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Description
California Health and Human Services Secretary Dr. Mark Ghaly provides an update on the State of California's response to the COVID-19 pandemic.
Recorded December 8, 2020.
For more information regarding the impact of the COVID-19 outbreak in Cupertino, please visit https://www.cupertino.org/coronavirus.
B
Good
afternoon,
and
thanks
as
always
for
joining,
I
hope,
you're
staying
safe
and
well
look
forward
to
giving
you
this
update
and,
as
always
taking
a
number
of
questions.
At
the
end
from
our
reporters
across
the
state.
B
So,
as
always
want
to
begin
by
updating
you
on
our
case
numbers
as
you've,
seen
just
in
a
little
over
two
weeks,
we've
seen
a
more
than
doubling
of
our
average
case
number
today,
reporting
23
272
cases
and
an
average
of
23
503
cases
remind
you
just
about
15
days
ago
we
were
reporting
a
seven-day
average
of
about
eleven
thousand
cases,
and
you
may
ask
why
the
twenty
three
thousand
two
seventy
two,
maybe
that's
reassuring,
because
it's
lower
than
the
numbers
of
25
or
even
thirty
thousand,
that
we
reported
earlier
I'll
remind
you
that
our
tuesday
numbers
reflect
most
of
the
day
of
sunday
into
monday
and
then
our
reported
monday
evening,
and
then
we
published
them
on
tuesday.
B
We've
done
as
the
governor
alerted
yesterday
and
I've
been
watching
a
significant
number
of
increased
tests.
Nearly
300
000
tests
reported
yesterday
with
a
14-day
test
positivity
of
8.7
next
slide,
so
our
seven-day
positivity
is
10.1
higher
than
our
14-day
positivity.
Essentially
telling
us
that
the
last
week
has
been
even
higher
test
positivity
than
the
week
before
a
trend
that
we
hope
to
reverse
through
some
of
our
new
actions.
B
B
Overall.
That
is
not
just
new
people
hospitalized,
but
when
you
account
for
those
who've
been
discharged
with
covid,
the
the
sort
of
increased
number
of
patients
hospitalized
is
increasing
rapidly.
Similarly,
for
icu
capacity,
we've
seen
a
nearly
70
68.7
percent
increase
in
icu
covet
hospitalizations
over
the
last
14
days
next
slide.
B
B
We
have
a
number
of
different
ways
of
segmenting
the
state
for
various
purposes
and,
although
I
think
we've
fielded
many
questions
about
why
these
regions,
these
regions
are
from
a
public
health
perspective,
have
some
common
features.
They
end
up
also
illustrating
how
some
of
our
delivery
systems
our
health
care
systems
work
together
across
counties.
B
Indeed,
you
know
there's
no
perfect
way
to
design
regions
in
a
state
this
size,
so
we
you've
used
something
that
has
been
used
in
other
areas
before
and
as
you
look
at
this
map,
we
see
that
certainly
the
southern
part
of
the
state,
the
southern
california
region
and
the
san
joaquin
valley
regions
are
really
seeing
a
significant
load
in
their
icus
from
kovid
and
therefore
have
a
small
remaining
percent
percentage
of
icu
beds
open.
B
As
you
move
farther
north,
you
see
higher
percentages
beds
open,
but
even
in
those
areas,
some
significant
concern
and
I'll
remind
you
that
five
counties
in
the
bay
area
have
elected
to
go
forward
with
the
state's
regional
stay-at-home
order
framework,
despite
having
greater
than
15
percent
icu
capacity.
I
think
it's
a
recognition.
B
I
applaud
this
recognition
that
the
sooner
some
of
these
changes
go
into
effect,
the
hope
that
the
impact
is
greater
and
that
we
can
shorten
the
time
that
these
orders
are
in
place
next
slide,
please,
so
why
a
regional
stay
at
home
order?
The
fact
is
that
transmission
is
now
so
widespread
across
our
state
that
most
all
non-essential
activities
create
a
serious
risk
for
transmission.
B
It's
also
based
on
our
past
experiences
in
march,
when
we
flatten
the
curve
I'll
remind
you
that
in
march
we
didn't
see
a
significant
surge
in
this
state.
Our
efforts
were
early
decisive.
We
all
did
it
together
and
we
were
able
to
frankly
keep
the
curve
down,
keep
it
flat.
We
didn't
see
a
big
bump
in
the
summer,
though,
we
did
see
a
significant
bump
smaller
than
the
one
we're
experiencing
now,
and
we
saw
how
additional
restrictions
were
the
path
forward
to
get
through
that.
B
You
might
also
ask
well
why
the
focus
on
icu
beds
just
to
paint
a
bit
of
a
picture
for
you.
You
know
an
intensive
care
unit.
Bed
is
that
bed
that
has
such
specialized
staff
and
equipment,
not
because
we
don't
have
the
equipment
in
beds
enough,
but
we're
worried
about
that
staffing
component
and
on
general
hospital
wards,
where
we
have
significant.
B
You
know
burden
as
well,
but
not
nearly
as
much
in
our
icu
in
the
icu
settings.
We
know
that
nurses
and
respiratory
therapists
and
other
clinical
leaders
are
not
just
hour
by
hour,
making
changes
to
a
patient's
care
plan,
but
really
minute
by
minute
the
need
to
monitor
breathing
machines,
patients
who
are
intubated
on
rest
on
ventilators
the
need
to
make
sure
that
patients
kidneys
are
functioning
well,
that
the
heart
is
pumping
enough
blood
to
the
rest
of
the
body.
B
So,
for
that
reason
we
have
taken
a
particular
focus
on
the
icu
that
we
know
that
icu's
are
not
just
called
to
take
care
of
patients
with
covid,
but
also
patients
with
heart
attacks,
strokes,
other
serious
conditions
where
that
same
minute
to
minute
fine-tuning,
is
necessary
to
get
patients
through
a
critical
period
onto
stability
where
they
can
go
and
get
care
in
our
hospital
wards,
our
general
hospital
awards
and
even
be
safely
discharged
home.
So
our
focus
on
that
icu
capacity
is
one
that
we're
newly
focused
on
we've
always
been
attentive
to
it.
B
Our
regional
stay-at-home
order
is
also
based
on
successes
from
other
parts
of
the
country
and
their
own
actions,
moving
through
restrictions
and
building
up
to
more
more
nationwide
closures.
Next
slide,
please,
so
we
wanted
to
highlight
a
little
bit
of
the
stay-at-home
orders
and
the
experiences
in
europe.
Europe
has
often
been
a
few
months
or
weeks
ahead
of
where
the
united
states
has
been,
even,
as
california
has
itself
had
lower
test,
positivity,
lower
impact
of
covid
compared
to
other
states.
B
Europe
is
a
bit
in
front
of
us
and
they
have
demonstrated
some
actions
that
we
can
learn
from
and
part
of
our
stay-at-home
order
really
has
learned
from
other
other
experiences
across
europe.
I'll
highlight
a
few
here,
belgium,
when
they
imposed
a
nationwide
closure.
The
positivity
rate
in
just
three
weeks
fell
from
21
to
8
percent,
showing
that
if
we
do
this
state
regional,
I
should
say
regional
stay-at-home
order
effectively.
B
We
can
see,
in
short,
amount
of
time
a
significant
reduction
in
our
own
test,
positivity
england,
when
they
imposed
after
weeks
of
going
through
less
significant
restrictions.
The
decision
for
a
four-week
national
closure
that
included
non-essential
businesses
limits
on
gatherings
very
similar
to
what
we
have
as
our
regional
stay-at-home
order.
They
saw
cases
dropped,
30
percent
overall
and
in
some
of
the
hardest
hit
communities
a
50
decrease.
B
Similarly,
in
france
and
the
netherlands,
when
they
have
done
nationwide
closures,
they've
begun
to
see
drops
in
their
own
positivity
rates
so
rather
than
focused
on
the
sector
by
sector
restrictions.
The
top
of
our
message
is
as
much
as
you
can
stay
at
home.
We
know
that
it
works.
We
know
that
we
can
bring
transmission
rates
down
and
move
back
into
the
blueprint
for
a
safer
economy
that
we've
been
using
for
the
large
part
of
the
last
three
months.
B
B
I
think
many
of
us
experience
this
over
thanksgiving.
I
know
I
did
we
had
my
mom
on
zoom
much
of
the
day
in
and
out
with
the
kids
enjoying
dessert
as
well
with
us,
and
it
worked
better
than
expected.
Wasn't
perfect.
We
know
it
was
quite
different,
but
it
did.
B
It
did
allow
us
to
connect
with
a
loved
one,
my
mom,
who
usually
spends
the
time
with
us,
but
this
time
around
made
the
decision
to
keep
her
safe
to
make
sure
we
didn't
create
additional
chance
for
others
to
be
impacted
by
our
actions
and
stayed
at
home
next
slide.
Please.
B
B
We
know
that
the
regional
state
or
home
order
restricts
us
significantly
in
those
communities
and
counties
affected
by
the
regional
state
home
order,
but
even
if
you're,
in
a
county
or
in
a
community
that
isn't
under
the
regional
state
home
order,
we
ask
you
to
consider
canceling
travel
plans,
discouraging
others
to
come
visit
you
we
know
that's
hard.
We
know
that
these
are
difficult
choices
to
make,
especially
eight
or
nine
months
into
our
response,
but
we
believe
that
these
are
important
decisions
to
make
to
keep
our
communities
safe,
hotels
and
vacation.
B
Rentals
should
not
rent
to
people
coming
from
those
regions
under
under
the
state
home
order,
except
for
essential
purposes.
Travel
for
our
critical
infrastructure,
business
sectors
that
require
employees
to
travel,
spend
a
night
in
a
hotel
to
do
business,
hopefully
return
to
their
homes
as
soon
as
it
is
safe
and
possible
for
them
to
do
so
that
that
is
an
appropriate
use
of
our
hotels
and
lodging.
B
Please
so
before
wrapping
up
I'll
end
with
the
way,
we
always
end
to
encourage
you
to
follow
these
simple
acts
that
make
a
big
difference
for
covid
and
the
flu
to
stay
home
as
much
as
you
can
to
wear
a
mask
to
maintain
your
distance
to
wash
your
hands
to
don't
mix
outside
of
your
household
and
another
reminder
to
get
your
flu
shot.
B
We
know
that
california
usually
experiences
our
surge
or
our
peak
and
flu
early
each
year
in
january
and
february,
but
as
we
approach
the
end
of
december,
we'll
see
cases
increase
and
that
pressure,
not
just
on
all
of
us
to
keep
our
households
healthy,
but
also
additional
pressure
pressure
on
our
hospital
system.
As
we
see,
the
pressure
already
from
kovid
is
real,
significant
impactful
and
additive.
So
we
want
to
do
all
we
can,
because
the
flu
shot
is
an
additional
tool
in
our
toolkit.
B
B
I
certainly
share
some
of
that
exhaustion
as
well,
and
I
know
that
it's
difficult
to
make
the
decisions
that
we're
asking
you
to
make.
I
know
that
many
of
us
feel
that
this
is
getting.
You
know
old
and
tiring,
but
with
that
said,
I
think
the
optimism
and
hope
of
vaccines
coming
around
the
corner.
Our
ability
to
first
protect
the
most
vulnerable
in
our
communities,
those
that
are
on
the
front
lines
of
our
health
care
delivery
systems.
B
Taking
care
of
our
sick
is
a
moment
that
we
can't
wait
for
any
longer
it's
coming
soon,
and
so
it
makes
the
decisions
of
the
day
and
our
actions
today
even
more
important,
as
we
see
the
glimmers
of
a
light
at
the
end
of
the
tunnel
and
the
hope
of
protecting
our
communities,
not
just
with
these
actions,
but
that
additional
tool
of
a
vaccine
in
the
weeks
and
months
to
come.
So
with
that
I'll
go
to
the
first
question.
C
For
the
central
valley,
one
of
our
big
issues
right
now
is
staffing
and
just
seeing
the
san
joaquin
valley
below
six
percent
icu
available
availability.
I
was
just
wondering
what
the
conversations
with
fresno
and
other
cities
within
the
san
francisco
valley
have
been
as
far
as
getting
more
staffing
to
the
central
valley.
Thank
you.
B
We
know
that
staff
is
our
main
scarce
resource
that
our
requests
both
across
the
state
and
the
nation,
are
hard
to
fulfill
because
of
what's
happening
across
america
with
kovid
we're
reaching
out
to
as
many
individuals
through
our
healthcare
health
corps
program
to
get
that
help,
and
as
soon
as
we
have
it,
we
try
to
get
it
to
the
facilities
where
it
can
benefit
them.
The
most
central
valley
is
certainly
that
area
currently
with
the
lowest
available
icu
capacity,
so
they
are
a
clear
target
for
additional
staffing
requests
and
it
is.
B
It
is
sort
of
a
work
in
progress
and
not
just
daily,
but
over
the
course
of
many
conversations
in
the
day.
We're
having
you
know,
communication
with
those
hospitals
trying
to
meet
the
need,
but
also
reinforcing
that,
in
order
for
us
to
really
get
through
this
difficult
time.
We
need
the
actions
of
our
communities
and
our
citizens
to
make
decisions
to
reduce
transmission
overall,
so
we
can
get
through
not
just
what
might
be
a
tough
three
weeks,
but
hopefully
prevent
three
weeks
turning
into
six
or
nine
weeks.
C
Thank
you
very
much.
Let's
give
her
a
quick
question.
Similarly,
to
this
santa
barbara
ventura
counties
are
asking
to
be
separated
from
the
regional
state
home
grouping
for
all
of
southern
california.
They
say:
they'll
continue
to
share
resources
that
other
counties
abide
by
health
safety
protocols.
Is
this
something
the
state
would
consider
and
why
or
why
not,
and
also
you
say,
any
non-essential
activity
right
now
carries
serious
risk,
but
non-essential
retail
still
is
being
allowed.
C
Why
doesn't
that
send
a
mixed
message
about
what
constitutes
an
essential
activity
and
the
slide
on
one
of
the
slides
you
showed
in
english
indicated
that
we're
not
allowed
there.
B
So
I'll
do
my
best.
It
was
a
little
hard
to
hear
the
last
part
of
your
second
question,
but
I'll
I'll
try
to
answer
it.
The
best
I
can
so
to
the
first
part
of
your
question.
Yes,
we've
heard
from
a
number
of
counties
questioning
the
region
that
they've
been
placed
into
the
southern
california
region
is
a
large
one.
B
Again
we
leaned
on
something
that
the
health
officers
have
used
in
the
past
to
work
together
to
consider
not
just
things
in
covid
response,
but
other
responses,
and
indeed
not
all
parts
of
every
region
are
experiencing
the
surge
in
the
same
way.
B
But
in
order
to
ensure
that
we
have
a
thoughtful
collection
of
the
resources
in
our
hospital
delivery
system,
making
sure
that
if
any
region
were
to
have
a
sudden
increase
in
pressure
on
their
icus,
that
we
had
a
network
and
a
system
to
move
patients
thoughtfully
from
every
part
of
a
region
to
those
areas
in
the
region
where
the
resources
exist,
we've
created
the
ones
that
we
have.
B
You
know
I've
certainly
been
part
of
conversations
asking
questions
about
it
and
at
the
moment
we
don't
have
an
intention
to
make
a
change
the
regions
and,
as
you
can
see,
at
least
from
the
southern,
the
two
regions
that
are
under
the
regional
stay-at-home
order.
In
some
ways
it
really
does
represent
the
southern
part,
the
southern
half
of
the
state,
even
though
it's
the
more
populous
part
of
the
state,
it
still
is
geographically
the
southern
part
of
the
state.
B
So,
even
if
we
delineated
different
boundaries
for
the
regions
in
southern
california,
I
believe
that
we
would
still
see
a
significant
part
of
the
existing
region
under
the
regional
stay-at-home
order
that
we
have
outlined
with
the
existing
five
regions.
With
regards
to
your
question
on
retail
there's
two
parts
to
it,
we
know
that
even
under
the
most
significant
closures
that
we
in
california
and
frankly,
almost
any
part
of
the
nation
have
experienced
that
the
need
to
be
able
to
do
some
essential
activities
to
get
our
food.
B
Our
eggs,
our
milk
other
essential
supplies
to
make
sure
that
some
of
our
daily
needs
are
taken.
Care
of
will
continue
and
the
need
to
not
do
what
we
did
the
first
time,
which
was
really
isolate
the
experiences
to
just
a
few
retailers
where
we
saw
large
numbers
of
people
gathering
indoors.
B
We
tried
to
create
a
system
that
allowed
a
variety
of
retailers
to
be
open
and
operating
so
that
customers,
consumers,
the
public,
could
go
to
places
where
we
weren't
seeing
such
sort
of
densely
populated
stores,
and
our
hope
is
that
that's
what
we'll
see
over
what
is
a
critical
period.
C
Hi,
dr
kelly,
I
want
to
ask
you
about
something
the
governor
mentioned
during
his
briefing
yesterday
about
a
new
two-day
training
program
for
nurses
to
then
work
in
the
icu.
Can
you
talk
a
little
more
about
what
this
training
is?
Has
it
started?
Yet?
Where
is
it?
Who
exactly?
Is
it
for
we've
heard
from
nurses
who
are
pretty
alarmed
by
the
proposal
saying
that
that's
a
very
short
amount
of
training
for
a
nurse
and
that
it
could
be
unsafe
for
nurses
and
the
public?
So
if
you
could
address
that,
thank
you.
B
B
The
ability
to
do
what
I
was
describing
earlier
make
those
minute
to
minute
fine-tuned
decisions
reporting
on
the
findings
to
other
parts
of
the
clinical
team
takes
a
long
time
to
not
just
learn
but
to
become
really
a
student
perfect
at
so
the
two-day
training
that
the
state
has
put
together
is
really
meant
to
give
nurses
who
may
find
themselves
in
a
situation
pitching
in
helping
out
with
critical
patients
a
bit
of
the
different
thinking
that
goes
into
providing
care
in
an
intensive
care
setting.
B
It
is
not
meant
to
create
a
cadre
of
now
suddenly
appointed
anointed
trained,
icu
nurses.
It's
meant
to
give
just
a
little
bit
of
the
details
and
thinking
that
go
into
providing
that
high
quality
care.
No
one
expects
the
nurses
who
complete
just
two
days
of
training
to
be
able
to
go
in
and
solo,
be
a
independent.
B
You
know
support
in
an
intensive
care
setting,
but
hopefully
gives
just
a
few
lessons-
maybe
some
refreshers,
so
that
when
nurses
are
pulled
into
other
settings
and
situations
that
they
can
help
as
much
as
possible,
we
know
that
this
is
not
meant
and
hopefully
never
relayed,
that
this
is
meant
to
certify
anyone
in
a
way
that
connotes
the
level
of
experience
and
knowledge
that
so
many
of
the
ic
new
icu
nurses
that
I
know
personally
have-
and
that
I
know-
are
working
hard
today
to
take
care
of
covet
and
non-covet
patients
alike.
C
Hi
dr
dally,
thanks
so
much
for
taking
our
questions.
I
have
several
just
on
issues.
Statewide
one
is
on
the
issue
of
the
outbreaks
among
cases
among
workers
at
the
foster
farm
plants
in
the
central
valley.
Do
we
do
you
have
a
sense
of
why
this
continues
to
happen
and
what
should
be
done
to
protect
workers?
C
There
have
been
some
criticism,
including
from
the
assistant
secretary
of
health,
from
hhs,
who
said
on
fox
news.
I
don't
know
of
any
data
that
says
you
could
shut
down
outdoor
dining
wondering
if
you
could
respond
to
that
and
then
finally,
there's
this
new
letter
or
relatively
new
letter
about
weekly
testing
of
hospitals,
is
it
a
recommendation
or
a
mandate,
and
can
you
talk
about
the
reasons
for
issuing
it?
C
B
Yeah
so
try
to
get
through
all
three
of
them.
First,
you
know
so
many
of
the
different.
What
we've
called
essential
workplaces
you
know
transmission,
especially
now
is
higher.
We've
seen
it.
What
happens
in
the
community
is
going
to
happen
even
greater
in
some
of
those
higher
risk
settings.
So
I
can't
comment
directly
about
the
current
on
the
ground
activities
at
foster,
farms
or
any
other
particular
factory
or
or
plant.
B
But
I
can
tell
you
that,
because
we
are
experiencing
widespread
transmission,
that
all
activities
that
were
maybe
lower
risk
a
month
ago
today
are
higher
risk,
and
that
includes
our
essential
workplaces
and
that's
why
I
think
the
work
we've
done
as
a
state
to
secure
ppe
in
abundance
to
improve
our
testing
capacity,
to
get
guidance
out
to
business
owners
and
factories
and
other
sectors,
so
that
we
can
put
them
in
place
are
important,
but
they
still
need
to
be
done
and
done
well,
and
so
any
industry
where
that
isn't
happening.
B
We
are
at
risk
of
having
outbreaks.
We
are
at
risk
of
having
very
large
levels
of
high
levels
of
transmission
throughout,
and
that
may
indeed
be
happening
again
in
foster
farms
and
other
places
like
it,
and
it
is
something
that
we
pay
close
attention
to
not
just
at
cdph
but
with
our
cal
osha
partners
and
our
local
public
health
and
other
health
partners
in
those
regions
throughout
the
state,
as
it
relates
to
the
question
about
indoor
dining
or
outdoor
dining.
B
I
think
one
thing
that
I
have
tried
to
message
and
emphasize
is
that
right
now
we're
seeing
such
high
levels
of
transmission
that
almost
every
activity-
I
should
say,
every
activity
that
can
be
done
differently
and
keep
us
at
our
homes,
not
mixing
with
others,
is
safer.
Those
are
going
to
be
the
tools
that
help
us
get
this
under
control.
So
the
decision
to
include
among
other
sectors,
outdoor
dining
and
limiting
that
turning
to
restaurants,
to
deliver
and
provide
takeout
options
instead,
really
has
to
do
with
the
goal
of
trying
to
keep
people
at
home.
B
Make
sectors
like
outdoor
dynein,
lower
risk,
but
right
now,
with
the
levels
of
transmission
that
we're
seeing,
we
advise
against
anything
that
you
can
do
in
another
way
in
a
lower
risk
way
that
avoids
you
either
leaving
your
home
or
only
leaving
your
home
in
a
way
that
doesn't
expose
you
and
cause
you
to
mix
with
others.
C
Yes,
doctor,
I
want
to
ask
about
the
vaccine
and
try
to
strain
out
exactly
how
this
is
going
to
work
between
the
state,
the
feds
and
the
drug
companies
themselves,
governor
newsom.
When
he's
been
talking
in
the
most
recent
press
conferences
about
getting
the
vaccines
to
california,
it
hasn't
been
entirely
clear
to
me
whether
or
not
the
numbers
of
vaccines
that
you're
anticipating
are
coming
directly
from
the
drug
companies
themselves.
C
If
you're
dealing
with
drug
companies
directly
and
those
companies
are
telling
you
the
numbers
that
you're
going
to
get
or
if
you're
dealing
with
operation
warp,
speed
and
they're
telling
you
what
to
what
to
expect.
Could
you
clarify
that
for
us
in
terms
of
just
where
your
planning
numbers
are
coming
from
what
kinds
of
insurances
you're
getting
either
from
the
feds
or
the
drug
companies
about
what
we're
going
to
receive.
B
Yeah,
thank
thanks
for
the
opportunity
to
clarify
frankly,
it's
both.
We
have
interactions
with
both
the
leaders
of
operation,
warp
sedan
and
have
direct
communication
with
pfizer
directly,
but
also
mckesson,
which
is
the
entity
in
the
middle
that
is
distributing
the
moderna
later.
The
astrazeneca
and
other
vaccines
that
that
emerge
and
the
way
that
it
essentially
works
is
our
federal
partners.
Let
us
know
the
volume
of
vaccine
that
we
should
be
receiving
the
sort
of
window
of
time
that
we
can
expect
to
receive
it.
B
We
then
use
that
to
advise
our
counties,
what
their
relative
allocation
from
our
state
total
will
be,
and
then
we
make
orders
through
the
counties
through
the
state
to
either
pfizer
directly
to
get
the
shipment
or
through
mckesson
for
the
other
vaccines.
B
So
it
is,
you
know,
certainly
communications
between
the
state
and
our
local
partners,
the
county
partners,
the
various
facilities
that
will
be
administering
the
vaccine
on
the
one
hand,
and
then
directly
with
manufacturer
in
the
case
of
pfizer
mckesson
in
all
other
cases,
and
then
certainly
with
the
cdc
and
operation
warp
seed
leadership
around
exactly
how
much
we'll
receive
of
each
vaccine.
C
Information
about
spreading
events,
I
wonder
if
the
state
has
a
more
firm,
data-driven
sense
of
what
kinds
of
activities
are
driving
this
surge
that
we're
in
now,
you
know
is
it
those
gatherings?
Is
it
college
students
coming
home
within
certain
workplaces
or
employers,
and
how
confident
you
know,
given
the
scale
of
all
this
argue
that
that
contact
trading
is
giving
us
an
accurate
sense
of
how
the
virus
is
spread.
B
I
think
so
many
activities
that
maybe
a
month
ago
were
indeed
lower
risk
that
you
could
do
it
distanced
with
your
mask
on
and
have
a
low
risk
of
either
becoming
infected
or
transmitting
infection
to
someone
else
with
today's
level
of
transmission.
B
I
think
it's
quite
a
different
situation
that
those
activities
a
month
ago
which
were
safe,
are
today
just
that
you
know
they
aren't
as
low
risk
as
they
used
to
be.
We
do
know
that
there
are
features
of
different
activities,
whether
it's
within
a
business
sector
or
outside
of
the
business
sector
that
cause
transmission,
anything
where
you're
spending
longer
durations
of
time
with
people
outside
of
your
household,
with
your
mask
down,
I'm
speaking
in
a
high
votes
or
voice
or
singing
those
all
increase.
B
Our
chance
of
transmitting
indoors,
as
I've
said
before,
is
worse
than
outdoors
from
a
transmission
risk
perspective.
Having
air
fresh
air
circulating
reduces
those
risks,
so
you
can
apply
all
of
those
conditions
and
features
to
a
very
to
a
different
activity
to
a
different
sector
and
begin
to
make
calculations
about
where
the
risk
lies.
We've
seen
some
of
that
bear
out.
It's
not
perfect.
We
work
with
our
local
health
partners
to
determine
where
they're
seeing
transmission,
as
I've
said
previously
different
regions,
different
counties
of
the
state
report
different
things.
B
They
often
have
the
features
that
I
just
mentioned
that
they're
activities
where
masks
come
off.
People
spend
time
indoors,
close
distanced
with
lots
of
individuals,
and
then
you
see
you
know
large-scale
transmission,
even
some
of
these
concepts
of
a
super
spreader
event
where
many
people
become
infected
in
one
setting.
Those
indeed
are
part
of
the
transmission
issues
that
we're
facing,
but
largely
it
is
so
ubiquitous
so
around
our
communities
that
many
actions
and
activities
are
causing
the
transmission
as
it
relates
to
the
contact
tracing.
B
I
have
been
very
impressed
and
pleased
with
our
county
partners
the
ability
to
continue
to
use
contact
tracing,
not
just
as
a
tool
to
identify
where
transmission
is
happening,
but
as
a
real,
powerful
tool
to
communicate
with
individuals
who
have
either
been
exposed
and
need
to
quarantine
or
those
who've
been
deemed
positive
by
their
tests
and
need
to
isolate
and
protecting
not
just
those
individuals
but
those
around
them.
B
That
really
brave
frontline
public
health
leaders
throughout
our
state
are
continuing
to
use
that
as
an
important
tool,
and
certainly
it
is
a
more
effective
tool
with
lower
rates
of
transmission.
C
Hi,
dr
galley,
thank
you
for
taking
the
questions,
we're
hoping
you
could
shed
a
little
bit
of
light
on
testing
and
you
know
when
we
have
these
big
increases
and
in
cases
carnivorous,
there
always
seems
to
be
perfect
jumps
in
the
in
the
lines
and
testing
and
the
labs
testing,
and
I
was
hoping
you
could
just
shut
a
little
bit
more
light
on
that.
B
Yeah
thanks
for
the
question,
I
think
we
we
are
proud
of
how
much
testing
that
we've
been
able
to
do
and,
as
the
governor
has
said,
we'll
continue
to
try
to
increase
our
testing
volumes
even
more
when
we
see
test
positivities
that
go
above
eight
and
nine
percent,
even
ten
percent
over
seven
days,
that's
concerning.
We
want
to
be
a
state
that
gets
it
as
low
as
possible,
certainly
below
five
percent
statewide.
So
we're
a
ways
away
from
that
and
one
of
the
ways
to
continue
to
chip
away
at
that
test.
B
Positivity
rate
is
by
doing
more
testing
identifying
those
who
are
positive
and
doing
the
work
of
isolating
and
quarantining
effectively,
and
so
we'll
continue
to
use
that
approach
and
tool.
We
know
that
as
the
rest
of
the
nation
surges,
some
of
our
other
testing
options,
the
large
national
labs,
even
the
suppliers
for
some
of
our
own
mighty
california-based
labs,
become
pressured
and
pressed,
and
so
that
turns
into
longer
lines
for
testing,
not
just
because
more
people
are
sick,
more
people
want
to
be
tested,
but
because
sometimes
it's
harder
to
get
a
test.
B
Thankfully
we're
doing
much
better.
This
time
around,
even
despite
greater
pressures
and
surge
on
testing
than
we
did
in
the
summer
in
part,
that's
because
all
all
of
our
testing
partners
have
increased
their
capacity,
but
also
because
we
have
additional
capacity
in
our
state-based
lab,
that's
able
to
support
various
industries
and
sectors
and
and
allow
us
to
provide
additional
testing
throughout
the
state.
B
We
are
also
laser
focused
at
the
state
level,
on
working
with
harder
to
reach
communities,
whether
those
are
rural
communities
or
disproportionately
impacted
communities,
even
in
urban
areas,
to
increase
the
volume
of
testing
new
testing
sites
coming
from
the
state
different
modalities,
including
more
mobile
testing,
and
what
we
call
pop-up
sites
which
aren't
you
know
everyday
sites,
but
they
come
periodically
to
reach
communities
that
need
some
testing,
maybe
not
every
day,
but
at
least
some
reliable
sense
of
testing.
So
all
of
those
are
our
approaches
to
increase
our
ability
to
bring
on
testing.
B
We
know
that
we
will
need
to
do
more.
We
continue
to
work
to
do
more
and
then
I'll
just
take
a
moment,
because
there
was
a
three-part
question
that
I
know
I
only
answered
two
parts
of
it.
But
there
was
a
question
about
testing
our
frontline
health
workers
in
acute
care
hospitals.
B
We
did
make
the
recommendation
that
facilities
plan
and
put
in
place
opportunities
for
frontline
staff
that
are
are
volunteering
and
wanting
to
be
tested
on
a
regular
basis
that
that
be
provided.
That
weekly
testing
helps
us
not
just
identify
individual
cases
in
high
risk
settings
like
hospitals
where
obviously
individuals
are
being
cared
where
for
who
know.
They
have
coveted
others
who
may
be
asymptomatic
or
being
worked
up
for
a
potential
coveted
infection
that
they
are
at
risk
of
transmitting
infections
throughout
those
acute
care
facilities.
B
C
Hi,
dr
gali,
thank
you
so
much
for
your
time
today.
So
california,
state
government
offices
have
been
seeing
a
rising
number
of
positive
cobit
test
results.
Our
employees
at
any
state
offices
undergoing
twice
weekly
testing,
as
required
under
cal
osha's
new
rules
for
a
major
outbreak
and
and
to
follow
up
on
that
will
prison
employees
be
tested
twice
a
week.
B
So
we
are
certainly
the
cal.
Osha
guidance
is
something
we're
working
with
our
various
sector
partners
across
the
state
to
determine
how
to
have
those
be
in
place
and
to
your
question
about
prison
employees.
Certainly
looking
at
the
testing
cadence
as
we
do
in
all
industries
to
determine
what
is
the
right
level
of
testing
not
just
to
ensure
that
we're
delivering
personal
individual
results
to
individuals,
but
making
sure
that
we
do
all
we
can
to
prevent
one
or
two
cases
from
becoming
large-scale
outbreaks,
especially
in
congregate
care
facilities
like
prisons.
C
Hello,
this
is
barbara.
Yes,
dr
golly,
thank
you.
Can
you
please
talk
about
how
testing
turnaround
times
are
rising
for
the
labs
that
process
tests
in
california,
including
the
commercial
labs,
the
health
care
labs
and
the
public
health
labs?
Looking
at
your
dashboard,
there
seems
like
an
overall
increase
in
turnaround
time
with
some
large
labs,
having
quite
a
bit
of
a
drop
from
the
first
week
of
november
to
the
last
week
of
november,
possibly
because
of
you
know,
increased
test
load.
Can
you
speak
to
the
reasons
why.
B
Yeah,
you
know,
I
think
the
nation
has
done
a
lot
to
ramp
up
testing,
but
in
the
face
of
a
surge
like
the
one
we're
seeing
where
states
are
reporting,
30
40,
even
higher
percent
positivity
rates.
What
that
tells
me
is
that
a
whole
lot
more
people
need
to
be
tested
to
get
this
under
control
in
those
regions
and
I'm
sure,
there's
delays
in
that
testing
and
that's
driving
towards
increased
test
turn
around
time
in
california.
B
We've
done
a
lot
on
this.
I
think
we've
seen
some
increase
in
test
turnaround
time
from
really
what
was
an
average
of
1.2
1.3
days
for
most
of
our
tests.
Coming
back
to
now,
seeing
that
creep
up
above
1.7
closer
to
two
days
and
I'll,
tell
you
that's
an
average.
We
still
have
a
majority
of
the
tests
for
our
sickest
individuals.
The
people
who
are
being
tested
in
our
acute
care
facilities
are
urgent
cares.
B
Often
those
test
results
come
back
much
faster,
but
those
who
are
asymptomatic
maybe
getting
tested
in
some
of
our
more
community-based
sites.
It
might
be
even
longer
the
problem
with
long
turnaround
times
is
that
the
value
of
the
information
both
from
my
individual
health
perspective
and
from
a
public
health
planning
perspective,
starts
to
be
diminished.
B
It's
obviously
it
takes
a
while
to
get
to
that
high
level,
but
during
the
surge,
we're
looking
for
additional
opportunities
to
use
that
lab
strategically
to
address
the
needs
of
californians.
Make
sure
that
we
can
keep
that
turnaround
time
as
low
as
possible
and
ensure
that
the
results
that
we
do
receive
are
valuable,
that
we
can
act
on
them
plan
on
them
and
get
this
surge
under
control.
B
I
think
that
california,
certainly
because
of
our
work,
is
in
better
shape
than
some
other
states,
because
we
not
only
have
depended
on
our
national
partners
who
have
been
wonderful
on
testing
our
local
labs,
which
can
do
certainly
a
mighty
volume
together,
but
also
having
some
state
assets
to
support.
All
of
that
as
well
final.
C
B
Sure
so
the
trajectory
is,
as
I
said
yesterday
when
we
look
at
hospitalizations
today
and
the
impact
on
not
just
our
what
we
call
the
med
surg,
the
general
hospital
awards,
but
also
on
the
icu.
We
know
what
the
hospitals
are
dealing
with
today
were
cases
from
two
weeks
ago,
maybe
even
three
weeks
ago,
and
you
look
at
our
level
of
transmission
and
the
number
of
cases
we
were
reporting
two
weeks
ago
three
weeks
ago,
we
are
even
less
than
half
of
what
we're
seeing
today.
B
So
when
you
ask
about
trajectory
and
projections,
we
anticipate
not
just
you
know
the
ongoing
slope
of
increase
that
we've
seen
now.
We
are
worried
about
a
rapidly
accelerating
increase
and
pressure
on
our
hospitals.
B
That
may
contribute
to
a
broader
spread
that
we
know
that
as
you
get
community-wide
transmission
and
that
the
virus
is
just
more
more
abundant
and
around
us
that
the
likelihood
of
continuing
to
see
high
case
numbers
without
some
major
change
in
our
overall
behavior
and
our
movement.
B
When
you
do
see
when
you
ask
about
a
surge
facility,
I'll
remind
you
that,
because
of
the
hard
work
that
we
did
as
a
state,
our
hospital
partners-
and
I
commend
so
many
of
them-
for
stepping
up
and
creating
the
space
acquiring
the
equipment
and
the
supplies
to
be
able
to
manage
those
spaces
that
that
exists.
B
So
the
need
for
a
separate
facility
is
not
as
apparent
today
as
it
was
when
we
started,
but
the
need
for
the
staff
to
run
those
beds
wherever
they
are,
is
something
we
do
need
we're
working
hard
to
find
as
many
staff
as
we
can
to
recruit
them
from
not
just
across
the
state,
but
when
we
can
depend
on
our
federal
partners
to
help
us
staff
up
that,
that's
a
very
different
need
than
the
need
for
additional
beds.
Certain
regions
we
talked
about
in
imperial
county.
B
We
talked
about
here
in
sacramento,
the
need
for
some
additional
beds
to
support
northern
california.
Those
are
being
moved
from
what
we
talk
about
warm
status
to
activated
status
in
order
to
support
some
of
those
locations
that
have
very
few
beds
available
for
the
number
of
anticipated
individuals
who
would
need
them,
but
by
and
large
we're,
depending
on
our
partnerships
with
existing
hospitals,
their
hospital
buildings
and
their
campuses
to
continue
to
care
for
californians
who
need
that
level
of
care.
B
As
in
regards
to
your
question
about
outdoor
dining
and
restaurants
in
general,
I
think
our
position
again
is
to
consider
that
the
stay-at-home
order
really
does
guide
us
to
reduce
our
mixing
to
reduce
our
movement
as
much
as
we
can.
And
then
this
is
the
time
that
if
you
want
to
enjoy
a
meal
from
a
restaurant
or
need
a
restaurant
to
provide
your
food
and
sustenance
that
we
still
have
the
option
of
take
out
the
option
of
having
food
delivered.
B
But
now
is
not
the
time
to
spend
additional
time
outside
of
your
household,
potentially
mixing
with
others
transmitting
the
illness
far
and
wide.
So
as
much
as
possible.
The
guidance
is
avoid
that
have
those
sectors
closed
in
the
regions
that
have
are
under
the
regional
stay-at-home
order
that
we
do
this
for
a
short
period
of
time
and
that
we
look
forward
to
moving
beyond
the
surge
having
that
industry
and
many
other
sectors
reopen
for
business
and
really
begin
to
to
move
beyond
the
period
that
we
are
in
now.
B
So
with
that,
I
know
that
was
a
lot
of
questions
and
and
mouthfuls
of
answers,
and
I
apologize
for
that.
But
really
always
appreciate
the
time
with
each
of
you,
our
reporters
for
asking
thoughtful
questions
that
help
us
not
just
illuminate
the
thinking
behind
some
of
the
decisions,
but
also
an
opportunity
to
clarify
some
of
it
I'll
end
by
just
thanking
each
of
you,
as
I
have
before,
for
your
incredible
work.
I
know
it's
hard.
B
They
need
our
help
and
one
of
the
best
ways
to
do
that
is
by
changing
your
own
personal
decisions
and
behaviors
for
this
period
of
time,
helping
us
get
transmission
down
and
hopefully
getting
through
this
month.
That
will
be
hard
that
will
be
different
and
into
early
next
year,
when
we
not
just
have
vaccine,
but
we
have
lower
rates
of
transmission
and
we
can
return
to
a
number
of
other
activities
that
we
all
miss
now
and
and
with
that
I'll
I'll
end
and
wish
you
a
good
rest
of
your.