WEBVTT Kind: captions Language: en 00:00:02.096 --> 00:00:06.414 So with that, I'll turn it over to Matthew Hymel, our county 00:00:06.414 --> 00:00:08.534 administrator for his report and for the COVID 00:00:08.534 --> 00:00:12.475 report. >>MATTHEW H. HYMEL: Good 00:00:12.475 --> 00:00:15.913 morning, Supervisors. We'll start with Dr. Willis 00:00:15.913 --> 00:00:19.912 giving the COVID-19 update and I have a couple of housekeeping 00:00:19.912 --> 00:00:22.536 items after that. >>DR. WILLIS: Good morning, 00:00:22.536 --> 00:00:25.787 Supervisors, glad to be here with you. 00:00:25.787 --> 00:00:27.910 We have a lot of ground to cover with regard to our COVID-19 00:00:27.910 --> 00:00:29.848 response. I'll start right in with our 00:00:29.848 --> 00:00:33.412 numbers. Next slide, please. 00:00:33.412 --> 00:00:36.161 So this is our numbers from the beginning of the pandemic in 00:00:36.161 --> 00:00:39.660 Marin. We've had about 5,000 cases with 00:00:39.660 --> 00:00:43.036 about 1,000 deaths, which is a 2% mortality rate 00:00:43.036 --> 00:00:47.099 across-the-board. Next, please? 00:00:47.099 --> 00:00:50.223 This is our hospitalizations and ICU 00:00:50.223 --> 00:00:53.225 visits in Marin. You can see there an increase. 00:00:53.225 --> 00:00:58.411 We had about five people in the hospital for the majority of the 00:00:58.411 --> 00:01:02.410 month of October and there was a spike up to 13 in the 00:01:02.410 --> 00:01:04.910 hospital last week down to 9 now and 00:01:04.910 --> 00:01:08.412 we'll talk more about what's contributing to that. 00:01:08.412 --> 00:01:11.223 Next, please? This is our epidemic curve, the 00:01:11.223 --> 00:01:15.284 number of new cases per day in Marin. 00:01:15.284 --> 00:01:17.599 You see there July our most significant surge occurred 00:01:17.599 --> 00:01:21.725 in early to mid July and then we've 00:01:21.725 --> 00:01:25.660 seen relatively progressive guidelines since then with the 00:01:25.660 --> 00:01:29.661 exception of just in the past week or two weeks there on the 00:01:29.661 --> 00:01:33.785 far right the beginning of increase in cases 00:01:33.785 --> 00:01:36.409 , which is part of a state and 00:01:36.409 --> 00:01:40.659 national resurgence of COVID-19 that 00:01:40.659 --> 00:01:43.160 we'll focus on. Next, please? 00:01:45.348 --> 00:01:48.787 in Marin to this one, this is the state of California. 00:01:48.787 --> 00:01:52.224 And you can see that there has been a dramatic increase in 00:01:52.224 --> 00:01:56.225 cases across the state since the beginning of November. 00:01:56.225 --> 00:01:59.285 Next, please? And this just offers 00:01:59.285 --> 00:02:01.473 a visual so that you can compare the 00:02:01.473 --> 00:02:04.973 California rates versus Marin County rates. 00:02:04.973 --> 00:02:09.222 And you can see that while we share that spike in July, we 00:02:09.222 --> 00:02:11.284 have not been experiencing quite as much of the surge that 00:02:13.097 --> 00:02:16.099 experienced since early November, but we 00:02:16.099 --> 00:02:20.163 are seeing a milder version of that same acceleration. 00:02:20.163 --> 00:02:21.723 Next, please? And then stepping back even 00:02:25.972 --> 00:02:26.784 what we see is that that July peak was much lower than the 00:02:30.786 --> 00:02:32.909 In fact, we're really seeing a rapid increase and a surge 00:02:32.909 --> 00:02:35.536 in cases in the United States that 00:02:35.536 --> 00:02:39.171 is unprecedented thus far in the pandemic. 00:02:39.171 --> 00:02:42.162 Next, please? And this is another way of 00:02:42.162 --> 00:02:45.724 describing that. The shows the number of cases in 00:02:45.724 --> 00:02:49.286 different states. And despite the fact that we are 00:02:49.286 --> 00:02:53.473 seeing surges in California, there on the far left you can 00:02:53.473 --> 00:02:56.223 see that we're actually in that second lowest tier of cases 00:02:56.223 --> 00:02:59.914 compared to other parts, especially the upper Midwest 00:02:59.914 --> 00:03:02.973 that are having case rates that are ten times or more the rates 00:03:02.973 --> 00:03:05.412 that we're experiencing in California. 00:03:05.412 --> 00:03:08.909 What's important about this is that in the previous surge that 00:03:08.909 --> 00:03:11.347 happened in July, it was geographically separated. 00:03:11.347 --> 00:03:13.285 There was areas of New York, there was California, there was 00:03:13.285 --> 00:03:15.473 the southeast where we were seeing surges. 00:03:15.473 --> 00:03:18.849 But other areas were relatively spared. 00:03:18.849 --> 00:03:22.348 Currently now the entire nation is seeing surges in cases, which 00:03:22.348 --> 00:03:26.409 makes it more difficult to move resources from one part of the 00:03:26.409 --> 00:03:28.223 country to another, especially with regards to medical staff 00:03:28.223 --> 00:03:31.287 when we're seeing surges in hospitals. 00:03:31.287 --> 00:03:33.099 Next, please? And then again stepping even 00:03:33.099 --> 00:03:37.097 further back, this is the global picture. 00:03:37.097 --> 00:03:41.787 And unfortunately we're seeing similar surges in cases in other 00:03:41.787 --> 00:03:45.724 parts of the world especially northern hemisphere Europe is 00:03:45.724 --> 00:03:48.786 seeing similar increases in cases with similar restrictions 00:03:48.786 --> 00:03:52.786 and lockdowns that are happening in most European countries. 00:03:52.786 --> 00:03:54.787 Next, please? This was the 00:03:54.787 --> 00:03:57.721 slide from the governor's announcement 00:03:57.721 --> 00:04:00.349 yesterday. He held a press conference that 00:04:00.349 --> 00:04:03.850 really sounded the alarm that it's time to put on what he 00:04:03.850 --> 00:04:07.975 referred to as the emergency brake on our blueprint for a 00:04:07.975 --> 00:04:11.848 safer reopening and highlighted that the rate of 00:04:11.848 --> 00:04:15.974 increase that we saw in our first surge in that later June 00:04:15.974 --> 00:04:19.847 into July period was less than the current rate of increase 00:04:19.847 --> 00:04:24.285 across the state now. We saw 51 percent increase in 00:04:24.285 --> 00:04:25.537 cases just in that first week of November across the state. 00:04:29.536 --> 00:04:32.662 from an epidemiologic stand point is that the slope 00:04:32.662 --> 00:04:35.160 of that curve often predicts the height 00:04:35.160 --> 00:04:38.099 of the peak. So when we see a very steep 00:04:38.099 --> 00:04:41.097 slope in increase in cases, the concern is that that next, that 00:04:41.097 --> 00:04:44.349 second wave that we might see might, unless we do something 00:04:44.349 --> 00:04:46.912 now and do something aggressive, might lead to a much higher 00:04:46.912 --> 00:04:50.973 overall peak with a greater number of overall cases. 00:04:50.973 --> 00:04:54.722 Next, please? So 00:04:54.722 --> 00:04:58.098 the governor announced -- and this, again sfrom his current 00:04:58.098 --> 00:05:01.286 press conference yesterday, that he's putting on the emergency 00:05:01.286 --> 00:05:03.597 brake for the state. If we go back, this is the 00:05:03.597 --> 00:05:06.723 update I offered you on the left side. 00:05:06.723 --> 00:05:10.410 This was our status last week and this corresponds to the 00:05:10.410 --> 00:05:13.973 slides we shared last week. There were at that time 13 00:05:13.973 --> 00:05:16.473 counties in purple, 22 in read, 17 in orange. 00:05:16.473 --> 00:05:19.912 We were one of those orange counties. 00:05:19.912 --> 00:05:22.975 Now moving to the right, 4 # counties have been moved into 00:05:22.975 --> 00:05:25.722 purple. And many counties actually 00:05:25.722 --> 00:05:28.534 accelerate from orange strit straight through the purple to 00:05:28.534 --> 00:05:32.474 the red tier. Now 95 percent of the residents 00:05:32.474 --> 00:05:36.849 of the state of California are in a county that is in a purple 00:05:36.849 --> 00:05:40.787 tier because it includes all of those southern counties that 00:05:40.787 --> 00:05:43.847 have the highest populations, Los Angeles County, 10 million 00:05:43.847 --> 00:05:48.100 residents, for example, and the majority of Bay Area counties, 00:05:48.100 --> 00:05:50.911 as well with the exception of Marin, San Francisco, and 00:05:50.911 --> 00:05:54.349 San Mateo currently are in red, all 00:05:54.349 --> 00:05:57.287 those those other two Bay Area counties have case rates that 00:05:57.287 --> 00:06:01.347 are much closer to purple than those in Marin. 00:06:01.347 --> 00:06:03.850 Next, please? So this 00:06:03.850 --> 00:06:07.599 on the left shows our case rates now. 00:06:07.599 --> 00:06:11.035 We have 6.2 new cases per 100,000 residents which adjusts 00:06:11.035 --> 00:06:13.288 because we have high testing rates adjusts down to 4.3 which 00:06:13.288 --> 00:06:17.349 brings us just into the that red tier. 00:06:17.349 --> 00:06:21.412 We almost actually squeaked into the orange tier again this week. 00:06:21.412 --> 00:06:22.848 But we are unfortunately seeing rapid increases in cases, also. 00:06:26.848 --> 00:06:30.034 rate is largely unchanged at about 1.5 percent overall and 00:06:32.909 --> 00:06:35.411 equity quartile, that's our lowest income communities. 00:06:35.411 --> 00:06:38.721 This is something that we would expect to change soon because 00:06:38.721 --> 00:06:42.161 it's changing across the state and across the region. 00:06:42.161 --> 00:06:45.349 But I think we can rest assured that there is something that we 00:06:45.349 --> 00:06:49.534 are doing right because we are not experiencing the same 00:06:49.534 --> 00:06:52.600 velocity of surge an as we are seeing around us. 00:06:52.600 --> 00:06:56.912 We do not want to be falsely reassured that we would remain 00:06:56.912 --> 00:06:57.722 an island and that's what we'll talk about some of the more 00:07:00.285 --> 00:07:04.286 taken from a polity standpoint shortly. 00:07:04.286 --> 00:07:07.350 On the right there you see metric 16. 00:07:07.350 --> 00:07:10.347 5 new cases Fernando Romero 100 thousands residents 00:07:10.347 --> 00:07:14.351 per day which is more than we're selling in Marin with a 5.2 00:07:14.351 --> 00:07:16.912 positive at this rate statewide. Next please? 00:07:16.912 --> 00:07:20.349 This shows our case rates in Marin. 00:07:20.349 --> 00:07:24.411 You can see there that over the month of October, we were in 00:07:24.411 --> 00:07:26.476 that orange tier, tier 3. This is the 00:07:26.476 --> 00:07:30.599 adjusted case rates. Again when we have our actual 00:07:30.599 --> 00:07:32.597 number of cases and then we are given 00:07:32.597 --> 00:07:36.788 credits for high testing rates which brings it down. 00:07:36.788 --> 00:07:39.034 We had an adjusted case rate of about 2 at the end of October 00:07:39.034 --> 00:07:41.787 . That an justed case rate has 00:07:41.787 --> 00:07:45.160 increased now to 4.3. So we have about a doubling in 00:07:45.160 --> 00:07:49.287 our adjusted case rate just over the past couple weeks. 00:07:49.287 --> 00:07:51.473 Next, please? One of the 00:07:51.473 --> 00:07:53.850 important characteristics of what we're 00:07:53.850 --> 00:07:56.162 experiencing in Marin is there has been a shift in the 00:07:56.162 --> 00:07:59.348 demographics of our experience with this pandemic. 00:07:59.348 --> 00:08:02.285 As we all recall, earlier for the first few months of this 00:08:02.285 --> 00:08:06.607 pandemic it was really a story about the disproportional impact 00:08:06.607 --> 00:08:09.474 on certain communities, certain communities characterized by 00:08:13.412 --> 00:08:18.099 opportunities, where they live, San Rafael, Canal, certain parts 00:08:18.099 --> 00:08:20.098 of Novato. With up to in some weeks 00:08:20.098 --> 00:08:24.660 80 to 90 percent of our cases being 00:08:24.660 --> 00:08:28.786 among people who really didn't have the choice of safely 00:08:28.786 --> 00:08:31.911 isolate because they were essential workers, relying on 00:08:31.911 --> 00:08:35.097 households where more people live. 00:08:35.097 --> 00:08:37.347 And now the last month of cases tlast three weeks, the majority 00:08:37.347 --> 00:08:40.474 of cases are among our white residents. 00:08:40.474 --> 00:08:45.411 And we're finding a greater proportion of those cases among 00:08:45.411 --> 00:08:48.472 people who are gathering indoors and might 00:08:48.472 --> 00:08:51.099 have a more reasonable option to avoid those exposures 00:08:51.099 --> 00:08:54.412 because they're based on personal choices. 00:08:54.412 --> 00:08:56.849 It's most discouraging that's what's driving it but also 00:08:56.849 --> 00:09:00.285 encouraging but we think those are behaviors people have more 00:09:00.285 --> 00:09:03.911 control over because it's not a matter of economic necessity. 00:09:03.911 --> 00:09:06.600 Next, please? This is the school status. 00:09:06.600 --> 00:09:10.476 So every week I'll be sharing with you where we are with 00:09:10.476 --> 00:09:11.661 regard to our school reopenings. We are still moving forward 00:09:11.661 --> 00:09:15.723 successfully with reopening schools. 00:09:15.723 --> 00:09:17.973 Now 7 # percent of schools in Marin are reopen 00:09:17.973 --> 00:09:22.224 to some classroom-based learning. 00:09:22.224 --> 00:09:25.852 82 schools of our 106 are open. Version of windows about 250,000 00:09:25.852 --> 00:09:29.413 accumulated student days since October 8th when we started 00:09:29.413 --> 00:09:33.160 reopening schools in that purple status and they had to reopen 00:09:33.160 --> 00:09:36.100 through a waiver office from the public health officer. 00:09:36.100 --> 00:09:38.598 Over that period of time, we've accumulated a total of 15 cases 00:09:38.598 --> 00:09:42.659 among students and one case among staff. 00:09:42.659 --> 00:09:45.160 There have been no occasions of transmission on a 00:09:45.160 --> 00:09:47.848 school campus between either students and 00:09:47.848 --> 00:09:51.725 staff or staff to students. All of the cases that I'm 00:09:51.725 --> 00:09:54.410 showing here, the 15 and the 1 are people who acquired the 00:09:54.410 --> 00:09:56.223 infection in the community, either at home or elsewhere, and 00:09:56.223 --> 00:09:59.225 were identified as being part of that school community. 00:09:59.225 --> 00:10:00.910 So we count them as cases but importantly they are not 00:10:00.910 --> 00:10:04.973 attributable to the school environment. 00:10:04.973 --> 00:10:08.163 Next, please? 00:10:11.785 --> 00:10:15.909 in adopting new restrictions and responding to this surge. 00:10:15.909 --> 00:10:20.226 In our case, we are being -- obviously 00:10:20.226 --> 00:10:22.723 the governor moved us into the red tier yesterday to 00:10:26.100 --> 00:10:30.535 That's a step that we had chosen to take voluntarily as a 00:10:30.535 --> 00:10:33.597 pre-emptive step last week, so it's no change in terms of that 00:10:33.597 --> 00:10:36.096 actual policy because it's just different in that now we're 00:10:36.096 --> 00:10:38.911 operating under the state order whereas we had intended to 00:10:38.911 --> 00:10:43.723 operate under a county order if the state had not taken that 00:10:43.723 --> 00:10:46.475 measure. We are now -- so the changes 00:10:46.475 --> 00:10:49.039 are indoor retail establishment, 00:10:49.039 --> 00:10:53.162 indoor malls are reducing to 50 percent capacity. 00:10:53.162 --> 00:10:56.348 We are closing restaurants to only allow for outdoor 00:10:56.348 --> 00:11:00.222 service. Places of worship are at 00:11:00.222 --> 00:11:02.159 25 percent capacity. Movie theaters are 00:11:02.159 --> 00:11:06.351 25 percent capacity with no concessions in theaters. 00:11:06.351 --> 00:11:08.099 Gyms and fitness centers have moved to 10 percent capacity tin 00:11:09.971 --> 00:11:12.036 pools. Libraries down to 50 percent 00:11:12.036 --> 00:11:15.848 capacity. And office work spaces have 00:11:15.848 --> 00:11:19.597 reverted back to only for essential workers, whereas in 00:11:19.597 --> 00:11:22.037 the orange tier it had allowed nonessential and essential 00:11:22.037 --> 00:11:26.348 office workers. Those are the primary changes 00:11:26.348 --> 00:11:28.100 that will go into effect today. Next, please? 00:11:32.159 --> 00:11:33.163 minute that the indoor dining risk because we are in red tier 00:11:37.161 --> 00:11:40.536 So we're opting all of the red tier policies 00:11:40.536 --> 00:11:43.534 the state is now requiring that. 00:11:43.534 --> 00:11:46.412 But we are taking the additional step of closing indoor dining, 00:11:46.412 --> 00:11:50.410 which normally corresponds to the purple tier. 00:11:50.410 --> 00:11:52.847 Again, 95 percent of the state is now in that purple tier 00:11:52.847 --> 00:11:55.661 . So indoor dining, there are very 00:11:55.661 --> 00:11:58.347 few locations across the state where any indoor dining would 00:11:58.347 --> 00:12:01.599 be allowed. The reason we chose to take that 00:12:01.599 --> 00:12:05.226 step in Marin is we recognize that indoor dining presents 00:12:05.226 --> 00:12:10.098 particular risk. It is a gathering indoors where 00:12:10.098 --> 00:12:12.535 people are across households. It is in a 00:12:12.535 --> 00:12:15.723 setting where people cannot cover their faces indoors 00:12:15.723 --> 00:12:18.159 because they're eating and drinking, often for a long 00:12:18.159 --> 00:12:21.412 period of exposure for an hour to an hour and a half. 00:12:21.412 --> 00:12:25.161 We know the duration of exposure as well as the proximity and the 00:12:25.161 --> 00:12:28.037 presence and absence of face covering are really the key 00:12:28.037 --> 00:12:30.725 factors if you're indoors for the risk of transmission. 00:12:30.725 --> 00:12:33.474 We know this also in our own data that when we look at the 00:12:33.474 --> 00:12:36.226 occupation of our cases among people who are essential 00:12:36.226 --> 00:12:40.911 workers, food service workers are among the most common in 00:12:40.911 --> 00:12:42.600 terms of percent positivity. So we know that's one of the 00:12:45.534 --> 00:12:48.475 Super spreader events are traced back to indoor dining 00:12:48.475 --> 00:12:50.099 experiences. So if somebody may be actively 00:12:50.099 --> 00:12:54.539 infectious in a restaurant, special budget lecialy if 00:12:54.539 --> 00:12:57.034 there's poor ventilation indoors and other people in the 00:12:57.034 --> 00:12:59.097 contact tracing who had shared that 00:12:59.097 --> 00:13:03.349 space are revealed to have been cases when they do that 00:13:03.349 --> 00:13:06.537 investigation a week or so later, there's been a few famous 00:13:10.600 --> 00:13:12.222 30 people who shared a given space that way were infected 00:13:12.222 --> 00:13:14.160 . So restaurants do contribute to 00:13:14.160 --> 00:13:17.286 that, as well. And they also contribute to 00:13:17.286 --> 00:13:21.356 mobility. As we open, as people are moving 00:13:21.356 --> 00:13:22.849 about and moving in the evenings to seek indoor dining, it 00:13:26.537 --> 00:13:30.848 which is another important principle in the 00:13:30.848 --> 00:13:53.666 shelter-in-place. We used to call it shelter at 00:13:53.666 --> 00:13:57.913 coming by the end of the week. 00:13:57.913 --> 00:13:59.849 Next, please? So, holiday gathering 00:13:59.849 --> 00:14:01.662 recommendations. This is something we released 00:14:01.662 --> 00:14:03.972 last week, and it's just more important than ever. 00:14:03.972 --> 00:14:06.347 Outside the safer. Gathering outdoors and following 00:14:06.347 --> 00:14:09.847 the safety guidelines that we've offered. 00:14:09.847 --> 00:14:12.223 Small gatherings to limit them to no more than three 00:14:12.223 --> 00:14:15.661 households. That's now the law is three 00:14:15.661 --> 00:14:18.350 households together are the maximum in that social bubble we 00:14:18.350 --> 00:14:20.784 had started with 12 people in Marin as one of the pioneers of 00:14:20.784 --> 00:14:24.909 the social bubble concept here in the Bay Area. 00:14:24.909 --> 00:14:28.286 It became a state recommendation that we gather no more than 00:14:31.348 --> 00:14:34.349 Gathering should be short. So no more than two hours. 00:14:34.349 --> 00:14:37.410 Again because it's both the proximity and the interval of 00:14:37.410 --> 00:14:39.348 time that contributes to risk. And then keeping the gathering 00:14:39.348 --> 00:14:41.099 stable. So not to participate in 00:14:41.099 --> 00:14:45.286 multiple gatherings at different households. 00:14:45.286 --> 00:14:47.722 So if you're fortunate enough to receive invitations to 00:14:47.722 --> 00:14:50.724 multiple gatherings, we really do need to 00:14:50.724 --> 00:14:54.973 pick our battles and really encourage people to stay with 00:14:54.973 --> 00:14:56.849 that hub, that hub of your three households that you've chosen to 00:14:59.725 --> 00:15:02.909 gather are the people you need to stick with through the 00:15:02.909 --> 00:15:06.975 holidays rather than jumping from one gathering group to 00:15:06.975 --> 00:15:09.912 another. Next, please? 00:15:09.912 --> 00:15:13.973 A travel advisory that was issued in Marin County last week 00:15:13.973 --> 00:15:17.161 and then reinforced by the state a few days later, the top 00:15:17.161 --> 00:15:21.723 recommendation is to avoid travel during the holidays 00:15:21.723 --> 00:15:24.410 completely outside of moving in your car with your 00:15:24.410 --> 00:15:28.347 household to gather with people who are 00:15:28.347 --> 00:15:29.160 already in your social group outdoors in a safely 00:15:29.160 --> 00:15:33.288 distanced way. 00:15:33.288 --> 00:15:35.285 But if you must travel, we're recommending the 00:15:35.285 --> 00:15:36.476 14-day quarantine for people after they 00:15:36.476 --> 00:15:40.097 return. And that's something that the 00:15:40.097 --> 00:15:44.160 state, again, reinforced as atry state recommendation. 00:15:44.160 --> 00:15:47.285 So Washington, Oregon and California have now 00:15:47.285 --> 00:15:50.159 instituted a travel recommendation that 00:15:50.159 --> 00:15:52.410 anyone expwomg these areas from other parts of the nation should 00:15:52.410 --> 00:15:55.853 quarantine for 14 days after they return. 00:15:55.853 --> 00:15:59.347 And again if you do travel, remembering to take these best 00:15:59.347 --> 00:16:03.221 practices that we've defined hopefully in Marin and apply 00:16:03.221 --> 00:16:07.346 them wherever you are. Many other parts of the 00:16:07.346 --> 00:16:11.849 country people are less adherent to those, wearing face covering, 00:16:11.849 --> 00:16:15.599 practicing social distancing, sanitizing your hands frequently 00:16:15.599 --> 00:16:18.536 and avoiding unsafe gathering, if people are gathered indoors 00:16:18.536 --> 00:16:21.285 and not covering their face, take a rain check. 00:16:21.285 --> 00:16:25.409 Avoid that environment and choose not to enter into that. 00:16:25.409 --> 00:16:29.535 Offer your apologies and go somewhere safer. 00:16:33.099 --> 00:16:35.785 COVID-19 testing options. So there have been some 00:16:35.785 --> 00:16:38.349 questions about where people can get tested. 00:16:38.349 --> 00:16:42.600 I think those questions have surfaced more frequently now 00:16:42.600 --> 00:16:45.912 because people are thinking about how they might 00:16:45.912 --> 00:16:49.986 use testing as a way to ensure safer travel. 00:16:49.986 --> 00:16:51.598 I want to be really clear that you cannot test your 00:16:51.598 --> 00:16:55.598 way out of the other recommendations. 00:16:55.598 --> 00:16:58.849 In other words, it's a misunderstanding to assume that 00:16:58.849 --> 00:17:02.034 if you just take a test and it's negative, then you can go ahead 00:17:02.034 --> 00:17:03.660 with whatever you planned to do. The risk is still the same with 00:17:03.660 --> 00:17:07.038 travel. We want to make sure that people 00:17:07.038 --> 00:17:09.786 don't assume that if they have a negative test that it's safe for 00:17:09.786 --> 00:17:11.286 them to travel because you can obviously, it only tells you 00:17:11.286 --> 00:17:13.538 about your status on that particular day. 00:17:13.538 --> 00:17:16.722 You could be infected in the course of travel. 00:17:16.722 --> 00:17:20.723 That's one of the reasons why travel itself is a concern. 00:17:20.723 --> 00:17:22.159 But for those who are seeking testing, the first 00:17:22.159 --> 00:17:25.725 and most important message is to reach 00:17:25.725 --> 00:17:29.285 out to your medical provider. We have offered a public health 00:17:29.285 --> 00:17:32.411 order that all medical providers should be offering testing to 00:17:32.411 --> 00:17:36.661 all of their patients. It is a state law that medical 00:17:36.661 --> 00:17:38.600 providers and healthcare systems provide testing to their 00:17:38.600 --> 00:17:40.787 patients. More and more medical providers 00:17:40.787 --> 00:17:44.222 are doing so. Right now one of the main, 00:17:44.222 --> 00:17:46.160 probably the largest single contributor to tests that are 00:17:46.160 --> 00:17:50.222 occurring in Marin County right now is cilzer. 00:17:50.222 --> 00:17:51.847 Kaiser has really stepped up. We're doing over 1,000 tests per 00:17:54.974 --> 00:17:57.537 We have one of the highest testing rates in the state as a 00:17:57.537 --> 00:18:00.160 county largely because of the fact that our medical providers 00:18:00.160 --> 00:18:02.035 have really stepped into the forefront with this and taken 00:18:02.035 --> 00:18:06.097 responsibility. Public health testing resources 00:18:06.097 --> 00:18:08.472 are being mobilized to do more mobile testing, to identify and 00:18:08.472 --> 00:18:11.097 respond to clusters when they're occurring earlier. 00:18:11.097 --> 00:18:13.786 So whether it's in a workplace, whether it's in a skilled 00:18:13.786 --> 00:18:17.537 nursing facility or residential care facility for the elderly, 00:18:17.537 --> 00:18:21.725 whether it's in a school setting or a community like the Canal 00:18:21.725 --> 00:18:25.100 area center where we were seeing lots of cases in the geographic 00:18:25.100 --> 00:18:28.412 area apartment complexes are blocked where we can go there 00:18:28.412 --> 00:18:31.599 and get testing, that's the role of public health and testing. 00:18:31.599 --> 00:18:34.534 When it comes to the baseline community for test agz a whole 00:18:34.534 --> 00:18:37.411 that's really the responsibility of our health cear providers. 00:18:37.411 --> 00:18:41.034 COVID-19 is going to be with us at least another year. 00:18:41.034 --> 00:18:43.784 Testing is going to be a key strategy for us despite the fact 00:18:43.784 --> 00:18:46.784 that the vaccine may be coming in a few months. 00:18:46.784 --> 00:18:48.849 It needs to be seen as a core element of provision of 00:18:48.849 --> 00:18:51.472 healthcare. First reach out to your doctor 00:18:51.472 --> 00:18:54.348 and ask for testing. If you're not able to get 00:18:54.348 --> 00:18:56.098 testing through your provider, there are other options. 00:18:56.098 --> 00:18:59.849 Self-referral. The public health testing is 00:18:59.849 --> 00:19:02.663 still available at the LHI site in San Rafael. 00:19:02.663 --> 00:19:04.538 You can register online and go get tested there. 00:19:04.538 --> 00:19:08.037 The state is going to be doubling our capacity there. 00:19:08.037 --> 00:19:10.473 So within a week or two weeks, we'll be able to do 300 tests 00:19:10.473 --> 00:19:12.972 per day at that site. There's other that I've listed 00:19:12.972 --> 00:19:15.599 here. This is an incomplete list but 00:19:15.599 --> 00:19:18.224 includes some of the key partners. 00:19:18.224 --> 00:19:22.163 Go health. Marin health. 00:19:22.163 --> 00:19:26.661 CS pharmacy offers testing. And then, importantly, there's 00:19:26.661 --> 00:19:31.534 at home self-testing with our FDA-approved mail-in products 00:19:31.534 --> 00:19:35.848 . Are all mail-in test Angela it's 00:19:35.848 --> 00:19:37.659 about a two-day turning around for those tests and they're FD 00:19:41.847 --> 00:19:46.162 So these are all available are if 00:19:46.162 --> 00:19:50.225 on our website which is coronavirus 00:19:50.225 --> 00:19:53.100 .marinhhs/testing 00:19:53.100 --> 00:19:56.034 . Or you can navigate to that on 00:19:56.034 --> 00:20:00.223 the website. Next, please? 00:20:00.223 --> 00:20:02.472 And quickly vaccine updates. So we have really good news 00:20:02.472 --> 00:20:06.224 . Pfizer and May dern oh vaccine 00:20:06.224 --> 00:20:09.723 they are both MRNA vaccines they're in phase 2 trials. 00:20:09.723 --> 00:20:12.660 40,000 patients each. Half received 00:20:12.660 --> 00:20:16.723 placebo, half vaccine. 80,000 patients total. 00:20:16.723 --> 00:20:18.912 And in both trials, they had about 90 COVID-19 00:20:18.912 --> 00:20:22.724 cases. So that's really good news in 00:20:22.724 --> 00:20:24.912 terms of measuring the efficacy of the vaccine because you need 00:20:24.912 --> 00:20:27.352 enough cases in the trial to see if it's effective. 00:20:27.352 --> 00:20:30.537 Half the group was given a placebo. 00:20:30.537 --> 00:20:33.035 Half was given a vaccine. And then afterwards they 00:20:33.035 --> 00:20:35.973 released the results to see who among the cases, who received 00:20:35.973 --> 00:20:38.911 the actual vaccine versus who didn't. 00:20:38.911 --> 00:20:41.721 And almost all the cases that emerged in those study groups 00:20:41.721 --> 00:20:44.784 were in people who did not in fact receive the vaccine. 00:20:44.784 --> 00:20:47.910 And those who did receive the vaccine, very few cases emerged 00:20:47.910 --> 00:20:49.974 in that group, which is how you measure efficacy of a drug or a 00:20:49.974 --> 00:20:53.285 vaccine. So the conclusion there is that 00:20:53.285 --> 00:20:55.909 those vaccines are 90 to 95 percent effective which is 00:20:55.909 --> 00:21:00.098 really good news. And especially good news that 00:21:00.098 --> 00:21:02.099 the Moderno product yesterday or the day before 00:21:02.099 --> 00:21:05.413 when these results came out doesn't require 00:21:05.413 --> 00:21:09.475 the same level of refrigeration as the Pfizer vaccine. 00:21:09.475 --> 00:21:12.225 Pfizer was a -70 Celsius. 00:21:15.288 --> 00:21:19.598 challenging from a logistical standpoint to have a cold chain 00:21:19.598 --> 00:21:21.785 that could actually store and move a vaccine that required 00:21:25.912 --> 00:21:26.722 So moderna is more conventional, regular refrigeration 00:21:26.722 --> 00:21:28.973 that is required. 00:21:28.973 --> 00:21:32.038 So that will open up some options for us. 00:21:32.038 --> 00:21:36.037 Next, please? Remember to get your flu shot. 00:21:36.037 --> 00:21:37.911 Your medical provider will be thrilled if you're also seeking 00:21:37.911 --> 00:21:42.097 testing. Right now it looks like Kaiser 00:21:42.097 --> 00:21:43.222 will be offering drive-thru COVID-19 as well as drive-thru 00:21:45.411 --> 00:21:48.535 So get your flu shot. If you haven't yet. 00:21:48.535 --> 00:21:52.472 It's still -- we haven't seen any influenza yet. 00:21:52.472 --> 00:21:56.410 Normally it's going to start in a couple weeks if this year is 00:21:56.410 --> 00:21:59.224 like last year or years before. It's in the next two weeks where 00:21:59.224 --> 00:22:03.284 really start seeing influenza start rising in the community. 00:22:03.284 --> 00:22:06.849 So this is the time. Next, please? 00:22:11.036 --> 00:22:13.222 underway with widespread restrictions statewide. 00:22:13.222 --> 00:22:17.096 Marin County is in tier 2, the red. 00:22:17.096 --> 00:22:19.660 We are less restricted than most counties for now. 00:22:19.660 --> 00:22:22.536 Indoor gatherings are driving cases. 00:22:22.536 --> 00:22:25.536 Holiday gatherings and travel are not safe. 00:22:25.536 --> 00:22:29.600 We've had some promising vaccine news. 00:22:29.600 --> 00:22:31.724 And remember to get your flu shot. 00:22:35.847 --> 00:22:37.662 presentation. Thank you. 00:22:41.660 --> 00:22:44.098 never over until we see that last slide. 00:22:44.098 --> 00:22:48.534 Thank you, Dr. Willis. Before I turn it over to Board 00:22:48.534 --> 00:22:53.158 Members for questions, just one thing on the testing front 00:22:53.158 --> 00:22:56.537 . Who should be seeking testing 00:22:56.537 --> 00:22:59.410 ? >>DR. WILLIS: Yeah, the moats 00:22:59.410 --> 00:23:02.224 important indication for testing is anyone who is having symptoms 00:23:02.224 --> 00:23:05.097 of COVID-19. What we don't want to miss are 00:23:05.097 --> 00:23:08.160 people that are infected and infectious to others. 00:23:08.160 --> 00:23:11.222 And the best way to diagnose COVID-19 is through a test. 00:23:11.222 --> 00:23:15.350 In fact, it's the only definitive way to diagnose 00:23:17.660 --> 00:23:21.785 The first point is if you're experiencing symptoms, shortness 00:23:21.785 --> 00:23:23.597 of breath, fever muscle sakes 00:23:26.474 --> 00:23:30.411 symptoms that go along with the early stages of a variety of 00:23:30.411 --> 00:23:33.223 viral infections, whether it's cold or influenza, those are 00:23:33.223 --> 00:23:35.722 situations where we want people to go ahead and seek testing 00:23:35.722 --> 00:23:38.597 immediately. The first one to reach out to 00:23:38.597 --> 00:23:40.846 your medical provider. You could talk through the 00:23:40.846 --> 00:23:43.287 contingencies. They may want to do a televise 00:23:43.287 --> 00:23:46.786 it with you rather than have you come into the office. 00:23:46.786 --> 00:23:50.159 Then they might have a place -- many clinics have a respiratory 00:23:50.159 --> 00:23:53.099 clinic, what they call respiratory clinic, outdoors, 00:23:53.099 --> 00:23:56.599 under a tent where people can come through. 00:23:56.599 --> 00:24:00.350 Or Kaiser drive through testing. First is people having symptoms. 00:24:00.350 --> 00:24:03.473 Next we've asked essential workers who are in public-facing 00:24:03.473 --> 00:24:07.535 jobs on a regular basis who are at risks themselves of becoming 00:24:07.535 --> 00:24:10.848 infected or at risk if they are infected to perhaps infect 00:24:10.848 --> 00:24:14.223 others within that workplace or even customers to seek testing 00:24:14.223 --> 00:24:16.972 on a monthly basis. That's also included in the 00:24:16.972 --> 00:24:19.538 state law that health care providers must provide testing 00:24:19.538 --> 00:24:23.536 to asymptomatic essential workers. 00:24:23.536 --> 00:24:26.411 So anyone who's symptomatic and asymptomatic whether or not 00:24:26.411 --> 00:24:28.910 you're having symptoms, if you're in that category of an 00:24:28.910 --> 00:24:30.847 essential workers, you should have testing monthly. 00:24:30.847 --> 00:24:34.098 Those are the two most important categories. 00:24:34.098 --> 00:24:37.101 And then if you know that you've been exposed, when we 00:24:37.101 --> 00:24:40.663 Delegation of Algeria contact investigation and we determine 00:24:40.663 --> 00:24:43.536 that someone in a household has been exposed, we ask them to go 00:24:43.536 --> 00:24:47.284 get tested because someone else is at higher risk. 00:24:47.284 --> 00:24:50.599 So those are kind of the default three highest categories: A 00:24:50.599 --> 00:24:53.162 known exposure to a known case, an essential worker, and someone 00:24:53.162 --> 00:24:57.413 who's having symptoms. Then there's others who are 00:24:57.413 --> 00:25:01.473 seeking test fog more from a reassurance standpoint. 00:25:01.473 --> 00:25:03.475 That's a lower priority. And, still, I think if 00:25:03.475 --> 00:25:06.662 people are concerned about their 00:25:06.662 --> 00:25:10.412 status, say when they return from travel, that quarantine 00:25:10.412 --> 00:25:13.286 period of 14 days, if someone tests five to seven days after 00:25:13.286 --> 00:25:16.286 they've returned and they are negative, it's very unlikely 00:25:16.286 --> 00:25:18.285 that they've been infected. It doesn't mean that we don't 00:25:18.285 --> 00:25:22.285 recommend that full 14 days of quarantine. 00:25:22.285 --> 00:25:25.225 We still recommend that full 14 days of quarantine. 00:25:25.225 --> 00:25:29.723 Some fraction of those people, even if they test negative, will 00:25:29.723 --> 00:25:33.038 be actually infectious. But it helps us understand, get 00:25:36.909 --> 00:25:40.975 if they test positive. >>PRES. KATIE RICE: Thank you. 00:25:40.975 --> 00:25:42.162 All right. Board Members, questions? 00:25:45.288 --> 00:25:48.098 to get us going? >>DAMON CONNOLLY: Sure, thanks. 00:25:48.098 --> 00:25:51.223 Good morning, everyone. Thank you, Dr. Willis, for the 00:25:51.223 --> 00:25:55.661 report. So in light of the increased 00:25:55.661 --> 00:25:59.097 case counts and Marin moving into a new tier 00:25:59.097 --> 00:26:03.098 , where do we stand with contact tracing? 00:26:03.098 --> 00:26:07.098 Do we have sufficient capacity now and for a 00:26:07.098 --> 00:26:10.287 surge in cases? And related, can you share 00:26:10.287 --> 00:26:13.475 some real life examples of what 00:26:13.475 --> 00:26:16.910 public health is learning from contact tracing? 00:26:16.910 --> 00:26:22.349 >>DR. WILLIS: Yes. You know, one of the challenges 00:26:22.349 --> 00:26:26.786 logistically in responding to a pandemic is the extreme 00:26:26.786 --> 00:26:29.348 fluctuations in demand you see. Right now 00:26:29.348 --> 00:26:32.724 quadrupling of cases in some parts of the country. 00:26:32.724 --> 00:26:35.347 So you staff for one setting and then you end up with four times 00:26:35.347 --> 00:26:37.224 the number of cases. That's true for contact tracing, 00:26:37.224 --> 00:26:41.661 et cetera. Fortunately we have a great 00:26:41.661 --> 00:26:43.910 bullpen of contact tracers. Early in the pandemic 00:26:43.910 --> 00:26:45.535 , March/April, we issued a call 00:26:45.535 --> 00:26:48.288 for people to come and volunteer for that work. 00:26:48.288 --> 00:26:51.535 We had the Marin medical reserve corps that's always been there 00:26:51.535 --> 00:26:54.535 for us in disasters. Many of those reserve corps 00:26:54.535 --> 00:26:56.036 members learned how to do contact tracing and are 00:26:56.036 --> 00:27:00.224 available as an extra pool fours. 00:27:00.224 --> 00:27:01.972 We've also expanded our own bullpen of full-time 00:27:01.972 --> 00:27:04.222 staff doing contact tracing. 00:27:04.222 --> 00:27:07.097 15 individuals who are full-time only doing that. 00:27:07.097 --> 00:27:10.286 And extra up to 70 other individuals who are able to be 00:27:10.286 --> 00:27:13.850 pulled into that work as disaster service workers or our 00:27:13.850 --> 00:27:17.785 volunteers. So that's the -- we are keeping 00:27:17.785 --> 00:27:21.161 up with the demand as we see more cases. 00:27:21.161 --> 00:27:24.662 Our goal is every single per swhon's identified as a case is 00:27:24.662 --> 00:27:27.347 reached out to within 24 hours. When we don't reach them it's 00:27:27.347 --> 00:27:29.789 because we don't have the proper contact information or there's a 00:27:29.789 --> 00:27:33.474 problem with the phone number. It's not because we don't have 00:27:33.474 --> 00:27:37.535 time to get to them. That's a key point. 00:27:37.535 --> 00:27:39.222 And then the interview obviously reveals a lot about 00:27:39.222 --> 00:27:42.410 where transmission is occurring. 00:27:42.410 --> 00:27:46.848 And I can just share some of the stories of the past week, one 00:27:46.848 --> 00:27:50.473 was that we had two individuals in a workplace 00:27:50.473 --> 00:27:52.913 who had not identified that they were in 00:27:52.913 --> 00:27:55.724 contact of one another. But when we reached out to each 00:27:55.724 --> 00:27:59.536 of them separately, we identified that they both shared 00:27:59.536 --> 00:28:03.597 a common workplace. And they had also both attended 00:28:03.597 --> 00:28:07.661 the same social gathering of a baby shower. 00:28:07.661 --> 00:28:10.161 And the exposure had happened in that 00:28:10.161 --> 00:28:13.972 setting, where they had been together at an indoor 00:28:13.972 --> 00:28:16.663 gathering. And what ended up occurring 00:28:16.663 --> 00:28:19.537 was a larger number of cases within that workplace. 00:28:19.537 --> 00:28:22.913 It was a good example and it was a very sensitive workplace. 00:28:22.913 --> 00:28:26.975 For confidentiality purposes, I won't share anymore information 00:28:26.975 --> 00:28:30.097 about that. But it's a setting in which it's 00:28:33.286 --> 00:28:37.474 others in that, a congregate living facility. 00:28:37.474 --> 00:28:39.722 So, again, that was a traceable to a baby shower. Obviously, 00:28:43.785 --> 00:28:47.161 And do at normal times. But something we can't do now. 00:28:47.161 --> 00:28:50.348 Another was traceable to very similar situation where we 00:28:50.348 --> 00:28:53.099 determined through the interview that two gentlemen had attended 00:28:53.099 --> 00:28:56.850 the same gathering where they were watching a football game 00:28:56.850 --> 00:29:01.035 together. Which seems like the right thing 00:29:01.035 --> 00:29:03.849 to do this time of year. But not this year 00:29:03.849 --> 00:29:06.724 . And that's where -- and, again, 00:29:06.724 --> 00:29:09.786 that's contributing, I think, to what we're seeing this 00:29:09.786 --> 00:29:12.475 demographic shift more among white residents and more 00:29:12.475 --> 00:29:16.412 geographically spread across the county. 00:29:16.412 --> 00:29:17.912 Mill Valley, Tiburon, San Anselmo, Novato 00:29:17.912 --> 00:29:20.286 . It's everywhere. 00:29:20.286 --> 00:29:22.847 West Marin. We're seeing much more 00:29:22.847 --> 00:29:25.722 geographic distribution. And it's because those kinds of 00:29:25.722 --> 00:29:28.410 gatherings are happening more widespread. 00:29:28.410 --> 00:29:30.411 >>DAMON CONNOLLY: Those real world examples are really 00:29:30.411 --> 00:29:34.471 helpful to understand what's going on. 00:29:34.471 --> 00:29:37.410 So thank you. Next couple come by way of 00:29:41.410 --> 00:29:44.849 One is that we're hearing from movie theaters regarding 00:29:44.849 --> 00:29:48.911 the closing of their concessions. 00:29:48.911 --> 00:29:49.410 Have our contact tracing shown spread in movie theaters 00:29:53.537 --> 00:29:56.661 Or is that becoming evident statewide 00:29:56.661 --> 00:30:00.666 ? So just kind of from the 00:30:00.666 --> 00:30:03.412 business standpoint, the thinking behind that 00:30:03.412 --> 00:30:07.098 particular strategy. 00:30:07.098 --> 00:30:11.288 >>DR. WILLIS: Yeah, you know, it's really challenging to have 00:30:11.288 --> 00:30:14.475 the evidence -- the local evidence for a specific 00:30:14.475 --> 00:30:16.785 setting to be counted for cases. 00:30:16.785 --> 00:30:19.225 One of the reasons is getting back to the interview that 00:30:19.225 --> 00:30:22.161 happened with contact tracing is you reach out to someone who may 00:30:22.161 --> 00:30:25.097 have been infected at some point in the past say 10 days. 00:30:25.097 --> 00:30:27.036 We try and have them recount where they have been in the past 00:30:27.036 --> 00:30:29.598 10 days. They went to the hairdresser, 00:30:29.598 --> 00:30:32.849 they went to the grocery store a few times, they went to a 00:30:32.849 --> 00:30:36.975 restaurant, they went to a movie. 00:30:36.975 --> 00:30:39.221 It's impossible to know, among that variety of activities 00:30:39.221 --> 00:30:41.099 they participated in, where did it 00:30:41.099 --> 00:30:43.912 occur? It would be one thing if the 00:30:43.912 --> 00:30:46.223 only thing they did was aside from being in their home that 00:30:46.223 --> 00:30:49.910 they went to a movie. We would know for sure. 00:30:49.910 --> 00:30:53.222 So, instead, we have to rely on what we know about epidemiology 00:30:53.222 --> 00:30:57.348 and what we know about patterns of transmission and the fact is 00:30:57.348 --> 00:30:59.787 that reasonably close concessions in movie theaters is 00:30:59.787 --> 00:31:02.474 that it is like indor restaurants in that it's an 00:31:02.474 --> 00:31:06.536 indoor environment where people cannot cover their faces. 00:31:06.536 --> 00:31:09.788 That's one of the themes about why 00:31:09.788 --> 00:31:12.910 we're making -- taking the steps we're taig that go beyond 00:31:12.910 --> 00:31:16.537 the red tier restrictions. It's those indoor gatherings 00:31:16.537 --> 00:31:19.225 where people cannot cover their faces are the highest risk. 00:31:19.225 --> 00:31:22.097 Because concessions, it's dining. 00:31:22.097 --> 00:31:25.597 People are indoors together. That's why we close that. 00:31:25.597 --> 00:31:29.223 And that's also a common strategy across the state. 00:31:29.223 --> 00:31:32.973 It's not just in Marin. Across the Bay Area concessions 00:31:32.973 --> 00:31:36.099 are closed in movie theaters. >>DAMON CONNOLLY: Right. 00:31:36.099 --> 00:31:40.098 Oh finally. Oh, sorry. 00:31:40.098 --> 00:31:44.097 On testing which you covered, an inquiry has been 00:31:44.097 --> 00:31:47.661 made concerning the color testing 00:31:47.661 --> 00:31:50.285 contract? Which sounds like it is now not 00:31:50.285 --> 00:31:54.722 in place. So if you can talk about about 00:31:54.722 --> 00:31:59.287 that. And then in light of that, you 00:31:59.287 --> 00:32:03.221 went through where we stand on testing, but just your sense 00:32:03.221 --> 00:32:07.538 of essentially how well utilized 00:32:07.538 --> 00:32:10.788 our testing sites are and the capacity going forward 00:32:10.788 --> 00:32:14.598 . >>DR. WILLIS: Yes. 00:32:14.598 --> 00:32:17.787 So I did go through where people can go for testing resources. 00:32:17.787 --> 00:32:20.409 I think that's important that anyone who's seeking testing can 00:32:20.409 --> 00:32:23.535 start with their medical provider and then go to the 00:32:23.535 --> 00:32:27.162 the website that I mentioned and you'll see the 00:32:27.162 --> 00:32:31.535 other options Tcolor testing site was one of the public 00:32:31.535 --> 00:32:33.159 health testing sites was by the Canal area, sorry, civic 00:32:33.159 --> 00:32:36.349 center. We have another public health 00:32:36.349 --> 00:32:40.472 testing site in the Canal area, LHI. 00:32:40.472 --> 00:32:42.847 Those are similar in that they're public health funded 00:32:42.847 --> 00:32:45.973 , one is state, one is county. 00:32:45.973 --> 00:32:50.663 Anyone can just in and register. Right now we're doubling the 00:32:50.663 --> 00:32:54.974 capacity at the LHI site. In fact, color testing was doing 00:32:54.974 --> 00:32:56.723 about 120 tests per day. LHI site is going to be 00:32:56.723 --> 00:32:58.534 increasing about 200 tests per day. 00:32:58.534 --> 00:33:01.662 So we're going to gain more than we lost. 00:33:01.662 --> 00:33:05.910 Right now unfortunately there was an interval of about a week 00:33:05.910 --> 00:33:08.724 where color had closed LHI hadn't increase that had 00:33:08.724 --> 00:33:10.599 capacity yet. We're looking to get that back 00:33:10.599 --> 00:33:13.787 online as early as Monday of next week. 00:33:13.787 --> 00:33:15.598 And it's going to be a few miles to the south of where it had 00:33:15.598 --> 00:33:17.348 been. But it's still going to be a 00:33:17.348 --> 00:33:21.161 public health resource for the community. 00:33:21.161 --> 00:33:25.163 But I also want to be really clear that it has been very 00:33:25.163 --> 00:33:27.973 convenient for people. And that was part of our service 00:33:27.973 --> 00:33:30.599 that we thought was so important, for people to just go 00:33:30.599 --> 00:33:33.598 online, schedule an appointment and goal get tested. 00:33:33.598 --> 00:33:37.786 No money. There was never any -- it was 00:33:37.786 --> 00:33:41.849 essentially a free service. That needs to change. 00:33:46.035 --> 00:33:48.347 So we want to make sure that our health care providers are 00:33:48.347 --> 00:33:51.350 offering testing. And that service is there. 00:33:51.350 --> 00:33:54.100 But we really want to protect that service for people who 00:33:54.100 --> 00:33:56.537 otherwise wouldn't have options for testing. 00:33:56.537 --> 00:33:59.474 There's enough people who don't have insurance or for whatever 00:33:59.474 --> 00:34:03.535 reason may not be able to get health care testing through 00:34:03.535 --> 00:34:06.099 their health care provider or we would use that resource for 00:34:06.099 --> 00:34:10.414 them. So my recommendation and my hope 00:34:10.414 --> 00:34:13.163 is Marin County residents now recognize that their healthcare 00:34:13.163 --> 00:34:16.847 providers can provide testing for them. 00:34:16.847 --> 00:34:22.286 >>DAMON CONNOLLY: Thanks. >>PRES. KATIE RICE: Supervisor 00:34:22.286 --> 00:34:27.285 Arnold? >>JUDY ARNOLD: 00:34:27.285 --> 00:34:31.097 Judy? You have to unmute. 00:34:31.097 --> 00:34:34.285 >>JUDY ARNOLD: Thank you, Dr. Willis. 00:34:34.285 --> 00:34:39.035 I am just interested. What is the emotional state of 00:34:39.035 --> 00:34:42.099 our essential workers here? >>DR. WILLIS: 00:34:42.099 --> 00:34:45.848 Thank you for asking. 00:34:45.848 --> 00:34:49.851 Yeah, I think people are -- I think everyone, you know, this 00:34:49.851 --> 00:34:52.785 has been hard for everybody. And it's e special 00:34:52.785 --> 00:34:56.973 ry hard to sort of realize that we're 00:34:56.973 --> 00:35:00.974 coming into another climb, another interval 00:35:00.974 --> 00:35:04.974 . So I would say, you know, I 00:35:04.974 --> 00:35:09.285 would say that people are tired. They're 00:35:09.285 --> 00:35:10.787 wonderful. Our hospital workers, we 00:35:10.787 --> 00:35:13.847 have multiple meetings every week 00:35:13.847 --> 00:35:16.535 with our frontline health care workers. 00:35:16.535 --> 00:35:20.100 Even though we haven't been seeing surges in cases, it is 00:35:20.100 --> 00:35:22.409 fatiguing just to provide healthcare in the COVID-19 00:35:22.409 --> 00:35:25.913 atmosphere because everything you do, you got to remember the 00:35:25.913 --> 00:35:28.286 PPE. The whole system is altered in 00:35:28.286 --> 00:35:32.411 ways that just make things more challenging. 00:35:32.411 --> 00:35:33.976 And there's always the spectre of the risk that 00:35:33.976 --> 00:35:37.037 they're facing every single day. 00:35:37.037 --> 00:35:40.660 And that's now eight months into that. 00:35:40.660 --> 00:35:43.286 And then to say on top of that that now we're actually seeing 00:35:43.286 --> 00:35:47.598 surges. And we have to be ready for 00:35:47.598 --> 00:35:49.287 hospital and surge capacity I think has been hard for 00:35:49.287 --> 00:35:54.035 everyone. You know, I think to me it's 00:35:54.035 --> 00:35:55.600 another just -- another example of what we've been learning all 00:35:55.600 --> 00:35:59.847 along, which is we're in this together. 00:35:59.847 --> 00:36:01.474 Abwe have to be working 00:36:01.474 --> 00:36:04.413 in partnerships. 00:36:04.413 --> 00:36:06.225 And wherever possible, claim the successes we had. 00:36:06.225 --> 00:36:10.348 We have learned a lot about how to control this. 00:36:10.348 --> 00:36:14.535 That first curve that we saw in July, we flattened 00:36:14.535 --> 00:36:18.598 that curve. And that was a 00:36:18.598 --> 00:36:20.599 hard month. So we know how to do this 00:36:20.599 --> 00:36:22.224 . And I think that's an important 00:36:22.224 --> 00:36:25.600 message is that we know how to do this. 00:36:25.600 --> 00:36:28.349 If the we do the right thing it's about the fundamentals. 00:36:28.349 --> 00:36:31.349 It's covering your face, physical distancing. 00:36:31.349 --> 00:36:35.160 Not attending social gathering. Hand washing. 00:36:35.160 --> 00:36:39.161 Ultimately that's the best way the virus, to control the virus. 00:36:39.161 --> 00:36:43.222 I mean, it's a natural, the virus has its 00:36:43.222 --> 00:36:47.223 own -- we know how to do this. 00:36:47.223 --> 00:36:49.909 I think it's just a matter of doing it more 00:36:49.909 --> 00:36:54.224 . So we are, I think, maybe a 00:36:54.224 --> 00:36:56.472 message for the community is to do everything you can to 00:36:56.472 --> 00:37:00.546 prevent surges into the hospitals 00:37:00.546 --> 00:37:02.721 because our health care providers are already fatigued 00:37:06.847 --> 00:37:09.787 And we owe it to them and to one another 00:37:09.787 --> 00:37:14.035 to protect them. >>JUDY ARNOLD: Give them our 00:37:14.035 --> 00:37:15.787 best. >>DR. WILLIS: Thank you. 00:37:18.536 --> 00:37:20.537 Rodoni or Sears, anything? >>DENNIS RODONI: Just to thank 00:37:20.537 --> 00:37:24.722 Dr. Willis. I think today you had some real 00:37:24.722 --> 00:37:27.536 important messages about testing, about travel, about 00:37:27.536 --> 00:37:30.098 gatherings. And I think those are important 00:37:30.098 --> 00:37:34.162 things to communicate to the public. 00:37:34.162 --> 00:37:37.848 The real message here is that we control this virus, 00:37:37.848 --> 00:37:40.285 too, by our actions and individually we can 00:37:40.285 --> 00:37:43.788 all make a difference. So I think that was a good part 00:37:43.788 --> 00:37:45.787 of your message today. Thank you. 00:37:45.787 --> 00:37:47.972 >>KATHRIN SEARS: I'll just follow up on that. 00:37:47.972 --> 00:37:50.848 I really appreciated the question from Supervisor Arnold 00:37:50.848 --> 00:37:53.597 and Dr. Will it's response. You know there was an article in 00:37:53.597 --> 00:37:57.912 the New York Times yesterday about health care professionals 00:37:57.912 --> 00:38:00.288 leaving the field because of the stress of working in that area 00:38:00.288 --> 00:38:04.099 . That's about the last thing 00:38:04.099 --> 00:38:07.098 really want to see happen given the importance of health care 00:38:07.098 --> 00:38:10.849 professionals in all ways. And so I really do appreciate 00:38:10.849 --> 00:38:14.847 that message, Dr. Willis. It's on all of us not only to 00:38:14.847 --> 00:38:18.600 take the steps that need to fight back the virus but also to 00:38:18.600 --> 00:38:22.722 try to help support our health care system in the long term. 00:38:22.722 --> 00:38:24.412 So thank you. >>PRES. KATIE RICE: 00:38:24.412 --> 00:38:29.034 And, Dr. Willis, I think just two 00:38:29.034 --> 00:38:32.412 more points. Just to reemphasize 00:38:32.412 --> 00:38:34.600 that gathering, limit your gathering 00:38:34.600 --> 00:38:37.975 to no more than three households. 00:38:37.975 --> 00:38:40.473 And, frankly, they should be the same three households every 00:38:40.473 --> 00:38:44.472 week, the stable group concept, stable cohort. 00:38:44.472 --> 00:38:49.222 And then if you could what would be 00:38:49.222 --> 00:38:52.410 your messaging to families who have kids coming home 00:38:52.410 --> 00:38:58.473 for the holidays from college in 00:38:58.473 --> 00:38:59.724 terms of those students, their kids' behavior when they get 00:39:03.786 --> 00:39:06.413 >>DR. WILLIS: I think one is that begins while they're still 00:39:06.413 --> 00:39:10.349 in college. So we want to make sure that 00:39:10.349 --> 00:39:13.475 whatever they -- obviously the messages are not ambiguous. 00:39:13.475 --> 00:39:15.850 But there's a variety of different ways people might 00:39:15.850 --> 00:39:18.410 adhere to those especially in the college setting. 00:39:18.410 --> 00:39:20.973 The first is before you come home, that's when you really 00:39:20.973 --> 00:39:24.473 need to be on your A game wherever you are. 00:39:24.473 --> 00:39:26.661 Because that's where you -- if you're really doing the right 00:39:26.661 --> 00:39:29.159 thing before that week you travel, you're going to be 00:39:29.159 --> 00:39:33.288 protecting your family much better. 00:39:33.288 --> 00:39:37.537 So that's quarantine 00:39:37.537 --> 00:39:41.912 in your college setting for a few days 00:39:41.912 --> 00:39:44.162 before you come, up to a week before you come 00:39:44.162 --> 00:39:46.663 . Some if college, my daughter's 00:39:46.663 --> 00:39:49.911 in college, they're doing regular testing. 00:39:49.911 --> 00:39:52.788 And make sure if you're doing regular testing in that college 00:39:52.788 --> 00:39:57.034 environment, do that testing three days before you travel so 00:39:57.034 --> 00:39:58.911 that that negative result is fresh is another important step 00:40:03.163 --> 00:40:05.349 If you're traveling by air, the N95 masks 00:40:05.349 --> 00:40:09.472 are less limited than they used to be. 00:40:09.472 --> 00:40:10.413 They're available actually in a lot of just the stores 00:40:10.413 --> 00:40:14.428 within airports. 00:40:14.428 --> 00:40:18.472 You can get the KN95 masks. That's a 00:40:18.472 --> 00:40:19.723 worthwhile investment because that protects the wearer 00:40:21.348 --> 00:40:25.412 That's another step you can take. 00:40:25.412 --> 00:40:28.222 And then if you're visiting grandma, depending upon the 00:40:28.222 --> 00:40:31.100 environment you're coming back into, modifying your practices 00:40:31.100 --> 00:40:34.598 so that you're actually having safe encounters with them. 00:40:34.598 --> 00:40:38.099 I think one of the most important points here is that 00:40:38.099 --> 00:40:42.224 when families come together, it's often intergenerational. 00:40:42.224 --> 00:40:43.474 And that our older residents are particularly vulnerable 00:40:43.474 --> 00:40:47.411 forbad outcomes. 00:40:47.411 --> 00:40:51.598 In Marin County, 95 percent of our deaths are among people 65 00:40:51.598 --> 00:40:53.412 or greater. And that's -- and we also 00:40:53.412 --> 00:40:55.598 know it's a lot to ask if someone 00:40:55.598 --> 00:40:59.662 trav else but not to see them at all. 00:40:59.662 --> 00:41:02.287 So the idea is if you do want to visit someone who's at Hispanic 00:41:05.224 --> 00:41:10.537 to do it socially distanced. You can get together with 00:41:10.537 --> 00:41:11.974 grandma outside where, go to a park or your yard and 00:41:11.974 --> 00:41:14.100 sit far enough apart. 00:41:14.100 --> 00:41:18.162 Cover your face. And you can have that time 00:41:18.162 --> 00:41:19.976 together but in a safer way. 00:41:24.098 --> 00:41:26.785 So, Matthew, you can have a few things for 00:41:26.785 --> 00:41:30.347 us, I think, also, and then we'll be 00:41:30.347 --> 00:41:32.975 going to public comment on the administrator's report and the 00:41:32.975 --> 00:41:36.974 COVID report. >>MATTHEW H. HYMEL: Yeah, I just 00:41:36.974 --> 00:41:40.097 want to point out a couple of comments regarding comments 00:41:40.097 --> 00:41:44.225 on consent calendar B this morning. 00:41:44.225 --> 00:41:46.598 HHS has submitted a revised 00:41:46.598 --> 00:41:48.350 1 A based upon the feedback. 00:41:48.350 --> 00:41:52.347 >>PRES. KATIE RICE: Can you say that again? 00:41:52.347 --> 00:41:55.221 >>MATTHEW H. HYMEL: CB1A. And that's 00:41:55.221 --> 00:41:59.288 based on some feedback from the towfn corps to 00:41:59.288 --> 00:42:01.288 Madera and be clear around the interim housing report of that 00:42:01.288 --> 00:42:04.848 service. And so if you could consider 00:42:04.848 --> 00:42:08.912 that item when you consider the Consent Calendar B. 00:42:08.912 --> 00:42:13.036 And then, secondly, based on some public requests, 00:42:13.036 --> 00:42:16.348 I'd like to remove CB2 for discussion. 00:42:16.348 --> 00:42:20.725 That's the sheriff's item. And the sheriff would be 00:42:20.725 --> 00:42:21.098 available to spec to that when we get to the Consent Calendar B 00:42:22.475 --> 00:42:26.473 >>PRES. KATIE RICE: Okay. All right. 00:42:26.473 --> 00:42:29.034 Thank you. So, Al, we can go to public 00:42:32.848 --> 00:42:36.350 And seeing that we've got a lot of folks here today, we'll keep 00:42:36.350 --> 00:42:38.849 it two minutes, please, for comments. 00:42:38.849 --> 00:42:43.038 >>MODERATOR: Okay. Madame Chair, we have speakers 00:42:43.038 --> 00:42:47.724 Tfirst speaker is Julia S. Followed by coalition of 00:42:47.724 --> 00:42:49.223 sensible taxpayers and roe v Paulson 00:42:49.223 --> 00:42:52.724 . Jewellia, please unmute and you 00:42:52.724 --> 00:42:56.224 have the option to share video. >>SPEAKER: Hi, hello. 00:42:56.224 --> 00:42:59.287 I actually, my comment was related to what was mentioned 00:42:59.287 --> 00:43:03.350 about the sheriff. And my name is Julia. 00:43:03.350 --> 00:43:07.600 I'm a resident of San Anselmo. >>PRES. KATIE RICE: 00:43:07.600 --> 00:43:10.475 Julia, we are going to be on the Consent 00:43:10.475 --> 00:43:12.222 Calendar pretty quick. We will be discussing that item 00:43:12.222 --> 00:43:14.035 then. If you could wait, that will be 00:43:14.035 --> 00:43:17.973 great. >>SPEAKER: I will have to go 00:43:17.973 --> 00:43:22.222 before then. >>PRES. KATIE RICE: Well, that's 00:43:22.222 --> 00:43:24.410 how this works. It should be fairly soon. 00:43:28.535 --> 00:43:33.225 coalition of sensible taxpayers. Please unmute and 00:43:33.225 --> 00:43:35.037 you have the option to share video. 00:43:35.037 --> 00:43:37.599 >>SPEAKER: Yes. Can you hear me? 00:43:37.599 --> 00:43:41.598 >>MODERATOR: Yes. >>SPEAKER: Okay. 00:43:41.598 --> 00:43:46.411 This is me me Willard. And I had 00:43:46.411 --> 00:43:50.411 three comments that I'd like to make that I'm hoping 00:43:50.411 --> 00:43:56.474 that Dr. Willis will comment on. The first one 00:43:56.474 --> 00:44:00.288 is just to encourage ablook for your in 00:44:04.040 --> 00:44:08.349 reopening that's sustainable, which I think is really 00:44:08.349 --> 00:44:11.287 important both for business and the public's unstanding of 00:44:11.287 --> 00:44:15.411 where we are. 00:44:15.411 --> 00:44:19.159 And we had the situation in June going 00:44:19.159 --> 00:44:24.348 into July where we had a pretty rushed reopening that 00:44:24.348 --> 00:44:28.035 resulted in a spiked follow that happened around the July 4th 00:44:28.035 --> 00:44:32.413 holiday. And we had another pretty 00:44:32.413 --> 00:44:36.788 dramatic reopening announced on October 27th only 00:44:36.788 --> 00:44:39.536 to be toggled back again now 00:44:39.536 --> 00:44:43.537 . I just would like some comments 00:44:43.537 --> 00:44:45.476 to that, what we can do to just put us on a more 00:44:45.476 --> 00:44:49.162 stable, predictable trajectory. 00:44:49.162 --> 00:44:52.725 Number two, communication. I think it's a little confusing 00:44:52.725 --> 00:44:56.787 because of this start/stop thing. 00:44:56.787 --> 00:44:59.598 And that we close the sit violation recording 00:44:59.598 --> 00:45:03.476 email on September 1. 00:45:03.476 --> 00:45:06.975 And on October 27th said we're no longer using the term of 00:45:06.975 --> 00:45:09.287 shelter in place and put an emphasis on individual 00:45:09.287 --> 00:45:13.223 responsibility. And I'm quite concerned that 00:45:13.223 --> 00:45:15.972 that kind of sends people the all clear signal to have bad 00:45:15.972 --> 00:45:20.972 behavior like all these gatherings that you're talking 00:45:20.972 --> 00:45:24.911 about, which aren't helping the public health and business side 00:45:24.911 --> 00:45:28.851 of things. I'd also, I'm not really sure 00:45:28.851 --> 00:45:31.599 how best also to get out your communication about the 00:45:31.599 --> 00:45:35.286 restrictions because a lot of people don't go to your website. 00:45:35.286 --> 00:45:38.223 IJ isn't always up-to-date on this, though they try. 00:45:38.223 --> 00:45:41.411 But it's not always realtime. And a lot of people don't read 00:45:41.411 --> 00:45:42.975 the IJ. >>PRES. KATIE RICE: Thank you, 00:45:42.975 --> 00:45:45.722 Mimi. >>SPEAKER: Something better 00:45:45.722 --> 00:45:47.918 could be done there. And, finally. 00:45:47.918 --> 00:45:51.974 >>MODERATOR: The next speaker is Robby Paulson. 00:45:51.974 --> 00:45:54.913 Robby, please unmute and you have the option to share video 00:45:54.913 --> 00:45:56.536 . >>SPEAKER: Good morning, 00:45:56.536 --> 00:46:00.660 Supervisors. Can you hear me? 00:46:00.660 --> 00:46:03.785 >>MODERATOR: Yes. >>SPEAKER: Yeah. Basically, I'm 00:46:05.412 --> 00:46:09.725 Willis. Looking for clarification right 00:46:09.725 --> 00:46:12.100 now in terms of guidance 00:46:12.100 --> 00:46:16.597 towards unhoused community members, 00:46:16.597 --> 00:46:20.036 people who are living in Richardson Bay, people living on 00:46:20.036 --> 00:46:23.410 Milford road right now because what we've seen out on the 00:46:23.410 --> 00:46:27.788 streets is that once the sip starts to come back, that tends 00:46:27.788 --> 00:46:30.473 to make the sheriffs boulder. Right now, I mean, on 00:46:30.473 --> 00:46:34.784 Milford road just the other day, the day 00:46:34.784 --> 00:46:37.535 after the HomeKey got rejected, the 70 beds got 00:46:37.535 --> 00:46:41.160 lost. Sheriffs came up to the top of 00:46:41.160 --> 00:46:45.160 the road to a motor home, unhitched a truck from the 00:46:45.160 --> 00:46:47.724 trailer of a couple lifelong residents, wife has 00:46:47.724 --> 00:46:51.537 cancer, took their truck that they used to 00:46:51.537 --> 00:46:56.033 move their motor home. Stranding them up at the 00:46:56.033 --> 00:46:58.036 top of bid Ford road. And now, you know, now 00:46:58.036 --> 00:47:01.660 they have to rely on other people to taxi 00:47:01.660 --> 00:47:05.537 them around. And I'm just questioning where 00:47:05.537 --> 00:47:07.599 is -- where has your stance been in regards to the sheriff's 00:47:07.599 --> 00:47:11.913 behavior? Including Richardson Bay where 00:47:11.913 --> 00:47:15.350 back on September 24th and back in July 00:47:15.350 --> 00:47:19.848 when there was those sip started to come back we saw 00:47:19.848 --> 00:47:23.409 threats from Curtis. We saw Hale 00:47:23.409 --> 00:47:26.221 y Allen lost her home and now she's couch surfing, 00:47:26.221 --> 00:47:27.785 still. And, again, that's during the 00:47:27.785 --> 00:47:31.537 pandemic. I think you ought to be giving 00:47:31.537 --> 00:47:35.847 clear direction and really be listening to those communities 00:47:35.847 --> 00:47:38.974 right now because I think what the sheriff's behavior is really 00:47:38.974 --> 00:47:43.413 uncalled-for and it's not -- it's going against the interest 00:47:43.413 --> 00:47:45.285 of public health. Thank you. 00:47:48.350 --> 00:47:52.413 Next speaker is caller with telephone number ending in 000. 00:47:52.413 --> 00:47:58.598 Please up mute. 00:47:59.912 --> 00:48:01.226 >>SPEAKER: Hello, can you hear me? 00:48:01.226 --> 00:48:03.349 >>MODERATOR: Yes. >>SPEAKER: Yes. 00:48:03.349 --> 00:48:07.475 Thank you. My name is Kevin Malone. 00:48:07.475 --> 00:48:11.099 And my question goes back to the pandemic 00:48:11.099 --> 00:48:15.475 . Does the county feel that we 00:48:15.475 --> 00:48:19.598 have adequate vaccine distribution infrastructure at 00:48:19.598 --> 00:48:21.600 this time, refrigeration and whatever else will be needed 00:48:21.600 --> 00:48:25.660 in this unique situation? 00:48:25.660 --> 00:48:27.850 Have you gone out and talked to private organizations like 00:48:31.785 --> 00:48:34.223 The good news is that we do have vaccinations coming, but are we 00:48:34.223 --> 00:48:38.348 set up to effectively distribute them? 00:48:38.348 --> 00:48:42.036 And if not, what will the Board of Supervisors do to help 00:48:44.034 --> 00:48:47.848 Thank you. >>MODERATOR: Thank you. 00:48:47.848 --> 00:48:52.039 The next two speakers are Lias K. 00:48:52.039 --> 00:48:54.473 Followed Noah grif 00:48:54.473 --> 00:48:58.911 . Please unmute and you have the 00:48:58.911 --> 00:49:02.975 option to share video. 00:49:05.911 --> 00:49:09.599 I have a question directly for you. 00:49:09.599 --> 00:49:13.975 I'm concerned about the number of folks who are essential 00:49:13.975 --> 00:49:18.038 workers for facing extreme debt right now 00:49:18.038 --> 00:49:21.285 . Moving in and out of the 00:49:25.098 --> 00:49:29.347 for those people because when we go into a shutdown situation, 00:49:29.347 --> 00:49:32.099 then debt collectors have less capability of 00:49:32.099 --> 00:49:36.162 collecting on debts. And then when we move out of 00:49:36.162 --> 00:49:38.660 them, debt collectors can then come back and start 00:49:38.660 --> 00:49:42.724 collecting again. 00:49:42.724 --> 00:49:45.723 They sometimes don't necessarily understand, the debt collectors, 00:49:48.910 --> 00:49:52.973 going back and forth. There's lag time in 00:49:52.973 --> 00:49:56.975 understanding. When we stop shutdowns the way 00:49:56.975 --> 00:50:01.224 we have been doing here in Marin County and seeing these waves 00:50:01.224 --> 00:50:02.847 of surges, which, I mean, I 00:50:02.847 --> 00:50:07.285 can't imagine that you couldn't have 00:50:07.285 --> 00:50:10.097 expected this to have happened. We're putting 00:50:10.097 --> 00:50:11.222 essential workers in a situation: They have to 00:50:11.222 --> 00:50:14.535 work. They don't have a choice. 00:50:14.535 --> 00:50:18.599 They have to work to pay their debts. 00:50:18.599 --> 00:50:21.974 Whereas, you know, there's folks here talking about well white 00:50:21.974 --> 00:50:24.850 people can stay home and this and that. 00:50:24.850 --> 00:50:28.099 That's not an options for people living in the Canal. 00:50:28.099 --> 00:50:32.224 They have to work. They have to go. 00:50:32.224 --> 00:50:33.787 Health care workers are not the only essential workers 00:50:33.787 --> 00:50:37.912 . Okay. 00:50:37.912 --> 00:50:39.225 There's all these people packing your goods and Amazon. 00:50:41.661 --> 00:50:43.286 your food. There's all these people working 00:50:43.286 --> 00:50:46.473 in the stores. They don't have a choice. They 00:50:46.473 --> 00:50:50.598 have to go to work. So when you keep opening up like 00:50:50.598 --> 00:50:52.162 this, you know, yeah, you're opening up for white folks to 00:50:52.162 --> 00:50:55.350 go down the store and infect all 00:50:55.350 --> 00:50:58.475 our brown people. It's super messed up. 00:50:58.475 --> 00:51:01.035 And you guys need to be talking about this. 00:51:01.035 --> 00:51:04.537 It's just ignored. It's kind of like oh, you know, 00:51:04.537 --> 00:51:08.350 I'll give it five minutes. Things got a little bit better 00:51:08.350 --> 00:51:11.097 for people living in the Canal. It's not the case. 00:51:11.097 --> 00:51:14.598 >>PRES. KATIE RICE: Thank you, Elias. 00:51:14.598 --> 00:51:16.722 >>MODERATOR: Thank you. The next speaker is 00:51:16.722 --> 00:51:21.223 Noah Griffin. Noah, please unmute and you have 00:51:21.223 --> 00:51:29.222 the option to share video. 00:51:31.098 --> 00:51:35.160 >>PRES. KATIE RICE: No. He's here. 00:51:35.160 --> 00:51:37.597 >>MODERATOR: I'm sorry. 00:51:41.661 --> 00:51:45.732 >>PRES. KATIE RICE: We can't hear you, Noah 00:51:45.732 --> 00:52:06.684 . 00:52:10.788 --> 00:52:16.223 see you but we can't hear you. 00:52:24.160 --> 00:52:28.473 cannot hear you. It locks like you are unmuted 00:52:28.473 --> 00:52:32.349 but we cannot hear you. Can you come back at open time 00:52:32.349 --> 00:52:35.412 ? All right. 00:52:35.412 --> 00:52:38.669 Thank you. >>MODERATOR: Madame Chair, we 00:52:38.669 --> 00:52:42.788 have one more speaker, Rodrigo Izquierdo. 00:52:42.788 --> 00:52:54.856 Please unmute and you have the option to share video. 00:52:58.913 --> 00:53:01.971 >> Hello there, good morning. Dr. Willis, I 00:53:01.971 --> 00:53:06.225 wanted -- looking at your stats that you showed a 00:53:06.225 --> 00:53:10.412 while ago, it showed that the Latino 00:53:10.412 --> 00:53:14.538 communities infections had gone down. 00:53:14.538 --> 00:53:19.348 And I was just wondering if that has to do with 00:53:19.348 --> 00:53:25.036 the term "herd immunity" 00:53:25.036 --> 00:53:28.037 . Versus reinfection. 00:53:32.472 --> 00:53:36.848 a person who already got the virus be reinfected 00:53:36.848 --> 00:53:40.409 ? Which will count, which will 00:53:40.409 --> 00:53:44.722 show up in your statistics. So would you comment on whether 00:53:44.722 --> 00:53:49.286 herd immunity has taken hold in the Canal 00:53:49.286 --> 00:53:53.910 area? Because that's basically a super 00:53:53.910 --> 00:53:57.910 spreader area. There's just no escaping 00:53:57.910 --> 00:54:02.723 being around a person 00:54:02.723 --> 00:54:05.785 or building that is used. 00:54:05.785 --> 00:54:09.785 It's a community place. And they just cannot escape it. 00:54:09.785 --> 00:54:13.849 It's the same grocery stores. It's the same gas station 00:54:13.849 --> 00:54:17.975 . It's the same community center. 00:54:17.975 --> 00:54:23.222 So would you comment on herd immunity and 00:54:23.222 --> 00:54:26.724 whether -- how that might pertain to reinfection 00:54:26.724 --> 00:54:30.912 ? Thank you. 00:54:30.912 --> 00:54:34.973 >>MODERATOR: Thank you. The next speaker is Eva. 00:54:34.973 --> 00:54:42.097 Eva, please unmute and you have the option to share video. 00:54:46.287 --> 00:54:47.475 looks like Eva changed her mind. We have no additional speakers 00:54:47.475 --> 00:54:50.223 . >>PRES. KATIE RICE: All right. 00:54:50.223 --> 00:54:54.538 Thank you, Al. Dr. Willis, a couple questions 00:54:54.538 --> 00:54:57.100 there around vaccine infrastructure, socioeconomic 00:55:00.038 --> 00:55:04.724 important, and then herd immunity. 00:55:04.724 --> 00:55:09.036 And the question around guides for the unhoused 00:55:09.036 --> 00:55:12.911 . >>DR. WILLIS: So vaccine 00:55:16.971 --> 00:55:20.538 are -- the way the vaccine distribution works is there will 00:55:20.538 --> 00:55:25.975 be the federal procurement of the vaccine from probably the 00:55:25.975 --> 00:55:28.472 two main manufacturers, Pfizer and moderno are likely to make 00:55:28.472 --> 00:55:32.037 it to Marin. That will be distributed to the 00:55:32.037 --> 00:55:36.348 state and then the state will distribute it to local health 00:55:36.348 --> 00:55:40.098 departments as well as local multi-county entities like 00:55:44.161 --> 00:55:47.098 So we are now in twice weekly conversations with California 00:55:50.848 --> 00:55:52.473 the statewide plan and Marin. We have a team dedicated to 00:55:52.473 --> 00:55:55.721 that. We also have weekly meetings 00:55:55.721 --> 00:55:58.349 with all of our health care partners to define not only the 00:55:58.349 --> 00:56:01.409 vaccine distribution process but this is something that's been 00:56:01.409 --> 00:56:05.536 going on since the beginning of the pandemic. 00:56:05.536 --> 00:56:08.286 Those relationships have -- historical 00:56:08.286 --> 00:56:10.035 relationships have really been strengthened by 00:56:10.035 --> 00:56:13.223 coming together around this pandemic response. 00:56:13.223 --> 00:56:16.035 Those are the rails we'll be righting on when the vaccine 00:56:16.035 --> 00:56:20.098 arrives to get it out to our communities. 00:56:20.098 --> 00:56:23.975 The current -- the priority right now is actually 00:56:23.975 --> 00:56:25.847 defining who will be in that tier 00:56:25.847 --> 00:56:28.349 1A they're calling it. That subset of individuals who 00:56:28.349 --> 00:56:32.286 will get the first doses when they arrive. 00:56:32.286 --> 00:56:36.597 That's likely to be essential workers, those who are at high 00:56:36.597 --> 00:56:39.285 rest risk themselves of being exposed and the higher risk of 00:56:39.285 --> 00:56:41.910 bad outcomes if they were in fact infected. 00:56:41.910 --> 00:56:43.600 Older healthcare workers and healthcare workers with chronic 00:56:43.600 --> 00:56:47.597 conditions. And then combination of those 00:56:47.597 --> 00:56:49.661 that are at the highest risk for the highest level of exposure, 00:56:49.661 --> 00:56:52.285 emergency department first responders et cetera. 00:56:52.285 --> 00:56:56.286 So those are some of the conversations that are happening 00:56:56.286 --> 00:56:58.536 now in so far as. The question 00:56:58.536 --> 00:57:02.599 was around refrigeration. 00:57:02.599 --> 00:57:04.974 The moderno vaccine, we basically already have 00:57:04.974 --> 00:57:06.349 that refrigeration infrastructure in 00:57:06.349 --> 00:57:09.413 place. It's conventional. 00:57:09.413 --> 00:57:13.536 It's the way we store vaccines of all types. 00:57:13.536 --> 00:57:15.911 It's part, we'll amplify that. Easy to he 00:57:15.911 --> 00:57:19.910 acquire Reg refrigeration. 00:57:19.910 --> 00:57:22.972 The ultra cold drious is the state is 00:57:22.972 --> 00:57:26.036 helping us with that. We have contracts with dry ice 00:57:26.036 --> 00:57:30.349 companies when that arrives. We're looking to implement as 00:57:30.349 --> 00:57:34.410 early as we would be ready as early as December for that. 00:57:34.410 --> 00:57:36.161 It's not likely to be really needed until the vaccine 00:57:36.161 --> 00:57:39.788 is looking like early January, 00:57:39.788 --> 00:57:42.038 early to mid January might be the earliest time within the 00:57:42.038 --> 00:57:44.972 state of California we would receive vaccine. 00:57:44.972 --> 00:57:49.222 That's partly because the state has imposed and I think 00:57:49.222 --> 00:57:51.660 appropriately an extra step, which is an interval of 00:57:51.660 --> 00:57:55.537 independent analysis of the safety and efficacy of the 00:57:55.537 --> 00:57:59.472 vaccine through a blue ribbon commission that's established by 00:57:59.472 --> 00:58:02.160 the governor and includes people I respect a lot in the 00:58:02.160 --> 00:58:05.224 Bay Area and others who will be looking 00:58:05.224 --> 00:58:08.348 at the data and really re-examining the data to be 00:58:08.348 --> 00:58:12.346 sure that we can stand behind this product before we bring it 00:58:12.346 --> 00:58:16.725 out to our people. The 00:58:16.725 --> 00:58:21.535 essential workers question, you know, I think Elias 00:58:23.912 --> 00:58:28.162 clear that the message I was trying to offer and will 00:58:28.162 --> 00:58:33.097 continue to offer is that as this epidemic shifts in 00:58:33.097 --> 00:58:38.035 its pattern for us in Marin 00:58:38.035 --> 00:58:38.785 and it is happening elsewhere in the 00:58:38.785 --> 00:58:41.786 state, we are moving from essential workers into 00:58:41.786 --> 00:58:44.910 lesseesential, nonessential activities. 00:58:44.910 --> 00:58:49.288 And there's a big difference in terms of those people who are 00:58:49.288 --> 00:58:53.097 exposed by virtue of an essential work, essential for us 00:58:53.097 --> 00:58:56.035 as a community that they serve those functions are grocers, are 00:58:56.035 --> 00:58:59.475 physicians, all are essential. Someone who's working on the 00:58:59.475 --> 00:59:02.349 front lines in the grocery store is just as essential in many 00:59:02.349 --> 00:59:05.098 ways as a health care worker because we lie on that for 00:59:05.098 --> 00:59:09.100 nutrition. So those people while they are 00:59:09.100 --> 00:59:10.600 lower paid are equally essential and in fact are less free to not 00:59:14.474 --> 00:59:16.910 on it to make ends meet. So we have always recognized the 00:59:16.910 --> 00:59:20.286 disproportional impact on our lower income communities, 00:59:20.286 --> 00:59:21.911 especially communities of color and really focus on that as a 00:59:21.911 --> 00:59:26.286 priority. I think one of the reasons we're 00:59:26.286 --> 00:59:31.163 seeing success in that is that we've -- and this is combined 00:59:31.163 --> 00:59:32.847 with Mr. Ease key heir dough's question about herd immunity 00:59:32.847 --> 00:59:36.349 . One of the reasons we're seeing 00:59:36.349 --> 00:59:38.663 success in fewer cases among our essential workers is that 00:59:38.663 --> 00:59:43.098 there's been a lot of work to make sure that they have the 00:59:43.098 --> 00:59:47.222 resources they need to not work if they're infected with 00:59:49.975 --> 00:59:53.534 housing available for them, that our contact tracers are reaching 00:59:53.534 --> 00:59:56.036 out and offering them those resources as early as one day 00:59:56.036 --> 00:59:58.786 after their infection is recognized and a collection of 00:59:58.786 --> 01:00:01.847 those things over time combined with a lot of the messaging 01:00:01.847 --> 01:00:05.535 that's gone through the Canal outbreak response plan and now 01:00:05.535 --> 01:00:08.660 the Novato outbreak response plan, the prevention plan in 01:00:08.660 --> 01:00:12.286 Novato, not an outbreak there, but we're trying to prevent it. 01:00:12.286 --> 01:00:15.910 Those messages have allle so table hold and the adherence to 01:00:15.910 --> 01:00:18.037 facial covering, I'm her in the Canal now where my office is, is 01:00:18.037 --> 01:00:20.100 really good. I mean people are walking around 01:00:20.100 --> 01:00:24.474 the community. You don't see people without 01:00:24.474 --> 01:00:27.662 masks. That's partly 01:00:27.662 --> 01:00:32.911 whole constellation of strategies has 01:00:32.911 --> 01:00:35.785 contributed to the dress. To herd immunity, we worked with 01:00:35.785 --> 01:00:40.099 Marin community clinics to do antibody testing for all their 01:00:40.099 --> 01:00:44.538 patients. They serve our Latinx community. 01:00:47.660 --> 01:00:52.285 20 percent individuals who live in the Canal area, high 01:00:52.285 --> 01:00:53.972 prevalence, 15 of a few hundred that have been tested with 01:00:53.972 --> 01:00:56.659 antibodies have those antibodies. 01:00:56.659 --> 01:00:58.598 So 08 percent or so still do not have antibodies. 01:00:58.598 --> 01:01:00.598 So that community remains vulnerable. 01:01:00.598 --> 01:01:04.723 So it's not due to herd immunity. 01:01:04.723 --> 01:01:08.848 There may be some fractional benefit from an 01:01:08.848 --> 01:01:13.099 immunological standpoint but some are more 01:01:13.099 --> 01:01:16.413 likely to be the reinfected. It's really more based on 01:01:16.413 --> 01:01:20.162 the strategies and the credit now 01:01:20.162 --> 01:01:24.787 for 5 to 3 percent positivity rate in that community where it 01:01:24.787 --> 01:01:30.100 used to be up to 40 percent positivity. 01:01:33.225 --> 01:01:36.348 So there was a suggestion that there feels herky jerky in terms 01:01:36.348 --> 01:01:39.660 of opening and closing and that's obviously, I think, part 01:01:39.660 --> 01:01:42.661 of the national and international dilemma with this 01:01:42.661 --> 01:01:46.473 pandemic response is we're trying to balance the economy 01:01:46.473 --> 01:01:48.224 and allowing things to be as relaxed as they can be, offer 01:01:48.224 --> 01:01:52.287 people as much freedom as we can. 01:01:52.287 --> 01:01:54.474 But then also recognizing that the things that prevent 01:01:58.849 --> 01:02:02.034 are restrictions, are less travel, are less commerce, 01:02:02.034 --> 01:02:04.788 closing things is one of the ways that we actually control 01:02:04.788 --> 01:02:06.536 the pandemic. And it's just a constant dance 01:02:06.536 --> 01:02:09.036 between those two competing values. 01:02:09.036 --> 01:02:11.722 And we're doing our best in Marin to do that. 01:02:11.722 --> 01:02:14.724 We've done that through the Marin recovers group. 01:02:14.724 --> 01:02:18.223 I would suggest that we've navigated this relatively 01:02:18.223 --> 01:02:21.159 successfully, given that we have been following the orange tier 01:02:21.159 --> 01:02:24.536 policies for the past month, unlike a lot of counties that 01:02:24.536 --> 01:02:27.534 chose to have more restrictive policies despite being in the 01:02:27.534 --> 01:02:30.723 orange tier, we've had lower increases in case rates than 01:02:30.723 --> 01:02:33.410 most counties around us despite the fact that we have had some 01:02:33.410 --> 01:02:36.848 of the more open policies We have' opened schools. 01:02:36.848 --> 01:02:39.349 70 schools open in Marin County. But we haven't seen the surges 01:02:39.349 --> 01:02:41.847 that we're seeing in adjacent counties that didn't open 01:02:41.847 --> 01:02:44.350 schools and had more restrictive policies. 01:02:44.350 --> 01:02:48.475 So to me that's where the nugget is in terms of the hope that 01:02:48.475 --> 01:02:50.285 we're doing something right that we can hang onto and do 01:02:50.285 --> 01:02:54.411 more of that might be particular to Marin. 01:02:54.411 --> 01:02:56.037 I'm hoping that it's a cultural norm, awareness within our 01:02:59.163 --> 01:03:03.725 which we protect one another by taking those everyday measures 01:03:03.725 --> 01:03:05.036 of physical distancing, covering our faces and hopefully, and 01:03:09.349 --> 01:03:11.849 attending indoor social gatherings. 01:03:11.849 --> 01:03:13.034 Are there any other questions you wanted me to address, 01:03:13.034 --> 01:03:17.038 Supervisor? >>PRES. KATIE RICE: I think the 01:03:17.038 --> 01:03:20.850 last one was just around guidance for the unhoused 01:03:20.850 --> 01:03:24.973 . >>DR. WILLIS: Yeah, well, the 01:03:24.973 --> 01:03:26.724 unhoused are housed. It's the same. 01:03:26.724 --> 01:03:28.787 We protect ourselves in the same ways. 01:03:28.787 --> 01:03:31.349 We protect those around us in the same ways. 01:03:31.349 --> 01:03:33.975 So we cover our face, we socially distance. 01:03:33.975 --> 01:03:37.224 The virus will not transmit between two individuals if 01:03:37.224 --> 01:03:41.035 they're not close together with no facial. 01:03:41.035 --> 01:03:42.347 People are CS-together indoors without facial, the virus will 01:03:42.347 --> 01:03:45.222 transmit. Doesn't matter whether you're 01:03:45.222 --> 01:03:47.225 housed or unhoused or whether you're rich or you're poor. 01:03:47.225 --> 01:03:50.473 That's the way the virus gets transmitted. 01:03:50.473 --> 01:03:54.537 So we want to make sure that people who are unhoused also 01:03:54.537 --> 01:03:56.285 have access to all the resources to protect themselves and those 01:03:56.285 --> 01:03:58.974 around them. Facial covering, social 01:03:58.974 --> 01:04:01.288 distancing, et cetera. We've also I think recognized 01:04:01.288 --> 01:04:04.347 that there are fewer opportunities to make safe 01:04:04.347 --> 01:04:07.599 choices for people that don't have those freedoms, especially 01:04:07.599 --> 01:04:11.911 unhoused. So we have offered housing to 01:04:11.911 --> 01:04:15.225 our unhoused population. The COVID-19 pandemic response 01:04:15.225 --> 01:04:18.350 if it has any silver linings, and there are some, one of them 01:04:18.350 --> 01:04:20.909 is what it's done to really jump start our effort to get people 01:04:20.909 --> 01:04:22.848 who are living on the streets into housing. 01:04:22.848 --> 01:04:26.347 And we have been successful in doing that. 01:04:26.347 --> 01:04:28.850 We've moved dozens of people who had been previously unhoused 01:04:28.850 --> 01:04:31.912 into housing as part of the pandemic response. 01:04:31.912 --> 01:04:33.224 And we've had special funding to be able to do that with new 01:04:33.224 --> 01:04:37.223 resources coming on Board to do that. 01:04:37.223 --> 01:04:38.100 And that will be a lasting positive legacy of this interval 01:04:42.222 --> 01:04:44.285 And so, again, I think the message is the same messages 01:04:48.036 --> 01:04:50.410 And the other message is for us in terms of civic leadership to 01:04:50.410 --> 01:04:54.410 make sure that the resources are available for people who are 01:04:54.410 --> 01:04:55.850 unhoused to get into housing. >>PRES. KATIE RICE: All right. 01:04:59.911 --> 01:05:03.099 Really appreciate all your work and also your really clear and 01:05:03.099 --> 01:05:07.909 thorough answers and communicating out to us and to 01:05:07.909 --> 01:05:10.286 the public, really important. So with that, have a good rest 01:05:11.849 --> 01:05:13.782 week. >>DR. WILLIS: Thank you.