>> good afternoon, everyone. today in san francisco we have 20,976 cases of covid-19. 173 people in a hospital. and sadly, 176 people have died from this virus. while san francisco's death rate remains very low, that is far too many families that will be

celebrating the holiday this is year with a recent loss and heavy hearts. my thoughts go out to all the families and to everyone who has lost someone to covid this year. now, we have been in this current stay at home order for two weeks now. and while our cases are still high, we have some data that shows people in san francisco have been moving around less over the past two weeks. that means people are being mindful and doing their best to comply. dr. colfax will show some numbers after me to demonstrate our stay at home orders are starting to have an effect, but we also know that number of cases and people in the hospital remain as high as they have ever been, and we are in a very dangerous place if we get a post-holiday surge. if we can just keep limiting our interactions in the public, we can reduce our exposure to each

other and slow the spread. i know it's hard. especially with the holidays. but the people of this city have shown again and again that even with all the fatigue and exhaustion we all feel, that we care about public health. look, it's been hard on me. i have been working out of my home and every day i take walks to get fresh air, exercise, and see the city, and shop at our local businesses and support our restaurants by ordering food directly there and picking it up from there. it is the bright spot of my day, visiting our local businesses and supporting them and seeing the holiday second racingses around town. i especially love what's happening with our fire station which i know are taking part in a holiday decorating contest, and i was really excited to be a judge in that contest, and i definitely have my favorites. the winner will be announced tomorrow, but really i want to thank all the firefighters for

taking part in this contest and doing their part to brighten up our city. in these tough times, it is the little things that can make a big difference. i will also say that walking around the city i notice that so many people have christmas countries in their windows which is really exciting to see the decorations and all the things that folks in san francisco are doing to just really provide that holiday cheer. as you can see, i am trying to focus on the positive, especially as we enter the holidays. you can imagine what christmas is like in the breed family in a normal year. we get really loud. we have a lot of fun and it's really just an opportunity for us to forget all the drama we have with work or other stuff in our lives. and just be together. i really love the holidays. so yes, it's hard not to do that this year. it's hard not to see family and friends and hang out and go to all the great events, but that's

what we have to do. we know if we can just get through these holidays and avoid any significant surge, we have an opportunity to get this virus under control so that next year we have an opportunity to celebrate with our loved ones which is so important i know to to many people. but we are still in a very dangerous place. just look at what's happening in southern california. los angeles is really struggling and overwhelming -- they have an overwhelming case load. field hospitals are being set up in laces like imperial county to deal with the overflow. nothing scares me more than if we get to a point where we have to turn someone away from the hospital because it's not just about the number of beds. it's also about the people who work in these hospitals specifically with covid patients. i don't even want to look someone in the eye and say to their mom or dad that their mom or dad died because we didn't have space in our hospitals for

them. that we couldn't give them a fighting chance, so as you make your choice this is holiday, please think about that. think about what you can do to get us through these next few weeks. now, there are bright spots. we are vaccinating people every day. yes, we started vaccinating our paramedics, the people who are going to be out on the streets saving lives. this week we are receiving more shipments of the pfizer vaccine and, well, as newly approved moderna vaccine gets done, we'll get those as well. but the distribution of the vaccine is a marathon. it's not a sprint. it's going to take time and patience. as we get through these coming weeks and months, we need to continue to find ways to support those who are struggling the most. yesterday we got some good news when congress finally passed a $900 billion relief package. i know speaker pelosi worked incredibly hard to get this deal

done, and i really want to appreciate her leadership. she overcame a lot of opposition and obstruction, and while the deal isn't perfect, there are some real bright lights for our city including support for our small businesses through the extension of the ppp loan and it's supposed to be a lot easier for small businesses to apply than it was the first time. there is direct support for the entertainment and theater venues which is not been able to open and are such an important part of what makes san francisco so special. i can't wait until we reopen and the opportunity to go to a concert or listen to live music. emergency funds that will stabilize muni and our public school, funds to shore up our covid public health response including testing and vaccinations. more money for snap benefits for our most vulnerable so we can make sure that no one goes hungry. and new programs to provide

rental assistance. i'm frustrated that the republicans blocked any effort to deliver relief to our local and state government, so we still have an enormous deficit to face, and i wish we could have provided more direct support for our families who are struggling, but orr all, it is good holiday news that some relief is on the way. my staff is currently analyzing the del days of this package and seeing what more we need to do here locally to fill the gaps, especially for our small businesses and i know that there is more to come. while we have provided tens of millions of dollars in loans, grants and tax waivers to small businesses through this pandemic, we know there is so much more to do. and i'm hopeful in hearing the news that president-elect joe biden will keep pushing for more federal support when he takes office next month, but like i said, we have a long way to go.

please keep doing what you are doing. wear the mask and sign up for the california notify alert on the phone to find out if you come in contact with anyone who has covid. keep your distance from others and please stay safe this holiday season. again, thank you for your cooperation. we are in a much better place but we're still in a very, very dangerous place in this city, and your work and your following these orders have been instrumental in helping us get there. now i want to turn it over to dr. grant colfax from the department of public health to share more data of where we are and what lies ahead. dr. colfax. >> thank you, mayor breed. we so appreciate your steadfast and steady leadership and support. good afternoon, everybody. i would also like to thank everyone in san francisco for

all of your support during this last 10 months. this has been a long and hard road, and as we continue through this holiday season, i know it is likely to get harder for many of us. unfortunately, the situation remains dire. the virus is running rampant across the state, and as the mayor referenced, southern california now lacks the i.c.u., the intensive care unit beds, to care for sick people. in fact, the entire southern california region is at zero percent i.c.u. capacity. health care providers working 24 hours a day are overwhelmed. tragically in this country this month alone we have hit days where a person died every 30 seconds from covid-19. think about that. every 30 seconds.

this would have been unfathomable just a year ago as reports of the virus began. now, here in san francisco our cases are still climbing, but there is some relatively -- and i stress relatively -- good news which is that the pace of increase is slowing down. now, we are still locally in a very dangerous position with the virus, but we are starting to see that our collective efforts are making a difference. as we enter these next challenging two weeks, these vital two weeks, let's remind ourselves that our collective actions change the course of this virus in march and again in july. while our infection rate is twice what it was in prior surges and many more people are getting sick, this could be temporary if we support each other and continue to make the good choices that we know slow

the spread of the virus. let me take you through some date. >> as this slide shows, cases in deaths across the state continue to increase at a staggering pace. california now has one of the highest covid case rates in the country at more than 100 cases per 100,000 people per day. across the state cases have increased by a staggering 96% over the last two weeks. and the entire state is experiencing widespread transmission of the virus. and what this means locally is that many behaviors we have gotten away with in the spring or summer are much riskier now. there is so much more virus out there that the likelihood of coming into contact with someone asifrpt mat wick the virus but still infection remains higher -- but still infectious remains

higher. this slide shows that our case count continues to increase, but as this slide also indicates on the far right, our case count is increasing at a somewhat slower pace than right after thanksgiving. but we are now averaging about 275 cases per day, the highest since the onset of this pandemic. but our changes in behavior are starting to show an impact. two weeks ago when we started the limited stay at home order, our cases were increasing on an average of 8% every day. today our cases are increasing on average at 2% per day. this is because of the changes that we have made in our behavior. now, this is a hopeful sign. it is an improvement, but i must stress we still have a long way

to go. remember, it is so key to get that rate actually decreasing even if we were to continue at this current rate, our situation would be very dire in the next few months. so, let's keep what we're doing and slow this virus. let's not have the situation that we had right after thanksgiving, a massive surge that increased cases by 50% given where we are now, we simply cannot afford that, and that would be catastrophic. let's keep slowing this virus. this slide shows how changing our behavior can have tremendous impact on the spread of the virus. on december 6, the day we started the limited shelter in place, our reproductive rate was estimated to be 1.46. and remember, when the

reproductive rate is above one, that means the virus is spreading out of control. as of december 20, our reproductive rate was 1.24. now, the virus is still spreading, the reproductive rate is still above 1, but -- and i know that this estimate, these differences, 1.45 versus 1.24, that doesn't sound like a lot. but as a result of that change, projected, peak median hospitalizations have decreased from 1490 to 590. and the additional estimated median death have increased by 330. that is 330 people who are projected to die from covid-19

in san francisco that may not die. and that is what we have done and must continue to do together as we go forward. by limiting our mobility, by wearing a mask, by social distancing and not gathering, even in small groups among people outside of our households, we have saved lives. but we need to continue to work together to further slow the spread of the virus and not overwhelm our health care system. if we reduce the reproductive rate further, we will continue to make progress. our destiny is truly in our hands. there is a slight improvement, and we have made progress. this slide show what is can happen if we come together and focus our efforts on staying at home and beating back covid-19.

in the next two weeks, if we reduce the reproductive rate below one, we would have 74 additional deaths here in san francisco compared to an estimate of 214. through our actions if we can get the reproductive rate below one, we are saving hundreds, hundreds of people from being hospitalized. pause for a moment. think about those numbers. the lives that we could save and the hospitalizations we could prevent if we work together, if we continue to work together and stay home. i hope everyone sees that by working together and making sacrifices and changes to our behavior we are saving lives, and we can still do more. think about that as you make

decisions over the next two weeks. we simply cannot afford to have another surge in cases that we had after thanksgiving. and this situation could be temporary if we all do this together. san francisco, we can beat back this third surge and give the gift of health to our community this holiday season. thank you for your sacrifice and perseverance. and i want to wish everyone a good holiday. be safe and during these challenging times, please be sure to take care of yourself and your loved ones, even if it has to be remotely for now. this isn't going to last forever. the new year brings hope and is filled with possibilities of what we can do. our destiny for 2021 is in our

hands. thank you. >> thank you, mayor breed and dr. colfax for your remarks. i am with the san francisco covid command center and i am going to help facilitate some questions from the press today. let's just pause for a quick moment so that we have enough time to let reporters submit their questions, and then i will go ahead and start with questions for mayor breed. just a few more moments. and madam mayor, whenever you are ready. all right.

mayor breed, your first question comes from stephanie sierra with abc 7. what was your initial reaction to the governor appointing alex padilla to feel vice president elect kamala harris' seat? how do you feel about no black women remitted in the u.s. senate? was this a missed opportunity? >> i think there was a lot of pride when not only kamala was selected as the vice president nomination for the party and is now our vice president elect for the country. and especially with that pride came, i believe, another opportunity with her seat to ensure as she continued to say, even though you may be the first, you are not the last. the sad reality is she was the only african-american woman in the senate at this time. and when you think about the

history of this country and the challenges that exist for african-americans especially african-american women in the senate, definitely this is a real blow to the african-american community, to african-american women, to women in general. i think it is really challenging to put it in words, but it was definitely a surprise and it's an unfortunate situation as we are trying to move this country forward and making sure that black lives truly matter and that african-americans have a seat at the table, especially african-american women after what was done in this race on a national level. definitely it is unfortunate. >> thank you. the next set of questions come from christian captain with kccu. where do we stand and what can be done to help san francisco

public schools reopen? >> this is, of course, been really hard, but let me just start by saying because i know a number of teachers have been concerned that they don't feel supported because they are still doing distance learning in the best way that they can. and this is not to say that teachers are not doing their part, but what we're being asked to do by the teachers union specifically is just not realistic. and when i say we, there is an expectation that the school district needs to provide a certain level of assurance in order to get the classrooms open. and what we have done as a city is provide that level of support to the school districts. to not only make sure that testing based on the guidelines of the department of public health is available, but also that we are evaluating the buildings and the classrooms and

other things because, of course, the last thing we want is something to happen to not just our students but our educators as well. so we are doing everything we can, financial resources, resources from city departments, and everything we can. we have really put everything on the table that we could to provide the level of support that we know the school district needs in order to move things forward, but ultimately it really is up to the school district working with the teachers union to come to some level of an agreement so that we can move forward. we were at a bter place at one point. the requirements have changed, and have been a little bit unfortunately unrealistic and not even recommended by the department of public health. i know the question is, how can we move forward? at this time we are going to continue to be as aggressive and push to move forward as much as we possibly can.

we do appreciate our educators for the work they are doing on distance learning. but the sad reality is we all know that our students are suffering, and we need to try and be prepared to get them back in the classroom as quickly as possible. and it will be up to the teachers union and the school district working together to do that. we will continue to do everything we can to support and facilitate that process. >> thank you, madam mayor. thank you for your remarks and for your time. we will now take a minute to gather the health-related questions for director colfax. director, we'll check in to go through the rest of the health care-related questions.

all right, dr. colfax. first question comes from ron lynn with the l.a. times. what explains why the current surge has been so bad? when was the moment you realized this wave would be far worse than anticipateed? and what kind of change in strategy did it cause you to pursue? >> well, i think the surge is worse than other surges for a number of reasons. why prayerly there is more virus

-- primarily there is more virus circulating in the country and the region than ever before so cases started to go up in san francisco. we were watching that very carefully and also people get tired, right? this is a long 10 months and we started seeing cases go up and that became great cause for concern which is why we moved quickly and with regard to getting the message out that people needed to socially distance, avoid gatherings, and we were very clear about that and issued a stay at home order that was consistent with the state's order early along with other neighboring counties to slow the spread of the virus. the travel quarantine issue is commensurate with the steps to

slow the spread of the virus to return to a deliberate reopening and to go back to business while also slowing the spread of the virus. >> i know that contact tracing is falling behind a bit and where people are getting infected now and to finish and we know there is like widespread community transmission, right? and the people may have gotten away with in the spring or summer are simply transmitting the virus and activities at much higher rates. and with the scene to continue

to reach out to people and doing contact investigation and supporting the people who are testing positive. but right now i think we just need to understand that behaviors that were lower risk before are now high risk and particularly around gatherings outside of the household needs to be avoided at all cost. we cannot -- and if we had case increases like after thanksgiving, this would be catastrophic. let's stay at home and be home for the vaccine to gather together next year and be with the people that we love in person. >> thanks, doctor. from jamie harr with the associated press. as of yesterday, ucsf had not

delayed elective surgeries. if so, the city and county, can they require them to stop? >> a we aren't aware of any hospitals that has cancelled elective surgeries. we are working closely with the hospital c.e.o.s and the chief medical officers to monitor bed capacity and elective surgeries could be cancelled and hospital beds available should it get to that point. >> thanks. next question, the pay area region will currently be eligible to lift the stay at home order on january 8. will san francisco extend the order further if not required by the state? >> the regional stay at home order by the state was in effect as of december 17.

and the state will lift it after three weeks have passed. so that is really dependent on the regional capacity. and with the local commentators and on that side. >> the next question from the san francisco chronicle. he has two sets so we'll start with the first one. and issue the phase one guidelines and which populations are likely to be included during this phase? >> we don't have information and when the state issues information, we will continue to follow the state guidelines going forward. >> also, are we aware if the new

variant is circulating in san francisco? is it cause for concern? >> we are not aware if the variant is circulating -- the new variant. this is the british variant, i assume that is being asked about. we are not aware at this time whether it's circulating in san francisco. and is cause for concern and number of scientists and looking to confirm the transmission and the increased transmission risk but i think that to emphasize the need for people not to travel and to stay t a home and for the travel quarantine guidelines to stay home so people returning to the city do not transmit covid-19. >> thank you, doctor.