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HomeMy WebLinkAbout12.03.20 FW_ SYASL COVID-19 Update From:Ring, Brian To:Alpert, Bruce;Bennett, Robin;Clerk of the Board;Connelly, Bill;Cook, Holly;Lambert, Steve;Lucero, Debra; McCracken, Shari;Paulsen, Shaina;Pickett, Andy;Ring, Brian;Ritter, Tami;Rodas, Amalia;Sweeney, Kathleen; Teeter, Doug Cc:Pickett, Andy;Snyder, Ashley Subject:FW: SYASL COVID-19 Update Date:Thursday, December 3, 2020 6:54:11 PM Attachments:SYASL COVID-19 Update 12.3.20.pdf Good evening Board – FYI. A summary of the Governor’s COVID update is attached. Brian Ring Assistant Chief Administrative Officer Administration 25 County Center Drive, Oroville, CA 95965 T: From: SYASL County Info <SYASLCountyInfo@SYASLpartners.com> Sent: Thursday, December 3, 2020 5:07 PM To: SYASL County Info <SYASLCountyInfo@SYASLpartners.com> Subject: SYASL COVID-19 Update ATTENTION: This message originated from outside Butte County. Please exercise judgment before opening .. attachments, clicking on links, or replying. To: County Administrative Officers and Interested Parties From: Paul J. Yoder and Karen Lange Date: December 3, 2020 RE: SYASL COVID-19 Update Please find attached our daily SYASL COVID-19 update. -Paul and Karen COVID-19 Updates www.covid19.ca.gov December 3, 2020 Newsom Administration - Resources / Mutual Aid / Executive Orders Today, Governor Newsom announced a new Regional Stay-at-Home Order that requires further sector shutdowns, a halt on non-essential travel, and self-quarantine for 3 weeks once a region has below 15% ICU capacity. There are five regions: Northern CA, Bay Area, Greater Sacramento, San Joaquin Valley, and Southern CA. All regions are anticipated to have to abide by the stay-at-home order during the month of December, some as early as next week. After the 3 week stay-at-home order, each county will then go back to the appropriate tier based on their own individual county data. —ƚǒ ƒğǤ ğƌƭƚ ǝźĻǞ ƷŷĻ ƩĻŭźƚƓğƌ L/ ķğƷğ ŷĻƩĻ͵ The Governor also highlighted programs available to small businesses and employees who miss work due to COVID-19. You may view the press release from todays briefing here, slides here and SYASL staff notes here. Please check the California Department of Public Health website here for the latest guidance documents. Broadband Today, Senator Lorena Gonzalez and others announced a Broadband for All bill that would provide critical funding to deploy high-quality broadband infrastructure to end the inequity California low-income, rural, urban families and minorities face in work, education, and healthcare due to lack of internet access. The bill aims to empower local governments to build securely with greater state support through bond financing and increase the ability to better leverage federal funds. You may view the bill language here, a fact sheet here, and SYASL staff notes here. Legislative / Budget News -19 here page for updates. The LAO has been releasing a series of reports regarding Federal actions affecting California related to developments around COVID-19. View here. 1:015031!!12;53!QN! SO!31!273:4!!QBHF2 Bo!bdu!up!bee!Tfdujpo!231:7/4/6!up!uif!Hpwfsonfou!Dpef-!boe!up!bnfoe! Tfdujpot!392-!:23/3-!boe!:25/8!pg-!boe!up!bee!Tfdujpo!392/3!up-!uif!Qvcmjd! Vujmjujft!Dpef-!sfmbujoh!up!dpnnvojdbujpot-!boe!efdmbsjoh!uif!vshfodz uifsfpg-!up!ublf!fggfdu!jnnfejbufmz/ E 31273:493286CJMMNT44 F S Z V Q D P F D T 1:015031!!12;53!QN! 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Uijt!cjmm!xpvme!qspwjef!uibu!op!sfjncvstfnfou!jt!sfrvjsfe!cz!uijt!bdu!gps!b tqfdjgjfe!sfbtpo/ )7*!Fyjtujoh!dpotujuvujpobm!qspwjtjpot!sfrvjsf!uibu!b!tubuvuf!uibu!mjnjut!uif!sjhiu pg!bddftt!up!uif!nffujoht!pg!qvcmjd!cpejft!ps!uif!xsjujoht!pg!qvcmjd!pggjdjbmt!boe!bhfodjft cf!bepqufe!xjui!gjoejoht!efnpotusbujoh!uif!joufsftu!qspufdufe!cz!uif!mjnjubujpo!boe!uif offe!gps!qspufdujoh!uibu!joufsftu/ Uijt!cjmm!xpvme!nblf!mfhjtmbujwf!gjoejoht!up!uibu!fggfdu/ )8*!Uijt!cjmm!xpvme!efdmbsf!uibu!ju!jt!up!ublf!fggfdu!jnnfejbufmz!bt!bo!vshfodz tubuvuf/ Wpuf;!34/!!Bqqspqsjbujpo;!op/!!Gjtdbm!dpnnjuuff;!zft/!!Tubuf.nboebufe!mpdbm qsphsbn;!zft/ E 31273:493286CJMMNT44 F S Z V Q D P F D T SB XX (Gonzalez) The Broadband for All Act S UMMARY access to broadband that has existed in our state for years. The implications of a continued long-term lack of Senate Bill XX will secure continuous funding and access to telehealth services for at-risk populations, or implement a number of critically needed reforms to the the loss of critical education time for developing California Advanced Services Fund (CASF) program students, are massive and must be addressed. administered by the California Public Utilities Commission (CPUC). These changes will help close the digital divide Even before the COVID-19 Pandemic, over half of all and meet the connectivity needs of Californians, both internet traffic was data-rich video, requiring higher- 2 during this unprecedented pandemic and for decades to capacity networks, and in 2017, 31% of Californians, 12 3 come. million people, had no or insufficient broadband access. E XISTING L AW Given current circumstances, the need for fast high- quality internet and future-proof infrastructure has never The CASF provides grants to bridge the digital divide in been more immediate or severe. The existing CASF unserved and underserved areas in the state.In 2017, AB program has a goal of providing sufficient internet access 1665 (E. Garcia, Chapter 851, Statutes of 2017) to 98% of Californians. However, four major problems authorized the CPUC to collect up to $330 million through with the current CASF program prevent the fund from the 2022 calendar year to fund the CASF through a achieving its goal. six public purpose programs, CASF is the only one that (1) CASF grants can be used for projects that deploy does not receive continuous funding. internet at speeds as slow as 10/1 mbps, which are incapable of meeting average household demands. On August 14, 2020, Governor Newsom signed Executive (2) Grant funds to build out broadband infrastructure are Order No. 73-20, which directed various state agencies to primarily reserved for areas that have internet at dial- collaboratively source solutions to address the digital up speeds or lower, leaving out many communities divide and set a goal for deploying high-speed 100 where Californians struggle with slightly faster but megabits per second (mbps) internet and infrastructure. still obsolete connectivity. (3) Local governments are currently last in the que to be B ACKGROUND/P ROBLEM considered for CASF funds, and many smaller and rural local governments with critical on-the-ground The COVID-19 Pandemic has exacerbated the deeply entrenched digital-divide, which has left many lower have the technical expertise to successfully obtain income, Latino, African American, and rural communities CASF grants. 1 without access to high-speed broadband services. (4) The CASF program is funded through a small Whether it be children doing homework outside of fast surcharge, which ends in 2022, leaving the CASF with food restaurants, or medically-fragile individuals who insufficient funding to achieve its stated goals. -health care, the pandemic has shown a spotlight on the inequality in 1. https://www.ppic.org/publication/californias-digital-divide/ 2. Strain, Garrett, Samir Gambhir, and Eli Moore. "AT&T's Digital Divide in California." (2017). 3. http://www.internetforallnow.org/2017_uc_berkeley_igs_study_on_california_digital_divide S OLUTION George Soares@sen.ca.gov SB XX will update the CASF by making communities eligible for grants based on their true internet need, promoting deployment of high-speed, 100mbps broadband, and making it easier for local governments to apply for grants and finance their own infrastructure. Additionally, SB XX recognizes that a long-term commitment is needed to develop future proof infrastructure, and removes the 2022 sunset on the CASF surcharge. SB XX ensures oversight and transparency by requiring a biennial audit of the program, and caps the surcharge fee at $0.23/month. Finally, the bill establishes the Broadband Bond Financing Securitization Account, which will fund the costs related to broadband bond financing and securities, including the deployment of infrastructure by a local government or nonprofit organizations. These programmatic and funding reforms are critical to bringing the CASF into the 21st century and finally investing in closing the digital divide in California once and for all. S UPPORT Electronic Frontier Foundation (Co-Sponsor) Common Sense (Co-Sponsor) Access Humboldt Access Now Fight for the Future Georgetown Friends of the Library Indivisible Sacramento InnovateEDU Louisville Metro Office of Civic Innovation and Technology New America's Open Technology Institute MakeKnowledge Mayor, City of Daly City Media Alliance MediaJustice Peninsula Young Democrats Public Knowledge Reddit, Inc. Tony Madrigal, Modesto City Councilmember, District 2 C ONTACT George Soares, (916) 651-4033 Senator Lena Gonzalez SB xx · (Lena Gonzalez) Fact Sheet · 12/02/20 Lena Gonzalez Broadband For All Press Conference 12.3.20 Gonzalez Grateful to incredible partners through this broadband discussion, this issue has become exasperated Thank partners Jim Steyer from Common Sense, Ilan Shapiro at AltaMed Health, Alpine County Supervisors David Griffith, Tracy Rhine from Rural County Representatives Here to talk about broadband for all We have witnessed how constituents across the state who struggle to access affordable reliable broadband Since this is required to function our economy, this is an urgent necessity, like any utility in the state Short term solutions are only a band aid to close the digital divide We need to think long term financing Broadband for all act is bold solution to update broadband infrastructure, potentially generate $1 billion in funding, make communities eligible for grants Bill recognizes long term plan for future proof, ensures long term capital to extend funding in California Services Fund Includes projects of infrastructure deployment Bill has over 50 organizations, also need federal leadership and many community supporters Anticipate federal partners to provide more support for broadband Jim Steyer, Common Sense Media Thank you for sticking to this, we are going to win this year You have to have broadband access to be a citizen in California, we need to provide this, There are over 1 million children, 1.3 million who lack sufficient access to broadband, many of them are Black or Latino This bill is the right solution and the good news it is a nonpartisan issue, applies to Alpine We are delighted to be a sponsor Gonzalez Thank you so much for sponsorship of this bill Supervisor Griffith, Alpine County Thank you, Senator Gonzalez for working to bring broadband to all Californians High speed broadband is a necessary utility We who live in area with no broadband or inadequate are Californians too Tracy Rhine, Rural counties Representatives of California This has become daily struggle, we had to purchase second plan We are able to coble together to limp along, our DSL is out again, I have to use my phone Past time to look at broadband as an essential utility Ilan Shapiro AltaMed Pleased to support this bill, I am a physician and have seen how reliable the technology is, but the access is where we have our problems We see how telehealth can be used to treat many things health wise Missing a day of work but having broadband access and opportunity to have conversation with doctors or other homes makes a huge difference Seen how medical patients have advanced in there health with products we have Black and Latino are the most impacted communities We stand proudly on this to close the digital divide Gonzalez Ended this portion, kick off to Q&A, LAO came out with reports that hundreds of thousands of urban and rural counties are unconnected in the State Questions XXXX How does this bill differ from the recent two broadband bills that failed to pass this past year? Gonzalez This will be introduced on Monday; this is different because it has a solution for funding The additional funds could be bond financing that we could receive from creating new fund, this is the largest opportunity to have funding that is substantial vs just having sunset Increasing technology standards and creates long term funding and financing XXXX What has changed since SB 1130 that failed and what are the chances you think for this in the next session? Gonzalez SB 1130 was created before the COVID environment, we knew with partners that there was an issue This made programmatic changes We are now shifting in this new bill to continuing to upgrade standards, but also create funding that will be long lasting XXXX What obstacles remain passing broadband for all in this session? Gonzalez We have to continue working with partners in Assembly, I look forward to working with Aguiar- Curry We will continue to work closely with our partners to grasp all the issues in this bill, we are seeing this is a health and small business issue Will continue forward for next year XXXX Do you think the pandemic experience of distance education has made this passage more likely? Steyer I do I think every parent I know, and teacher recognizes the critical need for this It is so unfair that Tracy is here by phone So unfair that low income kids and families are not able to access the internet to do proper distance learning The pandemic experience shows us why we were right to introduce this and that it is nonpartisan issue I hope the legislature will move this quickly because we will all benefit XXXX How will you ensure get projects get near the 100 mega bite goal? Gonzalez With SB 1130 we ensured the technology was there, we want to ensure there is future proof technology, ensuring fiber can be deployed learning lose and we have to ensure the technology is there This is the first draft and we look forward to inserting more elements and ideas Griffith The equity issue, we have in Alpine county doing well, we also have people on the other end have a laptop and it hits those kids hard and those kids will be suffering long after we are gone Rhine Just want to say thank you again for bringing this bill forward again and giving it the good try on why this is so important Steyer ful people, such a no brainer for all of us to do this Finally I think we will get help from the federal government Gonzalez We want to ensure this no fee structure fund getting high speed reliable internet for all Californians Thank all of you for joining Statewide Update on COVID-19 Response, December 3, 2020 DDb o Dec 2 18,591 new cases o 7-day average 15,121 The effects of Thanksgiving will be felt in a few weeks o 14-day positivity rate o Grown from 5.2% to 7% Hospitalizations have increased 86% over last 14 days ICU rates increased to 67% over last 14 days Nov 2 death rate o 14 Dec 2 death rate o 113 in last 24 hours 14-day change o 971 tinue to climb To blunt the surge and save lives, CA is introducing a Regional Stay-at-Home Order o Californians need to: Stop gathering with those outside your household Keep it outside and keep your mask on o Regions where ICU capacity falls below 15% will be placed into this stay-at-home order for 3 weeks o Regional Stay at Home Order goes into effect when a region falls below 15% remaining ICU capacity Northern CA Grater Sacramento Bay Area San Joaquin Valley Southern CA o Constructed based on pre-existing mutual aid system in CA o Part of a regional strategy, well-defined within the hospital and health care delivery system o Defined these 5 areas o Bay Area predicted date to fall below 15% ICU Capacity Mid-Late Dec o Greater Sacramento predicted date to fall below 15% ICU Capacity Early Dec o Northern CA predicted date to fall below 15% ICU Capacity Early Dec o San Joaquin Valley predicted date to fall below 15% ICU Capacity Early Dec o Southern CA predicted date to fall below 15% ICU Capacity Early Dec o Within next few weeks, if not days for most areas, this rate will be reached Sectors that will be temporarily closed when a region is placed into the Stay-At-Home include: o Bars o Wineries o Personal Services o Hair Salons/Barbershops Sectors that will remain open when a region is placed into the Stay-At-Home include: o Schools that have received a waiver o Critical infrastructure o Retail (20% capacity to reduce exposure) Insight and valuable consideration based on numbers seen and mixing predictions o Restaurants (take-out and delivery) I deeply empathize and understand the frustration Acknowledge Restaurant Association All non-essential travel is temporarily restricted statewide connected during these times Keep connected with loved ones virtually Get outdoors: o Go to a park o Go to a beach o Go on a hike o Go on a bike ride o Go fishing o Do yoga, meditate o Take your dog on a walk o Do an outdoor fitness class o Go on a run with your partner o Go skiing, snowboarding, sledding Important for physical and mental health o Temporary moment, not permanent state o Light at the end of the tunnel o Few months away from seeing true progress with vaccine o We do not anticipate having to do it again o Do everything we can to stem the tide, bend curve, give time necessary to get vaccines out The state is doing everything in our power to help hospitals prepare for this surge, while also supporting businesses and workers impacted by COVID-19 o Small businesses will not receive this news favorably, I acknowledge and appreciate that o Workers will also be impacted Facilities ready to receive patients: o Imperial Valley College FMS (Imperial) Beds ready to receive patients = 10 Beds in Warm Status = 115 o ARCO/Sleep Train Arena Practice Facility (Sacramento) Opening Dec 9th Beds ready to accept patients = 20 Beds in Warm Status = 224 9 Facilities in Warm Status: o Fairview Development Center (Orange): 180 beds o Porterville Development Center (Tulare): 123 beds o Riverside County Fairgrounds (Riverside): 125 beds o Vacant Sears Building (Riverside): 125 beds o San Mateo County Event Center: 250 beds o The Craneway Pavilion (Contra Costa): 250 beds o Fresno Convention & Entertainment Center: 125 beds o Palomar Medical Center (San Diego): 200 beds o San Francisco FMS (San Francisco): 125 beds As we move to the stay-at-home, increase in ICUs, moving towards active status PPE Inventory: o 339.3M procedure masks o 64.1M gowns o 179M N-95 masks o 145.5M gloves o 23.3M face shields Ventilators: o 12,233 available in state inventory o 6,996 still available in hospitals o Very aggressive in procuring and purchasing ventilators o o CA has sent excess inventory to other states who need help Billions in sales tax deferrals: o Automatic 3-month extension for taxpayers with less than $1M in sales tax o Expand interest-free payment agreements to larger companies with up to $5M in sales tax o 99.6% of businesses qualify for the extension $100M Main Street Hiring Tax Credit o $1,000 per qualified employee o Up to $100,000 for each business employer o Applications opened Dec 1: 2,492 businesses have already applied $20.9M has already been allocated Go to covid19.ca.gov website to learn more Emergency Relief Package: o $500M in COVID relief funds o Grants up to $25k for small businesses/non-profits/cultural institutions CA Rebuilding Fund: o $125M for low interest loans for small businesses Leverages additional private sector money o Loans up to $100,000 with affordable and flexible terms Working with the Legislature on broader relief package including: o Waiving or modifying fees for heavily impacted industries including bars & restaurants, hair salons, personal services, & more o Accelerating additional infrastructure funding o Need to look at impacted industries in a more comprehensive way o Putting together next budget in real time o Bridge to get us into Jan. and to see what fed gov will do o Encouraged by bi-partisan actions seen in last week in DC Support for Workers o COVID-19 Sick Leave Expanded COVID-19 sick leave benefits o Workers Compensation Ensures medical care and wage replacement for frontline workers and employees whose workplace experiences an outbreak o Health Coverage Access to COVID-19 testing and treatment for uninsured individuals o Mychildcare.ca.gov Portal for childcare options so essential workers can find childcare Housing o Evictions Moratorium Californians cannot be evicted before 2/1/2021 if rent is owed due to COVID-related hardships between 3/4/2020-1/21/20201 o Project Roomkey Providing non-congregate shelter options for high-risk individuals experiencing homelessness; sheltering 22k+ o Housing for Harvest Temporary, non-congregate hotel housing to agricultural & farm workers who need to isolate due to COVID-19 o Hotel Rooms for Healthcare Workers Provides hotel rooms to healthcare workers who give critical care to COVID-19 patients the virus to their household Food Resources o CalFresh: Emergency allotments bring every household to the maximum allotment $1.8B dollars in additional food benefits for California families o Pandemic EBT Food benefits for children who are eligible for free or reduced-price school meals and 3.7M children received benefits, nearly 95% statewide reach o Food Banks By mid-2021 CA will have distributed: $110M in food $15M in diapers $40M in reimbursement for COVID related food expenses CA Vaccine Update o Help is on the way o There is light at the end of the tunnel o Temporary state o Third wave of a pandemic with a vaccine that is being distributed by many different distributors o Monitoring through Scientific Safety Review Comte., Drafting Workgroups Comte, Community Advisory Comte. o Working for weeks and months o Vaccines will arrive in the next few weeks, more will be arriving in the coming months o The Drafting Guidelines Workgroup and Community Advisory Comte. have finalized recommendations for who will receive the initial vaccine (Phase 1A): Groups include critical healthcare workforce and long-term care residents Based on scarcity, we have sub-prioritized the 327k doses into 3 tiers Plan is online on covid19.ca.gov Will be able to find where you are on prioritization o Tier 1 Acute care, psychiatric and correctional facility hospitals Skilled nursing facilities, assisted living facilities, and similar settings for older or medically vulnerable Paramedics, EMTs and others providing emergency medical services Dialysis centers o Tier 2 Intermediate care facilities Home health care & in-home supportive services Community health workers Public health field staff Primary Care clinics, including Federally Qualified Health Centers, correctional facility clinics and urgent care clinics o Tier 3: Other settings and health care workers, including: Specialty clinics Laboratory workers Dental/oral health clinics Pharmacy staff not working in settings of higher tiers o Recommendations based on an equity and fairness lens Region 1: 126,750 Region II: 80,497 Region III: 8,592 Region IV: 35,145 Region V: 16,706 Region VI: 59,910 Tomorrow the regions will be making direct orders based upon prioritization of these tiers o Making orders directly to Pfizer tomorrow In subsequent distributions we have unique distribution o Pfizer distributes directly o Moderna distributes indirectly o Anticipate to learn more about when vaccines will be available We have reviewed the vaccines with some leading experts, they have been very active in reviewing protocols and trials, will quickly assess all available info Safety and efficacy, not just speed Equity lens We will be very aggressive in making sure those with means and influence are not crowding out those who are the most deserving of the vaccine We will prioritize and expect that everyone in healthcare delivery system will be held to the same standard Progress on Active Wildfires o Bond Fire, Orange County: 0% contained 6,600 acres FMAG obtained Evacuation orders issued o Record dry Oct, below average precipitation Express my deep respect and admiration to our firefighters ew and update Triggers that will impact all of us across the state We will get through this Have a light with these vaccines, need to take seriously this moment Most challenging moment since beginning of pandemic Put aside your doubt, skepticism, ideology Lives are being lost We will enjoy the other side of this Questions The state and counties have been tightening restrictions for weeks yet cases go up, how do you ensure that this will achieve what you want? Have you considering suspending elective surgeries? o They are already suspending surgeries, elected surgeries o The evidence you ask, is significant o We led the state with being the first state by using stay-at-home and we avoided a surge o We suspended the spread and flattened the curve before o o Looking for people to restrict o Imploring people not to have those gatherings o Avoid mixing and do best to mitigate spread o Ask Dr. Ghaly to provide thoughts Dr. Ghaly As you said, I want to begin by saying we recognize the gravity and importance of this moment Reducing transmission through own actions With 4 times the rate transmission that we had 6 weeks ago, we really have to limit movement and avoid mixing Know by reducing movement and mixing in short time we can get the gains we need We have our own experience with evidence We looked to Europe; Little by little tightening restrictions and then moving to something more significant Hospitals have built up capacity Staffing issue Know frontline health care workers who have carried a tremendous burden Difficulty with people dealing with unknown disease Opportunity to save a life Evidence is there with broad scale interventions Asking it to only get triggered when hospitals are overwhelmed, we know CA can do better Questions HHS says it expects 40M doses of the two vaccines will be ready by end of Dec, why are we only getting 327k doses? o receiving info about second d o Moderna still waiting for approval o o That 40M is an estimate o We will provide details once we receive it through manufacturers When you advised for stay-at-home several law enforcement agencies said they would not enforce, how will you respond to this and ensure stay-at-home will be effective? What about guidelines for traveling? o We talked about traveling o Seeing overwhelming support for enforcement o o As it relates to enforcement, we have worked with CSAC and our League of Cities and put together a protocol and process, worked collaboratively for them o We have CARES Act d enforce the rules and adopt protocols, we will redirect those dollars to counties that feel differently o WE have done this, not been shy o We have dollars o Point of additional consideration o Very small number of people in total denial o Saw in Orange County and Santa Ana great local leadership o As well as state agencies o From industry perspective and on the ground, some wonderful leaders doing extraordinary th o Dr. Ghaly will talk about travel guidelines and recommendations for quarantine Dr. Ghaly We have had a travel advisory since a bit before Thanksgiving holiday cancelling travel plans not leave Number of people who have travelled outside the state or visited, they have infected others Important tool to keep transmission low and make sure travel restriction makes sense As far as quarantine, asking people who do travel that they do quarantine appropriately based on current guidance CDC is updating their guidance on quarantine, giving more flexibility and allowing it to be shorter Determining how that will be implemented Will publish exact changes GGN In next couple of days Questions data behind why yo o Fundamental in terms of work with local health officers, national advisors as well o Want to mitigate mixing o Want to diminish amount of mixing o Create less opportunities for kind of contact, extended contact, that goes in these establishments o Encourage activities outdoors vs. indoors o Consistent strategies Dr. Ghaly Rather than getting to each specific sector and what data we have on each; Stay at home unless essential Spend times outdoors Stay healthy Consistent with prior guidance As much as you can, be at home, reduce interactions so we can get transmission rates down Message of day Many of the industries you spoke about, where you are not able to mask entirely or consistency, where physical distancing is difficult to m o All more risky o More COVID in communities Questions quarantine Dr. Ghaly Advisory is us asking communities to consider cancel plans Made a difference around Thanksgiving Will see results from Thanksgiving, but many people modified and decided not to travel Thank you to those Californians As we move into Regional Stay-At-Home, it is something we are requiring We believe that emphasizing this is what we hope citizens will do Hospitals have difficulty with capacity GGN All non-essential travel is temporary restricted statewide As it relates to hotels, restrictions are just for essential workers and guests Travel advisory is firm Questions Regions will remain on stay-at-home for 3 weeks, but counties are eligible to come off if reach higher than 15%, is coming off based on county not region? If ICU capacity gets below 15% again, can regions go back on list o Talk about 3-week period o Dr. Ghaly will be looking four weeks forward Dr. Ghaly Thank you for chance to clarify, important point that all listeners can use Using regional approach because that is how hospitals and healthcare delivery system works o Lean on larger facilities Exit we are looking at 3 weeks at the soonest Look at transmission rates at 3 weeks and projections are about 4 weeks after Know that by seeing transmission rate go down, should see projections of ICU capacity to improve Each county will go back to appropriate tier beforehand GGN Helpful question Questions How will this by-region system affect transfer of patients? If Imperial County is transferring patients to for them? Dr. Ghaly Using regional approach, looking at regional capacity first, if needed patients in one region may be asked for another hospital Mindful about impact of ICU capacity state Hospitals look to each other to lean on transfer systems GGN If I could go back to slide on facilities that are read to receive patients This is a supplement to the traditional 9 facilities Questions Dow Jones reporting Pfizer may only produce half what it anticipated, when we talk about that 327k doses, is that i meet that, do we have the freezer units? o Prepared to receive and we have all the confidence that the 700k+ doses will be ready to distribute o We have never gone under the presumption that what we hear nationally will materialize o We have been part of this vaccination conversation as long or longer than any other state o Working off many assumptions that have not materialized o Come to expect o Always have approx. numbers and dates o I have confidence in 327k doses and working off that number o Ordering on that basis with insurance form Pfizer Dr. Ghaly month May be limitations down the road Estimates will shift and transmission with weeks to come Heard from fed gov partner Not exactly sure on exact numbers, but building confidence About how prepared we are, we have confidence in freezer volume Conversations we have with regional and county partners GGN You may recall days there was a lot of promotion that vaccines were going to come out before election Sober about what is announced from national gov Conversations with Moderna we are putting together plans right now for short term In the immediate, there is available capacity Are limitations and issues once cold bottom storage is lost Easier with Moderna We have ordered and procured ultra-low storage and cold storage and many will be arriving at the end of the month, and more in Jan. We have existing capacity with network and providers Well-established vaccine network Look to supplement capacity Just waiting for delivery Questions Evidence that authority; do people? o o As it relates to curfew, have we been able to assess based on data of efficacy? o Recognize we need to do much more Dr. Ghaly There is some ability, rudimentary, seeing how movement is happening Can tell based on streets Slight reductions, but nothing too significant Had h the actions we can to make sure reduced mixing is what we achieve Trust that Californians will take this new order to heart and follow as well as possible so we can get through the next weeks and months so we can get through Questions As we approach this new series of regional stay-at-home orders, what is the situation with EDD? Is it still a mess? More stay-at-home means more unemployment, what will you do? o o New system in place after Oct. with reset ID.Me system Very effective Substantially address backlog May recall multiple presentations where we put a timeline o Five new people, worked with other departments o Medium- and long-term solution, long term IT strategy to address this challenge in the system o We are not unique in this country with these antiquated UI systems, never designed for pandemic o On medium term strategy, continue to improve upon ID.Me and timeliness o PUA Most of the fraud, presumption o Constant balancing act o Progress from summer GGN (Close) Active in providing info Will update soon Posting data on consistent basis Deep respect and empathy during this challenging and critical moment Minimize mixing Encourage outdoor activity Do what we can to avoid indoor mixing and abide by new regional orders Get us through next month, two months Get back to normalcy, resiliency and vibrancy