today and, yeah, we are in a time that is extremely hopeful. we are thrilled to be able to be putting vaccine into arms, and it's also very challenging. i would say in the last year of doing this response this is probably the phase that has the most anxiety, the most questions and anticipation, and so i just want to acknowledge that this is both hopeful and challenging for all of us. we have been working very hard at the covid command center obviously with a partnership center throughout the city, but primarily with our partners at d.p.h. to get our vaccines operations up and running. our goal is to be ready without

hesitation to get every vaccine into arms that we can as quickly as we can into different modes, and the doctor will talk a lot about the vaccine strategy. so with that we can go to the first slide, and i will turn it over shortly to the doctor. >> thank you, dr. carroll, the slides disappeared from me. >> i do see them. >> okay, great. so thank you. thank you chair preston and supervisor haney, supervisor mandelman and supervisor chan. i'm going to provide a brief update where we are with vaccination. things are rapidly evolving and everybody is working very hard to try to get as many shots in

the arms as possible. so in terms of vaccinating and where we're at, can you see that for all of san francisco -- or what's been administered in sprisk, i should say -- san francisco, i should say, we've had over 110,000 doses, and specifically for san franciscans it's over 80,000 doses. these have been divided between first and second shots, approximately 9% of the population has been vaccinated to the point of are we getting shots in arms fast enough. we are utilizing all of our allocations that the department of public health gets, 62% of vaccines have been given. the remaining 38% are earmarked either for a first appointment scheduled this week or for second doses. so all allocations, the entire allocation has been determined and accounted for. next slide. so i wanted to take a minute to

review the city vaccination strategy. as a reminder, we have a three-claw strategy, including our high-volume site, our community vaccine access sites, and our pharmacies. just to, you know, share how fast this is moving, the federal government announced this week that they would, in fact, start allocating directly to pharmacies outside of the nursing home and the long-term care facility partnership that they had already developed. so pharmacies will get direct allocations to the sites to be able to vaccinate the public. we are waiting to hear exactly which pharmacies will get these. it is -- the announcement is like to go into effect later next week. in general, our goal here is that all of these sites would serve the public. so it wouldn't not -- you wouldn't have to have a certain type of insurance or, you know, meet a certain type of criteria

to go to one of these sites. it's meant to be the easiest site to access that a person could go to it. as was mentioned, we know that one of the issues has been how do people find these sites. so having an easy front door accessible through the web, but we know that's not the only way people are going to have to access these sites, especially when there's digital divide concerns or other concerns that we're also going to have to use, you know, our community partnerships and other ways of reaching fairly vulnerable populations to schedule appointments. our goal is to create a network of vaccination sites to get as many people vaccinated as soon as possible, especially as the supply increases, and we are seeking to provide as many options possible for people to obtain their vaccine. the cheap obstacle that we're facing is currently supplied. even in our mass vaccination sites, they can gear up to a much larger amount. we just don't have those amounts coming in for san francisco at

this point in time. and then in this slide, the vaccine sites, you've heard about the high-volume sites and city college is under way. another got announced today and we are still working with the produce market and the bayview to get that site up and running in partnership with our health care partners. we also have our health network sites that are vaccinating in the western edition, chinatown, other neighborhoods. additionally we have specific neighborhood sites through safeway and the 24th and cap initiative to do vaccination. and we have community sites with our other partners such as chinese hospital and our consortium clinics to provide vaccine. finally obviously the big health care systems are also getting

vaccine and providing vaccine through their allocations. i'm going to turn it over to director carroll to talk a little bit about the high volume sites since that's been a really major accomplishment that's been done through director carroll's oversight. >> thank you, dr. baba. our three sites, city college and fs produce market, were specifically chosen to be in geographically areas of the city where we are seeing a pre-dominance of the disease within those particular communities for ease of access. the sf produce market will be a

drive through or walk to but walk-in site. the mocsony center south, which as i speak downstairs it is being announced will be a very significant site centrally located obviously in the city. it's a consortium of health care providers that led by kaiser permanente. overly the sites, these sites collectively will alone have the ability to serve well over 10,000 people a day capacity-wise once we have the availability of vaccine to do so. and so that allows us to have an outlet for general public and people in these neighborhoods to have access to the sites, and in general we also are trying to

diversify for some people especially for some people who are older, have mobility, if they have a vehicle, a drive-through site is helpful. obviously many people in san francisco do not have vehicles, and so these other sites are also located in areas where there is mass transit, mass kony being one of them. the sf produce site is a very good site for particular populations, for instance people who work in restaurant and ag come through that area for -- at all hours, and we're trying to adjust our hours for those sites. so that's really the high volume site, an ability for us to push out vaccine quickly. two different populations in different ways that will work. and that is obviously complementary to the other sites that dr. bobba is talking about that have a different strategy targeting different folks for different reasons.

>> thank you, director carroll. i'll talk a little bit about the community vaccine sites. these vaccine sites, we learn a lot through community testing how, you know, community sites should work, and so the community vaccine sites are really for the community, and before announcing them to the broader public, we would want to ensure that, in fact, the community that we are partnering with would want that. for testing, it meant a lot more them that we hold off on those broad announcements because they want to make sure, as we did, that the community that is surrounding those sites is actually served. so this will be on ongoing discussion, but we feel it's really necessary especially when the vaccine is in short supply that the most vulnerable populations in a specific geographic area actually have supply of the vaccine that we're putting in these community sites. next slide. so the selection of a site is --

it's informed by a couple different things. illustrate has to be in alignment with our d.p.h. vaccine strategy which includes both speed as well as equity and reaching target populations. we're prioritizing it in highly impacted san francisco neighborhoods and populations. locating vaccine resources in places that have been disproportionately or has proportionately carried the burden of the covid-19 case rates and infection rates, including hospitalizations and deaths, and that's by far the southeast sector of this city. we need to ensure once we put these sites up that there will be a daily and weekly capacity that can be maintained and that there will not be ongoing inventories. we want shots in arms as quickly as possible. and a commitment that it is a sustainable site and that it will be open to the general population.

once supply is readily available, we anticipation that the combination of high volume sites, community sites and pharmacies will help to really get vaccine out, and then the other strategy is we also are developing our mobile vaccine so that those that have access and functional issues will also be addressed as well. in terms of there has been some discussion about co-locating vaccination sites with testing sites, and we are definitely lacking at that, but not all testing sites can be converted to vaccine sites. there's a lot of requirements around the vaccine, including cold storage requirements, general logistical requirements, the fact that people have to wait 15 minutes after getting the vaccine and be monitored, and you need all the staffing support to do that monitoring and allow for the throughput, as well as the medical equipment on site. so again we're working with our community partners to identify

places and sites that would best work for the community given all these logistic needs. next slide. i know this slide has been presented in previous hearings, and the reason we're bringing it is just wanted to clarify a little bit about how d.p.h. receives allocations, and so we had talked about how the federal government allocates and then how the state allocates at previous hearings, but specifically in terms of allocation that d.p.h. gets, we are given -- and it happens usually tuesday nights we get an allocation amount from the state, and we are required by thursday to say we going to take that full allocation amount. it is not asking for a amount of vaccine, it is being told how much vaccine we have available to us, and then it is up to us if we want to order the full amount or not. we have always ordered the full amount, and any time there is a possibility of being put on a waiting list, we have done so, and in fact we are on a waiting

list for over 30,000 vaccines at this point in time, but we have ne'er turned down vaccine, and then once d.p.h. gets its allocation, then we have to provide it out to other health care partners, and these are outside of, you know, the major health care system. so our consortium clinics, which serve a very vulnerable population, our own d.p.o. safety net clinics, chinese hospital and any other clinics that, you though, would need tep in time and where things are at is what we would and are allocating to. so i just wanted to provide that clarification. next slide. and then finally the data. so we are working very hard to get more data into the system and up and running for the public to see. we want to minimize uncertainty and help people feel confident about the vaccine and how the process is working.

we are working on breaking down vaccination data by race, ethnicity, age and neighborhood of residents, and we plan to share data on the number of vaccines received and administered by the health systems, although our own d.p.h. vaccine allocation, how that gets allocated out. it is important that the data really truly reflect what is happening, and so there is -- it takes some time to collect and clean the data, and we want to make sure that what we're providing is accurate, but also timely. and then finally in terms of the vaccines planned, you can go to the sf website and see the plan. we were required early on to put a plan to the state, and the plan was how will we reach the workforce and vulnerable populations, including how we intend to outreach and what the subsequent needs will be in ongoing phases.

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>> supervisor haney, questions? >> yes, thank you both for the presentation and for the update, and again we are making some progress on -- have commitments on some of the things in the legislation which i really do appreciate. i have a couple questions before i ask any questions about the plan on some specific things. the first is on the registration site, so i was really excited to see that go up today, and i think people have been asking for it and again it's something that a lot of other counties have. one of the things that's different about our site and i wonder if there's a plan to change this is that it doesn't have all of the available locations where people can access vaccines on the site.

it's only i believe three of the san francisco state one, college one and mocsony and it doesn't have information about other sites. what a lot of other counties are doing is they have available places you can get vaccine, even on a map, and you can click on it and it will help a decentralized location to find the many options that exist, whereas ours doesn't have that, and they also -- it seems like even for our own sites we are using different registration systems. is all of that going to change? are you going to have a place where everything is put, and what is our plan for registration systems in terms of appointments? looks like we're using the state system for the mocsone site and an outside system for the safeway site, and eventbrite for the ucsf city college site. it's a bit messy.

>> yeah, i can answer and director carroll, if you have anything to say. so we are working on a centralized system. i think one of the things as you've alluded to, supervisor haney, is the state is also working on a system too. we really are looking for a system that will have multiple language capacity and capabilities, knowing the diversity in san francisco, and so that is actually going through process. we had to do a short r.f.p. on it, but the hope is ho get that up and running quickly so we can really address the need. now in terms of the health care system and if they will opt in, that's still an ongoing discussion into this centralized portal, but we are hoping given the fact that it has a lot of capacity and capability in terms of language that it will be the one that gets utilized for the entire city. and then in terms of, you know, sites, yes, we always want to try to update and include other places that people can get vaccinated, but we also want to be mindful, like i said, of

there are places in the city that we really want to have a very targeted approach, that that specific neighborhood actually gets vaccinated as opposed to everybody in the city coming in to try to get vaccine at a specific site, and i think these are specifically in areas that have been underserved, and so there is a balance there. but for, you know, the sites that are meant to be much more public facing, we are getting towards getting those up and running in the sites. >> yeah, because i know there's the my turn system which seemed like we're using for mocsone but not for other sites, and it's just -- again, it can sort of feel like a mad scramble in the sense of all of these links are living in different places and it's making -- it is causing a lot of confusion right now. i think particularly before we even had the site that went up today. and then are we using the outreach that is -- how are we using the outreach that was made

possible by the text notifications and the signup? like for example i know there was a site that was specifically targeted for certain zip codes. is everyone who got -- who signed up for that notification system who hauz eligible, who lives in that zip code, receiving a text message to go and sign up? how are we actually utilizing that system to help get people appointments now? because a lot of people signed up for that. i know we have over 100,000 people on that notification system and a lot of them are saying haven't heard anything since. >> so i think we are working with digital services on how to notify the people that are eligible that this site is up and running now and that they could potentially go to the website and be able to sign up. you were talking about for the

eligible population, correct? >> yeah. and also using it -- seems like it's a good tool for us to target as well in the sense that if somebody signed up and lived in certain zip codes where we are wanting to -- where we have sites where we're targeting those zip codes, it would target using this vaccine notification system. so i don't think -- it's my understanding that it hasn't happened yet, but i'm glad that that sounds like it's something that's a part of the plan. one of the things about this legislation is having us do a lot of the things that we are asking the most -- entities to do, particularly around the health order that came out around equity and their plan. have all of the multi-county entities complied with the health order and with the plan they were required to submit be shared publicly? >> was somebody going to chime

in? all right. i will say that i know that those plans were due i think this week and so we're taking stock of who has submitted. my understanding is that definitely our network has submitted, and some of the other entities have was the last update i have, but i can't remember the legislation that said it was going to -- or the health order that was going to be done publicly, so i'll have to check back in on that. but i do think that if they aren't that we can figure out a way to at least inform the public of what the general plans are for these health care systems. >> got it, yeah. that would be very good to know. on the data, you know, i'm -- when we had the hearing a couple of weeks ago, we were told that there was going to be additional data added to the dashboard, and that still hasn't happened, you know, i know you just noted the percentage of the doses that we

received that we have administered, even something as simple as that is not up on the dashboard, people cannot see the number of doses that we've received and who has received them, and again the disaggregation of data by race and by neighborhood is something that a number of other counties have. is there a timeline of when we would be able to have that data made public or shared? people act as a -- how many vaccine doses have san franciscans received, and we don't have that information as supervisors. >> yeah, and my understanding is the data that we shared in terms of how many have we received and what percentage have gone into arms and what percentage are allocated for second doses or appointments this week is something that is very close to happening, so my understanding is hopefully in the next week or so that that would go up. i think the race ethnicity data is a little bit harder because i believe that's actually coming

out of the kaerz data as well as some direct feeds to us, so it's a bit more complicated, but i know the team is working very quickly as well, very hard to try to get that data up and running as quickly as possible too. >> thank you. i think all of that is very important for us to track how it's doing and if there are populations we are not reaching and if we target our plan accordingly. i have no sense of is in anybody in the tenderloin having access to vaccine? if so how? i mean i don't know if we are tracking that and making that public similar to what we did with cases and testing i think is very important. on the doses, so we get our notification of -- from the state usually on a tuesday of how many doses we are going to receive the next week, or are they giving us greater notice, you know, the federal government made this big splash about how they're going to give everyone three weeks notice so that we

can plan ahead. does that allow the state to give us three week notice or they are still giving us one week notice? >> it is less than a week. we get late tuesday night, and we have to put the order in by thursday and the earliest we get it would be by monday, so it's less than a week that we have to plan for it. and i actually haven't heard that there's that changing any time soon. our understanding is that this is how it's flowing it from the federal government to the state. >> that seems to be a -- yeah, that seems to be a problem because part of what they are saying at the federal level is that we should now be able to plan, as you know, at least three weeks ahead so that -- and again, i now watch their briefings every morning so that i understand what they are saying. and you know, dr. fauci is saying, actually, that we shouldn't be holding back second doses because we should have the understanding of -- well, you

should -- we shouldn't be holding them back one to one at least because we should have the understanding of what we're going to get three weeks out. has anything in that regard changed? are we holding back a second dose for every dose that we administer? what is our policy specifically on that now? >> we are trying to get shots into arms. the state had come out with an early recommendation to use 50% of your second doses, but i will say this is a tricky game because it's not necessarily that you are going to get those second doses, and i know some counties have struggled with that, where potentially they have not gotten their second doses, so there's a little bit of a balance here. we are incuring a debt now by doing that and hoping it gets repaid in the phonetics few weeks, and -- in the next few weeks, and we don't have that forecast yet, so it is a week-by-week, but hopefully that will change. again, we need to be careful because the last thing we want to do is in three weeks say, you know, we don't have your second dose, i'm sorry. part of that is building the public trust, right, that we are

on top of it, that the systems will continue to work appropriately. so i think every county is working on this and trying to figure this out, but i agree, you know, hopefully the federal government will move to a three-week forecast because that will really make things much more easy to plan. >> absolutely. thank you for that update. there's a couple more quick questions and then i'll pass it back to the president. the governor announced a shifting vaccine priority guideline to an age-based system. that has created a lot of confusion and conternation and concern, particularly among essential workers who previously understood that they would be prioritized regardless of age. how does this shift in the state guidelines affect who we prioritize and plan to prioritize and how we are determining that? there seems to me to be a lot

of -- i've had a hard time getting an answer on this in terms of when and how we will move to the next priorities and who decides that and what exactly the priorities are now after the governor just kind of blew up the whole thing, it seemed, last week. can you help -- what are we supposed to tell someone who is younger and an essential worker who thought they were previously prioritized and now are totally unclear? >> yeah, it's a great question. i mean, so right now we're doing the health care workers in phase 1a, and then we're doing the over 65, and then after that, the expectation is the next set of people would be the essential workers in that phase 1b tier one. so it would be the child care, the educators, the first responders and food and agriculture. beyond that, i don't know what's happening at the state level, and we're waiting for that

guidance. we are at phase 1a and over 65 because we haven't gotten enough vaccine to even vaccinate that pool of people, and one of the reasons why the over 65 is so important is because they make up most of our deaths as well as our hospitalizations, so getting that group vaccinated really will protect our health care system. and as we reopen and there's more kind of, you know, people moving around, we want to prevent another surge. so that is i think one of the strategies that most of the counties are really behind, of vaccinating kind of the people most vulnerable for getting hospitalized, are dying, so we can continue to safely reopen and have less pressure on the hospital systems. as you know, that's kind of been what's really tied us in terms of -- specifically if our hospitalization rates go up, that makes reopening much harder, and we actually end up having to move back. so i think that might have been the reason why the 65 and older

were prioritized, but the next set is the essential workers. beyond that, we're still waiting for guidance. >> so just to -- just so i'm here, so does the state actually tell us the point at which we can move on to anyone who is not a health care worker or 65 plus, or is that a decision that we make ourselves based on everyone who at 65 plus having been offered the vaccine? i'm still a little unclear about how the process of moving on is. >> it is -- it's a combination, so we can't go ahead beyond what the state has said, but the state has said if you feel comfortable that you've gotten through a certain percentage, and they don't say which percentage, but if you've gotten through a number of your phase 1a and over 65 you can move on to the next groups. i think for us we know in san

francisco that we have vaccinated about 21% of the over 65, and that right now is probably not enough coverage to really ensure that we're protecting that vulnerable population. but it's not a -- you know, it's not a hard we have to get to 100% before you move on to another, right? there's a little bit of a balance. it's the same with phase 1a. we have not gone through completely phase 1a before we open it up to over 65. as vaccine becomes more available, as appointments start to open up and they are not getting filled with over 65-year-olds, we can start making those shifts, but we're just not there yet. >> that makes some sense. so it seems to be at some level of discretion based on how we do. it's not the state tells you, okay, now you can move on to 1b. i want to just ask also about a specific population that i think has been sort of lost now in the state's priority and that i hope we can keep an eye on in terms of how we're going to support, and that's people who are under

65 who are physically or medically vulnerable for other reasons, people who may be disabled, people who may have h.i.v. or cancer, people who are -- there are people who i think that we may want to have access to the vaccines that it seems now it's not clear where they fall the the state tier. what are we telling those people and what -- you know, they're not necessarily essential workers in 1b, so when will they have access to the vaccine if you're 50 years old and have h.i.v., for example? >> yeah, that's a great point. that actually is something the state has brought up as potentially one of the changes that they want to make to their guidelines. it is really prioritizing people with co-morbidities that put them at risk for covid. so we are waiting for that guidance, but i think the state will likely, you know, come out with something about that that, you know, hopefully suits.

>> so i would say that one of the challenges that we have right now that can be a part of our communications plan is people who are having a hard time getting any sort of answers, feel very much unclear about which tier or priority they fall into and, you know, it just -- in some cases these are very vulnerable people, and we really have to be there to support them. i hope we can have dual -- i know these thengs are shifting, but whatever answers we can provide people, a question i've also gotten a lot for the food workers who are in the next tier, does that include restaurant workers and chefs and cooks who we know are some of the most highly impacted? >> that's my understanding that they would be included in that, grocery store workers, restaurant workers, yeah, is my understanding. >> and we will make the decision based on when we feel we've done

enough of a job with the 65 plus to move on to that group next, but beyond that we don't know yet. beyond that, for example, if you aren't in -- if you aren't an essential worker that's in that category, for example, if you are a sanitation worker, it's really drk and you're 40 years old and you're cleaning the streets, right now it's very unclear where you fall, right? i mean, they haven't all -- because they have blown up this system basically and made it an age-based system beyond that relatively narrow category of essential workers. >> yes, that's correct, and i would just add, it is -- the essential worker category, and then as you said, the medically vulnerable, and then also this equity issue is something the state is looking at in terms of, you know, potentially prioritizing places that have had higher case rates. so all of those three things, i think it's hard because it's very complicated and that may be why it's taking the state a little bit of time to tli

through it, and then we just don't even have vaccine for this full initial phase 1b, but the hope is and we keep hearing there will be an announcement hopefully in the next week or two about what this will look like. >> great. well, i will just say a last thing and then turn it back over to you. i appreciate the committee for allowing me to ask these questions and for these answers. they have been really helpful. i looked at the plan originally written a number of weeks ago. i do think that we need a new updated plan that is more accessible for people that has more details that include where things are now, including these new sites that we've opened. i get a lot of questions, when is there going to be a tenderloin site. that's very important. what are the timelines for opening a digital community site? i know that reaching really disparately impacted communities like the mission and bayview is so important, and what organizations are we working with there to expand access, you know? i'm excited about some of these

community sites that have opened, but i know and thank you to the team of task force for their leadership on that, the mission site, the question is also how do we get into a scale where we're really reaching the need in that community. my understanding was just a couple hundred were able to be done and we need a lot more vaccines going there. that scale of it, and i do think that all of the things in the legislation are things that we feel are doable and some of which i know you're planning, and i'm very happy to see that, and i hope that ultimately this gets to, you know, a level of transparency and accountability and access that all of us are really working towards, and again, i thank you both for your leadership and our hardwork and your respective teams, and it is much appreciated. thank you, chair preston. i'm done. >> thank you, supervisor haney.

and i have a few questions that i know other committee members do as well. i just wanted to start to follow up on supervisor haney's questions, some of the responses, dr. bobba, were about what you were expecting or awaiting from the state. can you shed some light for us on what our actual role is on some of these? like, are we -- are we as a city actively advocating, for example, for the inclusion and prioritization of people with co-morbidities, disabilities? it's encouraging that we're expecting something from the state, but it just -- any clarity on what role the city is actually playing in the state discussion would be great. >> yeah, and i can talk at it from the department of public health side. the state definitely wants our input and does hold calls where they talk about these issues, and you know, from the department's perspective, specifically around the equity issue, that's been something that we've been very clear about that, you know, that there needs

to be a focus also on vaccinating those places that have been hardest hit and that -- disproportional impacts. so we continue to advocate for that, and that would include people that have co-morbidities and disabilities, potentially, in those hardest-hit areas. that is an ongoing dialogue, and the state department of public health is open to receiving that kind of input. >> and is that the same with i think the board's made clear our interest in educators and school staff being as high as possible in the prioritization. is that also being advocated for on those calls and when d.p.h. is engaging in these issues with the state? >> yeah, and so the educators and child care workers and food and ag workers and first responders, that is -- that will be the next group that goes.

that's already been decided. >> great. thank you. switching gears a little, you mentioned the outreach plan, and i don't know if this is for director carroll or for dr. bobba. i just want to observe that -- you know, i think early on during shelter in place the city did a really strong job around the -- looking sort of not at the online communications and digital communications but the actual fly ring, you know, the door hangers, the postings in neighborhoods, that really were everywhere, at least in my district, and really i think made a strong statement early on in the pandemic. i have not really seen that in the same way as rules have

changed, and so a lot of folks were sort of unaware of the shifting rules around, you know, restaurants, around other things. there hasn't been as visible an offline communications plan or presence, and i -- i'm curious if there's anything planned specifically around door hangers, posting of flyers and/or mailings in connection specifically with information about vaccination, where people can do and how they can get information -- where people can go and how they can get information. >> yes, thank you, supervisor. absolutely. we still have our teams together to do outreach. much of, you know, right now we do not have consistent and secure information to get out to

people, so as soon as we have more clarity around who and what and when, how, we will be getting our teams out there and have the collateral to put that out. but as you can imagine, right now things are changing definitely on a weekly if not a daily basis. but i think to your point, we know how to do it. we have the experience and the teams to do it. we can get it out. we have our -- you know, we can translate things. we have -- we do everything here from the content generation to the translation to the production and the boots on the ground, so it's absolutely part of our plan moving forward, and in addition, you know, we anticipate hopefully that we are going to be continuing to be able to expand wreepgs, and as

we expand reopening, we want people to understand what the expansion means for businesses and for the public, and thirdly really making sure that people understand that we have to continue to do so safely if we want to continue to keep our numbers down. so that's all to say we will continue to do what we've been doing from the beginning. we just -- you know, you've got to have the clear, correct accurate information before we put it out to the public. >> thank you, and just i guess my two cents on that, and i do understand that there's -- you want that clear communication. there is a tension with communicating quickly and proactively with trying to get things get more settled, and my

concern just on that front is that the lack of communication can really breed a lot of misinformation, and i think even if it's before things are settled, even just to get something out that directs people to the right site, even if that site is evolving, i just want to reiterate, and kudos to whoever did the design work on the door hangers, you know, sometimes when government gets out the word we don't always do it in the best way, those were very simple. they didn't need to have all the answers. it made a statement, and you saw them everywhere. you know, they were posted on -- posted throughout the neighborhood, hangers all over, and there are so many questions we're all getting around vaccination that i guess i would urge this impossible that we not await all that clarity, because i imagine things are going to be changing a lot. you know, it's not all going to be resolved next week, right, and just the sooner the better from this one supervisor's perspective on that front.

a couple other questions and then i see supervisor mandelman has some questions as well. i have had some inquiries about immigration status and eligibility and wanted to know if you could clarify in particular whether folks who are undocumented are eligible and if so where. >> yeah, they are eligible to get vaccinated and they would be eligible at any of the mass public sites, any of our community health clinics, at any of our safety net clinics. they should be able to get vaccinated. >> great. thank you for clarifying that. also on prioritization and you talked about geographical parts of the city, i'm curious how vulnerability factors in as distinct from prevalence of cases. as you know, my district

includes a large african-american population in and around the fillmore and also a huge concentration of seniors, both in the lesser edition and japantown. fortunately we have not seen the large outbreaks that those communities have experienced in other parts of the country and other parts of the city, but obviously we will want to act proactively. i note that the zip codes that are targeted do not include any of the zip codes in my district that i'm referring to, so how does the prioritization factor in vulnerability when looking at geography as distinct from where the cases are high? >> so in terms of one of the things is that our safety net clinics are spread across the city, and maxine hall was actually one of the first clinics to get vaccine and start

vaccinating, so you're completely right. it's not just about the location. and truly the people over 75, 80 that we need to vaccinate as soon as possible are all vulnerable. some have more access than others, but we are spread across the city and in all different districts, and so it is working with our health care providers. like i said, d.p.h. gets an allocation and then we allocate out to health care providers, small local health care providers specifically in chinatown, in western edition, fillmore, places where we know that they will be reaching a highly vulnerable population, we are prioritizing them for allocations as well. >> and other than maxine, what can you clarify about who's eligible at maxime hall on other resources, other mobile pop-ups or more permanent sites are planned for western edition and

japantown? >> so right now the health network is doing its population which is, again, the safety net population, but as soon as they get to a certain percentage, the likelihood that they will be able to open it up to other vulnerable populations, and we can check back and see where they are in terms of maxine hall in terms of getting to those numbers. in addition, the cds and other site will also have capacity to vaccinate. those would be other resources and places, and again we're working very closely with our neighborhood and equity branch and community partners to identify places where it would be really important that we either stand up a community site or have some type of global capacity. >> thank you very much. supervisor mandelman? >> thank you, chair preston. and thank you director carroll

and dr. bobba. i want to begin by just, you know, expressing deep and profound gratitude for all the work that covid command and d.p.h. are doing and have done over the past year. like each and every one of my colleagues, i have been hearing a massive amount of anxiety, confusion, consternation and upset. i have shared that frustration as i have watched our website and communications gradually sort of incorporate new elements that make it more user friendly but haven't quite, you know, i would agree, gotten there. i think it's important to remember that it is much easier to spot problems than to fix them, and you have not only 11 supervisors peering over your shoulders but 800,000 san

franciscans as well, and we're all screaming at you to move faster, smarter and better, and thank you for, notwithstanding that, still moving faster, smarter and better. and we're not there, the country's not there, but i impressed and grateful on a regular basis for the work that you all are doing. so with that little love fest to the side, a few -- just a few observations. perhaps helpful criticism. i do think that the communications continue to need improvement, as has been pointed out. i think the website being unveiled today is a big positive step. we did a town hall, working with d.p.h., i think it was earlier this week, and even then, i mean, the sort of confusion -- the sort of core request was an

easy way to sign up, which seems like we're getting closer, but just sort of even then we were not entirely sure what we were communicating. i know this is getting better and this website feels much closer to what we need, but still needs i think more work. i do think our notification system, i hope it is providing the information that supervisor haney has indicated and that at some point we will figure out how to use some of that. for the moment it has been more -- i mean, again, not to pile on, but i do think it has generated more confusion in some ways than actual help, because if you are over 65 and you signed up for a notification whether you're eligible, you're eligible but you still can't get it or haven't been able to get it reliably or easy to this

point. i think when people do that they are expecting more than the city has been able to give them, and that's been frustrating. so if we're at least able to use that information positively, that would be a great thing. and i do also think, and i'm not totally clear other than the volume on y'all is so great, that the information we're comparing to what we're receiving to what we're giving out is helpful, and that's something that i've asked for for a while, and i understand it takes a while, but -- and it seems like it shouldn't be so hard on the d.p.h. side of things. in fact, dr. bobba provided that information today, at least in terms of 62%, but that's not on the website and might be a thing as you continue to update that website that would be interesting for people to see. are we able at this point to know that for our non-public providers, what's received versus what's given, or is that too much of a mess?

i know at one point the doses were being received by kaiser regionally, by sutter regionally and piecing apart what was available in san francisco was pretty hard. are we any closer to that? are we ever going to be able to know how much is available for distribution in san francisco? >> yeah, we've made a lot of strides. i don't know. i have to check and see if all the health care systems are reporting, but a lot of them are. so yes, and so hopefully we can get to a place where, like i said, in the very near future we can talk about how much -- how many doses have been received within the city and then how many have been given out for that comparison specifically. >> okay, great. well, again, i'd asked for it been before and i know it's one of the gazillion things you have to do, but i think that would be both on the public side ant on the private side information that people would at least find useful. so in somebody's free time, if they could make that happen,

that would be really great. i'm curious about the supply situation because it says, you know, the ordinance before us anticipates a potential rapid increase in supply. you all are planning for an increase in supply. is there reason for us to believe there's an increase in supply coming and when -- like, do we think that -- is it that we are waiting on j & j? do we have any i see have -- visibility on when things might loosen up a bit, or are we just going to be kind of pulling our hair out, hah, you know, until june? >> i don't have any insider information. i probably read the same news stories that you do. i hear about an increase in production and some of the other candidates, that they will get approved in the next month, which will then hopefully just open up the number of vaccines that are eligible for people to

get vaccinated with. but other than that, i don't have any further information of when actually we will get that increased supply. >> in terms of we and our private partners are receiving, is that increasing week to week or is that some weeks it's more some weeks it's less? >> it's been variable. so yes, it's not increasing, and it's interesting, there are some weeks that dph gets more and others get less, so it is not stabilized at all. >> okay. and do we have anied in how much vaccine will be going to the pharmacies and what that will do? i mean, this new sort of initiative, which i think you said is happening in the next couple of weeks, to get cvs or safeway or walgreens, you know, a little bit more like we did the flu, except it will have to follow the groups. we don't know how much vaccine is going to be available for

that program and what it will mean for san franciscans at this point? >> yes. yeah, we heard i think it's going to include about 100 pharmacies across california, so you know, the number in san francisco probably won't be a huge number to start with. >> one or two or five, whatever, something small. okay, and you'd said that we're -- and we have said, and the issue that i'm now telling everyone this, the issue is not our infrastructure, although we need to set that up, but it's the lack of doses. it's the lack of supply. do we have the staffing? i mean, do we have in place what would need to be in place actually if we had 10,000 doses a day? is there going to be a point at which we actually do have some other constraints on our ability to deliver those? right now we don't because we don't have that, but are we going to have that staffing problem at some point? in a good world where we

actually do get supply? >> director, i don't know if you want to talk about the mass sites, but we are getting flooded by people who want to volunteer. i anticipate it will be okay, but director carroll, i don't know if you wanted to say more. >> yeah, thank you, supervisor mandelman. we feel very confident that we -- i mean, we are not setting up sites that we can't operate, so some of our sites are -- all the sites are structured slightly different in the sense of who's staffing them. for example, the site here at mocsone south is really a kaiser-run site. they are coordinating all of the services through -- you know, they sort of own and lead the site and we provide outside support and just general city support or services that they might need. city college is much more of a

city-owned fifty-fifty shared site with ucsf and potential other partners. so there is no reason that we can't -- that we cannot put as much vaccine as we get into people's arms here. our goal -- our stated goal by d.p.h. is 10,000 a day, but the structure -- i mean, the operation and the structure that we built can accommodate a higher number than that. >> you think we have the workforce for that, we or our private providers have the workforce to be able to do that? >> yes, absolutely. >> okay, that's good. >> another issue, i want to talk about the vaccine plan and the ordinance itself, but last question before we get there, i think there is this notion that people see other counties doing things -- and we've had this since december. people read in the paper that somebody is getting a vaccine at a hospital in freemont or

hayward, and then we find out, you know, a week later that they shouldn't have been and that hospital is not going to be getting any more vaccines, but people are seeing a lot of stuff going on in a lot of places, and inherently because human beings are like this, we are comparing how we are doing to how other places are doing. can you address that in any sense how you feel san francisco is doing relative to -- how are you thinking about whether we're keeping up in the joneses? >> i think that, you know, yes, we definitely had to build the infrastructure, but now that it's been built we are very confident that we are getting doses out as quickly as possible, and you know, given that san francisco has a very large health care workforce and it was a really big, you know, group of people that has -- yeah, it was a huge list, thank you. that had to get vaccinated, the estimate is that we were

potentially 80% through that, and you know, we're 20% through the over 65, so we're making huge strides here in terms of getting through the populations as quickly as possible. i think some of these mass vax sites can help, you know, first of all get people to one place to get vaccinated, so that there's clear communication, but then also get through the population as quickly as possible, and then our responsibility really will be for the people, again, that can't access a site, that have access functional needs and other reasons to not access it and have the community-based clinics as a supplement. >> all right, let's talk about the ordinance and the plan itself. [please stand by].

>> supervisor mandelman: i have been troubled by those instances where we have passed ordinances requiring things to happen, and the executive responsible for implementing those things has not done them, either because it -- often, you know, telegraphing or