>> good afternoon i'm dr. grant colfax from the department of public health. thank you for joining. yesterday, we reached a milestone that we were all hoping to avoid. unfortunately, the bay area's intensive care unit availability has fallen below 15% which is required all bay area counties to adopt the state's stay at home order. san francisco, along with five other area counties adopted the stay at home order proactively on december 4th in the hopes of

adequately slowing the spread of covid-19 and preventing an icu bed shortage. unfortunately, despite our efforts, this is not happening. let me walk you through some of the latest data. could we have the slide please? as you can see, our number of covid-19 cases continue to be extremely high, especially when you compare it to where we were in october. we unfortunately yet have to see a downturn. we are averaging an extremely high case rate, 242 cases per day. that is the highest average we've had since the onset of the pandemic. and as you can see from this slide, we have had a significant increase since thanksgiving, cases have increased by 50%.

and while cases remain far too high, a rate of increase of the virus has slowed just a bit, the rate has increased. this indicates that we still have time to turn this dire situation around. and as a result, save hundreds of lives. indeed, right now as i speak, we could be at a key inflection point. an increase over the next holiday period could put us over the edge into a truly catastrophic situation. we cannot afford another increase in cases, a further increase in cases, especially including an increase like we saw during thanksgiving. in contrast, an alternative is a levelling off of the rate of increase and this could be followed by a decrease. while hospitalizations would

continue to increase over the next few weeks, the worst of the third wave would be avoided. and for this to be reality, we must avoid a christmas and new year's increase. and we need your help in doing that. next slide. in regards to our intensive care unit beds across the state, today the bay area has only 13% of available icu beds to treat the sickest people. and right now, santa clara has no beds for any icu patients. here in san francisco, the

number of covid positive patients has increased by 27% in just the past week. we have a total, a total of 286 intensive care unit beds in san francisco. that may sound like a lot to some people but 207 are currently filled with patients with covid and non covid illnesses. given the continued rise in cases, we expect that our icu and acute care beds will continue to fill rapidly with sick patients. the availability of beds as well as having enough staff and nurses, doctors the other people on medical care teams, is the backbone of our healthcare system. having enough beds and having the healthcare teams is vital to

our ability to keep people alive and get through the most serious illnesses of covid-19. and this status is currently gravely threatened. imagine, imagine not having a hospital bed for your mom or dad, your grandmother or even your child or any other loved one. imagine them getting suboptimal care, not getting the care we come to expect and have a right to have in this city. would you want that? i certainly wouldn't want that. and i know that none of us want our city, our region to be in that situation. nor do i want our dedicated and hard-working healthcare workers and first responders to be forced to take care of patients

under the stress of a hospital surge. right now, san francisco is better off than some of our regional neighbors but we are all interconnected. we know infection rates outside the bay area are much higher than in san francisco or the surrounding region. for example, nationally, 47 of 50 states currently have higher covid-19 case rates than san francisco. ranging from almost twice as high in virginia to almost seven times as high in parts of the midwest. so while we in san francisco are in a grave situation, other places are unfortunately even worse off. this means people who travel outside of san francisco and visitors who come from other areas are at much higher risk of being infected and spreading the

virus. and remember, people infected but without symptoms are a major source of virus spread. you can still feel fine but still pass the virus to someone who may get very ill and even die. none of us want that. as we head into this holiday season and with causes still accelerating, at a staggering rate, we want to take every step to slow the spread and then the curve. that is why we're issuing a travel order starting tomorrow morning at 12:01 a.m. the travel order will require anyone traveling, moving or returning to san francisco from outside the area to quarantine for 10 days. the quarantine requirement applies to visitors, people moving here and returning

residents alike. there are exceptions for medical professionals, first responders, essential workers and others. we also strongly discourage any non essential travel within the bay area region at this time. please stay home this holiday season and celebrate with people in your immediate household. end slides please. now, i know that this is hard and i know this is yet another sacrifice in almost 10 months into this pandemic. but we are at a stage that was unfathomable a year ago. we have lost more people in this country due to covid-19 than americans who died in world war ii. we are losing more people

from covid-19 every day in this country than we lost on 9/11. but we know how to beat back this virus. precautions and containment will beat back this virus. if we dig deeper and slow the spread. something as simple as the face mask can stop the spread and stop people from getting sick. and avoiding gatherings with people outside your household can prevent healthcare workers from being overrun with patients this holiday season. we're the city of st. francis and we take care of one another, especially during the holidays. we are resilient and we are strong when we work together. we have done an amazing job of crushing two previous curves and when i go outside, i see so many

people wearing masks and social distancing and taking care of each other because it's the right thing to do. let's keep it up. and pass it on. so many of us have cancelled travel plans already. that is because of you and your commitment to protecting your loved ones and neighbors. this year let's give the gift of health and do not travel and do not gather. we can do that next year. and let's ensure we are all here for the vaccine. please stay safe and thank you. >> thank you dr. grant colfax for this important update. i'm going to help facilitate some of the questions from the press. i'm going to pause while questions stream in.

please give us a moment. thank you all for your patience. we'll start shortly with the question and answer portion.

okay dr. grant colfax, the first set of questions. can you elaborate how san francisco and the bay area while seeing an increase in cases is doing in comparison to the rest of the state? what is going right locally and where could we use improvement? >> can you hear me okay? sorry, my screen froze for a minute. i think right now our case rate is lower than the state overall, which is, you know, a bit of hopeful sign but as you see, just yesterday we went into that safety purple and therefore

needing to implement the state stay at home order. so relative to some parts of the country, we are still doing better, but i continue to be extremely concerned about the number of cases that we continue to diagnose in the city. we can't afford right now for the number to go up and we really need to drive that number down. i think what's going better and i think we need to continue to reinforce the support of each other in the city and masking and social distancing, think about the things we can do instead of gathering with other households during the holiday season. what can still be fun, what are the alternatives? whether it is on zoom or other ways to engage with your loved ones during this holiday season. but please cancel the airline reservations and don't plan to gather. remember asymptomatic spread,

people without symptoms can still spread the virus. i think there are many things going right but we need more things to go in the right direction before we can be confident that the third surge is behind us. i'm not confident at all right now. we need to see more data over the next couple of weeks but they're so vital over the next couple of weeks to determine our fate with regard to overwhelming our healthcare system and whether we are going to have hundreds of more people die from covid-19 or if we can turn this around. >> thank you so much dr. grant colfax for that response. we'll wait for the next question. in the meantime, please submit your questions via the chat and we will sort them. dr. grant colfax, the next set of questions from multiple

outlets, running out of icu beds moved from the 27th of december to three or four weeks, is this because people are getting less sick or there are fewer cases than thought. icu bed capacity is 28% higher than most counties. what is the bed capability at this time of the year in a non covid year? >> so, i will just run through some numbers. right now we have a total of 286 icu beds in san francisco. we have 207 occupied, 42 of those by covid positive patients. our remaining icu capacity in the city is 31%. now, the reason the timeline changes, these are models and they change because the data

keeps changing. with regard to our reproductive rate, if it goes up, our timeline for icu beds goes down and so we're constantly renewing our data to determine the projections of the icu beds. this also relates to the admission discharge of covid and non covid patients. that data also influences the icu capacity. we would like to see the date pushed further into the future as it indicates that the transmission of the virus is slowing or that we have more bed capacity than anticipated. but i want to emphasize here, the timeline is not meant to provide an exact date but rather a forecast of when to expect that. we shouldn't be focused on so much of a few days as much as the overall trend.

and as you know, we are at that very edge with regard to icu capacity in january at this point, and so we really need to ensure that the virus numbers -- the diagnosis numbers come down so the hospitalization numbers come down. and remember that hospitalizations lag the time from the time of diagnosis by about 7-10 days. so we have not seen the peak in hospitalizations anywhere near to where i think we are going. we expect to go beyond 200 hospitalizations in the next couple of weeks and get higher than that if we continue to see the numbers. and much higher than that if we have the increase that we saw over thanksgiving. >> thank you dr. grant colfax

for your response. the next set of questions, has san francisco been caring for covid patients outside of the city and bay area, for example from southern california? >> we have been coordinating with the state with regard to transfers into our hospital systems and right now, we have one transfer from inside the bay area. >> thank you dr. grant colfax for your response. next question from multiple media outlets. how will the quarantine be enforced? >> hotels can accept people who want to use them for quarantines. i think it's important to emphasize that most people have done a good job looking out for their neighbors and following

the health orders. we expect businesses and residents to continue to do that with this order. we are approaching this like we have with all of our health orders in terms of educating people and what is required under the health orders and expect and hope that people will support each other in doing this. this is truly not the time to travel, the consequences are severe. and we just ask that people understand that and comply with the health order because it's the right thing to do. the city can take additional enforcement steps if the situation demands and violation or failure to comply with the order is a misdemeanor. we are working to educate and issuing the order really to ensure that people understand that we are in a grave situation. we do have time to turn this around. but in order to do that, we need to ensure that people travel

only for the most essential activities as defined in the order. >> thank you dr. grant colfax for your response. the next question. do you have an update on the number of people who have received the vaccine since tuesday and how many doses the city has received to date. >> so, yesterday zuckerberg san francisco general, they vaccinated an additional 90 people in addition to the five vaccinated on tuesday. and today they expect to vaccinate another 180 key staff working in acute care settings. >> thank you dr. grant colfax. this concludes our press conference. thank you for your time and for the reporters. >> thank you.