you know, the vaccines affecting your reproductive system and so forth. that is not the case. all the experts who specialize in reproductive health are recommending that people get these vaccines. in fact, there was just a study out yesterday that shows for -- unfortunately, for pregnant women who didn't get the vaccine, they were more likely to have their babies early, and the babies were what we call preterm babies, so that was a very negative effect of covid-19. the benefits of these vaccines far outweigh the bad sides, but we all know someone who got the shot and got sicker than they thought, or my brother got the

shot and had an asthma attack a week or two weeks later, and it was, like, did that cause my asthma? no. >> thank you for that. and the last question from jessica? >> the last question is [inaudible] should they then test again. >> so, again, this is this is a situation where they're fully vaccinated and tested positive, basically, you need to isolate for the ten days until -- until you don't have symptoms, assuming you don't have any symptoms after ten days, and there's no further recommendation to get retested

again, and if you do get symptoms similar to covid-19 after that again, the best thing to do is to talk directly to your health care provider. but in general, there's no reason to get tested after the ten days after -- from the day of your positive test. so the most important thing is if you do test positive, to isolate, to wear the mask, and for goodness sake, if you have friends and family that haven't been vaccinated yet, get them vaccinated -- support them getting vaccinated, i should say. >> all right. thank you so much to jessica and fini for all of your work in the community, as you've heard many similar questions that they all have that they've been fielding in the community, so thank you, fini and jessica. so now, i'm going to get to

some of the questions that you've put in the chat. i don't think i'm going to be able to get to one of them, but i'm going to try to combine similar subjects. one thing that has been asked is will the city shutdown again, and will the city take any further efforts to reduce transmission, such as closing restaurants, bars, gyms, or any other place with high risk settings, and do we anticipate going back to the tiered shutdown? so all of these questions have to do with a shutdown? >> so we have no plans to quote, unquote, shutdown the city again. i think we are going to mitigate the virus in ways that allow us to resume the activities that we missed so much and love while also trying to slow the spread of the virus and prevent the most serious consequences, hospitalizations

and, of course, death. so vaccines are key to this. as i said multiple times here today already, they are key along with people wearing masks indoors. they are not as effective as vaccines, but they are another tool that works to slow the spread of the virus. the other thing that we're doing is mandating vaccines in certain settings, including in health care settings, and i think as people know, the city as a whole, the city is requiring employees across departments to become vaccinated, so there is effort to make the vaccine as available as possible. we will bring the vaccine to

you. in your house, if you have five or more people ready to get vaccinated, we can make that happen. and the other thing is now that we've made it as easy for people to get vaccinated, we support efforts for people not getting vaccinated. we support requirements for vaccine. a lot of businesses are requiring to show proof of vaccine status.

>> we're seeing a lot of questions in the chat about boosters and booster shots, so i'm just going to combine some of the questions here. what are the cost-benefit analysis to get a booster shot if they're ready to get vaccinated? how effective is the pfizer and moderna vaccine against the variant, and what's the criteria if someone wants to get a supplemental shot? they've read the news about sfdph affiliated facilities accommodating those requests, and do you recommend someone getting a shot from two

different companies, so if you got a moderna, getting a shot from pfizer or johnson & johnson. so many questions, similar topics. what are your thoughts about booster shots? >> i'm trying to hold all those topics. so a couple of things. starting with one of the questions that was in the middle there was, you know, about the second shot, whether it's from pfizer or moderna. it's just really, really important to get that second shot. there is no recommendation from any major health care body in the united states, including the c.d.c. and the f.d.a., that

people get boosters. i know there's a lot of questions, a lot of discussions about this. right now, we only need to focus on the support of people who haven't gotten vaccines to get the shot. that one shot is j&j or two shots of the moderna or pfizer vaccine. those are the current guidelines, and the health department has not changed its policy with regard to that. now there's a lot of data -- there's actually some data just out today of moderna. there's a lot of discussion around pfizer with booster shots, which would be additional shots based on evidence that people may need them. there are some countries that are exploring or planning to start booster shots in certain populations. that is not happening in the united states right now. we don't know yet. it's entirely possible that booster shots would be

recommended, but again, in the united states, that's not the case. now there has been some publicity about a comment that the health department made, which is giving -- if people who receive the johnson & johnson vaccine, which is a good vaccine, request an additional shot with a pfizer or moderna vaccine, that we will accommodate that, but it hasn't been a change in our policy. but if people have talked to their health care provider and say, you know, i'd really like to have an mrna shot in addition to the johnson & johnson shot that i got, we will accommodate that, but we are accommodating that because we heard from communities that people were concerned that they were requesting it. we wanted to be responsive, and we wanted to accommodate what

people were asking for in the -- in that regard. but it's not a change in policy, we're not recommending it, and we're not promoting it as a way for people to become more protected. >> okay. i know that's super helpful, just given all the questions rolling around that and the news coverage. question, especially with delta and other variants. you recommend upgraded respiratory protection. for example, n-95 masks for unvaccinated individuals in indoor settings, so again, this is unvaccinated individuals in indoor settings. >> yeah, what i recommended for all individuals in indoor setting is to get vaccinated. we know the masks work, but they don't work as well as the vaccines. in an indoor setting, i mean,

the more we know about them, really, it's both about getting that vaccine with delta here and, you know, if many people can't tolerate wearing an n-95 mask inside, so it's better to wear a surgical mask than certainly no mask at all. but i just -- i know that with the masking, the indoor masking mandate coming back in, that that -- that we focus our attention on masks, but i also don't want to lose sight of the fact that the vaccines are so much -- so important, so protective, and easy to get right now, so both the mask and vaccine are key to us getting out of this fourth surge. >> okay.

great. we have some questions about the new variant, the lambda variant. what do you know about the lambda variant in san francisco, and there's some questions that the lambda and epsilon variants might be vaccine resistant? >> yeah, we're working with scientists and researchers as much as we can to be responsive to further variants emerging. and i think one of the key issues that we've had across the country, in the region, and, as well, is in -- in san francisco is scaling up our ability to genotype the virus. and thankfully, at ucsf, we

have a lab that's leading the state in terms of genotyping. it's plausible that we'll see other variants emerge because we don't have high vaccine rates across the country, and we'll have to wait and see if these variants cause more illness or if they spread or are more crippling than delta. but i go back to -- i sound like a broken record -- the way to keep these variants from spreading is to get vaccinated so the variants slow down. the less people the virus is able to infect, the more the

virus slows down, and the less people we infect. the way to support all of this is to support all people getting vaccinated. >> all right. and we've gotten questions about have we seen any differences in outcomes, for example, hospitalizations, for people who have received different brands of vaccine? >> yeah. locally, i'm not aware of any differences in regard to that. >> okay. and i know we've had a series of town halls focused on youth and children in schools, but we do have a couple questions here

in terms of the delta variant specifically and its impact and everything on specifically three to five year olds. is it specifically safe to allow three to five-year-old children to not wear a mask in child care outdoors? what about the delta variant in pediatric outcomes? any sort of thought on the risk of kids under 12, so questions on covid and how the delta variant is affecting children? >> so this has come up in questions from our clinical experts, and i think it's really important to emphasize right now that the public health officers, pediatricians, feel that it's incredibly important that we return our kids to in-person learning, and

that this is thought that we can do it safely, we can do it safely, and it's so important for the health and wellness of our kids, our families, and our community. the best way that we can ensure that is for family members who are eligible for vaccines to get vaccinated. that can protect the children, and that can protect the school. and we have local data that supports that, so in the last 18 months, of the children who are found to test positive for covid-19 in the schools, all those cases were tracked back to the family, so i just think it's important for us to all do our part to support that. i was just talking to a number of infectious disease experts

at ucsf. you may have read the report from louisiana about children's hospitals being filled with children with respiratory illness. that's obviously a concern, and there's much more covid there, much more than we have locally. there's a much lower vaccination rate, somewhere in the range of 35%, compared to our 75% overall, and there's no confirmation that delta causes more disease among children. right now, the consensus is that children are expect -- you know, even if children get covid-19, that they will experience milder symptoms compared to adults. but again, as we've seen during these last 18 months, this is an evolving field and we're watching it very carefully. but we want to support schools

opening for in-person learning as much as possible. >> okay. thank you. we got a couple of questions about rapid testing and testing as soon as possible, so i don't know if you want to share anything about rapid tests? >> well, i think if people want to avail themselves of rapid testing, that's something we didn't have before, so i encourage them to use it. but i'd say to very carefully follow the instructions, and if you have questions, that you consult your health care provider, so just two important caveats to the use of home test kits, and again, they should not be a substitute for getting vaccinated. getting tested itself doesn't get you vaccinated. you can test as much as you possibly can, and it's not protecting you from the virus, right? so, you know, if you're tested,

get the vaccine. >> maybe just a follow-up question on that. if you can describe for the public quickly the difference between the rapid test and what we have traditionally had out there, where test results are sent to labs? >> yeah. well, i mean, i think there are a lot of different rapid tests out there, but basically, the rapid test allows you to get the results, you know, in as short a time as 15 minutes, and those are being used in many settings across the city and at d.p.h. we're using them at our shelters right now and certainly at our testing sites so you get that result very quickly. if you -- the traditional -- the traditional test that we used earlier, our tests that take a longer time to conduct,

and they can take a turnaround from anywhere from 24 to 72 hours. >> we had a lot of questions about the city shutting down again, but also specific events. we were planning for events to be held outdoors but with a lot of people. should we still hold them? should we cancel them? is there going to be a recommendation that people reduce participating in social gatherings indoors or suspend large gatherings? any advice you have on small outdoor private gatherings, so in general, i think the questions are along the lines i think we've talked about safety in covid areas on the spectrum, if you could share that. >> yeah, it is on a spectrum.

we know that being outdoors helps prevent the transmission of the virus, so that's key, as well, and the more people that you're engaging with, particularly inside, the greater the risk of transmission, especially if there are adults there who have not been fully vaccinated. the other piece is we know that people who are older, particularly 65 and older, people who have comorbid conditions are more likely to suffer from negative consequences from this virus, so i think we just all need to think through that and do our own risk assessment to make a determination about what we're comfortable doing. there's a big difference between an indoor gathering of

5,000 people whose vaccine status hasn't been checked versus an outdoor gathering of 25 people who are fully vaccinated or, you know, people eating inside either in a group -- in a group setting, in a restaurant -- if they're vaccinated, and the staff are fully vaccinated, there's a big difference in that risk compared to people that are not vaccinated in that setting. so i think it's just really being attentive to your own risk, the risk of the people that you love and who are around you, and making the determination about what you're comfortable doing while supporting getting vaccines and while wearing those masks indoors. >> and so along those lines, you know, especially given the high vaccination rate of our population, do you any insight

of where you're seeing outbreaks in san francisco at least? i think you mentioned earlier, but any specific places or demographics or clusters? >> well yeah, i think we're seeing clusters in the neighborhood map -- on the neighborhood map that i showed. we're also seeing larger numbers the people in the 25 to 35-year-old age group who are not vaccinated. that's our age group in san francisco that is least likely to be vaccinated, so if any of you are 25 to 35 or no 25 to 35 year olds who aren't vaccinated yet, please support them in getting vaccinated as quickly as possible. along those lines, we are seeing, when we're asking people their activities, we're seeing more outbreaks in indoor settings, including people who are frequenting bars, so that's

another place where we're seeing more people. it's basically younger people -- there's a higher risk for younger people, 25 to 35 year olds, who have not been vaccinated, who are going indoors into crowded settings where i think mask wearing is lower than it needs to be at this time. >> all right. well, i know we received many questions, and we apologize we couldn't get to all of them, but we will try to through our messages out to the public and other venues, as well, try to get as many questions addressed in those ways. our website,

of information, as well. i will leave it with one last question. many people are wondering how we can live with this virus in the long run like with the flu, so what are your thoughts on that? >> well, it's hard to project into the future, but we have the tools that work. there's a question, if you get the vaccine, will it work against mutations? the vaccine is key to keeping us from spreading the virus and from keeping us out of more serious variants, so i just want to emphasize that. i think in terms of where we'll be in the future, hopefully, we'll get more people

vaccinated. the masking, indoor masking, will help slow the spread of this surge, and then, we'll have to see where we are in terms of the science around further vaccines and determine, you know, if and when additional shots are necessary. but i think right now, the answer -- the most important thing that we know now is that these vaccines are going to be key and that the more people we get vaccinated now, the more we will be able to mitigate and -- and control the spread of this virus in our community and prevent people from dying. these are great medicines, and the vaccines are our way out. >> all right. thank you, dr. colfax. thank you to everyone who participated in this event today -- >> and if i could just say one more thing.

you know, this has been a long 18 months, and i've said a lot about the virus. there's been a toll on our mental health, our ability to care for ourselves and our families, and in addition to getting the vaccine, please make sure that you're taking care of yourself and your families in the ways that are so important for yourself to be resilient during what is a very challenging time. sorry to cut in, katy, but i wanted to say that, and thanks, everyone. >> oh, no, thank you to you, dr. colfax, and thank you to everyone who participated and thank you to sfgovtv, as well. if you want to view this again, it'll be available on sfgovtvs youtube channel.

so thanks, everyone, and have a wonderful day.

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