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Posted on: May 26, 2020

Orders and Strong Recommendations of the County of Orange Health Officer

OC Health

The following information is being shared on behalf of the Orange County Health Care Agency

ORDERS AND STRONG RECOMMENDATIONS
OF THE COUNTY OF ORANGE HEALTH OFFICER

[ISSUED May 22, 2020]

Pursuant to California Health and Safety Code sections 101040, 120175, and 120130, the County of Orange Health Officer ORDERS AND RECOMMENDS AS FOLLOWS:

ORDERS

Effective 12:00 a.m. on Saturday, May 23, 2020, and continuing until further notice, the following shall be in effect in unincorporated and incorporated territories of Orange County, California:

  1. Self-Isolation of Persons with COVID19. All county residents who have been diagnosed with or are likely to have COVID-19, as defined below, shall immediately isolate themselves in their home or another residence under the following criteria, as applicable:
     

    a) Individuals with COVID-19 symptoms shall isolate themselves until: (i) at least 3 days (72 hours) after they have recovered, meaning their fever has resolved without use of fever-reducing medications and their respiratory symptoms (e.g., cough, shortness of breath) have improved; AND (ii) at least 10 days has elapsed from when their symptoms first appeared.

    b) Individuals who have a positive COVID-19 PCR laboratory test result and are without COVID-19 symptoms shall isolate themselves for 10 days from the date when the specimen for the positive COVID-19 PRC laboratory test result was obtained.

    Unless one of the criteria, above, applies, i.e. 1.a) or 1.b), the individual may not leave his or her place of isolation except to receive necessary medical care.

    A person is considered to be diagnosed with or likely to have COVID-19, if the person has:
     

    a) Received a positive COVID-19 PCR laboratory test result; and/or

    b) Been informed by a physician that he or she is likely to have COVID-19 and/or;

    c) Signs and symptoms that are consistent with COVID-19 (i.e., new onset of fever, cough, shortness of breath or trouble breathing).
     

    If a more specific isolation order is issued by the County of Orange Health Officer for any county resident, that order shall be followed instead of this order.

    This self-isolation order DOES NOT in any way restrict access by first responders to an isolation site during an emergency.
     
  2. Self-Quarantine of Persons Exposed to COVID-19. All county residents who know that they have been in close contact, as defined below, with a person diagnosed with or likely to have COVID-19 shall take the following actions:
     

    a) Quarantine themselves in their home or another residence until 14 days from the last date that they were in close contact with a person that has been diagnosed with or likely to have COVID-19.
     

    Exposed persons shall self-quarantine themselves for the entire 14-day COVID-19 incubation period, the typical time between exposure and when symptoms and signs of the disease may develop. They may not leave their place of quarantine except to receive necessary medical care or to obtain such other goods or services necessary for their basic subsistence.

    Close contact refers to any person who has been within 6 feet of an infectious COVID-19 person for 15 minutes or more. A person who is diagnosed with or likely to have COVID-19 is considered infectious from 48 hours before his or her symptoms first appeared until the person is no longer required to be isolated.

    If a more specific quarantine order is issued by the County of Orange Health Officer for any county resident, that order shall be followed instead of this order.

    This self-quarantine order DOES NOT in any way restrict access by first responders to a quarantine site during an emergency.

    This self-quarantine SHALL NOT APPLY to health care professionals and law enforcement personnel.
     
  3. All businesses that are permitted to reopen in Orange County as part of Stage 2 of the State’s Resilience Roadmap shall comply with industry-specific checklist posting in workplace as stated on the State’s website at https://covid19.ca.gov/industry-guidance/. For dine-in restaurant industry specific checklist posting requirements see https://covid19.ca.gov/pdf/guidance-dine-in-restaurants.pdf. For destination shopping and malls industry specific checklist posting requirements see https://covid19.ca.gov/pdf/guidance-shopping-centers.pdf.

    The checklist posting shall be visible at the entrance of the business and specifically include an attestation by the business owner and/or operator that the business has:
     

    a) Performed a detailed risk assessment and implement a site-specific protection plan;
    b) Trained employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and stay home if they have them;
    c) Implemented individual control measures and screenings;
    d) Implemented disinfecting protocols; and
    e) Implemented physical distancing guidelines.
     

  4. Cloth Face-Covering. All Orange County residents and visitors shall wear a cloth face-covering when (i) in a public place; (ii) visiting a retail, commercial or other place of business; or (iii) at work, and when the resident or visitor is not able to maintain at least 6 feet of physical distance from another person who is not a family/household member or live in the same living unit.

    A cloth face-covering is a material that covers the nose and mouth; it can be secured to the head with ties or straps or simply wrapped around the lower face; it can be made of a variety of materials, such as cotton, silk, or linen; and a face covering may be factory-made or sewn by hand, or can be improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.

    The cloth face-covering order SHALL NOT APPLY to children under the age of 2; anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cloth face-covering without assistance; persons with a medical or mental health condition, or development disability, that prevents wearing a cloth face-covering.

STRONG RECOMMENDATIONS

Effective 12:00 a.m. on Saturday, May 23, 2020, and continuing until further notice, the following shall be in effect in unincorporated and incorporated territories in Orange County, California:

  1. All Orange County residents and visitors should maintain at least 6 feet of physical distance from another person who is not a family/household member or live in the same living unit, when (i) in a public place; (ii) visiting a retail, commercial or other place of business; or (iii) at work.
     
  2. All Orange County residents who are 65 years old or older; have serious underlying medical conditions (for example, chronic lung disease, moderate to severe asthma, serious heart conditions, severe obesity, diabetes, chronic kidney disease undergoing dialysis, liver disease); or have a compromised immune system should remain at home consistent with guidance provided by the California Department of Public Health (CDPH) available at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/PublicHealthGuidanceSelfIsolationforOlderAdultsandThoseWhoHaveElevatedRisk.aspx.
     
  3. All Orange County residents should avoid contact with people who are sick; not gather in groups; stay out of crowded places; avoid mass gatherings; wash hands frequently; wash face coverings frequently; cover coughs and sneezes; and clean and disinfect frequently touched surfaces daily, including tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.

GENERAL PROVISIONS

  1. This Order and Strong Recommendations shall not supersede any conflicting or more restrictive orders issued by the State of California or federal government. If any portion of this Order and Strong Recommendations or the application thereof to any person or circumstance is held to be invalid the remainder of the Order and Strong Recommendations, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect. To this end, the provisions of this Order and Strong Recommendations are severable.
     
  2. The orders contained in the Orders section may be enforced by the Orange County Sheriff or Chiefs of Police pursuant to California Health and Safety Code section 101029, and California Government Code sections 26602 and 41601. Any violation of these orders are subject to fine, imprisonment, or both (California Health and Safety Code section 120295).

REASONS FOR THE ORDER AND STRONG RECOMMENDATIONS

  1. On February 26, 2020, the County of Orange Health Officer declared a Local Health Emergency based on an imminent and proximate threat to public health from the introduction of a novel coronavirus disease (COVID-19) in Orange County.
     
  2. On February 26, 2020, the Chairwoman of the Board of Supervisors, acting as the Chair of Emergency Management Council, proclaimed a Local Emergency in that the imminent and proximate threat to public health from the introduction of COVID-19 created conditions of extreme peril to the safety of persons and property within the territorial limits of Orange County.
     
  3. On March 2, 2020, the Orange County Board of Supervisors adopted Resolutions No. 20-011 and No. 20-012 ratifying the Local Health Emergency and Local Emergency, referenced above.
     
  4. On March 4, 2020, the Governor of the State of California declared a State of Emergency to exist in California as a result of the threat of COVID-19.
     
  5. There is currently no vaccine to prevent COVID-19. According to the Centers for Disease Control and Prevention (CDC), the best way to prevent COVID-19 is to avoid being exposed to the novel corona virus. According to the CDC, the novel corona virus is thought to spread mainly from person-to-person due to the following: (1) between people who are in close contact with one another (within about 6 feet); (2) through respiratory droplets produced when an infected person coughs, sneezes or talks; (3) these droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs; (4) some recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.
     
  6. According to the CDC everyone should (1) wash their hands often with soap and water for at least 20 seconds (or use hand sanitizer that contains at least 60% alcohol when soap and water is not readily available) especially after having been in contact in a public place, or after blowing their nose, coughing, or sneezing; (2) avoid contact with people who are sick, stay at least 6 feet from other people, not gather in groups, stay out of crowded places, and avoid mass gatherings; (3) cover their mouth and nose with a cloth face cover when around others when they are out in public; (4) cover coughs and sneezes; and (5) clean and disinfect frequently touched surfaces daily, including tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.
     
  7. The CDC recommends that everyone wear cloth face coverings when leaving their homes, regardless of whether they have fever or symptoms of COVID-19. This is because of evidence that people with COVID-19 can spread the disease, even when they don’t have any symptoms. Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated, or otherwise unable to remove the mask without assistance. See https://www.cdc.gov/coronavirus/2019-ncov/downloads/cloth-face-coverings-information.pdf.
     
  8. The CDPH also issued a Face Coverings Guidance on April 1, 2020, available at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Face-Coverings-Guidance.aspx. The Guidance provides that a face covering is a material that covers the nose and mouth; it can be secured to the head with ties or straps or simply wrapped around the lower face; it can be made of a variety of materials, such as cotton, silk, or linen; and a face covering may be factory-made or sewn by hand, or can be improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.
     
  9. According to the CDC, COVID-19 is a new disease and there is limited information regarding risk factors for severe disease. Based on currently available information and clinical expertise, older adults (65 years older and older), people who live in a nursing home or long-term care facility, and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. See https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html. According to the CDC, this at higher risk population should stay home (if possible) and practice social distancing of at least 6 feet both in and outside the home. See https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-What-You-Can-Do-High-Risk.pdf. See also https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/PublicHealthGuidanceSelfIsolationforOlderAdultsandThoseWhoHaveElevatedRisk.aspx.
     
  10. The orders and the strong recommendations contained herein are based on the fact that there is currently no vaccine to protect against COVID-19, and no proven therapeutic treatment for it; scientific evidence regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically, as well as best practices as currently known and available to protect the older adults (65 years older and older), people who live in a nursing home or long-term care facility, and people of any age who have serious underlying medical conditions from avoidable risk of serious illness or death resulting from exposure to COVID-19.
     
  11. As of May 21, 2020, there are 4,941 reported COVID-19 cases and 118 COVID-19 related deaths in Orange County (see https://occovid19.ochealthinfo.com/coronavirus-in-oc); as of May 20, 2020, there are 88,444 reported COVID-19 cases and 3,630 COVID-19 related deaths in State of California (see https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx#COVID-19%20by%20the%20Numbers); there remains a strong likelihood of a significant and increasing number of cases of community transmission; some individuals who contract the novel coronavirus have no symptoms or have only mild symptoms, and so are unaware that they carry virus and are transmitting it to others; evidence shows that the novel coronavirus can survive for hours or even days on surfaces and can be indirectly transmitted between individuals.
     
  12. The age, condition, and health of a significant portion of Orange County population place them at risk for serious health complications, including hospitalization and death, from COVID-19. Younger and otherwise healthy people are also at risk for serious negative health outcomes and for transmitting the novel coronavirus to others.
     
  13. The orders and strong recommendations contained herein are necessary preventive measures to control and reduce the spread of COVID-19 in Orange County, help preserve critical and limited healthcare capacity in Orange County, and thereby save the lives of Orange County residents.
     
  14. The California Health and Safety Code section 120175 requires the County of Orange Health Officer knowing or having reason to believe that any case of a communicable disease exists or has recently existed within the County to take measures as may be necessary to prevent the spread of the disease or occurrence of additional cases.
     
  15. The California Health and Safety Code section 101040 authorizes the County of Orange Health Officer to take any preventive measure that may be necessary to protect and preserve the public health from any public health hazard during any “state of war emergency,” “state of emergency,” or “local emergency,” as defined by Section 8558 of the Government Code, within his or her jurisdiction. “Preventive measure” means abatement, correction, removal or any other protective step that may be taken against any public health hazard that is caused by a disaster and affects the public health.
     
  16. The California Health and Safety Code section 120130 (d) authorizes the County Health Officer to require strict or modified isolation, or quarantine, for any case of contagious, infectious, or communicable disease, when such action is necessary for the protection of the public health.

Health Order and Strong Recommendations
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