Loading...
HomeMy WebLinkAbout12.09.20 Embargoed information - stay at home order From:York, Danette 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:Kim, Sang;York, Danette Subject:Embargoed information - stay at home order Date:Wednesday, December 9, 2020 9:45:45 AM Attachments:12.3.20-Stay-at-Home-Order-ICU-Scenario.pdf Regional Stay at home questions.pdf Please note the following information is EMBARGOED until noon today: The Greater Sacramento Area region has fallen below the 15% ICU bed capacity threshold. The ICU capacity is 14.8%, which means we have until 11:59 pm Thursday night to implement the Stay At Home Order. Attached are some documents that may help answer questions regarding the order and all the details can be found at: https://covid19.ca.gov/stay-home-except-for-essential-needs/#regional-stay-home-order Public Health will send out a press release once the information is posted to the State website or immediately following the Governor’s press conference if there is one held today. We also plan to make ourselves available for media questions this afternoon. Please reach out to me via cell phone with any questions. Respectfully, Danette York Butte County Public Health dyork@buttecounty.net http://www.buttecounty.net/publichealth/ COUNTY OF BUTTE E-MAIL DISCLAIMER: This e-mail and any attachment thereto may contain private, confidential, and privileged material for the sole use of the intended recipient. Any review, copying, or distribution of this e-mail (or any attachments thereto) by other than the County of Butte or the intended recipient is strictly prohibited. If you are NOT the intended recipient, please contact the sender immediately and permanently delete the original and any copies of this e-mail and any attachments thereto. State of California—Health and Human Services Agency California Department of Public Health SANDRA SHEWRY, MPH,MSW GAVIN NEWSOM Acting Director Governor ERICA S. PAN, MD, MPH Acting State Health Officer Regional Stay At Home Order 12/03/2020 Upon assessment of the recent, unprecedented risein the rate of increase in COVID-19 cases, hospitalizations, and test positivity rates across California, the California Department of Public Health (CDPH) is taking immediate actions to prevent the spread of the virus. The State, like the nation, continues to record an unprecedented surge in the level of community spread of COVID-19. California implemented an accelerated application of the Blueprint Framework metrics on November 16 and a limited Stay at Home Order issued on November 19. However, in the interim, the number of new cases per day has increased by over 112%, (from 8,743 to18,588) and the rate of rise of new cases per day continues to increase dramatically. The number of new hospital admissions has increased from 777 on November 15, to 1,651 on December 2, and because of the lag between case identification and hospitalizations, we can only expect these numbers to increase. Current projections show that without additional intervention to slow the spread of COVID- 19, the number of available adult Intensive Care Unit (ICU) beds in the State of California will be at capacity in mid-December. This is a sign that the rate of rise in cases, if it continues, is at risk of overwhelming the ability of California hospitals to deliver healthcare to its residents suffering from COVID-19 and from other illnesses requiring hospital care. ICU beds are a critical resource for individuals who need the most advanced support and care and the ability to add additional ICU capacity is limited by the lack of available ICU nurses and physicians as a result of the nationwide surge in hospitalizations and ICU admissions. Because the rate of increases in new cases continues to escalate and threatens to overwhelm the state’s hospital system, further aggressive action is necessary to respond to the quickly evolving situation. While vaccines are promising future interventions, they are not available to address the immediate risks to healthcare delivery in the current surge. The immediate aggressive institution of additional non-pharmaceutical public health interventions is critical to avoid further overwhelming hospitals and to prevent the need to ration care. CDPH, MS 500 P.O. Box 997377 Sacramento, CA 95899-7377 (916) 558-1784 Department Website (www.cdph.ca.gov) NOW, THEREFORE, I, as Acting State Public Health Officer of the State of California, order: 1. CDPH will evaluate public health based on Regions, responsive to hospital capacity for persons resident in those Regions. 2. CDPH will evaluate the adult ICU bed capacity for each Region and identify on covid19.ca.govany Regions for which that capacity is less than 15%. When that capacity is less than 15%, the following terms(the Terms of this Order) will apply. a. All gatherings with members of other households are prohibited in the Region except as expressly permitted herein. b. All individuals living in the Region shall stay home or at their place of residence except as necessary to conduct activities associated with the 1 as required by operation, maintenance, or usage of critical infrastructure, law, or as specifically permitted in this order. c. Worship and political expression are permitted outdoors, consistent with existing guidance for those activities. d. Critical infrastructure sectors may operate and must continue to modify operations pursuant to the applicable sector guidance. e. Guidance related to schools remain in effect and unchanged. Accordingly, when this Order takes effect in a Region, schools that have previously reopened for in-person instruction may remain open, and schools may continue to bring students back for in-person instruction under the Elementary School Waiver Processor Cohorting Guidance. f.In order to reduce congestion and the resulting increase in risk of transmission of COVID-19in critical infrastructure retailers, all retailersmay operate indoorsat no more than 20% capacity and must follow the guidance for retailers. All access to retail must be strictly metered to ensure compliance with the limit on capacity. The sale of food, beverages, and alcohol for in- store consumption is prohibited. g. To promote and protect the physical and mental well-being of people in California, outdoor recreation facilities may continue to operate. Those facilities may not sell food or drink for on-site consumption. Overnight stays at 1 See https://covid19.ca.gov/essential-workforce/for full list of California’s Critical Infrastructure workforce. campgrounds are not permitted. h. Nothing in this Order prevents any number of persons from the same household from leaving their residence, lodging, or temporary accommodation, as long as they do not engage in any interaction with (or otherwise gather with) any number of persons from any other household, except as specifically permitted herein. i. Terms (a) and (b) of this section do not apply to persons experiencing homelessness. 3. Except as otherwise required by law, no hotel or lodging entity in California shall accept or honor out of state reservations for non-essential travel, unless the reservation is for at least the minimum time period required for quarantine and the persons identified in the reservation will quarantine in the hotel or lodging entity until after that time period has expired. 4. This order shall take effect on December 5, 2020 at 1259pm PST. 5. For Regions where theadult ICU bed capacity falls below 15% after the effective date of this order, the Terms of this Order shall take effect 24 hours after that assessment. 6. The Terms of this Order shall remain in placefor at least three weeks fromthe date the order takes effect in a Region and shall continue until CDPH’s four-week projections of the Region’s total available adult ICU bed capacity is greater than or equal to 15%. Four-week adult ICU bed capacity projections will be made approximately twice a week, unless CDPH determines that public health conditions merit an alternate projection schedule. If after three weeksfrom the effective date of the Terms of this Order in a Region, CDPH’s four-week projections of the Region’s total available adult ICU bed capacity is greater than or equal to 15%, the Terms of this Order shall no longer apply to the Region 7. After the termination of the Terms of this Order in a Region, each county within the Region will be assigned to a tier based on the Blueprint for a Safer Economy as set outin my August 28, 2020 Order, and the County is subject to the restrictions of the Blueprint appropriate to that tier. 8. I will continue to monitor the epidemiological data and will modify this Regional Stay-at-Home Order as required by the evolving public health conditions. If I determine that it is necessary to change the Terms of this Order, or otherwise modify the Regional Stay-at-Home Order, these modifications will be posted at covid19.ca.gov. 9.When operative in a Region, the Terms of this Order supersede any conflicting terms in other CDPH orders, directives, or guidance. Specifically, for those Regions with ICU bed capacity triggering this order, the Terms of this Order shall supersede the State’s Blueprint for a Safer Economyand all guidance (other than guidance for critical infrastructure sectors) during the operative period. In all Regions that are not subject to the restrictions in this order, the Blueprint for a Safer Economyand all guidance shall remain in effect. 10. This order is issued pursuant to Health and Safety Code sections 120125, 120130(c), 120135, 120140, 120145, 120175,120195 and 131080; EO N-60-20, N-25-20, and other authority provided for under the Emergency Services Act; and other applicable law. Erica S. Pan, MD, MPH Acting State Public Health Officer California Department of Public Health Open/Closed. LHDs are requesting a document that clearly outlines what’s open/closed. One idea was to build upon the dimmer framework and add a column for the regional stay at home. Schools Are playgrounds at schools (if open or using cohorts) open? Is it correct that schools with waivers, already opened, or proceeding through a phased reopening, can remain open? Regional Data/Timing The Governor didn’t announce which region(s) met the trigger today and now there is confusion with how quick those jurisdictions will need to close. Can you clarify who is under a Regional Stay at Home order today and how much time jurisdictions now have to comply, 24 or 48 hours? Release regional data Can you share how actual ICU capacity is determined, which data source and methodology, as well as how projected ICU capacity is determined. Enforcement What is the state’s plan for enforcement? Gyms/Fitness Centers They were mentioned this morning but are not on the list, are gyms and fitness centers open outdoors only or closed indoor and outdoors? Recreation Are parks and beaches open for sitting and gathering or must they be moving. You may recall that some jurisdictions had only allowed beach access for walking and running. Is golf allowed The Governor mentioned outdoor fitness during the press conference. Did he mean gyms or outdoor classes like yoga in the park. Drive In activities Any clarity on whether those are allowed. Drive in movies, Drive in concerts…etc. Youth Sports Has CDPH confirmed whether youth sports conditioning or distanced drills are allowed? Wedding and Funeral Services Are those allowed? They fall under places of worship, which we understanding is not changing. Talking Points Can the state provide any talking points being used to communicate this. We want to be clear and consistent as various questions come to LHDs, such as: o How/why these regions are being used o Why were these sectors closed. For example, the rationale behind closing salons, etc. CDC Quarantine Not related to the Regional Stay at home, but what’s is CDPH going to release regarding the change in quarantine recommendation from the CDC. LHDs need to know where the state is landing on this issue. 1. Are public pools allowed to be open? I think the answer is yes, provided people are social distancing and wearing masks while not in the water and no snack bars, etc since this falls under outdoor recreation. Would you agree? 2. Is it ok for critical infrastructure employees (e.g., transportation, water districts) to travel to work for night shifts? I think the answer is yes. 3. Is golf allowed? I think the answer is yes, with the same qualifications as with pools and no mixing households on carts. 4. Are drive thru events (holiday lights, etc) allowed under the order? I think no because the intent is for people to stay at home, but I am not sure. 5. Can college teams stay in local hotels? I know that college sports can still occur, so I am assuming that they can stay in local hotels?? But this is confusing because of travel ban, stay at home, etc. 6. Do we have any details on specifics of the travel ban? 7. The Order is confusing on hotels. It says under Section 3 that no hotel or lodging entity shall accept or honor out of state….but Section 2(h) says that nothing in this Order prevents any number of persons from the same household from leaving their residence, lodging or temporary accommodation as long as they do not engage in any interaction with any number of persons from any other household. So, hotels are interpreting this to mean that they can allow people from within CA to stay at their hotels – but I don’t think this was the intent of the Order?? 8. Can on campus housing at colleges and universities remain open? Classes are virtual, but can student housing still be open? 9. Lodging for reservists allowed? We have a large, reserve military base (March Air Reserve Base) and they frequently have their reservists come in for work or drills and they stay in hotels in the surrounding area. I assume this is allowed because they would be considered critical infrastructure/essential personnel. Would you agree? 10. For City Council/Board of Supervisor meetings – is it ok to have the meeting in person as long as the public is not allowed in? Or does the entire meeting have to be virtual? Or can meetings occur with the public being allowed to attend/speak as long as they are socially distanced, etc? 11. Is ICU capacity including surge beds? I think the answer is no, only licensed beds, but want to confirm. 12. Is CDPH planning on posting the new regional numbers at a particular time each day? Pasadena: Is outdoor fitness included as outdoor recreation (do fitness facilities have to close outdoor operation)? Pasadena: Any clarification on the ICU capacity metrics per region? Is the state going to send us calculations? Or do we just look at the web site (and why are the numbers different from what we heard on the call yesterday morning)? Berkeley: In terms of collegiate sports, will teams be able to travel for games outside of the state? If so, are they exempted from the quarantine recommendations? Berkeley: What about visiting teams? Are CA teams allowed to host teams from out of state and are there any restrictions on these teams beyond the guidance already provided in the Institutions of Higher Education Industry Guidance? Mariposa:There is a mismatch between the State Health Officer’s Order and the FAQs on the website with the website being more restrictive. The intent was as indicated in the FAQs, that lodging should be available only for critical infrastructure. That said, section 2.b. of the order indicates that all individuals within the region shall stay home. The gap I see now is that it would be permitted under the order to travel to an area that was under a Regional Stay At Home order from an area that was not under a Regional Stay at Home Order and use lodging in that region. My concern is that given this gap in the order that our lodging industry will push back on this. Lassen: What data sources is the state using for ICU capacity. Are they looking at adult ICU hospitalizations? Are they going to run the data on a day by day basis until we hit the 15% threshold or is it a multiday average? Ventura: Will the daily assessment of ICU % capacity assessment be done daily but only once and in the morning, including the weekend? If so, when a regions falls under 15%, will the county’s sectors affected have 24 hours starting from what time to change their operations? Will retailers for example have to close by 1pm the next day, or could (should) the affected sectors have till end of the day the next day after the daily morning assessment? That of course would be much better than having operations and workers be affected in the middle of a day. The other Qs I am getting, as of now, have to do with: 1) folks living in camp grounds: will they be affected (we hope not)?; 2) is Governor’s office and CDPH open to alterative options for regions: I think LA should be it’s own and as Penny has mentioned, and Van and I have discussed: Ventura, SB and SLO can be its own region and we might want to pursue advocating for that; and finally, and finally 3) a few related to ICU bed % capacity: when and how will we know of the projected regional %’s so as to anticipate when we will fall under the 15%, so that later after 3 weeks we know the projection to be back up to over 15%; and while capacity calculation is based on staffed and available adult and peds ICU beds, there’s also licensed and surge beds that can be staffed and available for ICU: just that it does not make sense cost and staffing wise to do to that for all those beds. But, they could be staffed fairly soon and thus increase the capacity, and thus improve the county and regional %. San Diego: 1. Are drive-in movies / concerts still permissible if a County / Region is under the Regional Stay At Home Order? 2. Are IHEs impacted by the RSTAHO? 3. If IHEs are impacted by RSTAHO, are they permitted to conduct outdoor in-person classes / lectures? Siskiyou: The order did not address Personal Services/Limited Service as our call with Dr Pan did yesterday morning. Has that been taken off the table?