people who have sadly lost their lives to this virus. today dr. colfax will give an update on where our numbers are and where they could be heading, because we are still in a very unfortunate situation. but, first, i really want to talk briefly about some really good news that i'm excited about. our playgrounds. this morning the state changed its guidelines on playgrounds to allow them to remain open if a region falls into the most restrictive category. in san francisco, along with several other bay county areas have opted into these restrictions, we will follow the state guidelines and what that means is that our playgrounds will reopen for our kids. and i really want to thank governor newsome for doing this and our public health officials at the state level and locally, for recognizing the importance of these playgrounds to our

kids' health, especially because our schools are not open, and i know how devastating this was to do when we did decide that playgrounds were going to be closed. and now because of a lot of conversation and using the science and the data and trying to look at the long-term impacts on our kids, the right decision was made. i also want to thank rec and park for working -- for the work that i know they've been doing and that they will continue to do to make sure that people are aware of the rules and that our public spaces are safe. now i know the -- i know following these restrictions is really hard. things change a lot, just as the impacts of this virus has changed quickly. and i'm not expecting anyone to be perfect. but we all need to try to do our very best. so when you take your kids to the playground, make sure that you know the rules.

educate yourself about what you need to do. do not visit a playground with anyone not in your household. do not arrange play dates. limit visits to about 30 minutes when others are present. visitors of all ages must stay six feet away from non-household members. everyone 2 and older must wear a mask. do not under any circumstances eat or drink at the playground. if it's crowded, come back later or choose a different playground. clean your hands before and after play. adults must actively supervise their children at all times. to maximize the number of children who can play, only one adult may accompany each child. remember, our playgrounds are not an excuse for you to get together with a budge ar bunch r

families and this is about your kids and their physical and mental health. we need to continue to do everything that we can to help to stop the spread of this virus. the last thing that we want is to see our numbers escalate out of control where we have to close playgrounds again. we don't want to do that under any circumstances, all of these closures hurt. but especially anything that we do that impacts our children hurts them even worse. do your part, be responsible, and let's get our numbers under control. and i want everyone to remember this -- when you do visit our playgrounds, you are not the park police. if you see something -- someone violating the rules or if people are crowding together, you don't have to confront them. you can choose to walk away. don't get into any altercations, don't get agitated, and don't start any fights. we are all suffering. have some understanding and some empathy and let the city

officials who are responsible deal with it. we are going to need empathy and understanding to get through these difficult times. we aren't just doing this because we want to. this is about people's lives. we are seeing our i.c.u. bed exasessity disappear -- capacity disappear across the state. if that happens more vulnerable people won't get the care they need and more people will die. it means that if you or your mom or your grandmom need a bed in a few weeks they may not be able to get one. they may not be able to get the care they need that could save their life. so, please, be thoughtful. like i said, the rules are challenging. they are fluid. so things change and sometimes it's confusing and you don't know what's what. but be mindful and do your very best. exercise -- take your walks, do your ar errands and take care of yourself and your families. and support our small businesses

by safely shopping or ordering online. support your local restaurants by ordering food. i know they did some amazing holiday dinner during thanksgiving and they'll certainly do those at christmastime. so please support our restaurants. but we need people to stop gathering in large groups and to limit outings to what is really important, what you really need to do. so, thank you, for everything that you are doing to help us to address this issue. it's going to be a tough holiday season. but the thing that i know about the people of this city, we will roll up our sleeves, we will do everything that we can to get through this. and i am confident that when we look back at our time during this pandemic, we'll be proud of every step that we took to make sure that the least amount of people are harmed as a result of this virus. and now i want to let dr. colfax to give you an update on where

we are with covid. thank you very much. >> thank you, mayor breed. and good afternoon. and thank you all for joining us today. this is probably the most important message i've had during this entire pandemic. so i really appreciate your attention. to be blunt, we have one chance to turn this serious surge around. and that chance is right now. but our window is narrowing and closing fast. san francisco, let's seize this moment, let's seize the day and turn this virus back. as you know, we are in the middle of a massive surge in san

francisco of covid-19 cases. by far the worst surge to date. and i want to stress the significant impact that this surge will have on you, your neighbors and friends and family and future generations if we do not bend the trajectory of this surge right now. the projections i'm going to show you of hundreds of deaths stretching towards the spring of 2021 are not our destiny. they are not our destiny yet. we have the power to avoid these terrible outcomes. the power to prevent significant death. the power to keep businesses open and to keep people in jobs and employed and healthy. this power is in our hands. let me show you for a minute how powerful our behavior can be.

can we have the first slide, please? so this is the trajectory of our hospitalization numbers since the beginning of the pandemic. and as you know in the spring and the summer that we beat back those two first surges. we are now in our third surge. and as of this morning, we have 123 covid positive patients in our hospitals across san francisco. that is more than we've ever had before and notice how steep that curve is. it is still going up and it shows no signs of going down. 30 of these patients are in the intensive care units. it doesn't sound like a lot, but that number is increasing dramatically every day. and just even before speaking to you i got data that we've had a significant increase above that 123 patients total in our

hospitals in san francisco. this number is climbing and climbing rapidly. now not only by the day but by the hour. we are currently predicting that san francisco -- san francisco will run out of intensive care unit beds by december 27th. in just 17 days. and that's if things don't even get worse. but they very well may. let's see the next slide, please. this is our number of new covid cases skyrocketing after the thanksgiving holiday. remember, when we were rolling out the new stay-at-home order just last week, we hadn't seen the impact of thanksgiving behavior on our cases. we are now seeing that and the reality is that, unfortunately, proving to be as harsh as we expected. we are continuing to see cases

skyrocket. every day at least 167 new san franciscans are testing positive for covid-19. and even more are getting infected. since the week of thanksgiving we have seen the average case rate per 100,000 skyrocket from 15 to 30. this is case rate that is a result of our behavior. this is the virus transmission that has happened since the thanksgiving holiday. next slide, please. but we are at a crossroads. we still have a window to turn this thing around. and here you have two very different futures represented on these projections that have been estimated by our colleagues in collaboration with d.p.h. at surch csf and u.c. berkeley. in blue, you can see the

projections of hospitalizations based on the reproductive rate of covid-19 in san francisco. in red, you can see the actual hospitalizations in san francisco. these are our two choices -- this is the fork in the road. on the left panel you can see if we do not decrease covid transmission by staying at home, that we are projecting that transmission will continue at a very high rate. right now we estimate that our reproductive rate is 1.5%. that means that for every one person who has covid, they are infecting 1.5 new people. that might not sound like a lot on average, but it means that the virus is raging throughout our city. and if it continues at this reproductive rate of 1.5, we

estimate on average -- on average -- which is shown in the solid blue line on this graph -- that we will have 1,410 covid positive patients on february 10th of next year. that is over 10 times the number of people that we have in the hospital with covid-19 right now. under even more serious scenarios, it is plausible with the reproductive rate of 1.5 that we could have almost 4,500 people in san francisco in need of a hospital bed. we also estimate that in this scenario that we will have more than 500 additional deaths on average and it is plausible that we could have as many as 1,500 additional deaths, in addition to the 164 san franciscans who

have already died from covid-19. now we have another scenario on the right side of these slides. this is what happens -- this is what could happen if we drive that reproductive rate below one. now the difference between one and 1.5, i know that it doesn't sound like a lot and normally it's not. but this is truly a matter of life-and-death. it dramatically changes the effects of covid-19 on us, on our loved ones, on our city. i cannot stress this enough. if we can get that reproductive rate below 1, and dramatically slow the spread of the virus, and do it quickly, that will change our future. our peak hospital census we

estimate will be 200 covid positive patients on december 21st. and while one death is too many from covid-19, our death rate on average would drop from those many hundreds to an additional 70. and the duringation o duration s challenge will be much shorter and we will be able to gradually reopen our city again so much faster. in this estimate we could start doing that as early as the new year. but if we don't take action and drive that number below 1, we will be in this scenario, serious scenario on the left, at least until the spring. with our immediate actions we can determine how many people will be sick. how many people will be hospitalized. and how many people will die.

we still have time to flatten this curve. and to ensure a faster recovery for all of us, for our city. now, look, i know that so many of us are doing our best as we have been doing for so long. and we have worked to keep those masks on. most of the time. but maybe -- maybe some of us have let our guard down. and we haven't gotten sick. some of us have been very lucky. others have not. too many have learned the hard way that this virus can still reach us. but others have heard about the stay-at-home order and we have been in this for a long time now and perhaps people think i'm okay, what i have been doing so far has kept me safe so far. i don't need to worry.

this virus isn't going to reach me or a loved one. the trouble with this thinking is that the virus is everywhere in our city right now. and in so many neighborhoods where it hasn't taken hold before. even lower risk activities now carry substantial risk because there's more virus out there than ever before. simply put -- and bluntly put -- we can't get away with things that we've been able to get away with so far. no one wants to accelerate this situation into 2021. not when a vaccine is so close at hand. but the vaccine is still months away from being widely available to the general public. and i must emphasize this -- that the vaccine -- the vaccine will not save us from this current national state or local

surge. there is simply not enough time. we are expecting 12,000 vaccine doses in our first allocation from the state and federal governments. there is no vaccine approved in the united states by the f.d.a. yet, but we anticipate that the first doses may arrive by december 15th. under the state's prioritization plan, the first to receive the vaccine will be acute care facilities such as hospitals and some nursing homes. widespread distribution could be underway by next spring or summer. in the meantime, remember that we know how to slow the spread of the virus. we have done it twice before. let's do it a third time.

people don't have to die. for the next month, for the next four weeks, think about the impact that your choices will have on our future. the virus knows no holidays. make the pledge to use your power, your behavior, for good. please, save lives by staying home whenever possible. and, please, follow the guidelines when you go out. please, help ensure that we are all here for the vaccine. thank you. >> thank you, madam mayor and dr. colfax for your time. at this time we have a variety of health care related questions for dr. colfax, so the director will take a minute. please let me know when you are

ready. >> i'm ready. thank you. >> so, dr. colfax, the first three questions have come from multiple media outlets. one, what is the latest on vaccine distribution for san francisco county? and whether are the first doses of vaccines expected to arrive in the city? >> so i think that i covered those in my remarks. we have -- we are planning on 12,000 doses of vaccines to come and they may arrive by december 15th. >> a third question from multiple reporters -- does the county have a centralized cold storage repository? or is that not necessary because dispensers get direct shipments? >> we have several cold

repositories for vaccine storage and don't anticipate that to be an issue. >> thank you, doctor. the next from the "san francisco chronicle." what are the realistic expectations for residents going into the holiday season? how can we help to mitigate the risks around christmas? >> well, again, i think that we have been emphasizing that the need for people to practice the masking, the social distancing. i think that really key here is please don't gather outside of your home with others. this virus is raging through the city. i know that we are tired. i know that some, you know, people have been able to get away so far with gatherings to some extent. this is not the time to do that. please don't have those holiday dinners with members outside of your household. even if, you know, they're close

friends and close family members, if they don't live in your immediate household, don't do it this year. make sure that we're all here for next year. and take this seriously. there is a window here. this is no longer, you know, for the foreseeable future. we will have vaccines -- vaccine is on the way, but it's not going to get us out of this current surge. we just need to dig a little deeper and to do the right thing to turn this surge around, distribute vaccines and to be here for the next holiday season when we can get together. and i am certainly going to get together with as many households as possible and have a big celebration. but right now we've got to take those precautions. >> thank you, doctor. the next question comes from gerald chen with s.f.a. why has the percentage of cases reached for contact tracing seen a significant decrease since november? >> well, i think that one of the key reasons is because we have

this huge surge in cases, so it is -- it is very hard, even though we have a robust team and our numbers are still better than many other jurisdictions, we continue to track and to contact trace as many people as possible. but you saw the surge in those cases and even with the incredible team that we have, we are not able to keep up quite as rapidly. we also shifted to the system recently that was a very important step for us to have complete data. so these numbers reflect that change as well. but, again, another reason for all of us to be safe and i also want to stress that if people get a text or a call about being exposed to covid-19, please respond to that. the incredibly important to respond so that we can turn back this curve. >> thank you, doctor. and, lastly, from erin alde with the "san francisco chronicle."

can you provide details on the i.c.u. surge capacity in san francisco? how many extra beds can you staff up quickly and what would trigger those beds being open? >> yes, we can get you those specific numbers, erin. we have those. and i think that, again, the important thing to emphasize is here is that with the current capacity of our i.c.u. beds we expect those to run out as soon as the 27th and that is, again, projecting -- based on the numbers that we have today. if we start to -- if we see those hospitalization numbers to continue to go up, we may even have run out of i.c.u. beds earlier than that. i think that we see what is happening at the state about other regions that are hitting that 15% threshold. we expect to potentially that by as early as some time this week, so very concerned about that. and we can give you the specific numbers after this specific

press conference. >> thank you, director colfax, for swferring those questions. at this time we have no more questions so that concludes today's press conference. to all of our participants you can email us at dempress@sfgov-tv.org. thank you. >> thank you.