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10.13.20 Email from Brian Ring 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:Tuesday, October 13, 2020 4:59:13 PM Attachments:SYASL COVID-19 Update 10.13.20.pdf Good afternoon all – FYI. Brian Ring Assistant Chief Administrative Officer Administration 25 County Center Drive, Oroville, CA 95965 From: SYASL County Info <SYASLCountyInfo@SYASLpartners.com> Sent: Tuesday, October 13, 2020 3:18 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: October 13, 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 October 13, 2020 Newsom Administration - Resources / Mutual Aid / Executive Orders Today California Health and Human Services Secretary Dr. Mark Ghaly provided an update on COVID-19 in California. Dr. Ghaly also provided guidance for gatherings for Halloween, noting that the guidance is a way to provide important ways to reduce risk, but the State is not in any way endorsing small gatherings. Trick-or- logistical issues related to contact tracing and fear of spreading the virus. Dr. Ghaly also provided the following update on the County Tiering System: o New counties in Red (Substantial); Colusa, Kern, Kings, San Benito, Stanislaus, Sutter o New counties in Orange (Moderate): Alameda, Placer, Santa Clara o New counties in Yellow (Minimal): Sierra here and SYASL staff notes here. Please check the California Department of Public Health website here for the latest guidance documents. CalMatters: What no Trump stimulus means for California schools, unemployment and more An October 15 deadline to restore $11 billion in funding for education, housing, and state workers in California looks likely to pass with no more financial help from Washington. View here. Wildfires October 13, 2020, 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. COVID-19 Updates www.covid19.ca.gov October 13, 2020 Newsom Administration - Resources / Mutual Aid / Executive Orders Today California Health and Human Services Secretary Dr. Mark Ghaly provided an update on COVID-19 in California. Dr. Ghaly also provided guidance for gatherings for Halloween, noting that the guidance is a way to provide important ways to reduce risk, but the State is not in any way endorsing small gatherings. Trick-or- logistical issues related to contact tracing and fear of spreading the virus. Dr. Ghaly also provided the following update on the County Tiering System: o New counties in Red (Substantial); Colusa, Kern, Kings, San Benito, Stanislaus, Sutter o New counties in Orange (Moderate): Alameda, Placer, Santa Clara o New counties in Yellow (Minimal): Sierra here and SYASL staff notes here. Please check the California Department of Public Health website here for the latest guidance documents. CalMatters: What no Trump stimulus means for California schools, unemployment and more An October 15 deadline to restore $11 billion in funding for education, housing, and state workers in California looks likely to pass with no more financial help from Washington. View here. Wildfires October 13, 2020, here. Legislative / Budget News -19 here page for updates. The LAO has been releasing a series of reports regarding Federal actions affecting California related to developments around COVID-19. View here. o o o o o o 3?F@ȯ)MIF;NCIH )HMNLO=NCIHM @IL )H>CPC>O;FM 7BI (;P? IL ,CE?FS (;P? #/6)$ȯdzǻ 7BS M?F@ȯCMIF;N?ȡ COVID-19 is very contagious. If you have tested positive or have symptoms of COVID-19, you should self-isolate to prevent spreading the disease to your family, friends, and community. (IQ FIHA MBIOF> ) M?F@ȯCMIF;N?ȡ You should self-isolate for at least 10 days aer your symptoms start (or 10 days aer you were tested if you never have symptoms). Aer you self-isolate and before you can be around others, your symptoms should also be improving (including not having a fever for at least 24 hours). (IQ >I ) M?F@ȯCMIF;N?ȡ ȶ3N;S BIG? ?R=?JN NI A?N G?>C=;F =;L?ȶ3N;S ;N F?;MN Ǹ @??N ;Q;S @LIG INB?L people, especially those in high risk ȶ$I HIN B;P? ;HS PCMCNILM groups more likely to get sick, such as ȶ7?;L ; @;=? =IP?LCHA ;LIOH> INB?LM people who: ȶ#IP?L SIOL =IOABM ;H> MH??T?M Are over age 65 ȶ7;MB SIOL B;H>M Ien with soap and Are severely overweight water for at least 20 seconds, or if you =;HȦN Q;MB SIOL B;H>Mț OM? B;H> M;HCNCT?L Have a chronic disease (like cancer, with at least 60% alcohol diabetes, heart/lung disease) ȶ$CMCH@?=N ;HS MOL@;=?M SIO NIO=B Have a weak immune system frequently ȶ)@ SIO GOMN <? CH ; MB;L?> MJ;=?ț IJ?H ȶ5M? ; M?J;L;N? <;NBLIIG IL >CMCH@?=N ; windows when possible shared bathroom aer each use (IQ =;H ) =;L? @IL GSM?F@ ;N BIG?ȡ While there is no specific treatment for COVID-19, proper home care (like resting and drinking fluids) helps most people get better without the need for hospitalization. You can take over-the- counter medications as directed on the bottle to provide relief from fever and pain. Contact your medical provider and discuss your symptoms. Be sure to alert your medical provider if you are in a high-risk group. #;FF ǻdzdz C@ SIO MN;LN NI B;P? ?G?LA?H=S Q;LHCHA MCAHM Qsfttvsf!ps!Cmvjti!mjqt!Dpogvtfe!ps!Puifs!tfsjpvt! Your Actions csfbuijohqbjo!jo!diftups!gbdfibse!up!xblftznqupnt Save Lives )@ SIO =;FF ǻdzdzț N?FF NB? >CMJ;N=B J?LMIHH?F NB;N SIO B;P? #/6)$ȯdzǻȚ www.cdph.ca.gov/covid19 3?F@ȯ1O;L;HNCH? )HMNLO=NCIHM @IL )H>CPC>O;FM %RJIM?> NI #/6)$ȯdzǻ 7BS CM M?F@ȯKO;L;HNCH? CGJILN;HNȡ If you have been exposed to someone with COVID-19, you could be infected and spread the disease before you feel any symptoms even if you never feel sick. (IQ FIHA MBIOF> ) M?F@ȯKO;L;HNCH?ȡ You should quarantine for 14 days aer your last contact with an infected person. (IQ >I ) M?F@ȯKO;L;HNCH?ȡ ȶ7?;L ; @;=? =IP?LCHA QB?H ;LIOH> ȶ 3N;S BIG? ?R=?JN NI A?N G?>C=;F =;L? others ȶ$I HIN B;P? ;HS PCMCNILM ȶ#IP?L SIOL =IOABM ;H> MH??T?M ȶ3N;S ;N F?;MN Ǹ @??N ;Q;S @LIG INB?L people, especially those in high-risk ȶ7;MB SIOL B;H>M Ien with soap and groups that are more likely to get sick, water for at least 20 seconds, or if you such as people who:=;HȦN Q;MB SIOL B;H>Mț OM? B;H> sanitizer with at least 60% alcohol Are over age 65 ȶ$CMCH@?=N ;HS MOL@;=?M SIO NIO=B Are severely overweight frequently Have a chronic disease (like cancer, ȶ)@ SIO GOMN <? CH ; MB;L?> MJ;=?ț IJ?H diabetes, or heart/lung disease) windows when possible Have a weak immune system 3BIOF> ) A?N N?MN?> @IL #/6)$ȯdzǻ >OLCHA M?F@ȯKO;L;HNCH?ȡ Your public health department may ask you to get tested. Getting tested is especially important if you have symptoms of COVID-19. Ask your medical provider or public health department about getting tested. To find testing in your area, visitcovid19.ca.gov/testing-and-treatment. 7B;N MBIOF> ) >I C@ ) MN;LN NI B;P? MSGJNIGMȡ Contact your medical provider or public health department and discuss your symptoms, testing, and treatment. Be sure to alert your medical provider if you are in a high-risk group. #;FF ǻdzdz C@ SIO MN;LN NI B;P? ?G?LA?H=S Q;LHCHA MCAHM Qsfttvsf!ps!Cmvjti!mjqt!Dpogvtfe!ps!Puifs!tfsjpvt! Your Actions csfbuijohqbjo!jo!diftups!gbdfibse!up!xblftznqupnt Save Lives )@ SIO =;FF ǻdzdzț N?FF NB? >CMJ;N=B J?LMIHH?F NB;N SIO B;P? #/6)$ȯdzǻȚ www.cdph.ca.gov/covid19 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor October 9, 2020 TO: All Californians SUBJECT: Guidance for Private Gatherings Summary This guidance provides an updated plan for Californians to gather outside their household and replaces the prior gatherings guidance issued on September 12, 2020and March 16, 2020. It applies to private gatherings, and all other gatherings not covered by existing sector guidance are prohibited. Gatherings are defined as social situations that bring together people from different households at the same time in a single space or place. When people from different households mix, this increases the risk of transmission of COVID-19. Mandatory Requirements for All Gatherings All persons planning to host or participate in a private gathering, as defined above, must comply with the following requirements. Local health jurisdictions may be more restrictive than this guidance. Refer to your local guidance for what is allowed in your area. 1.Attendance ½Gatherings that include more than 3 households are prohibited. This includes everyone present, including hosts and guests.Remember, the smaller the number of people, the safer. ½Keep the households that you interact with stable over time. By spending time with the same people, risk of transmission is reduced. Participating in multiple gatherings with different households or groups is strongly discouraged. ½The host should collect names of all attendees and contact information in case contact tracing is needed later. 2. Gather Outdoors ½%9L@=JAF?K L@9L G;;MJ GML<GGJK 9J= KA?FA>icantly safer than indoor gatherings. All gatherings must be held outside. Attendees may go inside to use restrooms as long as the restrooms are frequently sanitized. ½%9L@=JAF?K E9Q G;;MJ AF GML<GGJ KH9;=K L@at are covered by umbrellas, canopies, awnings, roofs, and other shade structures provided that at least three sides of the space (or 75%) are open to the outdoors. ½ ?9L@=JAF? G> FG EGJ= L@9F L@J== @GMK=@GDds is permitted in a public park or other outdoor space, even if unrelated gatherings of other groups up to three households are also occurring in the same park or other outdoor space. If multiple such gatherings are occurring, mixing between group gatherings is not allowed. Additionally, multiple gatherings of three households cannot be jointly organized or coordinated to occur in the same public park or other outdoor space 9L L@= K9E= LAE= º L@AK OGMD< ;GFKLALML= 9 gathering exceeding the permitted size. 3. Don't Attend Gatherings If You Feel Sick or You Are in a High-Risk Group ½ FQGF= OAL@ 9FQ !-4'"¸¢¸DAC= KQEHLGEK ¿>=N=J¤ ;GM?@¤ K@GJLF=KK G> :J=9L@¤ ;@ADDK¤ night sweats, sore throat, nausea, vomiting, diarrhea, tiredness, muscle or body aches, headaches, confusion, or loss of sense of taste/smell), must stay home and not come into contact with anyone outside their household. ½ FQGF= O@G <=N=DGHK !-4'"¸¢ within 48 hours after attending a gathering should notify the other attendees as soon as possible regarding the potential exposure. ½.=GHD= 9L @A?@=J JAKC G> K=N=re illness or death from COVID-19 (such as older adults and people with chronic medical conditions) are strongly urged not to attend any gatherings. 4.Practice Physical Distancing and Hand Hygiene at Gatherings ½$GJ 9FQ ?9L@=JAF?K H=JEALL=< under this guidance, the space must be large enough so that everyone at a gathering can maintain at least a 6-foot physical distance from others (not including their own household) at all times. ½1=9LAF? EMKL HJGNA<= 9L D=9KL >==L G> <Astance (in all directioFK»>JGFL¸LG¸:9;C 9F< side-to-side) between different households. ½#N=JQGF= 9L 9 ?9L@=JAF? K@GMD< >J=IM=FLDQ O9sh their hands with soap and water, or use hand sanitizer if soap and water are not available. A place to wash hands or hand sanitizer must be available for participants to use. ½1@9J=< AL=EK K@GMD< FGL := MK=< <MJAF? 9 ?9thering. As much as possible, any food or beverages at outdoor gatherings must be in single-serve disposable containers. If providing single-serve containers is not possible, food and beverages must be served by a person who washes or sanitizes their hands frequently, and wears a face covering. Self-serve items from communal containers should not be used. 5. Wear a Face Covering to Keep COVID-19 from Spreading ½5@=F ?9L@=JAF?¤ >9;= ;GN=JAF?K EMKL := OGJF in accordance with the CDPH Guidance on the Use of Face Coverings(PDF), unless an exemption is applicable. ½.=GHD= 9L ?9L@=JAF?K E9Q J=EGN= L@=AJ >9;= ;Gverings briefly to eat or drink as long as they stay at least 6 feet away from everyone outside their own household, and put their face covering back on as soon as they are done with the activity. ½$9;= ;GN=JAF?K ;9F 9DKG := J=EGN=< LG E==L urgent medical needs (for example, to use an asthma inhaler, take medication, or if feeling light-headed). 6. Keep it short ½%9L@=JAF?K K@GMD< := LOG @GMJK GJ D=KK£ The longer the duration, the risk of transmission increases. 7. Rules for Singing, Chanting, and Shouting at Outdoor Gatherings ½1AF?AF?¤ ;@9FLAF?¤ K@GMLAF?¤ 9F< H@QKA;9D =Pertion significantly increases the risk of COVID-19 transmission because these activities increase the release of respiratory droplets and fine aerosols into the air. Because of this, singing, chanting, and shouting are strongly discouraged, but if they occur, the following rules and recommendations apply: All people who are singing or chanting should wear a face covering at all times while singing or chanting, including anyone who is leading a song or chant. Because these activities pose a very high risk of COVID-19 transmission, face coverings are essential to reduce the spread of respiratory droplets and fine aerosols; People who are singing, shouting, chanting, or exercising are strongly encouraged to maintain physical distancing beyond 6 feet to further reduce risk. People who are singing or chanting are strongly encouraged to do so quietly (at or below the volume of a normal speaking voice). ½'FKLJME=FL9D EMKA; AK 9DDGO=< 9K DGF? 9K L@= musicians maintain at least 6-foot physical distancing. Musicians must be from one of the three households. Playing of wind instruments (any instrument played by the mouth, such as a trumpet or clarinet) is strongly discouraged. Context COVID-19 continues to pose a severe risk to communities and requires all people in California to follownecessary precautions and to adapt the way they live and function in light of this ongoing risk. The safest way to gather is to spend time with people in the same household or to gather virtually. In general, the more people from different households a person interacts with at a gathering, the closer the physical interaction is, and the longer the interaction lasts, the higher the risk that a person with a COVID-19 infection, symptomatic or asymptomatic, may spread it to others. Public health studies havealso shown that the risk of transmission is increased in indoor spaces, particularly when there isn't appropriate ventilation.\[1\]Unlike indoor spaces, wind and air in outdoor spaces can help reduce spread of the virus from one person to another. Planning scenarios published by the CDC estimate that, on average, a person with COVID-19 goes on to infect between 2-4 people, with a best estimate of 2.5 when there are no preventive measures.\[2\]For example, if each infected person spreads the virus to two people, who in turn spread it to two others each; those four will spread the virus to eight others; those eight will spread the virus to 16; and so on. As a result, after 10 transmission cycles, one person could be responsible for 1,024 other people contracting the virus.\[3\]Additionally, there is broad agreement that people who are not experiencing symptoms can still spread COVID-19\[4\]. The fact that COVID-19 can be spread by people who don't have symptoms or aren't showing symptoms yet is one of the aspects of the COVID-19 that makes it difficult to control. All gatherings pose a higher risk of transmission and spread of COVID-19 when people mix from different households and communities. The likelihood of transmission and spread increases with laughing, singing, loud talking and difficulty maintaining physical distance. Limiting attendance at gatherings is a way to reduce the risk of spread as it lowers the number of different people who are interacting. Additionally, by limiting attendance there is an improved ability to perform effective contact tracing if there is a positive case discovered, which can help to slow the spread of COVID-19\[5\]. People who do choose to attend gatherings should discuss and agree upon the specific group rules before convening together. \[1\]See, e.g., Hiroshi Nishiura, et al., Closed environments facilitate secondary transmission of coronavirus disease 2019(COVID-19) (PDF), (www.medrxiv.org/content/10.1101/2020.02.28.20029272v2.full.pdf); Hu Qian, et al., "Indoor transmission of SARS- CoV-2" (www.medrxiv.org/content/10.1101/2020.04.04.20053058v1)\[pre-print\] published in medRxiv on April 4, 2020. \[2\]See theCDCCOVID-19 Pandemic Planning Scenariosweb page \[3\]See, e.g., Report 3: Natsuko Imai et al, WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, J-IDEA, "Imperial college London, UK. Transmissibility of 2019 -n-CoV)." See also Inglesby T B JAMA Public Health Measures and the Reproduction Number of SARS-CoV-2. JAMA Network.2020.7878 (May 1, 2020). \[4\]World Health Organization (WHO)Transmission of SARS-CoV-2: implications for infection prevention precautions \[5\]See Harvard HealthPreventing the spread of the coronavirusSocial distancing, hand washing, and other preventive measures California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : October 10, 2020 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor September 12, 2020 TO: All Californians SUBJECT: CDPH Guidance on the Use of Antigen Tests for Diagnosis of Acute COVID-19 What is an antigen test? ½ FLA?=F L=KLK <AJ=;LDQ <=L=;L >J9?E=FLK G> 1 01¸!G4¸ viral protein (as opposed to viral RNA detected by nucleic acid amplification tests \[NAAT aka PCR tests\]). ½2@= E9AF 9<N9FL9?=K G> 9FLA?=F L=KLK 9J= >9KL LMJFaround time, simple to perform point-of-care use, identification of current viral infection, and lower cost. ½2@= E9AF <J9O:9;CK 9J= DGO=J K=FKitivity (more false negatives) and intended use limited to individuals suspected of COVID-19 within 5-12 days of symptom onset (number of days varies by manufacturer). ½.GKALAN= J=KMDLK AF KQEHLGE9LA; AF<Aviduals are likely to reflect an active infection, but negative tests are presumptive negative and depending on level of clinical concern may need to be confirmed with a NAAT/PCR. ½ F=?9LAN= 9FLA?=F L=KL E9Q FGL =P;DM<= AF>=;LAGF 9F< AK of insufficient sensitivity to make decisions about discontinuing isolation. ½ FLA?=F L=KLK 9J= 9HHJGN=< :Q L@= $"A for use on symptomatic individuals. No antigen test has yet been yet approved by the FDA for use on asymptomatic individuals. ½'> 9F 9FLA?=F L=KL AK MK=< GMLKA<= L@= J=;GEE=F<=< window from symptom onset or to test asymptomatic individuals, false positive results can occur. Depending on the level of tolerance for potential false positive results, confirmatory NAAT may be indicated. Rapid antigen tests for COVID-19 diagnosis in symptomatic individuals ½2@= 3£1£ $GG< 9F< "JM? <EAFAKLJ9LAGn (FDA) maintains a list of in vitro diagnostic testsfor COVID-19 that are approved under an Emergency Use Authorization (EUA). Only FDA EUA-approved viral diagnostic tests should be used. Current antigen tests with FDA EUA are approved as Clinical Laboratory Improvement Amendments (CLIA) of 1988 waived, point-of-care tests: 1) Quidel Sofia SARS Antigen FIA assay 2) BD Veritor System for Rapid Detection of SARS-CoV-2 3) LumiraDx SARS-CoV-2 Antigen Test 4) Abbott BinaxNOW COVID-19 Ag CARD Performance of antigen tests Sensitivity and specificity are measures of a test's ability to correctly classify a person as having a disease or not having a disease. ½1=FKALANALQ J=>=JK LG 9 L=KL¬K 9:ADALQ LG <=KA?F9L= 9F AFdividual with disease as positive. A highly sensitive test means that there are few false negative results, and thus fewer cases of disease are missed. ½1H=;A>A;ALQ J=>=JK LG 9 L=KL¬K 9:ADALQ LG <=KA?F9L= 9F individual who does not have a disease as negative. A highly specific test means that there are few false positive results. Antigen test processing specifications ½!MJJ=FL 9FLA?=F L=KLK <=L=;L L@= FM;D=G;9HKA< HJGLein of SARS-CoV-2 from a swab of a patient's nasal passage. Results are qualitative. A special machine may be needed. ½Dry swabs should be used for all tests. Transport medium should not be used. False positive test results have been reported when swabs are placed in viral transport medium prior to testing. ½1H=;AE=FK K@GMD< := L=KL=< 9K soon as possible after collection. Interpretation of positive test results ½ HGKALAN= L=KL J=KMDL AF 9 symptomatic individual indicates that SARS-CoV-2 antigen was detected and that the individual is very likely infected and presumed to be contagious. Positive individuals should be isolated per California Department of Public Health guidance. ½ HGKALAN= L=KL J=KMDL AF 9F asymptomatic individual has the potential to be a false positive result. Asymptomatic individuals with a positive result should be considered to be cases and managed as such. In these situations, the individual with the positive test result should be isolated until confirmatory NAAT/PCR testing can be performed and results returned. ½!GF>AJE9LGJQ FM;D=A; 9;A< L=KLAF? >GDDGOAF? 9 HGKALAN= antigen test may not be necessary when the pretest probability is high, especially if the person has a known exposure. ½$9DK= HGKALAN= J=KMDLK 9J= EGJ= DAC=DQ to occur if the clinical suspicion and pre-test probability for COVID-19 is low. Interpretation of negative test results ½,=?9LAN= J=KMDLK >GJ 9DD 9Ftigen tests are considered presumptive negative. ½ KQEHLGE9LA; AF<ANA<M9DK OAL@ HJ=Kumptive negative tests in a congregate setting outbreak investigation with confirmed cases may need confirmatory NAAT/PCR testing. ½Symptomatic individuals with presumptive negative tests should be isolated until confirmatory NAAT/PCR testing can be performed and results returned. When is it appropriate to use an antigen test? ½ FLA?=F L=KLK 9J= EGKL J=DA9:D= O@=F used on symptomatic individuals in populations with a high prevalence of disease. The goal is to quickly identify and isolate contagious individuals. A positive result would inform immediate, specific clinical, infection control, or public health action. In this setting, there is less concern about false positive results. ½ FLA?=F L=KLK 9J= 9DKG MK=>MD AF @Agh prevalence serial testing environments (i.e. congregate living settings, high-risk essential workers, work settings, particularly anywhere in health care, and in outbreak investigations. ½ FLA?=F L=KLK 9J= O=DD KMAL=< >GJ 9J=9s with little access to testing where access to frequent testing may be advantageous ½0=KMDLK >JGE 9FLA?=F L=KLK K@GMD< 9DO9QK := AFL=JHJ=L=d in the context of the exposure history and clinical presentation. Examples of scenarios in which SARS-CoV-2 antigen tests may reasonably be used: ½1QEHLGE9LA; H9LA=FLK OAL@AF L@= 9HHJGHJA9L= OAF<GO >Gr a given test and in settings with high rates of transmission. ½2G J9HA<DQ LJA9?= H9LA=FLK AF 9F #E=J?=F;Q "=H9JLE=FL GJ KAEAD9J K=LLAF?£ ½1=JA9DL=KLAF? 9F< GML:J=9C AFN=KLA?9LAGFK AF ;GF?J=gate living settings with confirmed cases, such as correctional facilities, long-term care facilities or other high-risk settings, particularly when PCR testing is limited or turnaround time is prolonged, e.g. >72 hours. ½0=EGL= HGHMD9LAGFK ¿=£?£ JMJ9D @GKHAL9DK¤ LJA:9D nations, etc.) with limited access to testing. ½'> 9FLA?=F L=KLK 9J= MK=< >GJ 9KQEHLGE9LA; L=KLAF? (e.g. routine screening or pre-admission testing in congregate settings where there are no confirmed cases of COVID 19), repeat testing at set interval(s) can alleviate the lower sensitivity of antigen tests. Testing facilities Facilities that perform onlyCLIA-waived tests must possess either a CLIA Certificate of Waiver or a Certificate of Compliance. These locations may include long-term care facilities, hospitals, prisons, physician offices, urgent care clinics, outreach clinics, pharmacies and temporary patient care settings. Persons performing the point-of-care test must be trained to perform the test, but these sites have no routine regulatory testing oversight and no testing personnel requirements. If a large volume of tests is anticipated, such as in a skilled nursing facility, this may require full-time staff during weeks when response driven testing is performed. Reporting of antigen test results ½$GJ ;DAFA;9D ;9J= 9F< >GJ HM:DA; @=alth investigation and follow-up purposes, all patients with positive antigen test results should be considered true cases. ½&GO=N=J¤ >GJ L@= HMJHGK= G> KMJN=ADD9F;=¤ H=J L@= EGst recent updated interim CSTE case definitionfor COVID-19, positive antigen tests are considered presumptive, rather than confirmatory laboratory evidence of acute infection. Per the case definition, if "the patient has tested positive for SARS-CoV-2 by an antigen test of a respiratory secretion" they are considered probable cases for public healthreportingpurposes. ½*9:GJ9LGJA=K H=J>GJEAF? 9FLA?=F L=KLK 9J= J=IMAJ=< :Q California law to report positive and negativeresults to public health agencies in the same way as other reportable test results. ½,GF¸D9:GJ9LGJQ K=LLAF?K ;GF<M;LAF? 9FLA?=F L=KLK EMKL report positive and negative antigen test results to the local health department where the patient resides. Please contact your local health department for reporting instructions. CDPH will update this guidance as more data become available. Resources ½$GG< 9F< "JM? <EAFAKLJ9LAGF£ .=J>GJmance characteristics of EUA-approved assays have been published in the "Instructions for Use"links on the FDA website. BD Veritor SARS-CoV-2 Antigen Quidel Sofia SARS Antigen FIA LumiraDx SARS-CoV-2 Antigen Test Abbott BinaxNOW COVID-19 Ag CARD ½!GMF;AD G> 1L9L= 9F< 2=JJALGJA9D #HA<emiologists. Update to the standardized surveillance case definition and national notification for 2019 novel coronavirus disease (COVID-19), Interim-20-ID-02. ½09E<9K )¤ "9JRA ¤ (9AF 1£ ¬2=KL¤ J=¸L=KL¤ J=¸L=KL¬¥ MKing inaccurate tests to greatly increase the accuracy of COVID-19 testing. Nat Med. 2020;26(6):810-811. doi:10.1038/s41591-020-0891-7 California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : September 12, 2020 COVID-19 Blueprint for a Safer Economy California has a new blueprint for reducing COVID-19 in the state with revised criteria for loosening and tightening restrictions on activities. Every county in California is assigned to a tier based on its test positivity and adjusted case rate for tier assignment. Additionally, a new health equity metric took effect on October 6, 2020. In order to advance to the next less restrictive tier, each county will need to meet an equity metric or demonstrate targeted investments to eliminate disparities in levels of COVID-19 transmission, depending on its size. The California Health Equity Metric is designed to help guide counties in their continuing efforts to reduce COVID-19 cases in all communities and requires more intensive efforts to prevent and mitigate the spread of COVID-19 among Californians who have been disproportionately impacted by this pandemic. Learn more about the Health Equity Metric Updates as of 10/13/2020: ½2@= !9DA>GJFA9 DM=HJAFL "9L9 !@9JL(Excel) has been updated to show county tier status, date of tier assignment, number of consecutive weeks meeting the next tier's criteria, case rates, adjusted case rate for tier assignment, testing positivity, and test rates for the weeks ending 9/26/20 and 10/3/20. ½!9K= J9L=K OADD ;GFLAFM= LG := adjusted based on Californiamediantesting volume.The California county median, which is recalculated every 4 weeks, was updated this week. ½Small county framework for tier movementcontinues to be applied to counties with a population <106,000. ½The health equity metriccontinues to be applied to determine tier assignment to a less restrictive tier for counties with a population greater than 106,000. ½"=>AFALAGF G> ;9K= J9L= 9F< L=KLAF? HGKALANALQ E=LJA; calculations updated to reflect removal of inmate state hospital cases. ½&=9DL@ #IMALQ $J9E=OGJC¥ 29J?=L=< 'FN=KLE=FL .D9F KMbmission due date updated. See Health Equity Metric link. ½#>>=;LAN= <9L= G> 9KKA?F=< LAer status and School Re-Opening guidance has been updated. Additional information about the Blueprint: ½$AF< L@= KL9LMK G> 9;LANALA=K AF QGMJ ;GMFLQ ½3F<=JKL9F< O@A;@ 9;LANALA=K 9F< :MKAnesses are open in the four tiers(PDF) ½*=9JF EGJ= 9:GML L@= !9DA>Grnia Health Equity Metric ½#PHDGJ= L@= ;GEHD=L= <9L9 :Q ;GMFLQ- California Blueprint Data Chart(Excel) ½$AF< 9J;@AN=< !9DA>GJFA9 DM=HJAFL "9L9 !@9JLK ½.JGQ=;LG H9J9 MF9 =;GFGE9 EsK K=?MJ9 Æ $GJ GL@=r languages, visit our Multilingual Documents page Plan for Reducing COVID-19 and Adjusting Permitted Sector Activities to Keep Californians Healthy and Safe This guidance outlines an updated framework for a safe progression of opening more businesses and activities in light of the pandemic. The framework for this guidance is informed by increased knowledgeof disease transmission vulnerabilities and risk factors and is driven by the following goals: 1) To progress in phases based on risk levels with appropriate time between each phase in each county so impacts of any given change can be fully evaluated. 2) To aggressively reduce case transmission to as low a rate as possible across the state so the potential burden of flu and COVID-19 in the late fall and winter does not challenge our healthcare delivery system's ability to surge with space, supplies and staff. Also, with winter weather pushing more activities indoors, low levels of transmission in the community will make large outbreaks in these riskier settings less likely. 3) To simplify the framework and lay out clear disease transmission goals for counties to work towards. Tier Framework This framework lays out the measures that each county must meet, based on indicators that capture disease burden, testing, and health equity. A county may be more restrictive than this framework. This framework also notes signals of concern, including impacted healthcare capacity that may lead towards a dimming intervention. This framework replaces the formerCounty Data Monitoring metrics. As the COVID-19 pandemic continues to be an evolving situation and new evidence and understanding emerges, the California Department of Public Health (CDPH), in collaboration with other State officials,will continue to reassess metrics and thresholds. See chart below for the framework metrics as set according to tiers based on risk of community disease transmission. Calculation of metrics is described in Appendix 1. ^Excludes state and federal inmates, and ICE facility residents *Population denominators from the Department of Finance: State Population Projections - Total Population by County- Table P-1 **Case rate will be determined using cases confirmed by PCR *** Counties are assigned a tier based on two metrics: test positivity and case rate. The case rate is adjusted based on testing volume per 100,000 population as described below. Due to variability in data, this adjustment does not apply to small counties (defined as those with a population less than 106,000 residents). ½$GJ ;GMFLA=K OAL@ L=KLAF? NGDME= 9:GN= L@= KL9L= E=<A9F, the factor is less than 1, decreasing in a linear manner from 1.0 to 0.6 as testing volume increases from the state median to 2x the state median. The factor remains at 0.6 if the testing volume is greater than 2x the state median. ½$GJ ;GMFLA=K OAL@ L=KLAF? NGDME= :=DGO L@= KL9L= E=<A9F¤ the factor is greater than 1, increasing in a linear manner from 1.0 to 1.4 as testing volume decreases from the state median to zero. However, this adjustment for low testing volume will not be applied to counties with a test positivity < 3.5%. ½+=LJA;K OAL@ N9DM=K ?J=9L=J L@9F GJ less than tier cut points by 0.05 arerounded up or down using conventional rounding rules. California COVID-19 Case Rate Adjustment Factor Testing VolumeCase Rate Adjustment Factor* 01.4 0.25* State Median1.3 0.50* State Median1.2 0.75* State Median1.1 State Median1 1.25* State Median0.9 1.5*State Median0.8 1.75* State Median0.7 2.0*State Median and 0.6 above ½!GMFLA=K OAL@ >=O=J L@9F ¤ J=KA<=FLK¤will be exempted from case rate adjustments, and counties with test positivity <3.5% will be exempted from adjustment for testing rates lower than the state median. ½'> L@= LOG E=LJA;K 9J= FGL L@= K9E= LA=J¤ L@= ;GMFLQ¬K tier assignment will be determined by the more restrictive of the two. For example, if a county's test positivity corresponds to tier 3 (orange, moderate), but the case rate corresponds to tier 1 (purple, widespread), the county will be assigned as tier 1. Moving through the Tiers Rules of the framework: 1.CDPH will assess indicators weekly on Mondays and release updated tier assignments on Tuesdays. 2.A county must remain in a tier for a minimum of three weeks before being able to advance to a less restrictive tier. 3.A county can only move forward one tier at a time, even if metrics qualify for a more advanced tier. 4.If a county's adjusted case rate for tier assignment and test positivity measure fall into two different tiers, the county will be assigned to the more restrictive tier. 5.The health equity metric isapplied to jurisdictions with populations greater than 106,000. Rules of the health equity metric are described below. 6.City local health jurisdiction (LHJ) data will be included in overall metrics, and city LHJs will be assigned the same tier as the surrounding county 7.An LHJ may continue to implement or maintain more restrictive public health measures if the local health officer determines that health conditions in that jurisdiction warrant such measures. 8.Tier status goes into effect the Wednesday following each weekly tier assignment announcement on Tuesdays. To advance: 1.A county must have been in the current tier for a minimum of three weeks. 2.A county must meet criteria for the nextless restrictive tier for both measures for the prior two consecutive weeks in order to progress to the next tier. 3.In addition, the state will establish health equity measuresthat demonstrate a county's ability to address the most impacted communities within a county. To move back: 1.During the weekly assessment, if a county's adjusted case rate and/or test positivity has fallenwithin a more restrictive tier for two consecutive weekly periods, the county must revert to the more restrictive tier. 2.Counties with a population less than 106,000 will have a small county criteria applied to it to ensure movement to a more restrictive tier is appropriate. Description of the small county framework is below. 3.Counties will have three days, beginning the Wednesday after tier assignments are announced on Tuesdays, to implement any sector changes or closures unless extreme circumstances merit immediate action. Small County Framework (updated 10/06/2020) Because California's case rate metric is normalized per 100,000 population, a number of counties with small populations have experienced large swings in their daily case rate as a result of a small number of newly reported cases. For some counties, this has raised the specter of needing to move back to a more restrictive tier despite overall disease stability and a demonstrated ability to trace, follow up with, investigate and support cases. For example, once a small county is in yellow tier, a sm9DD FME:=J G> ;9K=K º 9K DGO 9K ;9K= H=J O==C >GJ ;GFK=;MLAN= O==CK º ;GMD< ;9MK= AL LG J=turn to a more restrictive tier. While the overall proportion of cases may be the same as a larger county, the absolute number of cases is also an important consideration in gauging county capacity to control transmission through disease investigation, contact tracing and supportive isolation. It is not in the interest of the public health of communities to close or restrict entire business sectors on the basis of such a small number of cases, and in some situations a small swing in week over week case counts can move a county from yellow tier all the way to purple tier. Because the state wants to avoid swift shifts in tier status based on small absolute case number changes, we are creating an alternate case assessment measure to apply to small counties. Small counties are defined as having fewer than 106,000 residents.\[1\] Alternate Case Assessment Measure. Small counties are subject to all existing Blueprint rules (test positivity thresholds, minimum duration of 3 weeks in a tier, inability to skip over a tier while moving from more restrictive to less restrictive tier designations, etc.) with the exception of the case rate thresholds as delineated below. The alternate case assessment measure provides a small county protection against sudden tier changes as a result of small changes in cases over a two-week period. For a small county that has test positivity that meets the threshold of that county's currently assigned tier, but is flagged for potentially moving to a more restrictive tier based on its weekly case rate assessment, the following criteria based shall be applied in lieu of the Blueprint case rate thresholds. If the county exceeds the following absolute weekly case numbers based on its population and tier for two consecutive weeks, it will be required to move to a more restrictive tier: From TierTo TierPop 35KPop 35K-70K YellowOrange714 OrangeRed1421 RedPurple3542 \[1\]Twenty-two California counties have a population of less than 100,000. Sutter, which has a population of 106,000 is also included as it shares a health officer with Yuba County. Counties below this size have similar challenges and opportunities in controlling COVID-19 transmission and generally do not have major or large, densely populated cities. This distinction factors into how rapidly COVID-19 transmission can increase beyond households and the ability of the county to rapidly identify and contain outbreaks with existing contact tracing, isolation and quarantine resources. Risk Criteria Activities and sectors will begin to open at a specific tier based on risk-based criteria(PDF), as outlined below. Lower risk activities or sectors are permitted sooner and higher risk activities or sectors are not permitted until later phases. Many activities or sectors may increase the level of operations and capacity as a county reduces its level of transmission. Criteria used to determine low/medium/high risk sectors ½ :ADALQ LG 9;;GEEG<9L= >9;= covering wearing at all times (e.g. eating and drinking would require removal of face covering) ½ :ADALQ LG H@QKA;9DDQ <AKL9F;= :=LO==n individuals from different households ½ :ADALQ LG DAEAL L@= FME:=J G> H=GHD= H=J KIM9J= >GGL ½ :ADALQ LG DAEAL <MJ9LAGF G> =PHGKMJ= ½ :ADALQ LG DAEAL 9EGMFL G> EAPAF? G> H=GHle from differing households and communities ½ :ADALQ LG DAEAL 9EGMFL G> H@QKA;9D interactions of visitors/patrons ½ :ADALQ LG GHLAEAR= N=FLAD9LAGF ¿=£?£ AF<GGJ vs outdoor, air exchange and filtration) ½ :ADALQ LG DAEAL 9;LANALA=K L@9L 9J= CFGOF LG ;9MK= AF;Jeased spread (e.g. singing, shouting, heavy breathing; loud environs will cause people to raise voice) Schools Schools may reopenfor in-person instruction based on equivalent criteria to the July17School Re-opening Framework(PDF)previously announced.That framework remains in effect except that Tier 1 is substituted for the previous County Data Monitoring List (which has equivalent case ratecriteria to Tier 1). Schools in counties within Tier 1 are not permitted to reopen for in-person instruction, with an exception for waivers granted by local health departments for TK-6 grades. Schools that are not authorized to reopen, including TK-6 schools that have not received a waiver, may provide structured, in-person supervision and services to students under the Guidance for Small Cohorts/Groups of Children and Youth. Schools are eligible for reopening at least some in-person instruction following California School Sector Specific Guidelines once the county is out of Tier 1 (and thus in Tier 2) for at least 14 days, which is similar to being off the County Data Monitoring List for at least 14 days.The first day a county is considered in Tier 2 is the Wednesday after the weekly county tier assignments are announced and posted on the CDPH website (Tuesdays). For example, if a county is assigned to Tier 2 on Tuesday, October 13, the first full day the county is in Tier 2 is Wednesday, October 14. The county will have completed 14 days in Tier 2 on Tuesday, October 27 and may reopen schools for in-person instruction on Wednesday, October 28. As noted above, an LHJ may continue to implement or maintain more restrictive public health measures if the local health officer determines that health conditions in that jurisdiction warrant such measures. As stated in the July 17School Re-opening Framework(PDF),schools are not required to close if a county moves back to Tier 1, but should consider surveillance testing of staff. County TierAdjudication Process If a county finds that there is discrepancy between the county's and state's calculated data for the above defined measures, the county shall notify the CDPH LocalCoordinator. The county may request a meeting to discuss with local and state epidemiology leads to compare data. In addition, CDPH isworking with the California Conference of Local Health Officers and County Health Executives Association of California to develop other methodologies to assess qualitative and contextual information impacting these metrics and the most appropriate interventions. Once a discrepancy is adjudicated by CDPH, any updated tier status will be determined by CDPH and the tier status will be reflected on the public website within 48 hours, as appropriate. APPENDIX 1: Calculation of metrics MetricDefinition Case Rate (rateper 100,000 Calculated as the average (mean) daily number of COVID-19+ cases, this excluding prison cases, 7-day excludes: (a) persons out of state or with unknown county of residence and (b) average with 7-day lag)persons incarcerated at state or federal prisons, ICE facilities, or Department of State Hospitals (identified as cases with an ordering facility name or address associated with these locations), over 7 days (based on episode date), divided by the number of people living in the county/region/state.This number is then multiplied by 100,000. Due to reporting delays, there is a 7-day lag built into this calculation. For example, for data updated through 8/22/20, the case rate will be dated as 8/15/20 and will include the average case rate from 8/9/20 - 8/15/20. Linear adjusted case Rate per Calculated as the case rate multiplied by a case rate adjustment factor that is 100,000 per day, based on the difference between the county testing volume (testing volume, excludingprisoners (7-day tests per 100,000 per day, described below) and the median testing volume averagewith 7-day lag)calculated across all counties. The median testing volume thus forms an anchor for this adjustment and is recalculated every four weeks to prevent undue fluctuation while remaining sensitive to evolving testing trends. For counties with a testing volume above the median, the adjustment factor is less than 1, decreasing in a linear manner from 1.0 to 0.6 as testing volume increases from the anchor point to 2x that value. The adjustment factor remains at 0.6 if the county testing volume is greater than 2x the state median. For counties with a testing volume below the state median, the adjustment factor is greater than 1, increasing in a linear manner from 1.0 to 1.4 as county testing volume decreases from the state median to zero. The linear adjustment formula can be expressed mathematically as follows: ¸¿¿¿;GMFLQ L=KLAF? J9L= º KL9L= E=<A9F L=sting rate)/state median testing rate) * 0.4) There are two conditions in which this formula is not applied. The first is small counties, those with a population less than approximately 100,000 based on CA Department of Finance population projections (see reference * in tier framework table). The small county exception prevents potential spurious adjustment due to fluctuations in testing influenced by secular events unrelated to underlying transmission risk. As a second condition for exception from the adjustment, counties with a testing volume below the state median and testing positivity < 3.5% are not adjusted, based on the assumption that volume of testing in these counties may not need to be as high with low test positivity. Under both these conditions, the adjusted case rate is equal to the unadjusted rate. Calculated as the total number of positive polymerase chain reaction (PCR) tests Overall testing Positivity, excluding prisoners for COVID-19 over a 7-day period (based on specimen collected date) divided by over7-days (PCR only,7-day the total number of PCR tests conducted; this excludes tests for: (a) persons out lag)of state or with unknown county of residence and (b) persons incarcerated at state or federal prisons, ICE facilities, and state hospitals(identified as cases with an ordering facility name or address associated with prison/state hospitals locations). This number is then multiplied by 100 to get a percentage. Due to reporting delay (which may be different between positive and negative tests), there is a 7-day lag. Example:For cumulative lab data received on 6/30/20, reported test positivity is dated as 6/23/20 and is calculated based on tests with specimen collection dates from 6/17-6/23 Testsper 100,000 per day, Calculated as the number of polymerase chain reaction (PCR) tests per day over excluding prisoners (7-day a 7-day period (based on specimen collection date), excluding tests for persons averagewith7-day lag)incarcerated at state or federal prisons, ICE facilities, and state hospitals (identified as cases with an ordering facility name or address associated with prison/state hospitals locations), and divided by the number of people living in the county/region/state. This number is then multiplied by 100,000. Due to reporting delay, there is a 7-day lag included in the calculation. Example:For cumulative lab data received through 8/22/20, the reported 7-day average number of tests will be dated as 8/15/20 and will include PCR tests with specimen collection dates from 8/9/20 - 8/15/20. Data Source: CalREDIE Helpful Links ½$AF< L@= KL9LMK G> 9;LANALA=K AF QGMJ ;GMFLQ ½3F<=JKL9F< O@A;@ 9;LANALA=K 9F< :MKAnesses are open in the four tiers(PDF) ½#PHDGJ= L@= ;GEHD=L= <9L9 :Q ;GMFLQ(Excel) ½$AF< 9J;@AN=< !9DA>GJFA9 DM=HJAFL "9L9 !@9JLK ½1;@GGD 0=¸GH=FAF? $J9E=OGJC(PDF) ½%MA<9F;= >GJ 1E9DDCohorts/Groups of Children and Youth ½OOO£;GNA<¢£;9£?GN ½.JGQ=;LG H9J9 MF9 =;GFGE9 EsK K=?MJ9 Æ $GJ GL@=r languages, visit our Multilingual Documents page Page Last Updated : October 13, 2020 COVID-19 Response and Statewide CHHS Update, October 13, 2020 /II{ {ĻĭƩĻƷğƩǤ 5Ʃ͵ ağƩƉ DŷğƌǤ I want to pick up on what so many are thinking about Halloween! I have four young kids who are ready to go, they are planning their costumes identical presentation in Spanish Start with numbers, Today o 2,378 7-day o 3,421 Total Tests o 142,376 14-day positivity o 2.6% Hospital numbers o 2,226 hospital patients increases across the country Small Guidance for Small Gatherings; ways to reduce risk o Same old, same old o Wear face mask o Practice physical distancing o Good hand hygiene o o No more than three separate households Limit to two hours or less Must be held outside This is a way to provide important ways to reduce risk, but we are not endorsing in any way these small gatherings Halloween and Día de los Muertos o COVID-19 continues to pose an important risk o Door-to-door trick-or-treating and parties pose high risk and are strongly discouraged o Families should begin to plan alternatives now o Local guidance Safest Alternatives for Halloween o The safest way to celebrate is at home with your household or virtually Celebrate at home o Create a haunted house or candy hunt o Have a scary movie night o Paint faces and carve pumpkins o Decorate the home and yard o Design face masks that match Halloween costumes o Share treats only with those in your households Ensure you follow gathering guidelines Celebrate virtually o Having an online costume contest or pumpkin carving contest o Enjoy a Halloween themed art installation at an outdoor museum o Attend car-based activities Safer Alternatives for Día de los Muertos o Altars: consider create altars on front window o Virtual altar o Cemetery visits: if visiting, only visit with those you live with; wear masks Trick-or-treating o Some traditional Halloween celebrationssuch as parties and door-to-door trick-or-treating pose a high risk of spreading COVID-19 and are strongly discouraged o If a positive case is discovered, it could be very challenging to conduct appropriate contact tracing Regardless of how you choose to celebrate it is important to keep the following in mind o Wear a face covering that is not a costume mask o Practice physical distancing o Practice good hygiene o Minimize mixing o Stay home if sick 5Ʃ͵ Dźƌ /ŷğǝĻǩ Same presentation in Spanish 5Ʃ͵ ağƩƉ DŷğƌǤ Thank you so much Dr. Chavez for eloquently describing our guidance o Criteria for loosening and tightening restrictions on activities Every county is assigned to a tier based on: o Test positivity o Adjusted case rate o Health equity metric New counties in Red (Substantial); o Colusa, Kern, Kings, San Benito, Stanislaus, Sutter New counties in Orange (Moderate): o Alameda, Placer, Santa Clara New counties in Yellow (Minimal): o Sierra Last week we were tracking two large counties that missed the threshold for their red tier and were being considered to move back Riverside and looking at data and having a good conversation with them before further decisions Simple acts can make a big difference for COVID-19 and the flu: o Wear a mask o Maintain six feet of distance o Wash our hands o Minimize mixing o Get your flu shot vǒĻƭƷźƚƓƭ Can you give us more detail on the progress of the theme park guidelines? And also, can you comment on the setbacks we are seeing in COVID- going to suspend its trial and do these setbacks affect our approach? o partners o guidance that makes sense o Continue to look at data, at science, we will look at doing this when we can be sure this can be done methodically and safely o As it relates to vaccine, this is not unusual o There are plenty safety checks along the way o The company you mentioned is doing a responsible thing, understanding the impact and looking at the data and halting where appropriate o o As much as those things affect the timeline, it might create some delays, but we have continued to deliver the message that use of our masks and following guidance are the tools we have today and we will continue to use them are, they the only county today that might be regressing? o process o and understanding o We are in direct conversations right now CA has been stable for so many days while other states are rising, is it that the behavior here has changed or is it the weather, what is it making things different? o A number of things o Each state, there are states doing things similarly and others very different o We are doing slow and stringent here o Looking at level of activities and we believe that approach will help us through difficult times o Hope to prevent small upticks from turning into large spreads o I believe that the slow stringent approach will help support CA to manage through this stable period o te but what we see here we hope to maintain o I believe there is more a use of mask-wearing o of our strategy as well as broad adoption where we saw lots of early cases Several what are the lesser counties not doing? Also, we had only two deaths today what is the reason for this record low? o A number of counties are doing a number of things o in and continue to reduce transmission o Counties are all different o The more we see behavior changes, the more the numbers will stabilize and calm down o Sonoma and LA, the two counties you mentioned, are making good progress and I look forward to them to continue that o -and-down o As it relates to the death counts, we always knew that deaths are the most lagging indicator o Also, there is quite a bit of delay between coroner reports and causes of death, so some of the deaths we reported a couple of weeks ago happened months ago but there was lag o -to-day, but Monday and Tuesday we typically see reduced numbers due to the weekend The state released Halloween guidance today, could you talk about the decisions to recommend not trick-or-treating versus banning it? o A lot of counties themselves are putting out guidance and we want to make sure we are supporting Californians during this time o This strong recommendation against it is good for where we are o elebration and a time of joy into something that is difficult or contentious o We feel the need to provide clear understanding of the risks Could you speak more about this new harm reduction messaging we are hearing from the Admin, I wonder if due to the holidays people are going to gather, so I wonder that people are going to not adhere to the new restrictions, is it a concern about a spike? o Thank you for the question and you articulated it well o The guidance does not mean go o Governor said it yesterday, we believe and still support messaging that spending time with your household alone is the way we can reduce transmission the best o There are clearly small gatherings in communities o There are questions around whether this will happen safely o The guidance reflects the ways to reduce risks for people who feel the need to have small gatherings o All of the guidance are tips for reduction o We all need tools to get through this and reduce risk o happen o We want to carry through this difficult time for transmission and that we come out with continued reduc Will there be enforcement on businesses regarding trick-or-treating? A number of counties have been putting out their own guidance, and I wonder if that guidance conflicts with what the state says, are you encouraging those jurisdictions to be in line with the state? o The business sectors have guidance o Asking that they recognize and follow this guidance o We know how important it is to keep businesses open o My hope is that those planned activities in the past, we need to take a pause and wait for further years o The state is always putting out the guidance that counties can be more restrictive, but not less restrictive around o We will expect that county guidance reflects that Theme-park related, you mentioned a team went to Florida and a team of state agencies went, why did the team go to Florida and what theme parks? o wanted to understand in action how the theme park functions and what it looks like during COVID o The CA visits are upcoming o Together the info and the dialogue will help us land in a place that we can all feel confident about Do all counties that are on the verge go through that tier adjudication process or is Riverside with its size play a role? Also, has the state made progress on the task force for testing vaccines o Not all counties that have missed their threshold have asked for that discussion, we keep it open as an option o o Not every county has asked, but when they do, we believe it is the right thing to enter it and have conversations with the county o We require that this is resolved within a week so we can finalize that tier assignment o In terms of the vaccine safety comte., we are putting together the names of who will be on that comte. and once established that will be made public without CDPH team on their website o In the works as we respond to the FDA 5Ʃ͵ ağƩƉ DŷğƌǤ Λ/ƌƚƭźƓŭΜ I want to thank the reporters for their thoughtful questions I appreciate all of you in the weeks before Halloween and before the winter holidays Thank you for continuing to work with us We will continue to fight COVID-19 with our blueprint We look forward to seeing you again next week 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor October 13, 2020 TO: Todos los californianos SUBJECT: Guía para celebrar Halloween y Día de los Muertos de manera segura durante la COVID-19 Resumen Esta guía describe formas alternativas más seguras de celebrar Halloween y el Día de los Muertos durante la actual pandemia de la COVID-19. La COVID-19 continúa representando un riesgo severo para las comunidades y requiere que todos los californianos sigan las precauciones necesarias a la luz de este riesgo continuo. Algunas de las actividades tradicionales de las fiestas promueven la congregación y la mezcla de varios grupos familiares, lo que aumenta el riesgo de transmitir la COVID-19. Por esta razón, el CDPH recomienda que elija una forma alternativa más segura de celebrar Halloween y el Día de los Muertos, y desaconseja enfáticamente el tradicional dulce o truco. Es importante planificar con anticipación e identificar opciones más seguras. Su departamento de salud local puede tener restricciones adicionales; consulte con su departamento de salud pública local para obtener información sobre Halloween en su comunidad. Esta guía puede modificarse en función de las condiciones cambiantes de la pandemia de la COVID-19. Alternativas más seguras para celebrar Halloween La forma más segura de celebrar Halloween es pasar tiempo con personas del mismo grupo familiar o celebrar de manera virtual. Algunas alternativas específicas que son de bajo riesgo pero que aún capturan la diversión de la festividad incluyen: ½!J=9J MF9 ;9K9 =E:JMB9<9 G MF9 :KIM=<9 del tesoro de dulces en su hogar ½&9;=J MF9 FG;@= <= H=D;MD9K <= L=JJor y actividades con temas de Halloween (tallado de calabazas, pintura facial) en casa. ½.9JLA;AH9J =F >A=KL9KÅ;GF;MJKGK =F DF=9 ¿HGJ ejemplo, tallas de disfraces o calabazas). ½ KAKLAJ 9 DM?9J=K ;GF<A;AGF9<GK <GF<= FG F=;=KAL= 9:9F<Gnar su automóvil, incluidos los eventos de drive-in, concursos o películas; pasear por un área con exhibiciones de Halloween también es buena opción. ½!GE=J ;GEA<9K ;GF L=E9 <= &9DDGO==F ;GF KM ?JMHG >9EADA9J ¿KGDG G ;GF @9KL9 @G?9J=K EsK¤ KAF AF;DMAJ =D suyo, para una comida al aire libre siguiendo todos los demás lineamientos referentes a reuniones y encuentros). ½"AK>JML9J <= MF9 =P@A:A;A F <= 9JL= ;GF L=EsLA;9 <= Halloween en un museo al aire libre con su hogar. ½ <GJF9J D9K ;9K9K Q H9LAGK ;GF <=;GJ9;AGF=K L=EsLA;9K <= &9DDGO==F£ ½"9J ?GDGKAF9K =F ;9K9 H=JG solo a las personas que conforman su grupo familiar ½#FNA9J MF9 DAKL9 <= J=HJG<M;;A F K=D=;;AGF9<9 QÅo golosinas (o trucos) temáticos a sus amigos con anticipación. ½"AK=9J E9K;9JADD9K >9;A9D=K que reflejen los disfraces de Halloween de sus hijos ½.J=H9J9J MF9 ;9F9KL9 <= &9DDGO==F H9J9 KMK @ABGK o una cacería de Halloween en su patio trasero. Alternativas más seguras para celebrar el Día de los Muertos La forma más segura de celebrar el Día de los Muertos es pasar tiempo con personas del mismo grupo familiar o celebrar virtualmente. Algunas alternativas específicas que son de bajo riesgo pero que aún capturan la esencia de la celebración cultural incluyen: ½Altares:considere colocar y crear su altar en una ventana frontal o en el exterior para que otros puedan verlo desde una distancia social segura. ½Altar virtual:cree un espacio virtual para honrar a los seres queridos perdidos. Comparta con familiares y amigos por correo electrónico o redes sociales. ½Visitas al cementerio:si visita el cementerio, solo vaya acompañado con las personas con las que vive, use mascarillas y mantenga un distanciamiento social adecuado. Limite el tiempo dedicado al mínimo necesario. Dulce o truco En términos generales, mientras una persona interactúe con más grupos familiares en una reunión, más cercana sea la interacción física y cuanto más dure la interacción, mayor será el riesgo de que una persona con una infección por COVID-19, sintomática o asintomática, pueda contagiar a otros. El tradicional dulce o truco sin las modificaciones necesarias promueve la congregación y la mezcla de muchos grupos familiares, particularmente en las puertas abarrotadas, lo que puede aumentar la propagación de la COVID-19. Ese tipo de mezcla no está permitida actualmente en California. Además, si se descubre un caso positivo, es muy difícil realizar un seguimiento de contactos adecuado para identificar a todos aquellos que han estado potencialmente expuestos. Para protegerse a sí mismo y a su comunidad, no debe ir a pedir dulces o mezclarse con otras personas fuera de las reuniones privadas permitidas esta temporada de Halloween. Medidas de protección personal: Independientemente de cómo elija celebrar Halloween o el Día de los Muertos, es importante tener en cuenta lo siguiente: 1.Cubiertas faciales: Las cubiertas faciales deben usarse de acuerdo con la CDPH Guía del uso de cubiertas faciales del CDPH, a menos que se pueda aplicar una excepción. Tenga en cuenta que las máscaras de plástico, goma, vinilo y otras máscaras de disfraces de Halloween no son un sustituto aceptable de las cubiertas faciales de tela para la prevención de la propagación de la COVID-19. 2.Practicar el distanciamiento social: Evite los espacios confinados, especialmente en interiores. Manténgase a una distancia mínima de 6 pies (3 o más pasos de un adulto) de todas las demás personas que no forman parte de su grupo familiar, especialmente mientras habla, come, bebe y canta. 3.Buena higiene: Lávese o desinfecte sus manos con frecuencia. Limpie con regularidad los artículos que se tocan frecuentemente. 4.Minimice la mezcla de personas:Planifique actividades para limitar la mezcla entre diferentes grupos familiares. Actualmente, las reuniones de más de tres hogares están prohibidas en California. A los californianos se les permite reunirse con un máximo de otros dos grupos familiares. Esto significa que en Halloween, si pasa tiempo con otras personas, debe quedarse con un máximo de tres grupos familiares (incluido el suyo) y no mezclarse con otros. 5.Quédese en casa si está enfermo o pertenece a un grupo de alto riesgo:Si está enfermo o ha estado en contacto con alguien que está enfermo de COVID-19 o tiene síntomas de esta efermedad, quédese en casa y lejos de los demás. Se recomienda encarecidamente a las personas con mayor riesgo de enfermedad grave o muerte por la COVID-19 (como adultos mayores, personas con afecciones médicas crónicas) que se queden en casa. 1.Si está enfermo o en un grupo de alto riesgo, debe alertar a los que hacen dulce o truco de no ir a su puerta al apagar la luz del porche y otras luces decorativas de Halloween en la noche de la celebración. Por favor, respete a sus vecinos y a su comunidad:Todos están manejando la pandemia de la COVID-19 lo mejor que pueden y tienen diferentes niveles de comodidad sobre lo que es seguro hacer. Su comunidad local o sus vecinos pueden ser más restrictivos que estos lineamientos del CDPH, y le pedimos que respete los deseos y preocupaciones de sus vecinos. California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : October 13, 2020 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor October 9, 2020 TO: Todos los californianos SUBJECT: Guía para reuniones privadas Resumen Esta guía brinda un plan actualizado para que los californianos se reúnan fuera de sus hogares y sustituye la guía de reuniones anteriores emitida el 12 de septiembre de 2020y el 16 de marzo de 2020. Se aplica a las reuniones privadas, y todos los demás encuentros que no estén cubiertos por las guías de las industrias actuales quedan totalmente prohibidos. Estas reuniones se definen como situaciones sociales que congregan a personas de distintos grupos de familias al mismo tiempo en un solo espacio o lugar.Cuando las personas de distintos grupos de familias socializan, aumenta el riesgo de transmisión de la COVID-19. Requisitos obligatorios para todo tipo de reunión Todas las personas que planean organizar o participar en una reunión privada, como se define anteriormente, deben cumplir con los siguientes requisitos. Las jurisdicciones sanitarias locales pueden ser más restrictivas que estos lineamientos. Consulte su guía local para conocer lo que está permitido en su área. 1.Asistencia ½*9K J=MFAGF=K IM= AF;DMQ9F EsK <= 3 grupos de familias quedan prohibidas. Esto incluye a todos los presentes, incluidos los anfitriones y los invitados. Recuerde, cuanto menor sea el número de personas, más seguros estarán. ½+9FL=F?9 =D EAKEG ?JMHG >9EADA9J ;GF =D que ha compartido la mayor cantidad de tiempo. Al pasar tiempo con las mismas personas, se reduce el riesgo de transmisión. Se desaconseja enérgicamente participar en múltiples reuniones con distintas familias o grupos. ½#D 9F>ALJA F <=:= J=;GHAD9J DGK FGE:J=K <= todos los asistentes y la información de contacto en caso de que sea necesario hacer un seguimiento más adelante. 2.Reuniones al aire libre ½*9K J=MFAGF=K IM= K= DD=N9F 9 ;9:G 9D 9AJ= libre son significativamente más seguras que las que se realizan en espacios interiores. Todas las reuniones deben realizarse al aire libre. Los asistentes pueden entrar para usar los baños, siempre y cuando los baños sean desinfectados con frecuencia. ½*9K J=MFAGF=K HM=<=F DD=N9JK= 9 ;9:G =F espacios al aire libre que se encuentren cubiertos por sombrillas, marquesinas, toldos, techos y otras estructuras de sombra, siempre y cuando al menos tres lados del espacio (o el 75%) estén abiertos al exterior. ½1= H=JEAL= MF9 J=MFA F <= FG EsK <= LJ=K ?Jupos de familias en un parque público u otro espacio al aire libre, incluso si también se realizan reuniones no relacionadas de otros grupos de hasta tres familias en el mismo parque u otro espacio al aire libre.Si ocurren múltiples reuniones de este tipo, no se permitirá la socialización entre ellas. Además, las reuniones múltiples de tres grupos de familias no pueden organizarse o coordinarse conjuntamente para que ocurran en el mismo parque público u otro espacio al aire libre al mismo tiempo. Esto constituiría una reunión que excede el tamaño permitido. 3.No asista a reuniones si se siente enfermo o pertenece a un grupo de alto riesgo ½!M9DIMA=J H=JKGF9 ;GF KFLGE9K KAEAD9J=K 9 la COVID-19 (fiebre, tos, dificultad para respirar, escalofríos, sudores nocturnos, dolor de garganta, náuseas, vómitos, diarrea, cansancio, dolores musculares o corporales, dolores de cabeza, confusión o pérdida del sentido del gusto/olor), debe quedarse en casa y no entrar en contacto con nadie fuera de su hogar. ½!M9DIMA=J9 IM= <=K9JJGDD= D9 !-4'"¸¢ =F MF plazo de 48 horas posteriormente a asistir una reunión debe notificar a los demás asistentes lo antes posible sobre una posible exposición. ½1= J=;GEA=F<9 =F;9J=;A<9E=FL= 9 D9K H=JKGFas con mayor riesgo de enfermedad grave o muerte por la COVID-19 (como adultos mayores y personas con afecciones médicas crónicas) que no asistan a ninguna reunión. 4.Practique el distanciamiento físico y la higiene de las manos cuando asista a estas reuniones ½.9J9 ;M9DIMA=J J=MFA F H=JEALA<9 :9BG =KL9 ?Mía, el espacio debe ser lo suficientemente grande para que todos los asistentes puedan mantener al menos una distancia física de 6 pies de los demás (sin incluir su propio grupo de familia) en todo momento. ½*GK 9KA=FLGK <=:=F =KL9J ;Glocados con al menos 6 pies de distancia (en todas las direcciones, de adelante hacia atrás y de lado a lado) entre los distintos grupos de familias. ½2G<9K D9K H=JKGF9K IM= K= =F;M=FLJ=F =F una reunión deben lavarse las manos con agua y jabón con frecuencia, o utilizar desinfectante para manos si no hay agua y jabón disponibles. Debe haber un lugar para lavarse las manos o un desinfectante de manos disponible para que lo utilicen los asistentes. ½,G <=:=F MK9JK= DGK 9JL;MDGs compartidos durante una reunión. En la medida de lo posible, cualquier artículo o bebida en reuniones al aire libre debe estar en recipientes desechables de una sola porción. Si no es posible proporcionar envases de una sola porción, la comida y las bebidas deben ser servidas por una persona que se lave o desinfecte las manos con frecuencia y use un cubrebocas. No se deben usar artículos de autoservicio de contenedores comunales. 5.Use un cubrebocas para evitar que la COVID-19 se propague ½ D 9KAKLAJ 9 J=MFAGF=K¤ K= <=:=n usar cubrebocas de acuerdo a lo especificado en la Guía del CDPH sobre el uso de cubrebocas, a menos que se apliquen excepciones. ½*9K H=JKGF9K IM= 9KAKL9F 9 D9K J=MFAGF=K pueden quitarse el cubrebocas de la cara brevemente para comer o beber siempre que se mantengan al menos a 6 pies de distancia de todas las personas fuera de su grupo familiar y se cubran la cara nuevamente tan pronto como terminen la actividad. ½*GK ;M:J=:G;9K L9E:A{F K= HM=<=F IMALar para satisfacer necesidades médicas urgentes (por ejemplo, para usar un inhalador para el asma, tomar medicamentos o si se siente mareado). 6.Sea breve ½*9K J=MFAGF=K <=:=F <MJ9J <GK @GJ9K G E=FGK£ Cuanto mayor sea la duración, el riesgo de transmisión será mayor. 7.Reglas para cantar, corear y gritar en reuniones al aire libre ½!9FL9J¤ ;GJ=9J¤ ?JAL9J Q @9;=J =B=J;A;AG >KA;G aumenta significativamente el riesgo de transmisión de la COVID-19 debido a que estas actividades aumentan la liberación de gotitas respiratorias y aerosoles finos en el aire. Por este motivo, se desaconseja encarecidamente cantar, corear y gritar, pero si ocurren, se aplican las siguientes reglas y recomendaciones: Todas las personas que estén cantando o coreando deben usar un cubrebocas en todo momento mientras lo hagan, incluso cualquiera que esté dirigiendo una canción o un cántico. Debido a que estas actividades presentan un riesgo muy alto de transmisión de la COVID-19, cubrirse la cara es esencial para reducir la propagación de gotitas respiratorias y aerosoles finos; Se recomienda encarecidamente a las personas que cantan, gritan, corean o hacen ejercicio que mantengan una distancia física de más de 6 pies para reducir aún más el riesgo. Se recomienda encarecidamente a las personas que cantan que lo hagan en voz baja (al volumen de una voz normal o por debajo del mismo). ½1= H=JEAL= D9 EKA;9 AFKLJME=FL9D KA=EHJe que los músicos mantengan una distancia física de al menos 6 pies. Los músicos deben ser de uno de los tres grupos de familias. Se desaconseja encarecidamente tocar instrumentos de viento (cualquier instrumento que se toque con la boca, como una trompeta o un clarinete). Contexto La COVID-19 continúa representando un riesgo severo para las comunidades y requiere que todas las personas en California sigan las precauciones necesarias y adapten la forma en que viven y funcionan a la luz de este riesgo continuo. La forma más segura de reunirse es pasar tiempo con personas del mismo hogar o reunirse virtualmente. En términos generales, mientras una persona interactúe con más grupos de familias en una reunión, más cercana sea la interacción física y cuanto más dure la interacción, mayor será el riesgo de que una persona con una infección por COVID-19, sintomática o asintomática, pueda contagiar a otros. Los estudios de salud pública también han demostrado que el riesgo de transmisión aumenta en los espacios interiores, especialmente cuando no hay una ventilación adecuada.\[1\]A diferencia de los espacios interiores, el viento y el aire en los espacios exteriores pueden ayudar a reducir la propagación del virus de una persona a otra. Los escenarios de planificación publicados por el CDC estiman que, en promedio, una persona con la COVID-19 llega a infectar entre 2 y 4 personas, con una mejor estimación de 2.5 cuando no existen medidas preventivas.\[2\] Por ejemplo, si cada persona infectada transmite el virus a dos personas, quienes a su vez lo transmiten a otras dos cada una; esos cuatro propagarán el virus a otros ocho; esos ocho propagarán el virus a 16; y así sucesivamente. Como resultado, después de 10 ciclos de transmisión, una persona podría ser responsable de que otras 1.024 contraigan el virus.\[3\]Además, existe un amplio acuerdo en que las personas que no experimentan síntomas aún pueden transmitir la COVID-19\[4\]. El hecho de que la COVID-19 pueda ser transmitida por personas que no tienen síntomas o que aún no muestran síntomas es uno de los aspectos de esta enfermedad que dificulta su control. Todas las reuniones presentan un mayor riesgo de transmisión y propagación de la COVID-19 cuando las personas se mezclan en diferentes grupos de familias y comunidades. La probabilidad de transmisión y diseminación aumenta con la risa, el canto, el hablar en voz alta y la dificultad para mantener la distancia física. Limitar la asistencia a reuniones es una forma de reducir el riesgo de propagación, ya que reduce la cantidad de personas diferentes que interactúan. Además, al limitar la asistencia hay una capacidad mejorada para realizar un rastreo de contactos efectivo si se descubre un caso positivo, lo que puede ayudar a retrasar la propagación de la COVID-19 \[5\]. Las personas que elijan asistir a reuniones privadas deben discutir y acordar las reglas específicas del grupo antes llevar a cabo el encuentro. \[1\]Vea, por ejemplo, Hiroshi Nishiura, et al., Closed environments facilitate secondary transmission of coronavirus disease 2019(COVID-19) (PDF), que seta disponible en (www.medrxiv.org/content/10.1101/2020.02.28.20029272v2.full.pdf); Hu Qian, et al., "Indoor transmission of SARS-CoV-2"\[pre-print\] published in medRxiv on April 4, 2020, que seta disponible en a (www.medrxiv.org/content/10.1101/2020.04.04.20053058v1). \[2\]Vea CDCCOVID-19 Pandemic Planning Scenarios \[3\]Vea, por ejemplo, Report 3: Natsuko Imai et al, WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, J-IDEA, "Imperial college London, UK. Transmissibility of 2019 -n-CoV)." See also Inglesby T B JAMA Public Health Measures and the Reproduction Number of SARS-CoV-2. JAMA Network.2020.7878 (May 1, 2020). \[4\]World Health Organization (WHO)Transmission of SARS-CoV-2: implications for infection prevention precautions \[5\]Vea Harvard HealthPreventing the spread of the coronavirusSocial distancing, hand washing, and other preventive measures California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : October 12, 2020 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor September 12, 2020 TO: All Californians SUBJECT: CDPH Guidance for the Prevention of COVID-19 Transmission for Gatherings NOTE: The following guidance is superseded by updated guidance released onOctober 9, 2020. This guidance provides an updated plan for Californians to gather outside their household and replaces the March 16, 2020 gatherings guidance. It applies topublic andprivate gatherings and other gatherings not covered by existing sector guidance. Gatherings are defined as meetings or other events that bring together people from different households at the same time in a single space, or place. When people from different households mix, this increases the risk of transmission of COVID-19. To protect public health and slow the rate of transmission of COVID-19, gatherings unless otherwise specified are not permitted across the state of California until further guidance is issued by the California Department of Public Health. Background COVID-19 continues to pose a severe risk to communities and requires all people in California to follownecessary precautions and to adapt the way they live and function in light of this ongoing risk. California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : October 10, 2020 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor August 24, 2020 TO: All Californians SUBJECT: Guidance on Returning to Work or School Following COVID-19 Diagnosis Guidance on Returning to Work or School Following COVID-19 Diagnosis This guidance is intended for individuals, except those who work in health care settings, who have tested positive for COVID-19. CDPH recommends adherence to the current CDC guidance on discontinuing isolationand returning to work or school, summarized here for easy reference. Workers in health care settings should follow CDC guidance for health care personneland any relevant CDPH All Facilities Letterdirectives. Individuals who test positive for SARS-CoV-2, the virus that causes COVID-19, and who have had symptoms, may return to work or school when: ½ L D=9KL <9QK @9N= H9KK=< KAnce symptoms first appeared, AND ½ L D=9KL @GMJK @9N= H9KK=< OAL@ FG >=N=J (without use of fever-reducing medications), AND ½-L@=J KQEHLGEK @9N= AEHJGN=<£ Individuals who test positive for SARS-CoV-2 who never develop symptoms, may return to work or school 10 days after the date of their first positive test for SARS-CoV-2. Requiring a negative SARS-CoV-2 test prior to returning to work or school is not recommended. Instead, employers and schools should follow the time- and symptom-based approach described above in determining when individuals can return to work or school following COVID-19 diagnosis. Return to work or school guidelines for all individuals or for specific settings may differ in certain local health jurisdictions in California; individuals should also consult with and follow guidance from their local health departments. California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : August 25, 2020 Google Translate BudgetAccountingForecastingReportsProgramsCareersWhat's NewQuick LinksSearch HomebudgetCOVID 19 COVID-19 Information To respond to, and provide support for, the novel coronavirus, a disease known as COVID-19, the state and federal government has provided resources to support state and local government, respond to the public health crisis, encourage recovery, and support vulnerable Californians. This site provides information related to funding to address COVID-19 and suHHGJL L@= KL9L=¯K J=;GN=JQ£ .D=9K= NAKAL L@AK O=:KAte frequently as information is regularly updated. Allocations for Direct Disaster Response Operations The state has used funds available pursuant to Government Code section 8690.6 and Control Section 36.00, Chapter 2, Statutes of 2020 to support the state and local emergency response to COVID-19. Allocation summaries and letters, including notification letters to the Joint Legislative Budget Committee, by date for COVID-19 can be accessed here. Coronavirus Relief Fund Quarterly Report States are required to submit expenditure reports to the U.S. Treasury detailing expenditures of federal Coronavirus Relief Funds in 17 categories associated with COVID-19 response and mitigation. The first reporting cycle covers expenditures and obligations incurred from March 1 through June 30. Information will be reported to the Pandemic Response Accountability Committee quarterly beginning on September 30th. 'F>GJE9LAGF :Q J=;=ANAF? =FLALQ º KM;@ 9K 9 ;GMFLQ¤ ;ALQ¤ GJ DG;9D =<M;9LAGF 9?=F;Q º ;9F := 9;;=KK=< @=J=£ Coronavirus Relief Fund Reporting Portal The state has created a web portal to support reporting by recipients and sub-recipients of Coronavirus Relief Fund allocations and appropriations. Access to the portal, user guide, frequently asked questions, and information regarding due dates and federal requirements may be found here. Federal Stimulus The federal government has provided temporarQ >=<=J9D >MF<AF? LG KMHHGJL L@= KL9L=¯K J=KHGFK= LG L@= !-4'"¸¢ H9F<=EA;£ 2@AK >Mnding was made available through four federal bills. Additional information regarding the funding the state has received or expects to receive can be found on this page. This page will be updated frequently as additional information, including state awards and expenditures, becomes available. Coronavirus Relief Fund Allocations for Cities and Counties 9K=< GF L@= KL9L=¯K HGHMD9LAGF, California received a total of $15.3 billion Coronavirus Relief Funds (CRF) provided in the federal CARES Act, with $9.5 billion paid to the state and $5.8 billion paid to cities and counties with populations over 500,000. The Budget authorizes the "=H9JLE=FL G> $AF9F;= LG 9DDG;9L= ø£¡ :ADDAGF G> L@= KL9L=¯K K@9J= G> !0$ LG ;GMFLA=K 9F< ;ALA=K£ <<ALAGF9D <=L9ADK 9J= 9N9ADable on this page. County General Fund COVID-19 Allocations The Budget includes $750 million to provide support for counties experiencing revenue losses for realigned programs as a result of COVID-19. The link above provides the allocation for each county of the initial funding included in the Budget Act and the required certification to access these funds. Additional details and the required county certification are available on this page. ½!9DA>GJFA9 M<?=L½ M<?=L 0=HGJLK 9F< ½&AKLGJA;9D M<?=L ½19D9JA=K 9F< 59?=K ½2J9AD=J ADD *9F?M9?=AnalysesInformationSupplement ½ M<?=L "=L9ADK½$'ø! * 0=KGMJ;=K ½$MF< !GF<ALAGF ½0=KGMJ;=K >GJ ½1MEE9JQ G> !GF<ALAGF StatementsDepartments Statements Back to TopSite MapAccessibilityConditions of UsePrivacy PolicyAbout UsWebmasterTwitter Mailing Lists Copyright © 2020 State of California why did I get this? 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor AFL 17-_ September 28, 2020 TO: All Californians SUBJECT: Outdoor Playgrounds and other Outdoor Recreational Facilities Summary COVID-19 continues to pose a severe risk to communities and requires all people in California to follownecessary precautions and to adapt the way they live and function in light of this ongoing risk. This guidance provides direction on usage of outdoor playgrounds and outdoor recreational facilities (hereafter facilities), to support a safe environment for children and families. It applies to outdoor playgrounds located in parks, campgrounds, and other publicly accessible locations. This guidance does not apply to indoor playgrounds or family entertainment centers. Outdoor PlaygroundDefinition: ½$MDDQ GML<GGJK ½.M:DA;DQ 9;;=KKA:D= ½$J== LG =FL=J 9F< MK= ½-H=J9L=< :Q 9 ;ALQ¤ KL9L=¤ ;GMFLQ¤ GJ >=<=J9D ?GN=JFE=FL ½"=KA?F=< HJAE9JADQ LG K=JN= F=9J:Q residents within a half a mile ½!9F HJGNA<= 1L9L=¸E9F<9L=< GML<GGr space for preschools (which could be scheduled in advance to avoidoverlapping use) ½2QHA;9DDQ AF;DM<=K J=;J=9LAGF9D =IMApment, like play structures, slides, swings, etc. intended to enrich children's physicalhealth anddevelopment Visitors to outdoor community playgrounds must comply with the following requirements: 1. Face masks over the mouth and nose are required for everyone 2 years of age or older with caregiver supervision at all times to ensure face mask use. 2. Do not use the playground when different households are unable to maintain a physical distance of 6 feet or when the capacity limithas been reached. 3. Caregivers must monitor to keep adults and children from different households at least 6 feet apart. 4. Consider coming on different times or days to avoid wait times and potential crowded times. 5. No eating or drinking in playground, to ensure face masks are worn at all times. 6. Wash or sanitize hands before and after using the playground. 7. Elderly and persons with underlying medical conditions should avoid playground when others are present. 8. Limit visit to 30 min per day when others are present Note:Facility operators should download and printthis flyerto post at all outdoor playgrounds. All playground facilities operators should review and follow these recommendations: 1. An adult must actively supervise each child at all times to make sure that children two years of age or older keep their face covering over their nose and mouth and stay 6 feet away from adults and children outside their household. a. Children who are supervised by the same adult must stay together in the same play area or play structure at all times, to allow active supervision. b. If an infant or child requires attention (nursing, diapering) that precludes an adult from actively supervising other children using the playground, the adult should ask the other children to leave the play structure/area and stay by the adult's side until needed care is complete. 2. People standing outside the playground, including people waiting to enter the playground, should remain 6 feet away from areas of the playground used by children and adults. 3. Maintain six-foot distancing between children and adults from different households including children using or waiting to use play structures or play areas, and families waiting to enter the playground. 4. Increase cleaning of frequently touched surfaces, daily as practicable. 5. To the extent feasible, provide handwashing stations or sanitizer to facilitate hand hygiene, especially during times of heavy usage. Use a hand sanitizer containing (60% ethanol or 70% isopropanol). Never use hand sanitizers with methanol due to its high toxicity to both children and adults. 6. Post the maximum number of children allowed at the entrance of each playground. a. Determine and post the maximum occupancy of each play structure, (e.g., climbing structures, slides, swings, spinning structures, and sand areas) with 6 foot vertical and horizontal distancing. b. Determine and post the maximum occupancy for supervising adults to ensure that each adult can maintain six feet of distance from other adults and children. c. Provide directions on how to wait in line when maximum playground occupancy has been reached. 7. Mark playgrounds to help children and adults maintain 6 foot distancing. a. Mark spaces for families to stand while waiting to enter the playground. The spaces should be far enough apart to allow 6 feet of distance between households. b. For play structures or play areas that can hold more than one child while allowing 6 foot distancing: i. Post the maximum number of children allowed on each structure/in each area to allow 6 foot distancing vertically andhorizontally. ii. For play structures or areas that can hold more than 1 child, consider marking with tape or other visual indicators to help children assess whether they are 6 feet apart. c. Mark designated spaces 6 feet apart for children to stand while waiting to use a play structure/area. Additional Considerations If there is a pre-scheduled activity that will access the playground, the playground must be closed to the broader public during that time. Child care programs, schools, out-of-school time programs and other programs for children and youth where children must remain in cohorts may not use playgrounds during times when they are open to the public. However, if the playground operator permits, the childcare, school or other program may reserve a time for the exclusive use of the playground by the program. While on the playground, cohorts should maintain separation and avoid mixing. California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : September 29, 2020 COVID-19 *Tenga en cuenta que los documentos traducidos quizá no se actualicen tan rápido como las versiones en inglés. Proyecto para una economía más segura California tiene un nuevo proyecto para reducir la COVID-19 en el estado que incluye criterios revisados para reducir y ajustar las restricciones en las actividades. Se asigna un nivel a cada condado de California de acuerdo con los resultados positivos de las pruebas y el índice de casos ajustado para la asignación del nivel, lo que incluye las métricas de las últimas tres semanas. Además, una nueva métrica de equidad en materia salud entrará en vigor el 6 de octubre de 2020.Para poder avanzar al siguiente nivel menos restrictivo, cada condado tendrá que cumplir con una métrica de equidad o demostrar inversiones destinadas a eliminar las disparidades en los niveles de transmisión de COVID-19, según su tamaño. La Métrica de Equidad en Materia de Salud de California está diseñada para ayudar a guiar a los condados en sus esfuerzos constantes por reducir los casos de COVID-19 en todas las comunidades y requiere de esfuerzos más intensos para prevenir y mitigar la propagación de la COVID-19 entre los californianos que se han visto afectados de manera desproporcionada por esta pandemia. Obtenga más información sobre la Métrica de Equidad en Materia de Salud. Actualizaciones a partir del 10/06/2020: ½1= 9;LM9DAR D9 29:D9 <= <9LGK <=D HJGQ=;LG <= !9DA>GJFia(Excel) para mostrar el estado del nivel del condado, la fecha de asignación del nivel, la cantidad de semanas consecutivas en las que se cumplen los criterios del siguiente nivel, las tasas de casos, la tasa de caso ajustada para la asignación del nivel, la cantidad de resultados positivos de las pruebas y las tasas de pruebas. Los datos que se presentan corresponden a las semanas que terminan el20 y el 26 de septiembre. ½*9K L9K9K <= ;9KGK K=?MAJsF 9BMKLsF<GK= =F >MF;A F <= D9 media del volumen de pruebas de California. ½1= @9 AF;GJHGJ9<G MF9 =KLJ9L=?A9 H9J9 H9K9J <= MF FAvel a uno más restrictivo para los condados pequeños. ½*9 E{LJA;9 <= =IMA<9< =F E9L=JA9 <= K9DM< K= 9HDA;9 H9ra determinar la asignación de nivel a un nivel menos restrictivo para los condados grandes con una población superior a 106,000habitantes. ½1= 9;LM9DAR D9 <=>AFA;A F <= F<A;= <= ;9KGK Q DGK ;slculos de la métrica de resultados positivos en las pruebas para reflejar la eliminación de los casos de los hospitales estatales para reclusos. Más información sobre el proyecto: ½!GFKMDL= =D =KL9<G <= D9K actividades de su condado ½!GFGR;9 IM{ 9;LANA<9<=K Q F=?G;AGK =KLsF 9:A=JLGK =F DGK ;M9LJG FAN=D=K(PDF) ½-:L=F?9 EsK AF>GJE9;A F KG:J= D9 +{LJA;9 <= #IMA<9< =F +9L=JA9 19DM< <= !9DA>GJFA9 ½#PHDGJ= DGK <9LGK ;GEHD=LGK HGJ ;GF<9<G¥ 29:D9 <= <9LGK <=D HJGQ=;LG <= !9DA>GJFA9(Excel) ½.JGQ=;LG H9J9 MF9 =;GFGE9 EsK K=?MJ9| Para otros idiomas, visite nuestrapágina de documentos multilingües. Plan para reducir la COVID-19 y acomodar las actividades permitidas en el sector con el fin de mantener la salud y seguridad de los residentes de California Esta guía detalla la estrategia actualizada para progresar de manera segura con la apertura de más negocios y actividades teniendo en cuenta la pandemia. La estrategia informada en esta guía se desarrolló teniendo en cuenta el mayor conocimiento sobre las vulnerabilidades en la transmisión de la enfermedad, así como los factores de riesgo, y tiene los siguientes objetivos: 1) Avanzar con las fases según los niveles de riesgo y con un tiempo apropiado entre cada fase y en cada condado, para poder evaluar detenidamente los impactos de cualquier cambio. 2) Reducir de manera resolutiva la transmisión de casos al mínimo posible en todo el estado para que la potencial carga de la gripe y la COVID-19 a finales del otoño y durante el inverno no generen complicaciones en la capacidad del sistema de atención médica de administrar el espacio, los insumos y el personal. Además, como el clima frío hace que más actividades se realicen bajo techo, los bajos niveles de transmisión en la comunidad reducirán la probabilidad de que se produzcan brotes importantes en estos entornos más riesgosos. 3) Simplificar la estrategia y establecer objetivos claros sobre la transmisión de la enfermedad en los condados para el trabajo futuro. Estrategia en niveles Esta estrategia detalla las medidas que cada condado debe tomar, de acuerdo con los indicadores que analizan la carga de la enfermedad, las pruebas y la equidad sanitaria. Un condado puede optar por ser más restrictivo que esta estrategia. Esta estrategia también destaca las señales de preocupación, como el impacto en la capacidad de la atención médica que puede atenuar la intervención. Esta estrategia reemplaza a las métricas actuales de monitoreo de datos del condado. A medida que la pandemia de la COVID-19 continúe siendo una situación en desarrollo y haya nueva evidencia y conocimientos al respecto, el Departamento de Salud Pública de California (CDPH, por sus siglas en inglés), en colaboración con otros funcionarios estatales, continuará reevaluando las métricas y los límites. Consulte en la siguiente tabla las métricas de la estrategia establecidas según los niveles basados en el riesgo de transmisión comunitaria de la enfermedad. El cálculo de las métricas se describe en el Apéndice 1. ^No incluye los reclusos estatales y federales. *Denominadores de población del Departamento de Finanzas: Proyecciones de la población del estado:Población total por condado - Tabla P-1 **El índice de casos se determinará según los casos confirmados por PCR. *** Se asignará un nivel a los condados según dos métricas: los resultados positivos de las pruebas y el índice de casos. El índice de casos se ajusta según el volumen de pruebas cada 100,000 habitantes, como se describe a continuación. Debido a la variabilidad de los datos, este ajuste no aplica a los condados pequeños (es decir, los que tienen una población inferior a 100,000 residentes, incluso el condado de Sutter, que tiene aproximadamente 105,000 habitantes). ½.9J9 DGK ;GF<9<GK IM= LA=F=F MF NGDME=F <= HJM=:9K KMH=JAor a la mediana del estado, el factor es inferior a 1, el cual disminuye de manera lineal de 1.0 a 0.6, a medida que el volumen de pruebas aumenta al doble de la mediana del estado. El factor permanece en 0.6 si el volumen de pruebas es superior al doble de la mediana del estado. ½.9J9 DGK ;GF<9<GK IM= LA=F=F MF NGDME=F <= HJM=:9K AF>=JAor a la mediana del estado, el factor es superior a 1, el cual aumenta de manera lineal de 1.0 a 1.4, a medida que el volumen de pruebas disminuye de la mediana del estado a cero. Sin embargo, este ajuste para el volumen bajo de pruebas no aplicará a los condados con resultados positivos de las pruebas <3.5%. ½*9K =KL9<KLA;9K ;GF N9DGJ=K E9QGJ=s o menores que los puntos de corte de nivel por 0.05 se redondearán hacia arriba o hacia abajo usando las reglas de redondeo convencionales. Factor de ajuste del índice de casos de COVID-19 en California Volumen de pruebasFactor de ajuste del índice de casos* 01.4 0.25*Media del estado1.3 0.50* Media del estado1.2 0.75* Media del estado1.1 Media del estado1 1.25* Media del estado0.9 1.5* Media del estado0.8 1.75* Media del estado0.7 2.0*Media del estado y 0.6 superior ½*GK ;GF<9<GK ;GF E=FGK <= 9HJGPAE9<9E=FL= ¤ @9bitantes, incluido el condado de Sutter, estarán exentos de los ajustes de las tasas de casos, y los condados con una cantidad de resultados positivos de las pruebas <3.5% estarán exentos de los ajustes de las tasas de pruebas inferiores a la media del estado. ½1A D9K <GK E{LJA;9K FG están en el mismo nivel, la asignación de nivel del condado se determinará según la métrica más restrictiva. Por ejemplo, si los resultados positivos de las pruebas de un condado corresponden al Nivel 3 (naranja, moderado), pero el índice de casos corresponde al Nivel 1 (violeta, propagado), se asignará el Nivel 1 al condado. Avanzar por los niveles Las reglas de la estrategia: 1.El CDPH evaluará los indicadores una vez por semana, todos los lunes, y publicará las asignaciones de nivel actualizadas los martes. 2.Un condado debe permanecer en un nivel por un mínimo de tres semanas, antes de poder avanzar a un nivel menos restrictivo. 3.Un condado solo puede avanzar de a un nivel a la vez, aunque las métricas califiquen para un nivel más avanzado. 4.Si el índice de casos ajustado de un condado para la asignación del nivel y la medición de resultados positivos de las pruebas están en dos niveles diferentes, se asignará al condado al nivel más restrictivo. 5.La métrica de equidad en materia de salud será la tercera que se aplique a jurisdicciones con una población de más de 106,000habitantes. Más adelante se describen las reglas de la métrica de equidad en materia de salud. 6.En las métricas generales, se incluirán los datos de la jurisdicción sanitaria local (LHJ, por sus siglas en inglés) de la ciudad y se asignará a las LHJ de la ciudad el mismo nivel que el condado circundante. 7.Una LHJ puede continuar implementando o manteniendo medidas sanitarias públicas más restrictivas si el funcionario de salud local determina que las condiciones sanitarias de esa jurisdicción justifican dichas medidas. Para avanzar: 1.Un condado debe haber estado en el nivel actual por un mínimo de tres semanas. 2.Un condado debe reunir los criterios del siguiente nivel menos restrictivo para el índice de casos ajustado y los resultados positivos de las pruebas durante las dos semanas previas consecutivas para pasar al siguiente nivel. 3.Además, el estado establecerá las medidas de equidad sanitarias para demostrar la capacidad de un condado para abordar a sus comunidades más afectadas. Para retroceder: 1.Durante la evaluación semanal, si el índice de casos ajustado o los resultados positivos de las pruebas de un condado han caído en un nivel más restrictivo por dos períodos semanales consecutivos, el condado debe retroceder al nivel más restrictivo. 2.A los condados con una población inferior a 106,000habitantes se les aplicará un criterio de condado pequeño para garantizar que el paso a un nivel más restrictivo sea adecuado. A continuación, se describe la estrategia para los condados pequeños. 3.En cualquier momento, los funcionarios de salud pública del estado y el condado pueden trabajar juntos para determinar las intervenciones específicas o las modificaciones necesarias a nivel del condado para abordar la capacidad hospitalaria afectada y los impulsores de la transmisión de la enfermedad, según sea necesario. 4.Los condados tendrán tres días para implementar cualquier cambio o cierre en el sector, a menos que circunstancias extremas ameriten una acción inmediata. Estrategia para condados pequeños (actualizado el 10/06/2020) Durante el último mes, hemos estado siguiendo de cerca el impacto de las métricas y los niveles del proyecto. Debido a que nuestra métrica de índice de casos está normalizada por cada 100,000 habitantes, varios condados con poblaciones pequeñas han experimentado grandes oscilaciones en su índice de casos diarios como resultado de una pequeña cantidad de casos nuevos informados. En algunos condados, esto ha hecho surgir la necesidad de volver a un nivel más restrictivo, a pesar de la estabilidad general de la enfermedad y de la capacidad demostrada para rastrear, hacer un seguimiento, investigar y tratar los casos. Por ejemplo, una vez que un condado pequeño se encuentra en el nivel amarillo, una pequeña cantidad de casos (tan solo 1 caso por semana durante 2 semanas consecutivas) podría hacer que volviera a un nivel más restrictivo. Si bien la proporción general de casos puede ser la misma que la de un condado más grande, la cantidad absoluta de casos también es un factor importante para evaluar la capacidad del condado de controlar la transmisión mediante la investigación de la enfermedad, la localización de los contactos y el aislamiento. No redunda en interés de la salud pública de las comunidades cerrar o restringir sectores empresariales enteros sobre la base de una cantidad tan pequeña de casos, y en algunas situaciones un pequeño giro en el recuento de casos semana tras semana puede hacer que un condado pase del nivel amarillo al nivel violeta. Como el estado quiere evitar cambios rápidos en el estado del nivel sobre la base de pequeños cambios en la cantidad absoluta de casos, estamos creando una medida alternativa de evaluación de casos que se aplicará a los condados pequeños. Los condados pequeños se definen como aquellos que tienen menos de 106,000 habitantes.\[1\] Medida alternativa de evaluación de casos. Los condados pequeños están sujetos a todas las reglas existentes del proyecto (umbrales de resultados positivos de las pruebas, duración mínima de 3 semanas en un nivel, imposibilidad de saltarse un nivel mientras se pasa de una designación de nivel más restrictiva a otra menos restrictiva, etc.) con la excepción de los umbrales del índice de casos que se describen a continuación. La medida alternativa de evaluación de casos proporciona una protección a los condados pequeños contra los cambios de nivel repentinos como resultado de pequeños cambios en los casos durante un período de dos semanas. En el caso de un condado pequeño que tenga resultados positivos en las pruebas que cumplan el umbral del nivel actualmente asignado a ese condado, pero que esté marcado para pasar posiblemente a un nivel más restrictivo sobre la base de su evaluación semanal del índice de casos, se aplicarán los siguientes criterios basados en los umbrales del índice de casos del proyecto. Si el condado excede los siguientes números de casos semanales absolutos en función de su población y su nivel durante dos semanas consecutivas, deberá pasar a un nivel más restrictivo: Del nivelAl nivelHab. 35KHab. 35K-70K AmarilloNaranja714 NaranjaRojo1421 RojoVioleta3542 Criterios de riesgo Las actividades y los sectores comenzarán a abrirsegún su nivel específico basado en los criterios de riesgo(PDF), como se detalla a continuación. Las actividades o los sectores de menor riesgo pueden abrir antes y las actividades o los sectores de mayor riesgo no pueden abrir hasta que se encuentren en fases más avanzadas. Muchas actividades o sectores pueden incrementar el nivel de las operaciones y la capacidad, a medida que un condado reduzca su nivel de transmisión. Criterios utilizados para determinar los sectores de riesgo bajo/medio/alto ½!9H9;A<9< <= H=JEALAJ =D MKG <= mascarilla en todo momento (p.ej., para comer y beber, uno debe quitarse la mascarilla) ½!9H9;A<9< <= E9FL=F=J D9 <AKL9F;A9 >KAca entre personas de diferentes hogares ½!9H9;A<9< <= DAEAL9J D9 ;9FLA<ad de personas por pie cuadrado ½!9H9;A<9< <= DAEAL9J D9 <MJ9;A F <= D9 =PHGKA;A F ½!9H9;A<9< <= DAEAL9J D9 ;9FLA<9< <= H=JKGFas de diferentes hogares y comunidades juntas ½!9H9;A<9< <= DAEAL9J D9 ;9FLA<9< <= AFL=racciones físicas entre visitantes y dueños ½!9H9;A<9< <= GHLAEAR9J D9 ventilación (p. ej., en interiores vs. aire libre, cambio de aire y filtración) ½!9H9;A<9< <= DAEAL9J D9K 9;LANA<9<=K que aumenten la propagación (p.ej., cantar, gritar, respirar profundo; los ambientes ruidosos harán que las personas eleven la voz) Escuelas Las escuelas pueden reabrir para la enseñanza en persona según los criterios equivalentes de laEstrategia para la reapertura de escuelas(PDF) del 17 de julio, previamente anunciada.Esa estrategia permanecerá en vigor, salvo que el Nivel 1 se reemplaza por la Lista previa de monitoreo de datos del condado (que tiene criterios para el índice de casos equivalentes a los del Nivel 1). Las escuelas de los condados que pertenezcan al Nivel 1 no pueden reabrir para la enseñanza en persona, pero los departamentos de salud locales otorgaron algunas exenciones para los o grados kínder de transición a 6.. Las escuelas que no están autorizadas a reabrir, incluidas las escuelas de kínder o de transición a 6.grado que no recibieron una exención, pueden proporcionar supervisión y servicios estructurados en persona a los estudiantes de acuerdo con laGuía para cohortes/grupos pequeños de niños y jóvenes. Las escuelas serán elegibles para reabrir parcialmente para la enseñanza en persona de acuerdo con las pautas específicas del sector para las escuelas de California cuando el condado haya salido del Nivel 1 (y, por lo tanto, esté en el Nivel 2) por 14 días, como mínimo, lo cual es similar a estar fuera de la Lista de monitoreo de datos del condado por 14 días, como mínimo. Como se mencionó antes, una LHJ puede continuar implementando o manteniendo medidas sanitarias públicas más restrictivas si el funcionario de salud local determina que las condiciones sanitarias de esa jurisdicción justifican dichas medidas. Como se indicó en laestrategia de reapertura de escuelas(PDF) del 17 de julio,las escuelas no deben cerrar si un condado regresa el Nivel 1, pero sí deben considerar realizar pruebas del personal para controlar la situación. Proceso de adjudicación de niveles del condado Si un condado determina que hay una discrepancia entre los datos calculados del condado y el estado relativos a las medidas antes definidas, el condado deberá notificar al coordinador local de CDPH. El condado puede solicitar una reunión con los líderes de epidemiología locales y estatales para comparar los datos. Además, el CDPH trabaja con la Conferencia de California de Funcionarios de Salud Locales y la Asociación de California de Ejecutivos de Salud del Condado para desarrollar otras metodologías para evaluar la información cualitativa y contextual que afecta estas métricas, así como las intervenciones más importantes. Cuando el CDPH adjudique una discrepancia, actualizará el estado del nivel y este se verá reflejado en el sitio web público dentro de las 48 horas, según corresponda. APÉNDICE 1: Cálculo de las métricas MétricaDefinición Índice de casos (índice cada 100,000 personas, Se calcula como el número diario promedio (la media) excepto los casos en prisiones; promedio de 7 días de casos de COVID-19, excepto los casos entre personas con retraso de 7 días)encarceladas en prisiones estatales o federales, en centros de detención del Serviciode Inmigración y Control de Aduanas, o en el Departamento de Hospitales Estatales (identificados como casos con un nombre o una dirección de instalación asociados con estas ubicaciones), durante 7 días (según la fecha del episodio), dividido por la cantidad de personas que vive en el condado/la región/el estado. Luego, este número se multiplica por 100,000. Debido a los retrasos en los informes, este cálculo tiene un retraso de 7 días. Por ejemplo, para los datos actualizados el 8/22/20, el índice de casos será del 8/15/20 e incluirá el índice de casos promedio desde el 8/9/20 hasta el 8/15/20. Índice de casos lineal ajustado cada 100,000 Se calcula como el índice de casos multiplicado por el personas por día, excepto los casos en prisiones factor de ajuste del índice de casos que se basa en la (promedio de 7 días con retraso de 7 días) diferencia entre el volumen de pruebas del condado (volumen de pruebas, pruebas cada 100,000 personas por día, como se describe a continuación) y el volumen de pruebas medio calculado en todos los condados. Por lo tanto, el volumen de pruebas medio pasa a ser la referencia para este ajuste y se recalcula cada cuatro semanas para evitar la fluctuación excesiva y seguir teniendo en cuenta las tendencias en desarrollo de las pruebas. Para los condados que tienen un volumen de pruebas superior a la mediana, el factor de ajuste es inferior a 1, el cual disminuye de manera lineal de 1.0 a 0.6, a medida que el volumen de pruebas aumenta al doble del punto de referencia. El factor de ajuste permanece en 0.6 si el volumen de pruebas del condado es superior al doble de la mediana del estado. Para los condados que tienen un volumen de pruebas inferior a la mediana del estado, el factor de ajuste es superior a 1, el cual aumenta de manera lineal de 1.0 a 1.4, a medida que el volumen de pruebas del condado disminuye de la mediana del estado a cero. La fórmula del ajuste lineal puede expresarse de manera matemática del siguiente modo: 1-(((índice de pruebas del condado - índice de pruebas medio del estado)/índice de pruebas medio del estado) * 0.4) Hay dos condiciones en las que no se aplica esta fórmula. La primera son los condados pequeños, que tienen una población inferior a 100,000, aproximadamente, de acuerdo con las proyecciones de población del Departamento de Finanzas de California (consulte la referencia * en la tabla de la estrategia en niveles). La excepción de condado pequeño evita el posible ajuste falso a causa de las fluctuaciones en las pruebas influenciadas por los eventos seculares que no están relacionados con el riesgo subyacente de transmisión. Como segunda condición para la excepción del ajuste, no se ajustarán los condados que tengan un volumen de pruebas inferior a la mediana del estado y resultados positivos de las pruebas <3.5%, de acuerdo con la suposición de que el volumen de pruebas en estos condados puede ser inferior si los resultados positivos de las pruebas son bajos. En ambas condiciones, el índice de casos ajustado es igual al índice no ajustado. Resultados positivos generales de las pruebas, Se calcula como el número de pruebas positivas de la excepto los casos en prisiones, durante 7 días (solo reacción en cadena de la polimerasa (PCR, por sus PCR, con retraso de 7 días)siglas en inglés) para la COVID-19 durante un período de 7 días (según losdatos de las muestras recopiladas) dividido por la cantidad total de pruebas de PCR realizadas; esto excluye las pruebas (a) de las personas que no son del estado o cuyo condado de residencia se desconoce y (b) las pruebas realizadas a personas encarceladas en prisiones estatales o federales y hospitales estatales (identificados como casos con un nombre o una dirección de instalación asociados con ubicaciones de prisiones u hospitales estatales). Luego, este número se multiplica por 100 para obtener un porcentaje. Debido a los retrasos en los informes (los cuales pueden ser diferentes entre las pruebas positivas y negativas), existe un retraso de 7 días. Por ejemplo:Para los datos acumulativos recibidos el 6/30/20, los resultados positivos informados de las pruebas son del 6/23/20 y se calculan según las pruebas con fecha de recolección de la muestra entre el 6/17/20 y el 6/23/20. Pruebas cada 100,000 personas por día, excepto los Se calcula como el número de pruebas de reacción en casos en prisiones (promedio de 7 días con retraso cadena de la polimerasa (PCR) por día durante un de 7 días) período de 7 días (según la fecha de recolección de la muestra), excepto las pruebas realizadas a personas encarceladas en prisiones estatales o federales y hospitales estatales (identificados como casos con un nombre o una dirección de instalación asociados con ubicaciones de prisiones u hospitales estatales), dividido por la cantidad de personas que viven en el condado/la región/el estado. Luego, este número se multiplica por 100,000. Debido a los retrasos en los informes, existe un retraso de 7 días en el cálculo. Por ejemplo:para los datos acumulativos recibidos hasta el 8/22/20, la cantidad promedio informada de pruebas durante 7 días será del 8/15/20 e incluirá las pruebas de PCR con fechas de recolección de la muestra entre el 8/9/20 y el 8/15/20. Fuente de datos: CalREDIE Enlaces útiles ½!GFKMDL= =D =KL9<G <= D9K actividades de su condado ½!GFGR;9 IM{ 9;LANA<9<=K Q F=?G;AGK =KLsF 9:A=JLGK =F DGK ;M9LJG FAN=D=K(PDF) ½#PHDGJ= DGK <9LGK ;GEHD=LGK HGJ ;GF<9<G(Excel) ½#KLJ9L=?A9 <= J=9H=JLMJ9 <= =K;M=D9K(PDF) ½%M9 H9J9 ;G@GJL=K G ?JMHGK pequeños de niños y jóvenes ½OOO£;GNA<¢£;9£?GN ½.9J9 GLJGK A<AGE9K¤ NAKAL= FM=KLJ9página de documentos multilingües. Page Last Updated : October 9, 2020 MENU ECONOMY What no Trump stimulus means for California schools, unemployment and more BY LAUREN HEPLER OCTOBER 13, 2020 Regal Cinemas in Jack London Square remains closed due to the coronavirus pandemic in Oakland on Sept. 9, 2020. Photo by Anne Wernikoff for CalMatters IN SUMMARY An Oct. 15 state deadline to restore $11 billion in funding for education, housing and state workers looks likely to pass with no more financial help from Washington. Is there still hope for a reprieve, and could deeper cuts follow? Last week, as federal stimulus talks crumbled and CapmjsvrmeÅw$yriqtps}qirx$ system faltered again, Tracy Greer packed her car with recyclables and hoped the cash would pay for groceries. Greer, 48, is an accountant by training who was furloughed from her job as a restaurant server in the high desert town of Phelan just as the pandemic hit. It took three months to get her first unemployment check, and with no back- to-work date in sight, Greer and many of the other 2.1 million jobless Californians have been hoping for a reprieve with a second round of federal stimulus money. MxÅw$e$lsti$xlex$lew$h{mrhpih$ew$ President Donald Trump last week instructed$lmw$tevx}$Âxs$wxst$ ÂVmklx$rs{0$xli}Åvi$tpe}mrk$ negotiating until after the election {mxl$jmvi2$Xli}Åve making it so when, immediately after I win, we people are going to be {mpp$teww$e$qensv$Wxmqypyw$Fmpp2Ã$ lsqipiww2à Even after a reversal and call for ÁXVEG\]$KVIIV0$JYVPSYKLIH$\[EMXVIWW more individual stimulus checks, small business loans and an airline bailout, a deal has yet to materialize ahead of several looming political deadlines. ÂVmklx$rs{0$xli}Åvi$tpe}mrk${mxl$jmvi0Ã$Kviiv$wemh2$ÂXli}Åvi$qeomrk$mx$ws$ people are going to be homeless. By the time restaurants reopen, people evirÅx$ksmrk$xs$lezi$gevw$xs$kix$xlivi2Ã$ California workers and small businesses are trying to stop the financial bleeding before rent moratoriums and an emergency Pandemic Unemployment Assistance program for contract workers are set to expire xlmw${mrxiv2$Xli$wxexiÅw$tyblic schools, courts, parks and civil servants are already feeling the fallout after $11 billion in budget cuts and delayed payments took effect this summer, which lawmakers in Sacramento had hoped to reverse by Oct. 15 with funds from a new federal stimulus deal. The mounting financial uncertainty comes as California grapples with a record year for wildfires and surging inequality, testing how much the rexmsrÅw$qswx$tstypsyw$wxexi$erh$xli${svphÅw$jmjxl1pergest economy can do to save itself. After a historically unproductive year in Sacramento marked by labor groups crusading for new wealth taxes and moderates failing to deliver a promised state stimulus package, it will be up to voters to decide economic issues like a commercial property tax hike (Prop. 15), rent control (Prop. 21) and gig worker pay (Prop. 22). Â\[i$pmoi$xs$xepo$efsyx$syvwipziw$ew$e$rexmsr1wxexi0Ã$wemh$Qmgel$\[imrfivk0$ director of progressive advocacy group Gepmjsvrme$Jsv{evh2$ÂXli$mqtpmgexmsr$ of that is we need to start acting more like a naxmsr$erh$piww$pmoi$e$wxexi2à Keep tabs on the latest California policy and politics news Enter your email SUBSCRIBE By clicking subscribe, you agree to share your email address with CalMatters to receive marketing, updates, and other emails from the site owner. Use the unsubscribe link in those emails to opt out at any time. I'M NOT INTERESTED But unlike a nation that can go into defx0$Gepmjsvrme$gerÅx$tvmrx$qsri}$erh$mw$ required to balance its $202 billion annual budget. This constraint is why relief from Washington is crucial. Without federal stimulus money, high-tax California will be staring down a projected $8.7 billion deficit next year and have to either raise taxes or cut services that overwhelmingly benefit the poor. Already, there has been friction between Newsom and state finance officials over how to spend the $9.5 billion allocated to California by the federal CARES Act this spring. Assemblymember Phil Ting said the state is still evaluating a new tax voucher system to generate revenue and reduce future cuts, with a report from the Department of Finance due in March. In the meantime, Weinberg wemh$mxÅw$epws$tswwmfpi$xs$qeoi$gliet1but-controversial regulatory changes to expedite economic recovery, like easing housing permitting requirements or immediately spending existing infrastructure funds. Â\[lex$er$iuymxefpi$vigsziv}${syph$require would be a very minimal investment from the perspective of thi$wxexi$fyhkix0Ã$\[imrfivk$wemh2$Â\]sy$ gerÅx$hs$er}xlmrk${mxlsyx$e$tper$xs$hs$mx0$erh$vmklx$rs{${i$hsrÅx$lezi$tperw2à Deeper cuts to come? MxÅw$er}sriÅw$kyiww${lixliv$Gsrkress will pass its proposed $2 trillion stimulus deal in time for the Oct. 15 state deadline to reverse budget cuts, but Ting said lawmakers could react quickly if a deal happens later. Gov. Gavin Newsom could call a special session, he said, or the Legislature could move to reverse cuts when they return to the Capitol in December or January. It would be the state Department of Finance, in coordination with the governor, that would receive and dole out any additional stimulus funds to state programs, giving the Legislature 30 days to sign off, said California Department of Finance spokesperson H.D. Palmer. ÂMj$wsqixlmrk$hsiwrÅx$lettir$f}$Xlyvwhay, that does not mean there is another round of new state budget cuts0Ã$Tepqiv$wemh0$xlsykl$li$ehzmwih$ those watching the ups and downs in Washington to firh$Âe$kssh$wyttp}$sj$ dramamine, because motion sickneww${mpp$tvsfefp}$fi$mrzspzih2à If no more federal aid money is allocateh$xs$Gepmjsvrme$xlmw$}iev0$xli$wxexiÅw$ K-12 schools will have to absorb $5.8 billion in payment deferrals, state employees would lose $2.8 billion in compensation, and public universities would have to process their own nine-figure budget reductions, among other cuts lawmakers hoped to reverse. Another possibility is that the state cuts will proceed, but individual California residents like Greer will get relief from another round of stimulus checks, similar to the $1,200 sent this spring to Americans earning under $75,000 erryepp}2$ÂTpiewi$ksh0Ã$Kveer said, ticking off car insurance, utilities and sxliv$fmppw$tmpmrk$yt2$ÂM$hsrÅx$gevi$ls{$xli}$teww$mx2à Xlmw$}ievÅw$fyhkix$gyxw$gsyph$epws$be just the beginning. In May, the California Department of Finance projected a $32 billion drop in state revenue for the next year, though tax receipts have so far been higher than expected. The state has already borrowed upwards of $10 billion from the federal government to help pay unemployment claims, and there may be pressure in the coming months to extend benefits for longer than the maximum of 59 weeks currently available during the pandemic. As it stands, public schools will have to$gsti${mxl$xlmw$}ievÅw$fyhkix$hijivvepw$ while trying to pull off distance learrmrk$Á$e$fepergmrk$egx$xlex$Âfyvhir,w-$ districts with less property wealth xlex$vip}$qsvi$sr$wxexi$jyrhmrk0Ã$ according to a recent Public Policy Institute of California report. During the last recession, said report co-author Julien Lafortune, schools were forced into more layoffs and deeper spending cuts in the years after the initial shock of the financial crisis. He worries that history could repeat itself. ÂLs{$feh${mpp$xli$wmxyexmsr$fi$ri|x$}ievCÃ$wemh$Pejsvxyri0$er$ihygexmsr1 jsgywih$viwievgl$jipps{2$Ã\[lir$}sy$psso at the budget projections for next }iev0$mxÅw$e$kmerx$lspi2à Ting said lawmakers have so far tvmsvmxm~ih$Âxli$qswx$zyprivefpi$ Gepmjsvrmerw0Ã$erh${mpp$oiit$pssomrk$xs$avoid cuts to safety net programs like CalWorks, MediCal anh$GepJviwl0$wmrgi$xli$wxexiÅw$poorest residents have the least ability to draw on credit cards sv$sxliv$pserw2$ÂMr$iwwirgi0Ã$li$wemh0$ Â{iÅvi$fsvvs{mrk$jsv$qmppmsrw$sj$Gepmjsvnians, so they can keep food on the xefpi$erh$wxe}$mr$xlimv$lsywiw2à Recession risks When the first round of stimulus money went out earlier this year, California {ew$xli$rexmsrÅw$fmkkiwx$firijmgmev}$Á$sr$paper, at least. Thanks in part to federally backed programs like enhanced $600-a-week unemployment benefits and small business loans through the Paycheck Protection Program, Leila Bengali and her fellow economists at$YGPEÅw$Erhivwsr$Jsrecast this fall tvsnigxih$e$ better than expected Ã$vigsziv}$jvsq$xli$terhiqmg$sziv$xli$ next two years. But that was assuming that the federal government passed another stimulus package worth at least $1 trillion. And adjusting for ho{$fmk$xli$wxexiÅw$ population is, federal money to California to date$Á$mrgpyhmrk$:40444$wqepp$ business loans worth some $68 billion Á$egxyepp}$qehi$piww$sj$er$mqtegx$ vipexmzi$xs$xli$wxexiÅw$qewwmve workforce of more than 18 million people. ÂXlswi$ryqfivw$evi$fmk0Ã$Firkepm$wemh2$ÂGepmjsvrme${ew$xli$lmkliwx$sj$er}$sj$ the states. But you have to keep in mind that California has the most {svoivw0$ws$xli$qswx$te}vspp2à The goal with stimulus money, she said0$mw$xs$Âtvizirx$e$hs{r{evh$wtmvepÃ$ with rent, utilities, and food that can destabilize households. Unemployed Californians have still struggled$wmrgi$xli$GEVIW$EgxÅw$mrmxmep$$600 weekly boost expired 2$ÂMx$qeoiw$mx$levhiv$erh$levhiv$for them to find a job once the labor market sort of regszivw0Ã$Firkepm$wemh2 How far does a month of unemployment benefits go in California? Compare monthly benefits to the poverty-threshold cost of living in your county for a single parent with two kids. Alameda -threshold Source: Public Policy Institute of California's California Poverty MeasMJ=¤ "=H9JLE=FL G> *9:GJ ½ 9KA; cost of living is equal to the county-specific California Poverty Measure threshold for a renter household with one adult and two children. The threshold accounts for food, clothing, utilities, and @GMKAF?»>9;LGJAF? AF J=?AGF9D differences in housing costs. Monthly unemployment benefits estimate is equal to weekly amount multiplied by four. Average state benefit from first quarter of 2020. Horace Turner knows the feeling of staring down a financial cliff. The owner sj$TexxivwsrÅw$H}reqmg$Fymphmrk$Fpsgow daycare has stayed open during the pandemic to watch the children of nurses, Amazon factory workers and farm workers. He quickly ran through a $36,000 small business loan when a few families left, and more recently had to buy new desks and school supplies for kids coming in to do virtual school lessons. Even if there is another round of stmqypyw$jyrhmrk0$liÅw$rsx$wyvi$mj$ participating will help or dig him a deepiv$lspi2$ÂM$ger$ks$fego$erh$ewo$jsv$ qsvi0Ã$Xyvriv$wemh0$Âfyx$M$nywx$hsrÅx$ors{$vmklx$rs{2à Support in-depth reporting that matters As a nonprofit newsroom, we rely ONE-TIME on the generosity of Californians MONTHLY like you to cover the issues that matter. If you value our reporting, ANNUALLY support our journalism with a donation. $10 $15 $25 Other Your contribution is appreciated. DONATE I'M NOT INTERESTED WE WANT TO HEAR FROM YOU Want to submit a guest commentary or reaction to an article we wrote? You can find our submission guidelines here. Please contact Gary Reed with any commentary questions: gary@calmatters.org, (916) 234-3081. Lauren Hepler lauren@calmatters.org Lauren covers the California economy for CalMatters. Her past stories have been published by the New York Times, the L.A. Times, the Guardian and others. She previously worked as a staff reporter for Protocol... More by Lauren Hepler © 2020 CALMATTERS. PROUDLY POWERED BY NEWSPACK BY AUTOMATTIC PRIVACY POLICY 1L9L= G> !9DA>GJFA9»&=9DL@ 9F< &ME9F Services Agency California Department of Public Health Sandra Shewry GAVIN NEWSOM Acting Director Governor September 18, 2020 TO: All Californians SUBJECT: Responding to COVID-19 in the Workplace for Employers Click here for a pdf of the checklist Released June 16, 2020 ½0=NAK=< GF 1=HL=E:=J ¡¤ LG¥ 1.require all employers to notify local health departments when they meet the reporting threshold of three or more cases of COVID-19 in their workplace within a two-week period. 2.align return to work criteria with updated guidance from CDC on release from isolation, issued on July 17, 2020. 3.provide employers information on how COVID-19 exposure or infection in the workplace may impact operations. Responding to COVID-19 in the Workplace This checklist is intended for use by employers identifying cases of COVID-19 in their workplace. In non-healthcare or non-residential congregate setting workplaces, CDPH requires employers to report cases of COVID-19 to the local health department (LHD) in the jurisdiction in which they are located and the LHD where the infected workers reside. Employers must use the reporting threshold of three or more laboratory-confirmed cases of COVID-19 among workers who live in different households within a two-week period to notify the LHDs. Employers should be proactive and keep in mind that identification of even a single positive case among workers may quickly develop into a large outbreak. As outbreak circumstances and work practices vary, employers may need assistance from their LHD to plan and coordinate a response that meets the needs of the workplace. This guidance isnotintended for use in managing or preventing outbreaks in healthcare, congregate living settings, or other workplaces where the California Aerosol Transmissible Diseases (ATD) standard (title 8section 5199) applies. Employers should also consult: ½!"! ?MA<9F;= >GJbusinessesandsmall businessesfor information on preventing outbreaks; ½!9DÅ-1& ?MA<9F;=to ensure that they are complying with legal requirements for worker protection; and ½L@= !9DA>GJFA9 KL9L=OA<=industry-specific guidanceto reduce risk during and after reopening of businesses. Outbreak Management 1. Employers should prepare for identification of COVID-19 cases in their workplace. ½"=KA?F9L= 9 OGJCHD9;= AF>=;LAGF prevention coordinator to implement COVID-19 infection prevention procedures and to manage COVID-related issues among workers. ½'FKLJM;L OGJC=JK LG KL9Q @GE= 9F< J=HGJL LG L@= =EHDoyer if they are having symptoms of COVID-19, were diagnosed with COVID-19, or are awaiting test results for COVID-19. Symptoms of COVID-19 include subjective or measured fever (>100.4°F or 38°C), chills, cough, shortness of breath, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, or diarrhea. Develop mechanisms for tracking suspected and confirmed cases among workers. Ensure that sick leave policies are sufficiently generous and flexible to enable workers who are sick to stay home without penalty and ensure that workers are aware of such policies. California has additional servicesfor workers, including supplemental paid sick leavefor food sector workers at companies with 500 or more workers nationwide. Covered employers must provide notice to their workers of this benefit. The Families First Coronavirus Response Actrequires certain employers to provide workers with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19. Some cities and counties require employers to provide sick leave benefits to workers. ½'<=FLA>Q ;GFL9;L AF>GJE9LAGF >GJ L@= local health department (LHD)in the jurisdiction where the workplace is located. 2.Employers must prepare to share information with the LHD and other stakeholders. ½#EHDGQ=JK EMKL FGLA>Q L@= *&" AF L@= BMJAK<A;LAGF O@ere the workplace is located if there is a known or suspected outbreak in the workplace. An outbreak in non-healthcare or non-residential congregate setting workplaces is defined as three or more laboratory-confirmed cases of COVID-19 among workers who live in different households within a two-week period. Employers are also encouraged to contact the LHD regarding any laboratory confirmed case of COVID-19 in the workplace. The LHD in the jurisdiction where the workplace is located may have specific additional criteria for outbreak reporting requirements. Employers must follow the specific instructions of their LHD, if available. LHDs regularly transmit and protect confidential health information. Securely sharing confidential information about workers with COVID-19 is critical for the LHD to provide comprehensive support to the employer and protect the health of the community. ½5GJC=JK AF 9 OGJCHD9;= E9Q DAN= AF ;GMFLA=KÅBMJAK<A;LAGns outside of where the workplace is located. When the case reporting threshold is met, employers must contact the LHD in any jurisdiction where a COVID-19 positive worker resides and let them know about the outbreak. Typically, the LHD in the jurisdiction where the workplace is located gives guidance to the employer on managing the outbreak. ½!GEEMFA;9L= OAL@ L@= *&" GF @GO >J=IM=FLDQ L@= LHD expects updates from the employer on newly identified cases and symptomatic workers in the workplace. Determine how this information will be shared (e.g., telephone, fax directed to a specified person, secure e-mail). ½1@9J= 9 JGKL=J G> 9DD OGJC=JK OAL@ L@= *&" AF the jurisdiction where the workplace is located. An employer may be asked by the LHD to provide additional information on the workers, including job description, location, work schedule, city and county of residence, and other details that could help inform the investigation and determine which other workers in the workplace may be at risk of COVID- 19 infection. ½'> OGJC=JK AF 9 >9;ADALQ 9J= MFAGFAR=<¤ A<=FLA>Q 9 MFAGn contact and clarify the role the union can play in communication with workers. If workers in a facility are not unionized, identify a worker representative to serve as a point of contact for the LHD. ½'> L@= >9;ADALQ MK=K ;GFLJ9;L GJ L=EHGJ9JQ OGJC=Js, identify who should communicate information and instructions on the outbreak to these individuals. The host employer should notify temporary, contract, or other agencies that have workers in the workplace of the outbreak. All workers in the workplace, regardless of employment arrangement, should follow all instructions for infection prevention and outbreak management measures from the host employer, the LHD where the workplace is located, and the LHD were they reside. 3. Understand requirements for reporting worker cases to Cal/OSHA. ½ FQ K=JAGMK AFBMJQ¤ ADDF=KK¤ GJ <=9L@ G;;MJJAF? AF any place of employment or in connection with any employment must be reported by the employer to the local Cal/OSHA district office immediately but not longer than 8 hours after the employer knows. For COVID-19, this includes inpatient hospitalizations and deaths among workers. ½#EHDGQ=JK EMKL J=HGJL K=JAGMK AFBMJQ¤ ADDF=KK¤ 9F< <=ath, including hospitalization and death from COVID-19, even if work-relatedness is uncertain. ½!9DÅ-1& HJ=>=JK ;9DDK :Q H@GF= :ML OADD 9DKG accept email reports (caloshaaccidentreport@tel- us.com).Details on reporting (www.dir.ca.gov/dosh/coronavirus/Reporting-Requirements-COVID-19.html), contact information for district offices. (www.dir.ca.gov/dosh/districtoffices.htm), and the Title 8 section 342 requirement (www.dir.ca.gov/title8/342.html) are available online. 4. Identify additional worker cases and close contacts of cases to control further spread in the workplace. ½2=KLAF? 9DD OGJC=JK AF 9 OGJCHD9;= K@ould be the first strategy considered for identification of additional cases. Testing may be done at a single point in time or at repeated intervals. Employers should seek guidance from the LHD when developing a testing strategy, including how testing can be arranged and how to prioritize testing of workers. Examples of strategies may include testing close contacts of laboratory-confirmed cases first; prioritizing workers in parts of the workplace with higher case counts; or, if testing capacity is limited, sample pooled testing, also known as "group testing," should be conducted to obtain critical information about the extent of infection with fewer testing resources. Employers should offer on-site COVID-19 testing of workers or otherwise arrange for testing through the company's occupational or general medical services provider. The employer is responsible for ensuring all workers are offered and provided testing. Employers should also provide information to workers who may prefer to contact their personal medical provider or visit a CA Coronavirus Testing Task Force site (testing.covid19.ca.gov) for testing. LHDs may also be able to help facilitate testing options, if needed. ½5@=F L=KLAF? 9DD OGJC=JK AK FGL 9N9AD9:D= GJ FGL J=;Gmmended by the LHD, consider alternative methods for controlling the outbreak, in consultation with the LHD, including but not limited to tracing all close contacts of confirmed cases and instructing those individuals to quarantine, conducting sample pooling(group testing), or temporarily closing the workplace and quarantining all workers. ½!GF<M;L ;GFL9;L LJ9;AF? 9F< IM9J9FLAFAF? G> ;DGKe contacts of confirmed cases in the workplace. Employers must provide information to the LHD on the confirmed COVID-19 case workers in the workplace, including job titles, work areas, close contacts in the workplace, dates of symptom onset, and shifts worked while infectious. Establish if the employer, LHD, or both will conduct interviews of the cases to determine their close contacts. Close contacts should be instructed to quarantine at home for 14 days from their last known contact with the worker with COVID-19. Close contacts should be tested for COVID-19 when possible. A close contact is someone who spent 15 minutes or more within 6 feet of an individual with COVID-19 infection during their infectious period, which includes, at a minimum, the 48 hours before the individual developed symptoms. Interview workers with laboratory-confirmed COVID-19 by phone to determine when their symptoms began, the shifts they worked during their infectious period, and to identify other workers with whom they had close contact during their infectious period. Use employment records to verify shifts worked during the infectious period and other workers who may have worked closely with them during that time period. While at home, close contacts should self-monitor daily for COVID-19 symptoms (e.g., subjective or measured fever (>100.4°F or 38°C), chills, cough, shortness of breath, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, or diarrhea). 5. Consider whether to temporarily suspend operations due to COVID-19 infection in the workplace ½ MKAF=KK=K E9Q =D=;L LG NGDMFL9JADQ suspend operations when a case of COVID-19, exposure to COVID-19, or an outbreak has occurred in the workplace. This would allow investigation of the exposure and thorough cleaning and disinfection. Businesses may elect to do this if the exposure is in a worker, customer, or visitor of the workplace. To understand more about if this decision is right for your business, you can contact your local health department (LHD)for guidance. ½2@= *&" AF L@= BMJAK<A;LAGF O@=J= L@e workplace is located has the authority to close business operations while an exposure is being investigated or an outbreak is being managed. Cal/OSHA also has authority to prohibit use and access of affected areas of a workplace if it identifies an imminent hazard to workers. ½!JAL=JA9 >GJ E9CAF? 9 <=L=JEAF9LAGn for closure may include the size of the workforce, the number or percentage of the workforce impacted, the vulnerability of consumers who visit the business to severe COVID-19 infection, or many other local factors, including the epidemiology of disease spread in the community at large. ½*&"K E9Q N9JQ AF L@=AJ KH=;A>A; J=IMAJ=E=FLK >GJ workplace outbreak investigations, reporting, and suspension of operations. 6.Notify and provide instruction to workers. ½#EHDGQ=JK EMKL E9AFL9AF ;GF>A<=FLA9lity of workers with suspected or confirmed COVID-19 infection when communicating with other workers. ½#EHDGQ=JK K@GMD< FGLA>Q 9DD OGJC=JK O@G O=J= HGL=ntially exposed to the individuals with COVID-19. Employers should provide any healthcare consultations needed to advise workers regarding their exposure, which may be especially important for those with high-risk medical conditions(e.g., immune compromise or pregnancy). ½!DGK= ;GFL9;LK G> ;9K=K K@GMD< := ?AN=F AFKLJM;LAGns on home quarantine, symptom monitoring, and COVID- 19 testing. ½.JGNA<= 9FQ OGJC=JK O@G 9J= K=FL @GE= :=>GJ= GJ <MJAF? a shift with information about what to expect after they are sent home (e.g., instructions about testing, sick leave rights under federal, state, and local laws and company policies, return-to-work requirements, etc.). ½'F KGE= GML:J=9CK¤ :ML FGL 9DD¤ OGJC=JK O@G O=J= F=ver symptomatic and did not have close contact with any of the laboratory confirmed cases may continue to work, as long as the employer has implemented all control measures as recommended by public health authorities, Cal/OSHA, or other regulatory bodies. The LHD will make this determination based on strategies being used to control the outbreak and identify new cases. 7.Determine when it is appropriate for cases and contacts of cases to return to work. ½!GFKMDL OAL@ L@= *&" 9F< EGKL J=;=FL !"! ?MA<9F;= >GJ O@=F 9 ;GF>AJE=< ;9K= E9Q := J=D=9K=< >JGE @GE= isolation and return to work. The local health department may recommend a strategy for return to work similar to the following, although some variation may occur by jurisdiction and outbreak. Minimum Criteria for Return to CDC Reference Page Work (The most recent CDC guidance (As of September 18, 2020)should be consulted prior to allowing the worker to return to work) Symptomatic Positive At least 10 days have passed since For worker cases who did not symptoms first appeared;and at require hospitalization: Workers with symptoms who are least 24 hours have passed since last www.cdc.gov/coronavirus/2019- laboratory confirmed to have fever without the use of fever-ncov/hcp/disposition-in-home- COVID-19 reducing medications;and patients.html symptoms (e.g., cough, shortness of For worker cases who require breath) have improved. hospitalization: www.cdc.gov/coronavirus/2019- ncov/hcp/disposition-hospitalized- patients.html A minimum of 10 days have passed Asymptomatic Positive www.cdc.gov/coronavirus/2019- since the date of their first positive ncov/hcp/disposition-in-home- Workers who never had symptoms COVID-19 test. If they develop patients.html and are laboratory confirmed to symptoms, then the criteria for have COVID-19 laboratory confirmed cases with symptoms apply. Use the same criteria for return to Symptomatic Negative work as laboratory confirmed cases. Workers who had symptoms of COVID-19 but test result returned negative Workers should quarantine at home Asymptomatic Negative for 14 days after the last known Workers who never had symptoms close contact with the case patient. but were tested due to close contact Symptoms can develop even after with a laboratory-confirmed case testing negative within 14 days after exposure. The LHD may consider patient and were negative allowing earlier return to work only for a worker in a critical infrastructure industry in which the essential operations of the workplace would be compromised by quarantine of the worker and no alternate staff can perform the same role.* Testing is highly recommended. If Symptomatic Untested the worker cannot be tested, use the Workers who had symptoms of same criteria for return to work as COVID-19 but were not tested laboratory confirmed cases. Asymptomatic Untested Workers should be quarantined at www.cdc.gov/coronavirus/2019- home for 14 days after the last ncov/hcp/disposition-in-home- Workers who had close contact to a known close contact with the case patients.html laboratory-confirmed case patient patient. Testing is highly at work, home, or in the community recommended; if testing has not and do not have symptoms. www.cdc.gov/coronavirus/2019- occurred, the LHD may consider ORncov/community/critical- allowing a worker who had close workers/implementing-safety- contact to a confirmed case to Workers who refuse or are unable to practices.html continue to work only in a critical be tested after close contact with a infrastructure industry in which the laboratory-confirmed case, despite essential operations of the recommendation for testing from workplace would be compromised LHD or healthcare provider, and do by quarantine of the worker and no not have symptoms. alternate staff can perform the same role.* Workers who develop symptoms of COVID-19 while in quarantine should contact their healthcare provider. Even if they are not tested, the same criteria for return to work should be used as laboratory- confirmed cases. * Critical infrastructure workplace outbreak ½asymptomatic negative workers ½workers who were close contacts to confirmed cases Where 14-day quarantine would compromise essential operations, the LHD may determine that some workers in these two groups may return to work sooner than 14 days by considering certain criteria specific to the workplace and worker: The worker is able to wear a surgical mask throughout the workday, except while eating, and comply with all infection prevention procedures. A cloth face covering may also be used in the event of mask shortage. The facility has implemented all best practice infection prevention procedures, as determined by the LHD. Pre-screening to assess worker temperature and symptoms prior to starting work has been implemented, ideally before entering the facility. Worker is able to self-monitor for temperature and symptoms at home and work. Worker is able to maintain a minimum of six feet of distance from other workers in the workplace. Of note, six feet does not prevent all transmission of SARS-CoV-2. Physical barriers are in place between fixed work locations to supplement distancing. Cleaning and disinfection of all areas and shared equipment can be performed routinely in the workplace. Be aware that testing reflects a worker's status at a single point in time only. If a worker tests negative, they may still develop COVID-19 infection from a recent or subsequent exposure and should be instructed to quarantine at home if that occurs. Testing may be needed at repeated intervals to capture all positive cases, especially if an outbreak is ongoing. 8. Perform more frequent cleaning and disinfection, as well as deep/enhanced cleaning and disinfection after workers with COVID- 19 have been at work. ½5GJC 9J=9K G> AF>=;L=< OGJC=JK K@ould not be entered by workers until they have been cleaned and disinfected with products approved by the EPA for COVID-19. Work should be performed by cleaning staff trained on their safe use and supplied with all required and recommended PPE. ½.=J>GJE GF?GAF? =F@9F;=< ;D=9FAF?Å<isinfection of work areas when a worker with COVID-19 is identified, following CDC recommendations: www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning- disinfection.html ½!GFLAFM= LG A<=FLA>Q 9F< J=?MD9JDQ ;D=9F 9F< <AKAF>ect frequently touched surfaces throughout the workplace, such as doorknobs, equipment, and handrails. ½5GJC=JK K@GMD< FGL K@9J= @=9<K=LK GJ GL@=J G:B=;LK L@at may come into contact with their face, mouth, or nose. ½+AFAEAR= K@9JAF? G> GL@=J =IMAHEent between workers; for equipment that must be shared, conduct frequent cleaning between worker use. ½2J9AF OGJC=JK GF K9>= MK= G> ;D=9F=JK 9F< <AKAnfectants and provide necessary protective equipment. 9. Employers should regularly check for and follow new and updated guidance on their specific industry from the following sources: ½%GN=JFGJ¬K ->>A;= Resilience Roadmap Guidance for multiple industries: covid19.ca.gov/industry-guidance/ ½!9DÅ-1& General Industry guidance: www.dir.ca.gov/dosh/coronavirus/General-Industry.html Guidance for specific industries: www.dir.ca.gov/dosh/coronavirus/Health-Care-General- Industry.html ½!"! Landing page for workplaces: www.cdc.gov/coronavirus/2019- ncov/community/organizations/businesses-employers.html Landing page for industry specific worker safety guidelines: www.cdc.gov/coronavirus/2019- ncov/community/worker-safety-support/index.html Additional Resources CDC guidance: ½$GJ =EHDGQ=JK¥ OOO£;<;£?GNÅcoronavirus/2019-ncov/community/guidance-business-response.html ½$GJ G>>A;= :MAD<AF?K¥ OOO£;<;£?GNÅ;GJGF9NArus/2019-ncov/community/office-buildings.html ½$GJ ;@AD<;9J=¤ K;@GGDK¤ 9F< QGuth programs: www.cdc.gov/coronavirus/2019-ncov/community/schools- childcare/index.html ½5GJC=J K9>=LQ 9F< KMHHGJL >GJ 9 N9JA=LQ G> industries: Worker Safety and Support ½$GJ KE9DD :MKAF=KK=K¥ OOO£;<;£?Gv/coronavirus/2019-ncov/community/guidance-small-business.html ½$GJ E=9L 9F< HGMDLJQ HJG;=KKAF? employers: www.cdc.gov/coronavirus/2019- ncov/community/organizations/meat-poultry-processing-workers-employers.html ½%JG;=JQ 9F< $GG< 0=L9AD¥ OOO£;<;£?GNÅ;GJGF9NAJMs/2019-ncov/community/organizations/grocery-food- retail-workers.html ½2J9FKHGJL9LAGF 9F< "=DAN=JQ¥ OOO£cdc.gov/coronavirus/2019-ncov/community/transportation/index.html ½!GFK=JNAF? 9F< #PL=F<AF? $ADL=JAF? $9;=HA=;= 0=spirator Supply in Non-Healthcare Sectors: www.cdc.gov/coronavirus/2019-ncov/community/conserving-respirator-supply.html ½!GEEMFALA=K¤ 1;@GGDK¤ 5GJCHD9;=K¤ 9Fd Events - Guidance for Where You Live, Work, Learn, Pray, and Play: www.cdc.gov/coronavirus/2019-ncov/community/index.html ½$AJKL 0=KHGF<=JK 9F< *9O #Fforcement: www.cdc.gov/coronavirus/2019-ncov/community/first- responders.html Cal/OSHA guidance: ½OOO£<AJ£;9£?GNÅ<GK@Å;GJGF9NAJMKÅ&=alth-Care-General-Industry.html ½$GJ ?=F=J9D AF<MKLJQ¥ OOO£<AJ£;9£?GNÅ<osh/coronavirus/General-Industry.html ½$GJ 9?JA;MDLMJ9D =EHDGQ=JK¥ www.dir.ca.gov/dosh/Coronavirus/COVID-19-Infection-Prevention-in- Agriculture.pdf ½$GJ ;@AD<;9J= HJG?J9EK¥ OOO£<AJ£;9.gov/dosh/Coronavirus/COVID-19-Infection-Prevention-in-Childcare- Programs-Guidance.pdf ½$GJ ;GFKLJM;LAGF¥ OOO£<AJ£;9£?GNÅ<osh/coronavirus/COVID-19-Infection-Prevention-in-Construction.pdf ½$GJ ?JG;=JQ KLGJ=K¥ OOO£<AJ£;9£?GNÅ<GK@Å!GJGF9NAJMs/COVID-19-Infection-Prevention-in-Grocery-Stores.pdf ½$GJ DG?AKLA;K =EHDGQ=JK¥ OOO£<AJ£;9.gov/dosh/coronavirus/COVID-19-Infection-Prevention-in-Logistics.pdf ½$GJ EGJLM9JA=K 9F< >MF=J9D @GE=K¥ OOO£<AJ£;9£?GN/dosh/coronavirus/COVID-19-Infection-Prevention-in- Mortuaries.pdf ½'FL=JAE %MA<9F;= GF !-4'"¸¢ >Gr Health Care Facilities: Severe Respirator Supply Shortage: www.dir.ca.gov/dosh/coronavirus/Cal-OSHA-Guidance-for-respirator-shortages.pdf Governor's Office Resilience Roadmap guidance and employer checklists: ½+MDLAHD= AF<MKLJA=K¥ ;GNA<19.ca.gov/industry-guidance California Department of Public Health PO Box, 997377, MS 0500, Sacramento, CA 95899-7377 Department Website (cdph.ca.gov) Page Last Updated : October 7, 2020