not at all associated. maybe there were outbreaks, but they are not all. so that's what we're sort of left with, that intuition, and then we're left with -- we have better evidence, and so that's what ends up being promulgated down, and we mix it with what we

think is what we know, and that's sort of how things -- that's how things play out. our commitment is to allow what is allowable and to do it as safely as possible and to let people know what is risky so that they can make the informed choice if they want to take those risks. >> i wonder if some of that has to do with the trickling down of the early news reports of all those cases coming from that south korean church where people were in close proximity and sweating and right next to each other, you know, maybe there was some early reports of that that are kind of -- been filtered into those guidelines. can i ask a couple more questions? is that all right? >> the chair: yes. >> there has always been quite a bit of outbreaks associated with religious services, and the challenge is that the reason we notice the outbreaks is because it's -- we can see a church, right? we can see a church, and so it becomes something that's easier for us to observe, and that's

why we're able to detect the outbreaks. it's possible that there are outbreaks happening in other settings, and even more, but we just can't see them. it doesn't mean that they are not happening. >> right. i think my only point on that, dr. aragon, is it's the same thing probably with restaurants in that i think large religious institutions with lots of space, i'm thinking of temple emmanuel, for instance, they would love the opportunity to show that they can safely bring people inside, spread them out, require masks. >> right, right. >> that kind of thing. >> i'm now going to take my religious jew hat off and put my event planning hat on. if we were open in person i would love to invite you and have an audience. i think i probably did that earlier on before the pandemic. i think a lot of -- obviously the event industry and the independent venue alliance suffering so much, and unlike indoor restaurants, there really is no light at the end of the tunnel for that industry, except

for perhaps your office coming out with guidance for medium to large-sized outdoor events. but i guess my question to you on that is how do you think about indoor and outdoor gatherings where mask usage, other p.p.e. usage is required and there's spacing and it's very strict? it seems like from hearing you give your presentation now i think four times, one of the things that really worries you, and it makes sense, is when you are forced to do activities that -- when you're doing activities that force you to take your mask off. but we're now getting into month seven of this shutdown, and there are effects, and i know it might be hard to hear this because you're thinking epidemiologically, and perhaps i'm thinking purely culturally, but the effects of not being able to attend events, culture, artistic, in my case civic and political in eight days will be the presidential debate. i will not be able to gather to watch these debates in

communities. so forbidding these, even when there's a potential path to have gatherings where people are required to wear their masks and distance, i fear might be having downstream effects on just the general health, well-being and the mental and emotional and spiritual health of our city. so how are you thinking about gatherings, whether indoor and outdoor, that bring people together and create a framework where people can do that in a way that you feel is safe. >> so at the end of the day, it's really about what is the prevalence of active infections in the community. so if the prevalence of active infection in the community is really, really low, we can go out there and play football, tackle football, right? no, seriously. >> i have never played tackle football, and i probably never will. but we can go to a drag show, you and i. >> and so, yeah, my point is

that for the countries that have been able to keep the infection rate as low as possible, they were able to do riskier activities. and that's sort of the balance that we have. as a nation, we've never gotten to that level, and so now we're -- because we've never gotten to that level, we're now at the area where we are now trying to open up these high-risk things when there's infection in the community, our testing is not optimal. there's a lot of gaps that make it hard for us, and so we're moving cautiously because we don't want it -- we don't want -- remember i showed you that effective reproductive number? if it gets above one, it starts going like this, and then all of a sudden we start backtracking and shutting things down. i don't want to go backwards. if we can continue moving forward, then that's the best

path, i hope. >> okay, and dr. aragon, i just have two more quick questions. one is a follow-up to what you just said, and this is coming off the comments of my fellow commissioner, there is a clear disproportionate number of cases of covid-19 in parts of san francisco. the ca-- so are you thinking of the different -- when you think about a reopening timeline, permitted activities, distribution of resources, i'm glad to see that finally at 16th and mission, a block away from my small business, there's finally free covid testing and a full center for people to come and get tested, but have you thought at all about thinking about this timeline and what's permitted in different communities and areas depending on the prevalence of covid in that community? or is that kind of not the way you think about it? >> yeah, you're bringing up a really good question, and that

is when indoor restaurants open, the risk is going to be different in different parts of the city. that's just the way it is. and i think -- and we are trying to be -- treat everybody the same, but i think you're absolutely right. there's certain parts of the city that have more community transmission. and so people going to have to take that into their own decisions that they make in terms of mitigating risk or taking -- or you know, eating out, for example. you have to have a really good solution. we don't -- we've tried not to -- we don't want to -- we don't want people to start discriminating against other people and not doing business activities in certain neighborhoods, but you're bringing up a really good point. >> i know it's a touchy subject. and commissioners, this is my last question. i really appreciate you giving me this much time. and this goes kind of back to

where we started, dr. aragon, which is thank you for giving my industry the ability to reopen. we are all really scared as well because this -- you know, we did have post-memorial day, you know, a closing back of a lot of our activities. i remember when you released the timelines for reopening restaurants and i celebrated, my restaurant celebrated, we hired a bunch of people, and people are really nervous about a potential closing back of our reopening timeline. so i wanted to ask: what are you going to need to see to decide that you're going to roll back the reopening that you have announced recently? specifically for indoor restaurants, but in general. is it the kind of thing where you're going to wait for two weeks of higher numbers or are you going to wait for the state to change our tier and then change our tier? how are you thinking about the rollback if [indiscernible] do it? >> currently, our current thinking right now is to follow

the state, is to follow the state tier system. >> okay. >> because -- yeah, so that's our current thing. and the other thing i want to say, when you said thank you to me, it's really not me. it's the -- it's all of us. it's the combination of this battle between the virus that's trying to replicate and all of us as a city community doing everything we can to get it to go down, and that's why i think it's really important. i think working with the restaurant industry is going to be really critical because we need to work with you to make sure that the work site is as safe as possible, that essential workers are not becoming infected. so all of us have to do that, because all that contributes to the rates going up, and then things have to shut down, and so we all have to work together. >> thank you very much, dr. aragon. thank you, commissioner laguana for giving me that much time. >> the chair: oh, please, ask. commissioner adams? >> can i get a copy or the commission get a copy of your

presentation? because it will help me because i get inundated with questions. your presentation, i can really when i'm speaking to people, like, i can cite some of the stuff in there, if that's possible. >> of course, yes. yeah, they have my presentation. >> great. and again, thank you, excellent presentation. >> you're welcome. >> the chair: commissioner dooley. >> thanks for the presentation. it was really great. my question is more about small businesses are becoming a little lax about enforcing masks and i just wanted to ask as a community member, short of asking the health department to come out, can you suggest a way to encourage these folks to actually, you know, follow our guidelines so we don't start

shooting up? i've had photos sent to me of a few businesses that, you know, out on the sidewalk, no mask, drinking alcohol, singing and dancing, and as i say, our -- we don't want to shut anyone down, but can you give us a little guidance on how we might be able to connect with these owners? >> you're asking a really good question. yeah, i -- i know we do have an enforcement team that goes out and looks at the different complaints, and sometimes we will amend the orders to try to influence behavior. so one of the things we did was one of our orders was we have people who are eating and drinking when they are not actively eating and drinking. they may have finished and they just want to converse. we require them to put their face covering on, back on.

and that actually came from complaints from the waiters. the waiters were saying they're done eating and they're just talking and they're not wearing their face covering, and i don't feel safe [indiscernible] wearing their face covering. so we do do that. it's really -- it's very hard because we can't -- it's hard to regulate people's behavior at that level. and so a lot of public health depends on social norms and social pressures, where if they see everybody doing it, and so we really depend on the owners. here's an example where the owners want to open up, and so all of us have to do our part, and so they should really be encouraging the patrons to put their face coverings on. if there's a complaints please let us know, and we do have people that will go out and look into it. >> yeah, i was just hoping there

might be something a little less difficult for the owners, you know, than having the health inspector come out. >> yeah. >> i don't know what it is because [indiscernible] a lot of violations here and there, and other patrons are upset about it. >> yeah, i get emails from people who are upset, and sometimes a business can say, you know what, we're not going to serve you here again because you're not following our rules. right? >> right. >> and i'm not in that situation. i don't know how hard it is to do that, so hopefully the business community can come up with something to help in that area. >> thank you. >> the chair: wonderful. let's see, any other questions here? okay, great. i get to ask questions now. hooray. dr. aragon, first going back to your presentation, the fisher ten port study, i didn't see who the institution was that

released that out, but that -- this was the study that indicated, you know, the degree of i guess comparative risk between restaurants and i think it showed a higher risk level for bars. this was the one with the air bars on the side. >> okay, yeah, so that's a cdc, centers for disease control. >> right. so i saw the press releases on that. i was curious, i don't believe that that study discriminates between indoor dining and outdoor dining. is that correct? >> correct. >> yeah. so do we have any data or any guidance at all on indoor versus outdoor, comparative risk level on -- nothing? >> not that i'm aware of. i'm sure that -- this study will be replicated, and they will

make those distinctions in the future studies. >> the chair: hopefully, yeah. and i was going to say along those same lines, if memory serves, we opened up outdoor dining on july 15, but by that point our big post-memorial day surge was already in full effect, and there -- you know, please correct me if i have this wrong or i misunderstood, but there doesn't appear to have been a surge that is directly correlated with opening up to outdoor dining in mid july. does that map to what you're seeing or what your gut is telling you? the truth is that in the absence of these types of studies we twoel don't -- nobody knows, to be honest with you, and i think one other comment, just the previous study, the fisher study, so because they didn't distinguish between outdoors and

indoors, to the extent that some of that was outdoors, it actually underestimates the true risk. in other words, it dilutes it because probably outdoors is lower risk. >> the chair: right. >> so that statistical association is an underestimation of the true risk, and so the truth -- and so the next question you're asking is that without these specific types of studies, we have no idea. we know what [indiscernible] we have suspicion. we know there was a lot of socializing, so you'll hear people say we think it was a lot of the social gatherings, a lot of the small social gatherings. the truth is that we don't absolutely know until we do more of these studies. >> the chair: okay. you know, i guess one thing we could say is, you know, since we have allowed outdoor dining we have slowly but steadily

approached an effective rate of under one. >> yes, that's true, absolutely. so even -- we know that these activities don't eliminate all risk, right? we know that. so there has to be -- there's some small numbers of infections probably happening, but in spite of that, we've got our reproductive number down below one, and so that means fantastic. actually, i just wanted to let people know, if you do have a complaint about a specific business, you could always call 311, and they'll -- they will send out -- the covid command center as a community education response team that will go out and investigate the complaint. >> the chair: yes. so great, that's helpful information, but i guess the point i'm driving at is it does seem -- you know, something that could be reinsurine assuring t both the public and the community is that we could have an effective rate under one and still have, you know, some

degree of business -- you know, service of outdoor restaurant service that it's not mutually incompatible, that we're not just forced to seesaw between the two extremes, either we have a pandemic or we have outdoor dining, but we can't -- we can't have -- under control and also have outdoor dining at the same time. it does appear that we can do that, and it's -- that's what the evidence seems to show so far. >> i completely agree with you. yeah, i -- you're bringing up a really important point, and that is when i presented that slide, i don't want to make it sound as if i believe that outdoor dining is risky. that's a really important point. my point is that as for us to think about as we move into indoors, that we sort of -- we really take seriously how we mitigate risk for all indoor

activities. >> the chair: yes, i know our community of small business owners is really clear on this point, but i know it's not always clear to the public. and so that's particularly with respect to shared spaces. that's a source of tension. there's a feeling that, you know, it's being reckless or, you know, putting the public at risk. and i think we can discriminate between some marginal level of risk that just comes with being, you know, outdoors in the middle of a pandemic. >> right, right. >> the chair: and you know, the second and third order of health impacts of employees not being able to work and not being able to make a living, et cetera, versus, you know, more contained serious risks that, you know, sharing the same indoor -- same air indoors for long continues

periods of time. >> correct. >> the chair: so i guess i wanted to talk about communications for a bit. first of all, i think you've heard, particularly from the restaurant community, but from small business -- you know, even just within the past two weeks since we made the request of this meeting, there's been a lot of changes that i think have been well received by the small business community, and that has been, you know, as manny expressed, there's been some gratitude for that and an ability to open, knowing full well that it's an entire team that is trying to assess and decide. but you know, it does seem like there's -- you know, it leaves some possibility that, you know, fingers crossed we don't get

there, but that things could backslide or that we have to, you know, perhaps the state sets us back a tier in the future. and so it does seem like the communications part of it is really important because i know that that was a pain point for many in small business. i'll offer one bit of feedback that i've heard repeatedly from several different folks, is that the working groups strategy for dealing with communications internally, coming into dph, that that felt like a really productive strategy, because part of the frustration is how do we get information to dph in a way that is being ingested and understood. so i wanted to let you know that the working groups approach is -- has been successful.

>> great, that's great. >> and there's probably other sectors besides restaurants that could possibly benefit from that approach, and certainly the commission and osw and oswd would be happy to work with you on fleshing out those working groups on who the right people are when and if we get to that stage. the second part, of course, is getting the information out to folks, and that's the more challenging part, partially because there's nobody that -- you know, i -- it's hard to get information out to small businesses who aren't necessarily paying close attention to oewd or even the mayor's office, maybe they don't check their mails. mail takes time to get to them, and that's expensive and time

consuming. so you know, i have a couple questions around your process. so when you decide to make either a directive or an order, does dph have its own coms team? or are you relying exclusively and entirely on the mayor's office and eowd to get your message out? >> so every department has their own communications team. >> the chair: mm-hm. >> but the whole covid response is so -- it's so massive that we really -- and there's so many moving parts in all the different aspects of covid, that the covid command center, which is our emergency response center down at muscony, that they brought together the communications people from all the different departments, and it's called a joint information command, and that's really the center of our communication activities. really everything goes through

them. >> the chair: okay. when you make, issue an order, and i'm assuming when -- when you generate a new order or directive, that's a conversation with a whole bunch of people and then you develop some degree of consensus on how you're going to move forward. it's not just you woke up from a nap and decided you're going to do something completely different that, you know, there's some sort of iterative process. but when you issue that order, do you contact the ert team and say this is the order that's coming out and you're relying on them to get it out? what is the actual process? >> yeah, there's a whole list of things that we do, and i primarily work with the subject-matter experts and the city attorney in crafting sort of the key principles, the information and guidance. they have a whole database that has guidances from around the

country that are tracking what's happening in other areas. they look at what the state puts out, what's available, and then they put it together with what principles we're trying to accomplish. and then you have early drafts, and then we actually get -- we have a process of getting the drafts out for feedback, and so whenever -- sometimes things move so fast that it's not as ideal as it could be, but when there's plenty of time, it really works best -- we did that with the outdoor dining, is when we had a directive, we -- through oewd, they went ahead and asked folks: does this make sense to you? and we got a lot of feedback and then we made adjustments and directives because we don't want to ask people to do things that can't be done and don't make sense on the ground. it's really that process. it takes several days before it goes through the whole process of review and feedback before it actually gets issued. >> the chair: okay, but the process in terms of communications is you tell a

staff member -- >> yeah, so the communications folks, they like to know what is happening along the way so they can start planning their communications strategy, and then -- because core materials have to be translated into the threshold languages. so there's this whole other process that has to happen, and so they want to know as soon as possible so they can start planning their communications strategy and also the translation of materials. >> the chair: okay. but again, the process is you'll -- so you're having ongoing conversations with communications staff so they can start to prepare the materials, and then there's some point where the trigger is pulled or, you know, we're going to -- this is going to happen on, you know, two days from now or 72 hours -- >> but it's not as -- it's not as good as it should be, and that's why the mayor's office has assigned a communications

person, because people recognize is that this whole reopening area is so complex with the state -- with what's happening at the state level, the local level, all this other activity, that we needed to have a dedicated communications person that can sort of synthesize all this information and so that it can really improve communications. so hopefully next time i come back it will be different. actually, yeah, maybe we'll even have the communications person come and talk how they are planning to make things better. but yeah, that -- it's so complicated that we needed an additional person. >> the chair: yeah, i want to emphasize, we've -- i think a lot of progress has been made even just within the past couple of weeks at getting a better rapport established, and i want to acknowledge the progress that's being made and just emphasize what appears to be still left to do.

from the outside looking in. and we may be passed that point even now as we speak. so at any rate, i wanted to convey that. let me -- let's talk about math for a second, because i think, you know, as you have correctly pointed out, the business community has an interest in keeping this virus as under control as possible. the more under control it is, the more open we can be as you pointed out. i noticed with interest this starbucks study. i think it was observational. all of the workers were wearing masks and the diners were not, and the diners got infected and the workers did not. and that seemed to suggest that masks could play a -- you know, i think just reading it from the

outside looking in, the language has always been that masks are like a vaccine, they protect not the wearer but the people that might be breathed on by the wearer. but this seemed to suggest that the mask may provide some protective benefit to the wearer. and i'm curious if you have seen anything, any similar studies or if, you know, your spidey gut sense is telling you similar things based on your work and what you're seeing. >> so mask is one of the things that have been studied because there's been respiratory virus outbreaks for -- so we have sars before -- we had pandemic influenza in 2019, so there's actually been a lot of research around mask, and basically there's just two basic concepts, and one is barrier protection, so a face mask or face cover is a barrier protection, and that's

really going to -- as a barrier, it's going to protect things going out and going to prevent things coming in, especially big droplets. so that's just barrier protection, and so we know that a barrier protection protects others and protects me, and in addition, there's new -- there's hypothesis that it reduces the amount of virus that you get exposed to so that you're less likely to develop severe disease. there is that. and then you have -- when things become aerosolized and really small and can go around the barrier, then it really becomes about ventilation and filtration. and so then the filtration can both be engineered in a room, but it can also be respirators. n-95 is an example of a felt ration device that filters that, that filters air, so it has to fit tightly around your face. that's pretty much it. there's a lot of evidence for

both of those. they both work as barrier protection, but only one of them works in terms of airborne and as a filtration device. >> the chair: so speaking of filters, we talked earlier about restaurant air filtration systems and how recirculating air is less desirable without the filters. i guess my understanding of viruses, and you can correct me if i'm wrong, that they are so small that it's difficult to have a filter that really captures these. i guess n-95 meets that criteria. with these air filtration systems, is ultra-violet light, has that proven to be helpful? i guess what i'm looking for, what are some things restaurants can do if they, you know, don't

have -- and i'm not trying to pin you down. but i think they are looking for guidance -- >> these are great questions. i think these are fantastic questions, and there are -- there's two websites that you can go to, and we'll make sure that we can pass them on. one is from harvard that has a whole area to help people to understand how to improve the quality of air indoors, including practical things for schools. and then the state health department just put up a website dedicated to ventilation. i haven't had a chance to look at it closely, but it addresses the practical issues, uv light, recirculated area, level of filter you need for your ventilation system. all of it is there so that people can go ahead and say what can -- what practical steps can

do to improve ventilation in my indoor space. >> yeah, it does seem like even if there's, you know, modest things we could do that, you know, lower the risk or lower the severity of the disease by even 5%, that you know, compound interest, cumulatively that accrues to the benefit of all of us. >> absolutely. >> the chair: so i think, you know, going back to the communications side of this, i think that's a really important critical point that certainly we as a commission would be delighted to assist you with and d.p.h. and r.o.w.d. and everybody else. but you know, we really want to make sure that the entire business community has the best practices and guidances, whatever they are, whatever they -- whatever is within their possibility or capability to do, because even if it's just, you

know, improving the odds even modestly, or marginally, that's better than not doing anything at all. just, you know, the nature of the power law of the math just seems to push in that direction. so that invitation is outstanding. so with that, those are my questions. i appreciate you spending your time on them. i imagine we'll have some public comment as well. but before we jump to public comment, are there any last commissioner questions? feedback or comments before we go to public comment? i don't see any, so do we have any public callers on the line? >> yes, we do. we currently have five people on line in the queue. >> wonderful. please proceed. >> good evening.

my name is steven cornell. are you hearing me? >> the chair: we sure are, steven. please go ahead. >> thank you. thank you for the presentation, and i too listened to the one on the health division. i would like to talk a little bit about the communications. i understand that the city only can communicate with a relatively few number of businesses directly, and i feel that if the health department and your office is making the rules out there and want to get them out, it's up to you to get them out there. we out in the community, we really don't care if it's this department or that department and how they work in -- just get the information out. and it seems like no department has the names and addresses of all the businesses.

but one department does have it, and that's the tax collector. they are always out there. they are sending us bills. i think your department should just send the information to the tax collector and have them send it out. it is so important that all this information gets out directly to the businesses who are going to need it without it being filtered through a lot of other people. and that's -- and my second point is we need to have especially guidelines as early as possible, guidelines out there doesn't mean a promise that we're going to open up tomorrow or in two weeks, but it gives us the opportunity to start preparing for what we're going to do, or as manny said, if we're going to have to put in five or $10,000 extra in filters, maybe we don't want to do that and we can pull the plug, or whatever we want to do. but that information is so important. if you look at our state, the state seems to be sending out

guidelines weeks, even months ahead of time, and that's very helpful. i hope that's something you guys could achieve. again, it's the health department that wants to get it out. we want to be part of it. we want to open up, and everybody wants to survive. i appreciate your time. >> the chair: thank you. i'll point that steven provides legislative advice to the council of district merchants, which is one of our largest storefront associations in the city. next caller, please. >> hi, my name is marnia. i'm from a non-profit studio in the castro. and i need some advice on what programs we can reopen now that all of our health and safety protocols are in place and we have a schedule to limit capacity. we have -- of course i scoured

all the directives and all of the orders to see what pertains to us and what does not, but for example, we have adult education programs which are no longer in use. we've canceled all our public programming. however, we do rent space to other businesses who have keys to our business, to our physical plant, for example. so i could use a little bit of advice, and i'm not sure who to contact about that. who do i contact about questions on how i should interpret or how i am interpreting these orders? >> the chair: so we're not allowed to actually interact with public commenters. we can only listen. we are all -- many of us are taking notes on the comments, but we're not allowed to interact. i don't know

[microphone feedback] >> i think they have their speakers turned up. they'll need to turn their speakers down. >> president laguana, if there are questions that do come up that do merit follow-up, perhaps a recommendation is to have them to send the questions to sfosb@sfgov and we can follow up on that. >> the chair: yes, and i will try to take notes on some questions and follow up as well, although i missed with what her business type was, but hopefully somebody else got it. next caller, please. >> good evening, commissioners, and dr. aragon. thank you for having this meeting tonight. my name is mario magano. i'm the president of the san francisco council of district merchants, as president laguana

had mentioned, we represent some of the smallest and most important businesses on the san francisco streets when it comes to engaging with people in covid-19. thank you for everything that you're doing. the biggest complaint or concern that i get from merchants is that every time something comes out as a mandate that they have to scramble to get operational and they do not know how long it will last, and i understand the clinical safety of the community is important but we also have to know how to work with people. every time plans come up and businesses are trying to get their businesses operation, it can cost thousands of dollars and take weeks of time for merchants to get going. and a good, clean pipeline of communication, absolutely essential to keep these people from going to the tipping edge

of frustration. i understand the rules are changing on all of us on a regular basis, but as soon as we can get information out to people, the sooner they can respond and the less they'll have to react, and i believe also just to be a little bit more comfortable in what comes up in being able to handle it without having to panic every time a new mandate or a new regulation seems to come up as a bit of a surprise. i understand there's a lot of moving parts here and there's even a little bit of politics, but if you could just, you know, please think about those people that those decisions impact the most and the sooner we can get them the information, the media can do the rest for the general public, which is always happy to hear everything. thank you very much for everything that you're doing. thank you. >> the chair: thank you. next caller, please. >> my name is dean erickson. i'm calling on behalf of my small family business.

i'm also a member of the san francisco fitness independent studio coalition. i first wanted to thank the -- thank sharky and dr. aragon for the small business commission dph work with the industry of this past few months. being able to open at a limited capacity is a lifeline for not only my family business but many other family businesses as well. the feedback coming back has been overwhelmingly positive as many can't since go outside since they need to keep with their fitness regiment with low-impact machinery. to keep this in mind, the coalition is questioning what is dph doing to help the industry identify the next direction, like it has with the restaurant industry, in regards to indoor dining. what direction will it be taking and what direction will it be taking given small group classes and allowing us small group classes indoors, such as kick boxing and so forth, high cardio

classes. the other point we would like to establish is what can be done to establish this fitness industry as essential like that of physiotherapy in case any surges cause them to shut down, will independent studios also be required to shut down even though physiotherapy studios are allowed to remain open? and finally, we would like to understand the rationale behind the 18-year-old age limit allowed for anybody older than 18 allowed into the gyms for indoor workouts. with high school sports shut down, we're having a lot of demand for high school students being allowed to come in and work out indoors in order to stay in shape for their high school sports. so i just wanted to thank you all very much for your assistance thus far, and we look forward to further collaborating with the dph, the small business commission and all the board of supervisors moving forward. thank you.

>> the chair: thank you. next caller, please. >> dr. argon and small business commission, hello and thank you for a great presentation. i'm the broker and owner of -- properties in the castro. as the president of castro merchants and faced with lifestyle changes resulting from the covid-19 pandemic, we recognize that the wearing of the mask, social distancing and frequent washing of hands must be considered essential in order to keep our community healthy and safe. at the same time, as a business district, we all must work together to keep our businesses open and operating in a manner that will ensure the health and safety of all concerns. as business owners working with city agencies thus far has been

challenging due to an inadequate guidelines and communications in general. case in point, we have not been consulted and informed in any part of health order decisionmaking process. yet we are required to deal with many pages of health orders that are difficult to understand by employees and customers. much of such information has come by the way of the media. we should be included in the decisionmaking process. we should also be given guidelines that are clear to understand and can be administered and implemented in an orderly fashion. thank you for your time. >> the chair: thank you. next caller, please? >> hi, my name is tracy sylvester. i'm the owner of a pillates in

the mission. i'm a board member of the mission merchants association and have been advocating for small business for over 10 years. i also am a delegate for the council of district merchants and on the legislative committee. i am also a member of the san francisco fitness independent studio coalition, and today i just wanted to thank all of you guys for the hard work, dr. aragon, commissioners, and i wanted to echo my fellow business owners in saying that communication is key. i am a very engaged citizen, and even with the new order that came out for my industry to be able to start operating at 10% capacity, i also found out through the media, and as prepared as i was and as much preparation over the last five months that i've put into this, i am falling down on the finish line. my clients and my employees and the trainers that i work with are demanding us to open, and i'm still digging through all of the information necessary to

make sure that i'm fully prepared and in compliance. one of the big gaps in the communication is what to do with contact tracing, responsibilities for the business owners and how do we communicate if there is any infection or if trainers have a housekeeper that has been infected, how far do we go, where do we report, what protocols are in place to make sure that we are in full communication so that everybody in the city that's making decisions understands what's going on. i do echo steven. he mentioned that the tax collector's office might be a great way to get this information out to people, and again, as engaged as i am, there's probably many small businesses that are not plugged in to get the information first-hand from regina's department. i also wanted to talk a little bit about how we can be better engaged, an also as a business owner being brought to the table when decisions are being made, we can come up with a lot of

creative solutions to keep everybody safe, and once again i just wanted to thank everybody and know that you have an army of people out here to help you for the city to be successful in helping the mitigation of the spread of the disease. >> the chair: thank you. next caller, please. >> hello, good evening, dr. aragon, this is janet clyde. i am one of the owners of the studio café in north beach, and first i just want to thank you for your work and the work of the department during this time. it's been pretty remarkable what the city has been able to accomplish on behalf of bars, restaurants and cafés, but the entire small business community is pretty amazing. i also want to thank the commissioners as well for your work. i listen to you regularly and speak very seldom, but i just want you to know that as the owner of a cocktail bar and the

holder of a type 48 license, we are committed to stopping the spread of covid-19, just like everyone else. our staff is committed to that goal, and we are trying to reopen right now. i'm the holder of a type 48 license without a kitchen, and i am calling you because i'd like you to work with the department to standardize the rules regarding food and beverage service for the outdoor tables. the type 48 with kitchens and without kitchens are treated differently than the other food serving businesses because the department used an existing pop-up rule to give us a way to operate, but the rules aren't really fitting the current situation. we aren't temporary pop-ups, and we are partnering with restaurants, and we are expected to behave like restaurants. so what i'm asking is a standardization and that our

businesses be allowed to use the same protocols that restaurants are using at this time. we can't really operate unless we're, as a restaurant, or as a café, unless we're allowed by the department to operate. i can get more in the weeds about this. i'm very nervous when i speak in public, but i just don't want a situation where all this work has been done to standardize the behavior of people, you know, at restaurants outside and then we have to explain that we have to give them service in a different way. and so it would just be a big help if these rules were examined. it would be safer for my staff. it would be safer for the customers. and it would just be a much more predictable situation for us, and anyway, again, you know, thank you very much and i'd like some way to follow up on this,

that we can be treated the same way as type 47s because we are doing the work that -- the same work that they are doing. so thank you very much and have a good evening. >> the chair: thank you. next caller, please? >> hello, how are you? can you hear me. >> >> we can. please go ahead. >> perfect. i'm a new business owner in the mission, 2512 mission street. i just wanted to thank everybody for making everything possible for everybody to open up and for the economy not to tank more than this at this point. i just wanted to say that i am opening up a multi-function business, which is a retail store and a restaurant, and i know that everybody talks about businesses with one function, and i wanted to ask if in all

these guidelines we can provide also how does the capacity work, how -- if we are able to open indoor, does the capacity include everybody who is in there or is it the -- like, the sort of retail separate from the restaurant? i am still in the middle of construction and remodelling, hoping to open in about two months, but i am completely new in this whole owning a business in san francisco, and i'm confused and uninformed about how i should gear up to open at all. thank you so much. >> the chair: thank you. next caller, please? >> hi, my name is mya katsumat, i'm the owner of a vegetarian restaurant on valencia street. thank you for taking my call. one of my biggest concerns

through operating this and through our shared streets -- shared spaces street closures is that i feel that there is a lack of action by the abc, the alcohol beverage control. i know that all businesses are trying to be as safe as possible, but it's proven that, you know, when you're in a bar or a restaurant with loud music in the background, you're going to talk louder. 90% of the time when you're seated at the table people are not wearing their masks because they are either eating or drinking. and the abc has been so sorely absent. in fact, they have kind of -- you know, it's kind of the wild west right now. people are allowed to make to-go

cocktails. there's no patrolling of irresponsible serving. alcohol license holders are supposed to serve responsibly, and i'm not seeing that on friday and saturday nights, and that is a huge concern for me going forward. i know that through the shelter-in-place, people are cooped up. they -- regardless of what, you know, what the pandemic is, people want to go out and have a good time, and they are coming out to do it on friday and saturday nights on valencia street, right in front of my very eye, and it's very disturbing to me. >> next caller. >> the chair: next caller, please. thank you so much. >> good evening, thank you, commissioners, for everything you do. thank you, dr. aragon, for your guidance. pi name is page scott. i am the general manager and vice-president of the -- ice skating and bowling center. we are on the roof of the convention center, and we recently were very excited to hear that the adults are allowed

to come back in to do their fitness. we have frozen fitness. and we are just deeply concerned about why the children are now being told they need to go outside. our main concern is for children to stay mentally and physically fit. we are their out-of-school-time programming, but we cannot move our activity outdoor. we have a sheet of ice. i could open all our doors, but then the ice may felt. so we just would like to give the children a reason while they are no longer allowed to skate and to explain to parents why we are not letting them in the building at this time? once again, thank you all so much. i want to comment that dcyf and d.p.h. did an excellent job of getting that new order to us, and they really are working very hard, and i commend them for it.

thank you again. >> the chair: thank you. next caller, please? >> that was the last public commenter who raised their hand. >> the chair: great. and then before i move on, we have one other public comment which would be read allowed by commissioner ortiz-cartagena from the latin task force. >> thank you. this is a statement sent to me from the latin task force small businesses and [indiscernible]. the latino [indiscernible] in san francisco. [indiscernible] we know that

latinos are 50% of the population and account for 50% of the covid cases in the city. we also know that as of today [indiscernible] general hospital. we are bearing the brunt of this. we need the city's support. [indiscernible] level of attention when it comes to reopening. [indiscernible] we expect better because we are better. we should be setting the bar for what other cities do [indiscernible]. >> the chair: thank you. so dr. aragon, before we continue, i thought this might be a good opportunity to talk about a few of the questions that came up. so something that we heard

repeatedly in a number of contacts could be summarized in when can we do cardio again, whether it's gyms or i surmised that indoor ice skating is also a form of cardio. is that a state guideline? what is the boundary for cardio indoors? and perhaps that's related to what is the boundary for singing indoors. perhaps that also has a component. you're muted, dr. aragon. >> yeah, you're asking a really good question, and i think, you know, as we learn more about how the virus is transmitted and its aerosolization, we become much more concerned about anything that causes more aerosolization. [please stand by]

>> okay. and then, related question. somebody asked me this, and i

forgot to ask this during the normal period. where does yoga fall in this? is that considered cardio or -- >> that's a good question. my wife does yoga every single morning. she's been doing for almost 20 years, and i know it's incredible for physical fitness. i don't have an immediate answer to that one. >> that's fine. that's fine. i understand. several callers mentioned t.t.x. as being a possible pathway towards a -- as a better resource for communications with small business, and you or anyone in oewd or o.s.b. had any conversation with using t.t.x.

as a possible -- >> i have not. yeah, so this is the first time that i've heard about this as a communication channel. i think that's a great suggestion. we'll have to follow up on that. >> and then, one of the callers asked about how, you know, when we talk about 10% or 25% capacity, what the denominator was; in other words, what they're supposed to be using? 25% of what, and i assume that's occupancy, but perhaps you could answer that more authoritatively. >> when you say 25%, i'm thinking of the customers that can be in a space, but that's my assumption.

if normally you have 100 customers that you can fit in there, normally, now, it would be 25. >> i'm thinking of the signs that hang on the walls that say fire occupancy is 60, and it's 33%, just for ease of math, then 20 would be allowed. it sounds like we don't actually know for sure what the denominator is. >> i don't know. i was on a call with the state, was asked that question, and they didn't know that, either. so we have to nail that down because there's different ways of interpret that go. >> mr. president? >> yes. >> if i could add there are different businesses and restaurants. i'm trying to remember the fire department's terminology. it's basically you can have one

capacity when you have tables and chairs and one capacity when you have fewer or no tables and chairs. i think it's called, like, concentrated and unconcentrated capacity. for instance, manny's has one capacity when we have our lounge set up, and one capacity when we have our [inaudible]. >> yeah. and dr. aragon, you're informed that you've got to think of both those problems when it comes up with the state. one caller was asking for type 48 -- for those that are calling in and don't understand the issues, type 48, this is the kind of alcohol license that bars have that allow them to serve mixed drinks. under the current rules, and

somebody can correct me if this is wrong, type 48 can serve outdoors if they are a food service provider such that 50% of their sales are nonalcoholic consumables. so the question i think for type 48 providers, and i think this is what the caller was getting at is what does this mean for indoor usage. i know that's kind of an ongoing conversation, but i don't know if you have any new or emerging thoughts around that, you know, where d.p.h. is likely to come down on that question? >> so we're in discussion with the city attorney to be able to nail down that question. so i don't have a answer now, but we're actually discussing those specific topics. >> okay. >> and we're anticipate transgender may align with what's being allowed outdoors,

but i don't have a final answer. >> and then, the last question, i meant to ask this previously, but if -- if the city were ever to take a stance that there would be citations for masks or, you know, one of the other callers spoke about concerns about whether people are behaving safely. would enforcement of something like -- well, i guess the first question is where would a mask citation policy come from? would that come from d.p.h. or the mayor's office or would it take an act from the board of supervisors. do you have a sense of what the mechanism like that would be? >> yeah. it could happen -- it could happen different ways. i know recently, the health department -- the health

department outside of the health officer has been given more authority around enforcement, and the city has developed an enforcement plan that is going to be rolled out -- should be rolled out relatively soon because i know there's a lot of work going into this in the covid command center. i think the general approach is to start with support, education, and to do any type of citation rooch really as a last a -- sightration -- citation approach really as a last resort. >> i've noticed at several points during the pandemic that the city has taken an approach of trying to coach, guide, educate over punish and

enforce, and i want to commend the city on that because i think that that has led to better outcomes. that's a personal observation and a personal choice because it gets more buy-in. and certainly things are harder right now. >> right. >> we don't need to be adding injury to insult and misery. i think just guiding people is helpful. do we have any other commissioner comments or questions? if we have anything, now is the time. okay. seeing none, dr. aragon, thank you so much for your time. we really do appreciate you coming here. it's very helpful and -- here we go. commission commissioner yakutiel, good

timing. >> sorry. commissioner yakutiel. i thank you for your time this evening, and i wonder if you would be willing to come back before the board and give us an update on how the rollout's going so if you need to make some recommendations or ideas, we can distribute it accordingly to the small business commission -- oh, that's my purview. i am not allowed to do that. excuse me, mr. president. i'm going to take that back. >> when has that ever stopped you in the past, commissioner yakutiel. >> i was going to say, you can agree to come with me to a drag show,