who will update a session at Miramar our regional partners shame strong for we're fulfilling from cities disease for hand washing being collaboration around at a stem for this dress. We've placed 80 - six hand washing station The 70 - eight Portland. He's not relying on people relying services for them and we are continuing to carry on this with critical services, but we are seeing where we need to focus our County lab. Public but they buy check he received some yesterday availability for a report the microphones and so what we're day is we're gonna ask you to line up and says your identified ask your questions that way you will be heard by by the way I wanna talk about my voice my Street that I am in fly at the vocal cords, zero film and recreate, so I sound a little weak lack of wellness in my voice, but I can tell feeling very well people's concerns. Let me introduce my colleague. Nathan Fletcher. Cox and thank you to the County tax plans are emerging Mission Center running proactively working through that we are taking every possibly can to us and respond and confront the challenges in front of us in real time on a daily basis. we continue our engagement with all sectors to make sure they are getting information they need a lot to ask when presented to them today doctor and I had a series of a virtual a video conference at first with our education combined County Super public instruction Kathy, along with all of the support of all of the San Diego County in a video conference provide updates status report engagement, we appreciate labor. Their efforts to continue to provide service and meal service those families who are most in need. We stay strong allies and participation of leaders separate entity the first MCA care services. They are the officials on they're the official entity for the San Diego and the YMCA, says partner in our liaison and all of these we again from the information that we addressed any concerns or issues they may and those continue but tomorrow or type titled with business community homeless kids in with the faced community engagement with each of these ribs towards are video ongoing effort located staff for. Each of these sectors merely Amazon and answer it comes to the homeless at 11 rooms that are available for individuals who are exhibiting symptoms symptoms. we are in my communication with our providers with alter operating with everyone else so that they know how to facilitate books entry into that. In addition to have our homeless outreach, teams are who have public health nurse at them healthy County they are in downtown areas now spreading in North and others in the County in an effort to engage population available let them available service fighting hygiene. Kits care screenings continue to do that Regular Commission in contact pretty of Sandy with their announcements that I talked with the mayor of Sandy. our efforts are coordinated and anything that they need they have and likewise so those will continue along with basement with the mayor's of of the other 18 cities throughout we do want to look I know that we have next service alert system updates on coded 19 City allows County Health to send real time information about develop instant they received these mentally text CEO D C O. Teen the number you text that message to 468 311 I did out earlier, Nice and send you a text CEO The CIO VP ID. Number 19. you send that message or that mean the podium and we will be putting our information real updates and although our County has service of Ebook, there are thousands and thousands of ebooks that are San Diego access and phone or tablet and Yesterday I signed up for it. we made a little instructional video. It's really really easy and so we would encourage folks you don't every card you don't need any ocean. you just simply download the Libya. I just search for Libby search for San Diego and then you will get connected. You have access to all of those and then last thing our San Diego 18 community yesterday we million dollars have a release coming but the totals that we received in the first 20 -fourth is exponentially greater started probably encouraging to see if they come to. Other very, very generous entities making science drivable flood of folks all donations and joining us. We're very very grateful help and support from that. You gotta go Family dot org where folks can hear them and get them from access to so all efforts are continual speed acting in real time to of our partners in this effort and the need to do is very our public health and professionals. Thank you. Next, we're gonna hear from our counter Doctor Walmart Wood. Thank you guys. Thank all of you for day. I'm very brief with allowed you all to have questions going to do with this four where we are as of lasting and some additional updates and then I will go into the dish date and in the Miramar so well of the last evening I had a total of 50 - five so this includes 20 females, 30 -, five males, and in terms of the age distribution isn't there are no cases 17 we have. Team board and 1360 - five plus our young age 20 - one years of age is the early eighties is about eight two so in terms of hospitalization, total number of KN have been hot and to date, we think not had any now compared to the compared to today and then this morning over a hundred and 80 deaths for I'm sorry over housing cases and over a thousand of these numbers aggressively today, End of close of business yesterday of Ends deaths and then fortunate update we have had 4137 one deaths and we also this afternoon or working on cases that have been reported that will be end of the day or report and we may specific other cases from the equal commercial level as well as the Huddles, but the cases that we won that at our public health laboratory that runs but again, we will all the. Known cases that as of this afternoon now I would like to invite Doctor Mcdonald to come and talk about a little more information two cases we do and working on this afternoon and update us on going on at Donald. Thank you Doctor Wooden to we are investigating two clusters of amongst five faces that described by Putin, one is sister individual apparently treated the in the city three of those individuals at home on isolated individual hospitalized. These individuals are known to her identified close contacts of those individuals. this investigation is being conducted military because sexuals are actively nurse but that investigation is on going heard about one of them was announced by the name of their first cases here in the And the other goods being investigated is of who were in Colorado, Colorado an advisory that there were in several where their key resorts. This was that infant and develop symptoms I presented for care are seven of them is hospitalized and some are not hospitalized relation. that's all also a current investigation again. they're investigating will have developing as a time I did wanna mention. The conditions that are going, I'm the on the operations and it's worth noting that they total of a 409 individuals in cruise ship that was team for the last several days. I'm 30 - two left Miramar various States where these individuals and leaves a hundred and 50 individuals last night who are here at the Marine Corps Air Station Machine and there were plans to have up to a hundred and 15 individuals A basically a flights to many, they called this operation where all the individuals will be continuing a quarantine in their home States. There are A hundred and 30 California residents who are at Miramar under federal 14 and to their San Diego on the group there County has been in contact with both visuals had been providing their support needs while they're in federal custody two May County has been support with the federal quarantine at Miramar. The first is a higher level of medical care and seven and go to our Higher level those individuals stay tuned to Miramar other support that we have provided laboratory support merrily of these indoor leaving Miramar a person's under invitation for developing symptoms and it's that seen on our weather. I think it was last night and today at five and positive for the virus updates and I'm available for questions. Thank you before we get to the questions just take a moment to thank the media getting the word out there just said the measures that the geeking we know this is a difficult time you need to get out acronym in public in a very tanner and we really rely about you that you guys are working long hours too. So just supposed to know we really appreciate your help and gration at this point, what we'd like to do is if you have questions we went up to the microphones ahead in your name and the media you represent they go ahead and ask the question will direct at the appropriate. Hi everybody audio from Channel seven News now when you say the word clusters at gets my attention attention now is this just a matter of a cases that you did a contact history and found that that's how these cases it can. We expect more stores to be at once learn more of histories for who have tested. yes, let's watch it when I worked here if individuals close contacts of each other, usually define one pair we do enter and individuals are close contact endorse and we go in. And seek care that's the dynamic of of at least one of these investors are Watterson comes in for somebody care and other locations and find out that they came social network and are able to them that way and then indeed did with military civilian cluster so it will crown with the individual interview ask activities we find out who their car to give them to do if they have ended badly linked these groups of their it appears that the who are on the skies as a well-defined group and we're confident that they end. Perhaps some household members, I will be able to contain that cluster other group is still under investigation. so just a quick follow up. there was made last week of two Colorado. Those two Colorado casted to this particular club is the expectation that that be more posters well, the this group in Colorado cases that were referred to but so it has grown from that may be as I would expect others to be identified. That's why we do these contact investigations urge people. Up symptoms to contacts Instead, we can again draw around those be able to contain it. I am Claudia with Vision so yesterday, we mentioned thought a form that fill out spending is that any update on that aspect. we have the form we'll track we definitely have it so we'll we'll push up which will be on yesterday. You had mentioned that some possible solutions for people who are struggling care, is there any planet front well currently childcare still facility open. We have not issued on shoes or but we actually did have a call with them to recommend it well guidance in terms of distancing so if they've a facility that's large to get the children into 10 supervision. About issued innovate guns to date regarding childcare working for from this so that we can impact locally. Andy Duke yes, are you doing for non-profit health costing help with getting masks personal protective so there have been chance of say Tammy two weeks ago, we are able to right now you are able to use the five masks that when they had expired federal government and say we can now use currently, we have changed from transmission to air transmit health care world use regular surgical. They are interacting with someone the Department as opposed in 90 -. The use of if there, if there's a perform that produces personalization going from the droplet, sorry. Well, I don't know what I'd be going on with you, but we have changed to go to droplet trends was that understand no yes. Alright. Yes we were we did have lines for aerosol We issue again and to change during transition. I knew I had two questions specific to the H one and you had written up in the Bay after actually put like it's all just here and then yes, one of the recommendation that after actually put was to provide trains in command system and emergency to identify the 2019 after identified as needing that training and whether they completed it all the staff in the health and Human Services Bleeded by the end of it, and then there was another for continue to use testing Mass between staff and formalized relations to build a deadline June thirtieth 2019. Can you get in here? It's recommend Tony calls for continuing to work with the CDC to use their 10 model to determine relation between sustain an outbreak and formulation ships with extra. Capacity and bio information and that was a July 19 deadline completed. Yeah, it was looking at there are partnership and developed hands our Tory testing capacity and we work in sisty and scripts actually stand our boy appetite during the habitats pretty any of the stations that we to deal with we have brought on that testing tea and public health laboratory. So now we we are just doing this A outbreak for hepatitis A but we are. Also use those limitations has for see B as and then now with and I think you heard about this. I know if it was yesterday we are working with provide capacity. I hope that process being worthy Paul System contribute I wonder you talk about tell rooms for folks who may not have places to live and you've also talked about how many. Have sometimes like fever or cough and often they're they're coming into their health care plan right now, just because they don't tournaments. Could you say a little bit more about what those requirements are and be talk a little bit about these folks should be separating themselves. families. they're sick. Maybe they may are like no parent or thinking don't have child care. Well, I'll start and then I'll have Doctor Donald talk and supervisor so in terms of And this was last week we had matched supply. We have more supply now have more supply, but at that time totals and the stories were being their supplies, but not just the test kit is whether you squat and the containers that this was in and to test the spending and sweet there was I don't wanna say a limitation, but the ration the spent the supplies so that's on the most on those individuals that were in the hospital so that called and this was a culture lab. We call them last week and we have. So that Peter tested can't we actually have drive by testing that was lame and that is through a fighter referral and if individuals are referred, they can live through and be tested if they have symptoms by tear for testing, particularly end up being admitted and gender about 70 to 80 percent visuals that get Cove at 19, have mild to moderate symptoms here messaging amount to moderate symptoms like when you get through go home, I go through the process. And CDC just issued guidance discharged from home. You need to be seen Bush and then provider and arrange for evaluation and isolation, and I would if they provide needed additions traveled to actually, but it's any covered affected area. I couldn't quite choose if you are been exposed to has an can't satisfy the first two if you have a risk and particular to gets a chest and have new monia fascinated think about Cove team. So those are the criticize that it goes to the doctor. We're going to over our health care, urging people very much if you have to moderate symptoms home and but if you need to be better than will bite her in arranging a answered, most of your questions like do anything to add yes regarding testing what interject here is people out contaminating their families. Don't know where Oh, that's the CDC is recommending that a family member is positive family becomes quiet. With the that's isolated, that's a mission that may not adults so trying to separate or finding alternate thing, and that's something supervisor Fletcher more about. on on hotel rooms, motel are available the aim was to move aggress. We had rooms available for any positive test who had a simple did not have the opportunity to self so if you show simulation your care how you despite what you're showing symptoms and so this is what through them with shelters and temperatures looking for simple. If you show any time you were immediately environment and place in the rooms Wall Week in the process of testing you but just if you're in a care type setting, these rooms will be available for individuals who are or or. Just any individual who doesn't have a place where they they they can self identify or they can go into and so the purpose good service. We haven't site Princess fine if if they are to stay on, then we would have location for them now to separate into state of California and the almost, which is just a vibe rooms to get people often we fully those ups and we think those are values but the rooms we have at those times are to those individuals for exhibiting symptoms positive test or a pending. It's and they don't have those I just wanted to make a comments about testing and I know it's trading and yeah concerning that we don't have as we would like and I think that when between test, we have to be very careful. our in our health alerts were for doctors to be submitted a test to our public health and we were trying this for very specific parliament to capacity for high impact situations as the supervisor just someone's in a congregate meet right away to take action example would be skilled nursing facility cases as host individuals who are exhibiting symptoms, all of them to negative that our public health lab by using our to be able to get answers quickly to help decide that or does not either be taken in that 10 to more and more commercial availability. Be any barrier we're not there yet, and that's the part of the forest so our public health lab is the transition further who supporting our local labs to independent. So, for example, a scripts bottle has a testing capability that they've been using and diagnosing patients. we have been verifying their test. We think by tomorrow, we will have enough positive and negative tests to public health life to let them be able to verify them with us and use those as a confident confirmed test with the. Cape Test tomorrow so that are from the which we still have for for all so that our hospital fat over eventually, we'll see collabs do it or testing tenNews again. I have two somewhat really quite following up on what change in the mask there any reason to believe it's viral air and also do we know how long in the guidance that we've done he sees and you look up and submitted through drop transmission so and if you see yourselves are recommended to you now. Five mask. Now evidence all of it right now points to the fact that it's transmission again that or the guidance that we've from the very surface, there are studies about that the type of surface it's plastic a cardboard it just on the type of surface recommend that in their hands soap and that the best organism or that for getting rid of the bus offerings, and I think upset the virus can be on. you really have to get into the respiratory but when you have it on. Touch your eye your nose your face That's how it gets into the system. Andy, with for senior citizens that are are there is available to make food what their response is actually by law, The counties were stability Okay. Alright worth Union Tribune Yeah, Public Health nurses outreach Team Bridge Shelter. Other planned also has wondered when Chantelle rooms yet who for any reason would yes to all three and I'll have supervisor provide deep. Yeah, Gary D nursed shelter down and visit. I saw them what they're doing screenings and then they also were with that are going but again those are not just said. We're expanding that that that we are addressing and the rooms are begin. and and we're going to we're working updates and numbers rooms that are they're being utilized. We're in the there stood up, they're ready and now we're in the girls. We've worked out the transportation for how individual and where they go and so we're all the shelter of their health care providers and others know the process by which they get here. They haven't gone yet like at the object as far as which goes they've they've been okay at the Alpha project Walk into our public health set up an attempt. Sorry I meant to reach into like there's a unsheltered people going up the Street to the people who are there though in the shelters but well it's. They weren't there and point now they are thanks. Brad Racino one more question for my new about what you say to health care workers who believe they're being prescriptions thing and the contract the virus and spread it around the hospital Well. Doctor Mcdonald correct me if I'm wrong. But while it's been in from the news we have had out of cases of health care. We have not been as a result exposure in the hospital. That's one thing so we have not had that have occurred thrilled exposure in okay, but has concerns from nurse others. Well we we use Russian for influenza so people come into the emergency for many infectious disease transmitted through droplets. And that's he says this fire is that so please be very afraid of and hearing on the of cost but at the science, the supports that droplet transmission four drop health care providers can use regular surgical mask. They are being aerosolize station or parasols 90 - five amount that I think that's a very good questions that health care workers have. I know that we've program consists about that and there Individuals who work in the hospital and women who are they're physician providers who work with patients who have infectious diseases all the time their deal aerosol transcend transmitted diseases have a very good level with that as we get to expand or of people who work with patients have a droplet at a disease located comfortable with that, and I know that our hospitals have been working very hard their health care staff to be able to understand the understand the protection and comfortable. It's a problem until someone is gonna be writing themselves and we do have evolving guidance protection and concerns about whether there will be enough, send his anxiety. so I think it's control to plus a lack of discuss our hospital systems and reaching out into our are becoming about this so they can be okay. We'll take since I have a question about the clusters. of course, we know a lot of families go for spring break. Can you information about Colorado anything? but yeah Force specific case in Colorado and I had except for 15 cuz I've personally been there. Pitkin County look that up on the Colorado have a nice discussion about advisory because of that, but it's a great question trip since right now, I mean we really doing the things that we both ordered and recommend about your social engagement vigils in the community. so planning a trip now isn't consistent with that. so I would not do that and to add although be both. Sing for each other emotionally distant each other, I mean that's a name us to learn. I was doing together to being clean. both of those and everyone is dealing with us every family has to in their own way and again about what people can do and they're Segway or you should be planning you should do things that we actually outlined in DC yesterday in terms of you can personally take to take as families look over here. I'll tell you what we started with with go ahead. Hey Paul DT again you should have ordered one regarding down another going up front only you know variance. How's it going buddy shutting down do any law enforcement issues to health for sending letters out that have missed out yesterday beer even we do have investment. Ready and able to do what's necessary for that? so we are and we know the businesses asking them to come with the yeah excited. I just want to in terms of the capital shutting on elective I've checked with their some of their shutting down, but it's not like bright line. I noticed you got bait on that and I wondered why if you might talk to say, cut it off to my why not put a data? Yeah. I'll let you want to sort of follow on. you know I actually a place before all of the orders were and they were the things to do. Before we that's probably a most of our community businesses in San Diego, they they were ahead of where we actually eating cuz they're watching. They're reading your newspaper and they are adapting and things internally. so I have everything that they are continue with adopting types of things. police for that. I think they're on their own to maintain business all of lead to the there was a capacity is running in which the hospitals were actually doing this very issue reduce their be able to bring the potential for coming. Doctor Ruth and I think it was on that call. If you tell that I wanted to comment on timing and top of the orders were at midnight on so effective time on me, so they're minors and then there were three strong but all of them yesterday a question from Is there the vaccine that enough your love has working on and kind of collaboration. I didn't ask for the vaccine saw in the newspaper today vaccine being if you're a mental been with it is going to take some time to bring to the general pub public to buy commercially so we are still what the. Government is saying, is that we're still anywhere from a year to 18 months out from a vaccine. So that's why it's very that participate bending stopped up about the color. Yes, I actually would like to answer that question. you have a state that are working with somebody and we get updates from the federal Ministry and we also get updates directly from our colleagues about case valuated and say that they've had confirmed cases in Baha California. As of the report that I saw I have evaluated. individuals under invest one of those individuals was actually someone that our public health tested that was in a hotel in Mexicali. That was a collector. so there's lots of jurisdictions there, but we routinely invest communicable diseases together together and we were able to listen ships popular case kind of to be so we are collaborating closely with them. Thank you. okay. We're gonna cut this off at this point as far as if you have any questions you can talk to Doctor Wooten or doctor. We sincerely appreciate the media again in their attention and I wanna just emphasize that the County is open for business and we're certainly modifying how wide that businesses medical services that we provide child protective services, a lot of people trying to still foods services that we have so we are in a way that we deliver all the services just as we announce to the libraries will not be to the public, but they both books If they wanna call very or let them know what books they will be put together. Be made up of those drop-off locations at each Lee County Public race, and we increase buddy to check the county's White. if you have questions if you are in need of of food stamps that we would encourage you all only resource Center where you won one and naked application going on by those critical services have to adapt in order to create to keep that social distance and to attack with either each other. So we think for your attention we have another brief afternoon and additional questions you can the doctors. Thank you.