page four, strike the language that says online four and five that says the third supplemental proclamation all the way to omicron surge and add language that says immediately establish a coordination team to address omicron surge and other possible surges and to require this team led by the department of public health required by the board every two months for the next six months. again, i want to thank the mayor's office and the departments for their quick responses and my colleagues for their action and reacting to what we've seen on the ground and staying on top of this and all of the departments, department of emergency management, public health, oewd and h.s.a. and others they can react and respond and stay ahead of this surge as we move

forward. >> president walton: thank you supervisor safai. you have a motion to amend. >> supervisor safai: yes, sir. >> president walton: seconded by supervisor preston. on the motion to amend item number 30. >> clerk: on the amendment of item 30, [roll call] there are eleven ayes. >> president walton: thank you, motion to amend passes unanimously. on the amended resolution. >> clerk: on item as amended, roll really [roll call]

there are eleven ayes. >> supervisor safai: thank you colleagues. >> president walton: thank you. and without objection, the amended resolution is adopted unanimously. all right. madam clerk, let's go back to item number 25. >> clerk: given the approval of item 31 item 25, the board of supervisors has agreed to convene as a committee as a whole for a public hearing to consider the update to the city's response to address the omicron surge including

increase testing capacity and to coordinate response across city departments. >> president walton: thank you, madam clerk. supervisor chan, did you have any opening statements? >> supervisor chan: thank you, president walton. and, colleagues, thank you so much for your support to allow us to have this committee as a whole. i really am coming from a place where i just want to be first really thankful for our department of public health for their effort for guiding us through the pandemic both as just the residents in san franciscans and now as the district one supervisor. today, my intent really is to learn about the latest really information about omicron, about covid, you know, two years now, i just really want to have a good grip and a good understanding not just from myself but really on behalf of my constituents. i am learning conflicting information online and kind of everywhere.

i really look to our department of public health for the guiding authority to tell us where they're heading and that's really to help us understand, you know, what are some of the testing frequency and conditions for different populations and my thought is there are seniors kids, unhoused individuals, travelers, just different people that, you know, how do we deal with these populations. also, just thinking about the latest vaccination rate and really where we're going, what is the future for us. i didn't think that i was going to ask about masking and protocols, but just kind of learning the information in the last couple of days including some of the information that has been released by department of public health including today i think they were on kqv

radio and talking about how the future of this pandemic is heading in the direction of endemic so i love to have this information and thank you, colleagues for your support for this committee as a whole hearing. >> president walton: thank you so much, supervisor chan. and this evening, we have dr. grant colfax and dr. navina baba from the department of public health to present. thank you so much for being here, dr. colfax. >> thank you, president walton. and good afternoon supervisors and thank you for your support and your shared wisdom during these last two years and as we enter our third year of the pandemic. and i'm also joined here today by the department our board liaison and our main school lead from the department of public health as well as we'll be joined by our health officer

and activation population health director dr. susan phillip. i do have a number of slides that i hope will answer some of your questions and, of course, we are available to continue the conversation and to continue to work towards addressing this unprecedented pandemic going into a third year. next slide. so in terms of our current state of covid, i really want us to focus for a few minutes on what we know. we know that omicron is far more infectious, but thankfully causes less severe disease than the delta variant. very importantly and i will say this multiple times during this presentation, vaccines are very effective in preventing severe illness and death and just to provide the board with the

latest data on this the cdc released startling data on friday that showed for people over 65 if they had received a booster, they were 49 times less likely to be hospitalized due to covid and for people between the ages of 50 and 64, they were 44 times less likely to be hospitalized for covid. and as a physician, i can tell you that rates of reduction as seen with these vaccines are rarely seen in medicine. so these continue to be the foundation, the vaccines and the boosters continue to be the foundation of our ability to mitigate the effects of covid. our robust efforts that save lives and help maintain hospital capacity and covid is here to stay. it has adapted to us and we need to adapt to it. and as we adapt to it, it's important to emphasize that we all need to continue to show compassion and grace to those

with covid-19. most of us have gotten our vaccines and boosters, most of us are doing the best we can and i think at this point, most of us know people who have become infected with covid-19. in terms of what is likely in the near future, surge in cases has peaked and will likely be followed by a peak in hospitalizations and a leveling off and we'll go into this a little bit later in the presentation and thankfully supplies and test kits and treatments should improve. both at the local, state, and federal level. in terms of our ongoing response and planning at the local, state, and federal level, it's clear we must be flexible and elastic to respond emphasizing that now and we are no longer in 2020, our goal is not to prevent every case, but we need to continue to focus on equity and maintaining hospital

capacity and preventing deaths. there's a shared responsibility going into the third year of the pandemic for all health care providers to provide access to vaccines and testing. that we as a society, as a city, as a health department must balance our covid response with multiple competing health issues including behavioral health and very importantly and i want to emphasize to take the lessons learned from covid and for the department to strengthen our community health partnerships to continue to address not only covid, but the other health issues where there are significant health inequities that covid is only further highlighted. next slide. so i did want to take a moment to show national state and county comparisons with regard to where san francisco stands in terms of deaths per 100,000 population and our population who've completed their initial vaccine series and just to

point out here that compared to other comparable counties and cities in the united states, san francisco has the lowest deaths per 100,000 population at 80.7. we have tied for the highest percent of the population that has completed its initial series of the vaccine and then our booster rate compared to the state and the united states overall is far higher than the national or state average. and just going back from it in terms of deaths per 100,000, it has been estimated by u.c.s.f. that if the united states had the same death rate that san francisco had over 600,000 deaths would have been prevented nationwide. over 600,000 deaths would have been prevented nationwide. next slide. in terms of cases, our cases have peaked.

you can see on the left graph here our cases have started to peak, for those who have not been vaccinated and those shown in the orange and dotted blue line and you see that our cases peaked at over 200,000 and are now going down. and just to emphasize that this case rate was far higher than anything we had ever seen before including in 2021. in terms of deaths by months overtime. thankfully we are not in the winter of 2021 when we were just starting to roll out those vaccines as you see. on the death thankfully are not anywhere near where they were in 2021. we will unfortunately still have some additional deaths

because of delays due to reporting, but we do not expect the magnitude that we saw last winter. next slide. in terms of hospitalizations, this graph shows the total covid-19 patients in acute care and intensive care over time. you can see with that number of 271, we've exceeded the number that we saw in our winter surge. because of the boosters and because omicron is less than prior patients. and our hospitals have maintained capacity, so they are able to continue to care despite the fact we've had really major challenges in terms of staffing because so many of our incredible staff came down with covid and just to provide an example, zuckerberg san francisco hospital at one point had over 500 staff out due to covid but

because of the heroic effort of our front line workers, we were able to continue to maintain staffing ratios to provide optimal care not only for people with covid, but for people who came in with so many other health conditions. and our focus continues to be to ensure capacity throughout the hospital system. next slide. in terms of vaccinations we are using and children under five are currently not eligible. but we do expect for younger children that the pfizer vaccine may be approved by spring of 2022.

being up to date on vaccination is required for those that work in high-risk settings and we continue to have a robust network of nearly 100 vaccination sites in san francisco with nearly all san franciscans within a 5-10 minute walk or drive to a site. in terms of vaccines, 82% of residents have completed the initial series and you can see here, our booster rate is now at 63% with nearly half a million residents having received a booster vaccine. in terms of testing, we had a huge surge in testing demand with the surge in cases just to highlight on the graph here on the blue graph, we were down to about 3,400 tests to date in

late october, early november. and you can see we peaked here at 44,688 in tests and earlier this month. so we peaked at about 14,500 tests. testing at our d.p.h. affiliate sites are at an all-time high. i can say we are now able to provide testing to people. there are appointments available and there are drop-in appointments available as well and our turn-around time which i know has been a real challenge for many of us and our families. that number has come down and our average turn around time is 1.4 days and continues to drop. getting those rapid test kits was so key during the surge we were ordering those home test kits when we saw what was coming. unfortunately, as you know at the international national and state level there was not a supply of test kits to be had,

but as soon as kits started arriving which was 10 days ago now, we had the first shipment of 150,000 rapid test kits that were distributed to our emergency responders testing sites, skilled nursing facilities and c.b.o. partners of highly impacted communities and very importantly, we are now requiring through the health order, we revised and updated the health order to make tests available per the health order and as you know, the mayor also issued an order penalizing the health care systems to not provide a plan to show that they are going to be able to test their staff and their patients within 24 hours if patients have symptoms or report an exposure. finally, on the lower graph here, you can see that our current seven-day average testing rate is 18.3% coming down just a bit from from the peak earlier this month and,

again, we expect that to continue to drop. next slide, there's a lot of information and dr. susan phillip, our health officer is here to answer any detailed questions with regard to health orders, but just to go through this we are in alignment with the state to require health care workers to get their booster by february 1st. we suspended the indoor masking exemption. that was something that we modified as the surge occurred. we are in alignment with the state to redefine megaevents and beginning february 1st, there will be a requirement that staff and attendees 16 years and older be up to date on their vaccination series and then march 1st, we will require

that attendees 12-15 be up to date on their vaccines as well. skilled nursing facilities because we know that that's where among the most vulnerable to covid reside. we required on site testing of visitors and residents were limited to two visitors per day indoors and i already mentioned that health care facilities are provided covid-19 tests for those symptoms or close contacts and i just want to emphasize the reason for this order was that of the large health care systems in the city that we're doing the' majority of testing in the city. and we need all health care systems to do their part and we had updated and quarantine guidelines to align with the california department of public health cdph which allows returning to work or school after day five is asymptomatic

or symptoms are improving with a negative test. next slide. to emphasize that the city and the department continue to support unified school district at the health department, we affirm support for in-person learning for its positive health effects and positive behavioral health effects that we continue to support vaccines and boosters. we continue to provide vaccines at community sites where there's a high demand from sfusd families and we are working to re-establish school vaccine and booster clinics at schools. we have provided face coverings to the schools and we continue to provide testing, rapid testing test and more tests are arriving from the federal government dedicated to schools and just to emphasize, we have been very close -- we have a close working relationship with the school we provide technical

systems and this has been upon going for the two years we have been in this pandemic. next slide, please. in terms of the future state of covid and i want to declare that these last two years, we have been humbled by being able to predict the future, but i just want to also emphasize we still have a lot of uncertainty going into the future. we do know that the virus for the foreseeable future will remain with us and there may be future variants and surges. we will continue to follow the data and balance the benefits and harms with our approach and

public and other health experts agree that we need to continue to focus on equity, focus on preventing hospitalizations and deaths whenever possible. and, again, that we cannot focus on preventing every case. our focus is to put the best protections in place to achieve these goals including vaccinating and boosting everyone who is eligible, layering strategies to reduce transmission and i would just add we do this for other diseases with sexually transmitted diseases. we have a combination of vaccines, barrier protections such as condoms, treatments that mitigate the worst of stds

for the vast majority of people to use a nonmedical analogy with regard to the risks that we take when we drive. we have the air bags, we have the seat belts, we have the traffic lights, we have the speed limits and depending on the condition, the weather conditions which one might have an analogy with regard to covid prevelence, so this layering of interventions to mitigate the spread and prevent the worst outcomes. we will continue to work with community partners and leaders to prevent and mitigate covid-19 and i think it's also important to emphasize this, but we have learned from hiv in particular and in other conditions the community really needs to lead and show us the way. i think that's one of the key

reasons san francisco has been so successful here and we are deeply committed to doing this and taking the lessons learned from covid-19 and the further inequities that covid-19 has highlighted to address covid and other health inequities. in terms of other possible scenarios for covid in the long term. our covid response could evolve similar to our food response where we have variants on some frequency and vaccines are modified to keep up with those variants, but we are able to continue to live in a functional and society that is not necessarily obsessed with covid and at the same time, there are plausible scenarios where further disruptance highlighting boostering vaccines not only locally but nationally and, of course, reaching vaccine equity at the international level as well.

next slide. in terms of how you can help, this is for everyone. just continue to ensure that vaccination and booster efforts are promoted. support the covid risk reduction approach that i just mentioned. focus on hospital capacity and preventing deaths. help communicate the layered approach to reduce transmission. assist health care providers to provide access. continue to work with us in our work with community and neighborhoods to ensure people have access to covid prevention strategies as well as other health care and balance public health in societal needs. thank you for your attention and i'm happy to take questions and our key dph leadership is here to answer any other questions you may have. >> president walton: thank you so much, dr. colfax. we do have some folks with some

questions. supervisor haney. >> supervisor haney: thank you, president walton, and thank you, dr. colfax and team for this update. you know, obviously the surge, you know, hit us very hard and there was a lot of uncertainty and a lot of, you know, concerns about access to testing and particularly as folks were going back to school and so i hope that as we go in the coming months, i know, we don't know exactly what the future holds, but that hopefully we have learned some things in terms of how to respond when we do get hit with such an increase in cases. it did seem like for an amount of time it was hard to give information on people although we do not know what the future

holds, i think if we do have a similar type of sort of surge or new challenges related to the virus, we want to make sure we're able to communicate effectively and expand appropriately. i wanted to ask about something that came up a little bit, but didn't -- i think i've wanted to have more answers to which are access to masks. over the weekend, i was out in viz valley and there was a mask give away and they had n95s given out and they had 500 people show up and wait in line for masks and these were very vulnerable seniors and it's something that i think that is in addition to the tests which we know a lot about may be an unmet need and i know it's something that the federal government is responding to. how are we making sure that

people who want masks particularly those type of masks have access to them? what is our level of ability to deploy those? to deliver them? to send them to people at their homes? there is a massive need out there that i do not think we are meeting right now. >> thank you, supervisor. and just to emphasize that we have emphasized the mask distribution for people and we've been working with multiple community-based organizations. our task force, the hubs that as you know have been focused on covid prevention and distributing thousands of masks since the beginning of the pandemic and during this surge. we also just created many masks and are also now distributing the n95 masks. [please stand by]

>> is there a place where people can call or register or request masks? i appreciate that. we are distributing. i'm sure we're distributing

many. it's just when vulnerable seniors are prepared to wait in line three or four hours and then have the masks they waiting for run out, we still -- i still feel that we need to do more to figure out how to make sure that they have access. is there a number -- what would you recommend people do who don't have access to masks who are not connected to a neighborhood provider. >> we do have a number a number for covid assistance that people can call to get more information where masks are available. we can provide that. >> thank you. on the healthcare providers and their -- the degree they are

following some of the request you made and the mayor's order that she's issued, do you have any data on that? is that being made available in a transparent way? when we were doing vaccines, we were able to track how many they've done and by which provider. are they sharing data with us that you're making available? >> i will turn to dr. susan philip to provide the details and response to your question. we just recently issued the order and the providers are required to report. dr. phil can give you that updated information. >> thank you dr. colfax and supervisor haney. the requirement for reporting has been in place since august.

there was renewed requirement with the surge. we are still processing that data. and working with the health system. the main point of this was really to be in partnership with them and continue to encourage them to provide this for the patient and people that are seeking care at their sites. we don't have data at the moment. it's going to be reviewed. >> supervisor haney: we don't know if anybody -- if part of what we're doing here is monitoring in a realtime way, and potentially fining people, are we getting enough of the da so you can monitor that? obviously, if we don't find out that they haven't been testing at the levels needed until weeks after we needed it, that was not really all that useful.

are you getting the data in any kind of realtime or immediate way that is useful to monitor the testing as we need it? >> we are working to get it on a weekly basis. we are looking at -- it comes to us twice weekly. we ask that they give it in a slightly different format. in the meantime, i have been speaking with them. there's a hospital council leadership to make sure they understand the ask and the reasons for the request for testing. like all providers, they also experience the surge and challenges with access and with delays. the main point of this order is to make sure that the health systems are continuing to contribute for their own patients to do testing that it is not just the city ramping up when there's a surge as we had in omicron.

we are looking at the data regularly and speaking with them as well. >> supervisor haney: thank you. >> president walton: thank you. supervisor melgar? >> supervisor melgar: thank you very much. thank you dr. colfax and dr. phillips. thank you dr. colfax for the briefing that you provided me in my office few days ago. i appreciate that. as we spoke earlier, my concern still remains the little ones and since our conversation, n.p.r. yesterday did a story about the effects of omicron on child care. it is not just in san francisco. it's all through the country that the latest surge has had a devastating effect on preschool

and child care. we've lot of folks who work in those settings have gotten ill and lost staffing. that has repercussions on folks, family's ability to learn a living while their kids are taken care of. this is like an entire population that is unvaccinated by definition because they can't be vaccinated yet. my question is, because the stakes are so high, what are we doing to specifically address that population? i realized it's more difficult to do because there's not like a central office like we have at franklin. it seems to me that i'm not the public health expert, i'm asking a question, what is our plan? what can we do to focus on this

population in this industry? it's so important, they are so important for the health of our city. >> thank you, supervisor for the question. i want to emphasize that we've been working with the child care providers providing technical assistance and guidance in regards to best practices. as we come down out of this surge, we are also working with our colleagues at the state to see if more flexibility can be made with regard to the child care providers similar to some of the policies that are currently permitted in schools that will allow a greater ability to function. we've also been working with the office of early childhood education and first five to

facilitate the technical assistance and the guidance and to provide support and guidance wherever possible. i will turn this over to our deputy director to provide some more details to answer your question further. >> good afternoon supervisors. i wanted to follow-up and say that we know that there are definitely gaps in the child care centers and working very closely with that community in terms being able to provide testing. we do have some testing resources that we've been connecting child care providers with in order to make sure they have access to testing. the state is also setting up a program to ensure that rapid tests are available for child care providers. i know it's been a very difficult time and we are trying to support the best way we can. there should be more resources in the future. >> supervisor melgar: i'm wondering what we can do to

dedicate those resources. technical assistance is great. because this population has suffered more than the general, because they are so important to the life of our city, i'm wondering what we can do to get them testing, not just hook them up to resources? how to provide p.p.e. when needed. i'm just wondering what the request is and who would make the request? is that something that you guys are coordinating with the children council with? i'm wondering what the plan is and how we can support you if there's more resources that are needed or anything that we can do? >> we have been working with the child care providers as well as the agencies that work with

them. we're also at such a burden to quarantine and to isolate and looking at the state to potentially modify some of their recommendations around this. we do know it has a huge impact on families. may not have -- it might not caw the most bang for the buck to quarantine in these little kids that are not high risk for severe disease. continue to have those ongoing discussions with the state to ensure that child care access is available. >> supervisor melgar: thank you. >> president walton: thank you. supervisor chan, do you mind if i call supervisor preston first? >> supervisor preston: thank you president walton. thank you director colfax and dr. phillips and the whole

d.p.h. team for the presentation and all the time spent with our office. i do really want to thank supervisor chan for calling for this hearing and also supervisor safai for calling for the resolution. i think there was a feeling among most of our offices that things were rapidly changing, evolving and lot of different messages out there. i think it was important to move this forward. i think this hearing is important part of that. i did have a few questions on this. one is regarding the unvaccinated right now. director colfax, if you could expand on what we know about who are the remaining -- not fully

vaccinated i should say in san francisco. we know that the under 5-year-olds are not eligible to be vaccinated. who else are we talking about in terms of any demographic information and -- [ indiscernible ] >> thank you, supervisor preston. i think just to emphasize for the people who are eligible and not having to complete their initial vaccine series at this time. this will take out the 5-year-old and 11-year-old, they are eligible and we're at about 58% of those have completed their series and 70% received at least one shot. that's far higher than the national average. if you're over 12 and up in san francisco, the group that is least likely to be vaccinated on sort of the demographic basis

are the age group between 25 and 34. least likely group by identified race, and ethnicity people who identify white or latino. we continuing our efforts to get every person who hasn't been vaccinated who hasn't received that initial series and up to date on their vaccine and eligible, we are continuing with our community sites, our clinical sites, our healthcare partners tourism out and ensure that everybody has the high touch, repeated touches to have the conversations about how safe, effective and these vaccines are. it's literally conversation by conversation, trusted partner. we realized that for some people, having a conversation

with a clinician is not necessarily the first step to getting people to be vaccinated. we're doing everything we can to get those rates to continue to rise. we also have number of incentives that we can go into detail if you like. also as you know, the vaccine requirements are also some of the mandates are also encouraging on people to get vaccinated as well. that work continues where vaccination teams collaborating across other systems to get every shot possible into as many arms as possible as quickly as possible. we still over 100 vaccine sites. we also have our mobile teams. they are going out to people who are homebound reaching groups of people who may not come to a site. we really have done everything that we can support and everything that the community or

whatever we can with the community to ensure that there's low barrier access and the conversations continue. we are continuing to try to get these rates higher even though they're already higher than the vast majority of other jurisdictions in the country. >> supervisor preston: are there any specific strategies targeting the demographic you mentioned, the 25 to 35-year-olds, it's interesting. i think for a lot of us, certainly in our offices are focused all the way through has been on lot of communities of color and promoting vaccines among seniors and so forth. it's interesting that there's a gap seems like in vaccination in that age group. i'm just wondering what if any strategies there are that target

that younger demographic that you referenced? >> i think for the reasons the fact that the pandemic has disproportionately affected black african-american communities, asian pacific islander communities, and latino community. we are focused on ensuring there's testing access and vaccine and booster access in those communities. it's just so important. i think that's one of the reasons we have this outcome. i want to stress that those inequities in parts of our vaccine systems still exist. for instance, among those 5 to 11 that are only recently eligible, we are seeing disparities by race and ethnicities where black african-americans having lower

rate. with the booster numbers we are seeing booster vaccine inequities. that's where we're focusing. we know what's possible. with those initial series that i talked about earlier, we have to a large extent close that equity gap. we're continuing to work with age group between 25 on 34 years old. i don't want to deemphasize that we continue to really support the equity efforts that are so important. dr. bobba can provide more on the 25 to 34-year-old. >> our efforts here really are focusing on where the 25 and 34-year-old may congregate and where we can meet them. it's med through community

partners that do lot of the outreach engagement to understand what the barriers are. as it becomes available and if they are appropriate, we offer those as well. as dr. colfax mentioned, it's not a one size fits all with everybody in different populations have different concerns and trying to understand each of these populations concerns and provide them the information. that could potentially sway their decision. >> supervisor preston: what percent of san franciscans have gotten omicron? i understand there's documented cases and there are also just projections. not all the cases come through testing facilities. where are we and how does that relate to us moving past the

peak of infection? >> i really appreciate the question. just to give you what we know in terms of diagnosed cases. we are 104,982 cases diagnosed. we know lot of people are asymptomatic and haven't been tested as a result being asymptomatic. some people may have been symptomatic and not tests and they are not counted. some of the rapid test kits results are not necessarily counted if people are buying kits off the shelves. when we talk to our modelers that we've been working with since the beginning of the pandemic, these are estimates. what we -- this could change -- they are telling us that by end

of this year, they estimate between 25 and 40% of san franciscans would have been exposed to covid. that's not -- that's an estimate based on their modeling. we don't have studies to site more specific number. >> supervisor preston: thank you. i will say that in my view and certainly no contact, constituents there was some level of confusion how we were not seeing restrictive measures. we're allowing folks to gather whether it's a warriors game or a bar. lots of folks gathering. some limited restrictions but not a big clamp down and change. i will say for my own evolution on this, it is seeing the

numbers over 100,000 confirmed cases recognizing the shift in strategy here which is not a recognition that everyone will get this. something close to that is probably where we're headed what we're really doing is trying to limit the rate of the spread so we don't overwhelm hospitals as well as trying to do everything we can to protect the unvaccinated and get them vaccinated wherever possible. i don't want to be putting anything out there that's misleading. that helped me understand some of the shifts in how we're approaching this as i think some have characterized, learning to live with it in some sense because it's almost not

impossible to contain in the way we have with prior variants. >> i think the reason that we have been -- this omicron surge really put a tremendous stress test on our city san francisco, city services and the health department. i think the key reason that -- i'm not suggesting there weren't major challenge and there was a need that were not necessarily be able to be met in the peak of the surge. because of our high vaccine rate and booster rate, we are not in a situation like other parts of the country that have lower vaccination rates where there are very high numbers of deaths. they are not able to staff their hospitals adequately. that's happening as we speak. we see deaths going back up to the levels that we saw last year

at the national level. just to emphasize the bulwark of the foundation of being able to move forward in this. what will be new stages of covid is keeping people up to date on their vaccines and keeping them up to date possible. that also protects the young people, the under five who are not eligible for vaccines. >> supervisor preston: one final area that i have a question on, you and i discussed this when you briefed our office. i think especially with such high case numbers. even if the hospitalizations and deaths will be low are going down, hospitalizations are going down and deaths have remained low. i was hoping you can comment on the status of research regarding

long covid. just with so many folks contracting it, now, i do understand there's a new study that's going. i was hoping you could update the board and the public just on the status of research into long covid. >> with regard to long covid, there was some promising results that came out from study last week that strongly indicated that again, being boosted is suggested that it's strongly protective against long covid. i want to emphasize that. our department is collaborating with some key researchers at ucsf who have been funded on a national institute of health study to study the prevalence of

long covid in people who have had covid in san francisco. that research study is commencing and we are collaborating with the lead researchers at ucsf on this. it will help inform our work going forward and luckily because we will be so closely aligned with the researchers, we'll have this information in a very timely manner. >> supervisor preston: thank you very much for that. i will wrap up just with a comment. i do want to thank the team at d.p.h. i want to recognize all of our residents for being the biggest reason we have these numbers. i don't want go into political sizing these things. for san francisco for all the

grief we get, we have very few science deniers in this city, relative to other jurisdictions. i think that shows up in lot of our strong numbers in our public health response. i want to give the credit where it's due, not just to all the professionals, the health professionals working hard on the pandemic but also to all of our residents who have worn their masks and who have gotten vaccinated and boosted and the work continues. thank you very much. >> president walton: thank you. supervisor chan. >> supervisor chan: thank you president walton. dr. colfax, my question is, i look forward to a bit more clarification and guidance when you talked about living with covid. what does that mean and i specifically am asking about just testing protocols and frequency in general. i think that i'm a mom of a third grader that attends public school in san francisco.

right after the holidays, we all tried to get ready to return to school and that's when we start thinking about -- that was weekend like a panic, thinking about, we need to get tested in order for us to return to school safely. i know i wasn't the only parent with that situation. luckily, we have some home testing kits readily available in my home. that's just because, previously i was searching for it. i want to understand testing protocols, testing frequency for different population, are there any difference between kids and seniors unhoused individuals and our essential workers or they pretty much the same. what does living covid means for testing and masking protocol. masking mandate is still not

required for outdoors but indoors, it is required. if you can walk me through like where we're at this moment with testing protocols and masking protocols? >> to reiterate, one of the challenges it's been that the testing recommendations were shifting from the cec to the state shifts at the local level in terms of recommendations. i appreciate the question. you're correct that outdoor masking is not required but indoors masking is required in many settings. dr. susan philip, our health officer, is the expert on the testing protocols and the health order. i'm going to ask her to provide more detailed responses to your

question. >> thank you, supervisor chan. there's a lot of change and there is confusion. we align -- we look to the c.d.c. guidance and then the state takes that guidance and it creates its own guidance which then are local health jurisdiction are required to follow that guidance or at least as strict as that guidance. we have done that in san francisco because of the density in our city. it worked throughout the pandemic. right now for testing, real indication getting a test are more important than what we were originally. [please stand by]

>> and that people who have previously tested positive or a contact to someone who has tested positive and so those are generally the protocols for which testing is recommended at this point. and for the masking protocols, you have it exactly right. right now the state has a general indoor masking requirement statewide and we also have had an ongoing indoor mask requirement, but outdoors, we recommend it in crowded settings, in large crowds where we can't distance from people but it's not an order or requirement or in our health orders to do it in outdoor settings. but that's the general overview of how we are now thinking about testing and about masking. >> supervisor chan: that's good to know and i think another question just to the

clarification point about traveling. right now it is true or it is accurate to say that the cdc is only requiring testing for international travel and i'm just trying to better understand the testing capacity for international travel in san francisco. i think it also has a lot to do with the fact that, you know, san francisco as we head into economic recovery, we definitely see that tourism is really key to that and just wanted to understand how do we as a city, you know, and partnering with sfo truly understand to boost that capacity for testing for travelers. >> thank you, supervisor, for that reminder, i was thinking more of our day-to-day lives. but certainly if we're

traveling outside of san francisco and particularly to an area that may have higher rates of covid, then we would want to consider testing after travel as well after three to five days of returning. the question is really an interesting one. we have talked with our state colleagues and they had done a voluntary system for international travelers to be tested upon arrival and the cdc has also been working to do something similar, but all of those programs have those challenges, it's not mandated, it's voluntary, and they are able to test a small percentage of people who come through. i think for the most part, the federal government requirement for vaccination to enter the country and then our own local

requirements for vaccination to go to large events or go into restaurants and those types of settings are probably, you know, what is more effective in trying to keep our case rates down, but i agree testing has a role and we'll continue to see what our state and federal colleagues find from their work at sfo and what they end up recommending. >> supervisor chan: thank you. i think i will have followup not today, but separately specifically about travel capacity or just the testing around travelers for sfo on a separate day. this question is the last question that i have. the first time i got stumbled when i was asked this question actually by a school parent, a constituent in the richmond, i didn't realize because i

thought i would justice dispose it. how do you dispose a home testing kit? is there a specific way to dispose it or is it just dump it in the trash? i just want to confront that? >> is it fine if i answer this, dr. colfax? >> please, dr. phillips. >> for the people taking it at home, these are waived tests meaning they are created specifically to be safe to be disposed in regular trash and does not require a special bio hazard bag or disposal. it's a different story when we talk about the rapid tests in a medical setting and those are disposed the way we do in a medical setting and it poses no harm to anyone in the household or anyone collecting the trash and doing that type of work.

>> supervisor chan: thank you. i have no more questions. thank you, president walton. >> president walton: thank you, supervisor chan. supervisor peskin. >> supervisor peskin: thank you, president walton. and i sincerely want to thank dr. colfax and our chief health officer and dr. baba and all of the staff at the department of public health. i have been particularly focused in a very dense area of the city where there's a lot of congregate settings of shared bathrooms and shared kitchens namely s.r.o.s and i know others of you have and thank you for your support over the last two years and i know that d.p.h. as well has taken that very seriously and last week when my staff and i met with dr. baba and we were talking about the omicron surge, the good news of course is that you

are much less likely to die and much less likely to get it if you are twice or thrice vaxed and have the entire series, but given that it is extremely more transmissive, if you end up with a much higher transmission rate, you end up with the same number of people in the hospital and in acute care as you did when there was a much more veer hasn't virus and less vaccinated population relative to the number of people who were showing up in acute care and in i.c.u. and the reason i bring that up is because as we seem to be turning another page and that's the page we're coming in terms to live with the virus. i am hearing a lot from s.r.o.

residents which is an extremely transmissive environment and there's no way without those resources that the virus doesn't run ram ped in these facilities and ibeen hearing that a lot from constituents and i mean and the cases are really emotionally very charged and at the same time, we are providing beds for our unhoused population which is a good thing, but it's a great thing, but it begs the question about why we are not deploying those resources anymore in that particularly vulnerable environment. and i know that resources are

you know is a constantly changing landscape as well as to what we get from the feds and whatever, but i wanted to respectfully pose that to dr. colfax and his team. >> thank you, supervisor. and i just wanted to emphasize that as we go into a stage where as we come down through this surge and that we hopefully will reach a state where there's a lower prevalence of covid and we mitigate the fact where we have a deep commitment of caring for those most vulnerable to covid including in the s.r.o.s and i know that you've talked to dr. baba about this and i'd like to she had in regard to us going forward.

>> yeah. thank you for that and thank you for the question, supervisor peskin. i fully agree this is a critical population to think about the barriers and the needs and we will continue to work with the task force to understand those needs and provide, you know, the adequate prevention and interventions that we can. in terms of the i.m.q., i do really want to clarify, our i.m.q. is meant for cases that are having moderate disease, but may not need hospitalization or if the hospital needs a place to discharge somebody that can't go home, we are not necessarily providing it to anybody that is unhoused or sheltered because what we've seen is many of those people are asymptomatic or have mild cases. for s.r.o.s if there is a situation where somebody is positive and they're around somebody that's very vulnerable, for example, very advanced age and they're worried about it transmitting to that person, that could

qualify for an i.n.q.. so definitely there is, are you know, casebility there and we can talk more about if those resources are not reaching the right people how to better assist. >> supervisor peskin: maybe we can take it offline with some of the community folks and see what we can do, but i really feel like we've kind of moved our resources out and maybe at the wrong time. anyway. let's continue this conversation. i am worried and with i think good reason. >> absolutely. >> president walton: thank you, supervisor peskin. supervisor safai. >> supervisor safai: thank you. thank you, supervisor peskin, for highlighting that. i think we all might of seen

the story published in the sf standard that highlighted some of the incidents that are happening now for s.r.o. residents. so just to build on that last point, isolation and quarantine hotels were an important part of how we helped and dealt with covid and moved people away from their homes when they needed to quarantine. particularly in districts in the city and neighborhoods in the city with overcrowded living conditions. so my question to dph is will you still be allotting beds for people residing in overcrowded conditions particularly like those living in sro housing and other forms of overcrowded housing and how do you plan to deal with that dr. colfax and/or anyone on your team? >> yeah.

and just to emphasize, i think the omicron variant is going to be around for the foreseeable future and the most important interventions we need to do is to ensure that everything in crowded conditions is up to date on their vaccinations and as dr. baba just emphasized is that people themselves are at high risk, or are exposed, if they are at high risk and exposed or if and vulnerable to the worst outcomes from covid that we will do everything we can to make beds available. i think during this latest surge, one of the key factors was we need today make sure there was hospital capacity across the city and many of those isolation beds were being used for people we really didn't, we couldn't have stay

in the hospital. they didn't need to be in the hospital from a medical perspective because there were other people who were very ill who needed ton careded for and could be discharged to a place where they were safe and secure in the isolation bed. so going forward, we are committed to doing as much as we can to ensure people who are most vulnerable due to bad outcomes are able to access some level of the isolation in a new era and i think people who get covid will not have a poor outcome. we certainly want everybody to here we're committed to caring

for those who need to care the most and focusing on the people who are really truly still at high risk of the worst outcomes with covid including those who may be boosted and, of course, those who for some reason may not have received vaccines. and, dr. baba, i don't know if you have more to add to that. >> no. i would agree with that. i do think, you know, again, if people have factors even if they're immunized and boosters, but have factors and put them at high risk, we definitely want to prioritize that population. >> supervisor safai: thanks. so my next question is one of the things that we've heard and some of my colleagues have already mentioned and i know that you and i spoke about this last night, dr. colfax, the requests that we're getting for simple things like testing, access to testing, access to

masks or properly fitted masks particularly for children throughout this covid crisis in our city is one of the reasons why we adjusted as a covid coordinated team. can you talk about that coordination and how it will play out. i understand and i think we all see the numbers that you presented that the surge is coming down but there's still going to be impacts felt in many communities over the coming months, particularly children that can't be vaccinated and families that don't have access to testing and so can you talk about how you see that play out and how a coordination between multiple departments can be helpful in responding to this crisis right now? >> absolutely. and first of all within the covid task force at the health department, we have a number of

people who are working on various teams to ensure that people have that were responding to community requests particularly and especially in the communities again where covid has had the biggest impact and the greatest health inequities. so we have our community teams that work closely with our community health that are led by as you know community based organizations. we have our neighborhood teams, we have our health equity teams to make sure we're doing everything we can to meet the needs. whether it's a pop-up clinic for testing or boosters or distribution of ppe. we work very closely with the department of child, youth, and

families, with regard to working with their stakeholders and providing technical assistance and also engaging around vaccines and testing as well. the department of emergency management which as you know led the response early on through the covid command center. we worked very closely with them and since our rapid tests that had been arriving, we have been working with them to distribute the tests to other city departments so that the city can keep functioning and across the variety of other city departments as well with our colleagues that the department of homelessness and supportive housing and h.s.a., the human services agency. so there's a whole level of coordination that's still going on both within our -- the communities that we have focused on as well as within the city and then i would say we also work with our other health care system partners to a great degree, you know, ucsf

and the health department have a special relationship. it's been going on for decades and that work has continued both with regard to ensuring we're using the best science and data to drive our decisions and of course, our staffing, the physician side at san francisco general hospital and with our other health care systems, we work with them including through the hospital council so that we're ensuring that everybody is doing their part and offering testing and ppe and other support to the people who pay for their coverage. i think you know that the vast majority of people in san francisco have health care coverage and we think it's encumbent upon people to get their money's worth in regard to addressing this pandemic. so we have been collaborating with the other health care systems with regard to, of course, the vaccines,testing, and ppe. i think we've already gone over some of those challenges, but

we are seeing progress to varying degrees verdict other large health care systems in the city. >> supervisor safai: so just to go back to the quarantine and isolation hotels because i don't think i got a straight answer on that just so i can understand it. if people need access to that and they need to isolate, do folks in overcrowded living situations i guess s.r.o.s and other housing in the city, do they have access to that type of housing? are you still making that available? >> dr. baba. >> yeah. so there is a specific line that people can call and talk about their situation and, again, if they qualify because there's a vulnerable person in their household that potentially could have a severe consequence from getting covid that they do qualify. so all of those are taken into

our team and then are reviewed in terms of qualifying at this point in time. >> supervisor safai: through the chair and dr. baba, i guess i'm talking about the in s.r.o. housing and having shared spaces either kitchen or bathrooms, if someone contracts covid and there might be other vulnerable people living in that building, in some situations like was referenced in the article, they then are asked not to use the bathroom or the kitchen and then the people that are sharing their room ended up with covid, they might not have a vulnerable person in their immediate room, but there are other vulnerable people living in there and to go back to supervisor peskin's point i think for those living in overcrowded housing, i think

we might of transitioned away too quickly the support. i'm aware of the rules that you set if you have someone in your house hold that's vulnerable then you become a priority, but all the other priorities that people fall into that may not have an immediate family member disqualifies them or doesn't qualify them. so can you talk about that for those living in overcrowded housing because that's playing out on the ground still. we're still seeing and hearing those problems. >> yeah. i do think, we can definitely talk more about this with s.r.o. task force and the providers on the ground and what they're seeing. in general, as dr. colfax mentioned, with omicron what we're seeing is if you're vaccinated and boosted, it tends to be a milder illness. it goes through the population very quickly and with our resources that we had, really

making sure that intervention prevents the most severe consequences with covid but as you point out, there might be wholistic factors that we might consider and we're definitely open to hearing that feedback. >> supervisor safai: yes. i think that overcrowded housing is another one we need to take a look at. it does happen quickly but it does impact peoples' earning ability and their ability to go to school and work and that has consequences based on the isolation and quarantine rules they have to follow from their work place and their school environment. so i want to overemphasize that and so we can talk more about it off line so i just wanted to underscore that here today. my last question is about d.p.h. has talked about scaling up additional testing capacity and bringing on another vendor

to support color. can you talk a little bit about that, dr. colfax, and who that vendor is. >> i can certainly say that i think with the challenges that we had with color, we are looking at other vendors and, supervisor, i just want to respect the city policies and i don't know rules. i'm not sure i am able to name the vendors that we're talking to. >> supervisor safai: it's not finalized yet. >> no. but we are d. looking to expand the number of vendors in the city that are offering testing and, again, i know that we've said this before, but we also are working to ensure that the health care systems have greater capacity as well and then as you know with the rapid test kits coming in through multiple channels now, we are optimistic that for what we

know now that there will be adequate testing in the city of course, if we get a major surge it will still be a challenge, but i think as we've reiterated, it had been better and better prepared for research that has come before us. i'm hoping we will be more prepared for the next one if and when it does come. >> supervisor safai: so how many tests were we initially doing and what does our initial capacity. in terms of testing kits in preparation if there were additional services in the future, do you have any plans to have additional testing kits available as things move forward? >> again, i would go back to with regard to the amount of testing that we were at the in the late fall, we were doing about 3,500 tests a day across

the entire city across all of our sites and at the peak of the surge, we reached 14, 500 a day and our sites were functioning at 500% to 900% capacity. we were taking as many people as possible and the staff were just heroic on their ability. 500% extension beyond what was planned for in terms of the d.p.h. contribution to those tests, we have been doing about 4,000 to 4,500 test its a day across our city sites and with other systems coming into place and requiring of the other health care providers, we are working to maintain that level of capacity and, again, with these rapid tests coming in and the major health care systems

in the city being held to the health order and penalties, there will be other capacities that is happening. of the large systems in the city. 60% of the testing was being done by then and dph was doing 60% of that. and i think entering our third year in the pandemic, we have to distribute that burden. it has major implications in terms of cost. and there's a shared responsibility for people who pay their health care provider that they get the care they need from that provider and d.p.h. will be there for people who don't have other options and make testing as convenient as possible for those populations and the people that we serve in our large clinical system as well. >> supervisor safai: and then, my last piece of that question was about the kits? do we have any plans about the testing stock piles or to prepare for any future surges?

>> yeah. i think we would want to have more rapid tests ready to go if and when there's another surge occurring. we would have been -- had those if there was a supply chain. so i think we would have some level of an ability to have test kits one thing is these test kits expire. so having a very large number of those if a surge does occur and obviously there may be some waste in the system. so we're working to balance that. i think hopefully everybody on this call has ordered their test kits from the federal government and we're waiting whether the federal government or state are able to strengthen those supply chains, i mean, it did feel like march of 2020 with regard of not being able to get the raw materials that we needed and i think we also are hopeful with our testing

providers and we're doing this in contract negotiations making it clear they need to have a better turn around time and demonstrate that and if they're not able to, there will be potential penalties in terms of providing reimbursement for their services if the testing turn around is so far out. and then, again, with our other health care providers ensuring and i know that some of us experience this, our health care provider, you try to make a test for -- an appointment for getting tested for covid and at one point, for some of us that was eight, nine, ten days out and really ensuring that they follow the health order to the degree to make sure that testing is accessible and we have to have an elastic system that responds and i don't think we can prepare for every possible scenario but i also think we'd be better prepared for what are more

likely scenarios going forward, i mean, my crystal ball is out of batteries and into this third year, it's hard to predict beyond what we know right now. >> supervisor safai: thank you, dr. colfax, and i think you and your team as i've said all along along with the people on the front lines have done a tremendous job. and we're all feeling fatigued and overwhelmed but we want to end on a note as soon as possible. i would just say my last closing comment is many of our community based organizations when other child care providers when we were doing at the height of this, we were distributing hand sanitizer. we were distributing as many

things to support their work on the front lines as possible and we've gotten and as you can imagine over the last month and a half, two months, a resurgence of requests for that type of like to respond to as we've done in the past, we were really good at providing that support on the ground and that's somewhat why i asked to have that have that covid coordination team we scaled back so quickly and it scaled up so quickly and the surge happened so quickly that some of the types of organizations and community based folks that need us and rely on it came back again asking for that

support. what are the strategies as we move past this phase to support our community based organizations with p.p. and testing support like our early childhood care providers? >> yes, i really appreciate the question, supervisor safai. and just to reiterate our support for addressing the needs of our organizations that continue to serve the most vulnerable and as you know, in your district and other districts we have the community hubs that are working very hard to ensure as many of those needs can be met as possible. i think the other thing supervisor, during this surge different from the last surges is not only do we need to redeploy people who had been in the emergency state for two years we've had very large numbers of that was particularly a challenge in being able to staff some of these basic issues that you're

bringing up and being able to have people available to help these struggling organizations. we literally had hundreds of staff out across the department and certainly across the other city departments as well. so i think we're over the most challenging in that regard and, again, our supply chains of the tests are strengthened. the ppe is coming in and we're able to supply those tests and the masks to our most vulnerable and i think we need to strengthen the coordination with our other departments to make sure if they have a point of contact or the correct point of contact in the other departments or other points in the city like the c.b.o.s to make sure they get the supplies they need. >> thank you, dr. colfax. thank you, mr. president.

>> president walton: thank you, supervisor safai. supervisor mar. >> supervisor mar: thank you, president walton. first, i want to thank d. colfax and baba for engaging in this discussion. colleagues, you've all asked i guess my first question is more around evaluating our city's preparedness for this latest omicron surge and, you know, unfortunately for me personally, i kind of experienced a lot of what you just described in your beginning presentation and what played out over the last month here in san francisco. two thirds of my household got sick that first week in january which was the peak. it coincided with the return to school and there's just a lot

of confusion and anxiety that and really most of this last month confusion around what the new protocols were on isolation and quarantine not being able to access testing and, yeah, so, you know, fortunately, for our family, we also like most people recovered really quickly and it was mild, but i guess it seemed like service just a chaotic situation when the omicron hit and there was a lot of scrambling and anxiety and it seemed like we had dismantled a lot of the covid response infrastructure that we had built up for the first year

or two, that was really so effective. almost like eye fine tuned machine and it really allowed san francisco to become a leader in the country in responding, but then when omicron hit. we were prepared to ask the question how would you assess our preparedness for this latest surge and is there anything, you know, out of our experience looking ahead that we could do in case there's another surge coming? >> thank you, supervisor. and i would go to the outcomes that we've had and i agree this was a tremendous stress test on the city and we have really minimized i think the worst outcomes in terms of the deaths

and that is because of the hard work that our team and many of you supported with regard to vaccines and boosters into arms, you know, i think that we were better prepared then almost in any other jurisdiction in the country as far as i'm concerned because of the fact we had such a strong coverage. these vaccines in boosters were the foundation and if you -- i reviewed in the data we are doing much better with regard to those outcomes and also our hospitals continue to take care of people who had other health care needs and that was different from 2020 where we were basically asking people to stay out of the hospital so i think those have no consequences with people dealing with care. i think for the most part able

to stay open. there was a lot of information that was developing. i think we were all under the shared education of what we knew and didn't know about omicron and that was changing rapidly depending on what the science showeded us. testing was a challenge, but i would also emphasize we did more testing during the omicron surge than we averaged in the last two years so just on the fact that we still weren't able to meet all the needs, i would respect that and i would go back to the fact we need our other providers to step up as well and the fact that the raw materials are simply not as available. so i would certainly hope we'd have more test kits available and other health care systems

are able to do their parts so we can there was so much traveling. communications were particularly difficult over the holiday season and just in terms of our public messaging, i was particularly challenged in a time where a lot of people just need it and were given a break and i certainly understand that as well. >> supervisor mar: yeah. thank you. thanks for that. and um, yeah, i'm just well, and then so yeah, thanks, dr. colfax. i guess my other question is looking ahead. i understand the new approach now given the understanding of where we're at with the

pandemic is to focus not so much on preventing every case which is what the approach was earlier on in the pandemic to reduce hospital stations and i.c.u. i have a question if that applies to seniors and other vulnerable populations and whether for them given the fact if they do contract the virus that they're more likely to require hospitalization and have serious health effects whether it's the same approach for them or whether there's some additional protocols and protective measures we have for even yours and vulnerable populations in this new phase. >> i appreciate that, are supervisor, and, again, if somebody is 65 and above, it's key that people get those boosters again to the cdc data

that came up last week. so that's just huge and and i think we at the health department as you know the largest health facility in the country we are continuing to layer those defenses and there will be a continued effort to layer those efforts probably to a larger degree than what will be in the public. in term of masking protocols and we will align with the state that requires people to be up to date on vaccinations. even with those vulnerable populations how we can go back to a less disruptive state when we're not in the middle of the most disruptive surges and i'm optimistic we will be able to do that, but it is so key that the most vulnerable in these

congregate residential settings have access to the vaccines and boosters which is why we do everything we can. we've had mobile teams go out. we've had lots of events to ensure we've had such a high coverage rate among 65 and over and we really do, i'm proud of that, but we need to continue to make sure that everybody in that age group is up to date on their vaccine series. >> supervisor mar: thank you, dr. colfax. and thank you supervisor chan. and thanks, president walton. >> president walton: thank you, supervisor mar. i'm sorry. i don't see anyone else in the roll and i know we have interpreters that are leaving. so if we could go to public comment, madam clerk on this item specifically. >> clerk: yes, the board of supervisors will now hear board of testimony on the city's response to address the omicron

surge. the telephone number is streaming on your screen. using a touch phone dial 1 (415) 655-0001. when you hear the prompt, enter the meeting id, 246884621722. you'll hear the discussion, but your line will be muted and once you're ready to get into the queue to provide it testimony, press star three. when it is your turn, listen carefully for the prompt that you have been unmuted and you may begin your comments. we appreciate as the president stated for the interpreters being with us. operations, let's hear from our first caller. we have eight who are listening and three in the queue. welcome, caller. >> caller: hi, thank you. i want to very briefly thank the honorable supervisors and

all the health professionals for keeping san francisco safe and listening to the science unlike other jurisdictions like idaho and sadly kasichet county washington where the meeting was canceled today. endanger in serious thoughtful discussion in how to defeat covid-19 like the brave souls you are. but i die aggress. i just wanted to call and give you moral support and as always praise supervisor stefani for standing up to crime. thank you for all you're doing, god bless you and be safe. >> clerk: thank you for your comments. mr. atkins, let's hear from our next caller, please. >> caller: good evening board of supervisors, madam clerk,

president walton. this is gilbert chriswall of district 8. i want to thank supervisor chan for having this hearing and supervisor preston for his questions and president walton for his concerns of covid. i know the city attorney is prosecutoring or suing these fake testing sites, but i mean there was a fake testing site yesterday in the castro. and over the weekend there was a fake testing site over in delores park. what is going on? what harm is this causing to the community. i don't even know if i want to

go get tested whether it's going to be a real site or a fake site. please address those concerns. thank you. >> clerk: mr. atkins, let's hear from our next caller, please. >> caller: good evening supervisors. my name is paul. i wanted to call tonight to emphasize that i agree with the by in large public health guidance from our city. but a specific piece needs more clarity and needs more specificity. as we've seen emphasized tonight. congregate settings are not safe and this new plague proves that our mass incarceration system is fundamentally unscathed. when we examine the public

health guidance from our city we see on april 24th of last year recommended to chasa boudine's office recommends that he should not hold more than 99 people. around why it was made. but the honest answer is that it was in response to medical guidance. as the majority of the epicenters of this plague in our country have been behind bars. so seeing these continued process and seeing this continued guidance, last year, on october 14th, dr. so i have to ask tonight as associated

with omicron and how many more prisons should we let go and how do we deal with a campaign surrounding these essential releases for our public health. they've been nationwide with even william barr from the ex-d.o.j.. we've had jerry nadler. >> clerk: thank you for your comments. mr. atkins, do we have another caller in the queue please. >> caller: hi, my name is jessica lamen and i'm with senior and disability action. i appreciate all the comments and questions of support tonight. my biggest concern and we in san francisco and across the country have been deeply concerned about how often we've been ignored and many of us

have really isolated ourselves and are so isolated and so people talk about kind of going back to normal. what does that mean for those who are at risk and recently the head of the cdc said it was quote unquote encouraging that people are dying of omicron with multiple health conditions. that was not okay. she apologized for that. but we can't assume that omicron is mild and we don't need to worry. there are also people who are immuno compromised so there's a number of questions that i hope we can talk about. what are the plans for people in skilled nursing facilities and other care facilities. what are we doing about unhoused facilities. what about sick leave for people at risk of severe covid or have a high-risk person in their household. what about people who can't find or afford home test kits. people who can't afford to stay

home from work. people who live in a household with more than four people because of all the u.s. government is sending to folks. what do we understand about long covid. i urge us not to be woven to a false sense of security, but to be very real about what we can do and who we are sacrificing. thank you. >> clerk: thank you for your comments. we understand there are seven individuals who are listening. if you would like to speak this evening, you should press star now. mr. atkins, can we hear from our next caller, please. >> madam clerk, there are no further callers in the queue. >> clerk: thank you, mr. atkins. mr. president. >> president walton: thank you. seeing no other speakers, public comment is now closed. colleagues, any other comments, supervisor chan, what is your wish? my apologies. supervisor preston. >> supervisor preston: thank you, president walton. i just wanted to ask on just

following up on some of the public comment iffed the department of public health had any guidance, i believe it was mr. chriswell raised the questions about feeling the lack of confidence at the testing sites because of some of the fake testing sites out there. so if there's any update or any information on what to look for in deciding whether to trust a testing site, i think that's an important thing to address. >> president walton: thank you, dr. colfax. >> i'm pleased to say we do have an update and our health officer, dr. susan phillips has been addressing this issue. >> thank you, dr. colfax and thank you, supervisor preston. yes. there are two ways in which we are approaching this. we do feel this is a really important issue. we want the public to be able to trust the test sites that are in place in san francisco

and we don't want unscrupulous and rogue site collections setting up so the city attorney's office as you all have seen is following up as well and looking into and pursuing action against some of these rogue collection sites. additionally today, we have released a health order that requires a certain standard for these collection sites that are operating in san francisco. right now there are gaps and statewide requirements and it sets the standards by which they should have for people who potentially use the site as well as the city to make sure that everything is being followed. there will be requirements for this site. there will be informed consent

requirements for people getting the testing and they'll have to have all the information for the lab that they're working with which has to have a documentation including license over the laboratory. that is being issued as of today. we'll put in an additional layer of protection and we will be looking into any sites that are reported to potentially being not legit mate sites serving the public in san francisco. >> supervisor preston: thank you. and just one other question that i think was elevated in public comment, but i was hoping that someone from d.p.h. could address which was specifically the plans for people with disabilities. i think it really was unfortunate to be charitable the way this was framed and i do appreciate the apology at

the national level. obviously that's not the message that should be sent or how our policy should be structured for people with disabilities. i just want to give d.p.h. an opportunity to send whatever the san francisco message is in how we're addressing the particular risks for the community in san francisco. >> yes, supervisor preston, i can answer that. we have continued to work with the mayor's disability office. not every population is going to have the same needs as we go into this next phase and really again talking about the most vulnerable populations of this disease may require added layers such as ongoing masking

can and really thinking through the benefits as people act with the society and so i'm really looking forward to having those conversations with the disabilities advocates to try to chart a path for it. >> supervisor preston: thank you, mr. president. >> president walton: thank you, supervisor preston. supervisor chan. >> supervisor chan: thank you, president walton. and thank you colleagues for your engaging conversation with the department of public work i mean public health and to make sure that we get our questions answered and really just for our constituents too and for this information that's much needed. i would suggest that we file this hearing today and so i hope to have your support because i think that we should really continue to, one, continue to track the reports that we get weekly from the department of public health and

thank you, president walton and his office for helping to provide that information and in the event that we feel like we see another surge which i hope not then we can come back and have another hearing. at this time, i urge for your support to file this. >> president walton: thank you so much. this hearing is now filed. thank you, dr. colfax, dr. baba and dr. phillips. madam clerk, do we have any imperative items. >> clerk: i have none to report, mr. president. >> president walton: thank you, and is there any other business for us today? >> clerk: the in memoriams today's meeting will be adjourned on behalf of supervisor mar for the late

mr. ronald kadero and mr. glenn foster. >> president walton: thank you, madam clerk, is there any other business for today. >> clerk: that concludes our business for today. >> president walton: blaming has no positive effect at all nor does trying to persuade reason and argument. that is my experience. no blame, no reasoning, no argument, just understanding. if you understand and you show that you understand, you can love in the situation will change. thick not hand. this meeting is adjourned. .

>> shop and dine the 49 challenges residents to do

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will. >> good morning. welcome to the january 20th 2022 meeting of if board of supervisors. i am chair of the committee joined by vice chair director co n nie and soon to be joined by supervisor mandelman. the committee clerk is john carroll. thanks to sfgovtv for staffing this meeting. we also have supervisor ronan with us for item 1. >> we are participating through video conference to the same extent as if