|COUNTY HEALTH OFFICER
CLAYTON CHAU M.D., PhD
NICHOLE QUICK, MD, MPH
405 W. 5TH STREET, 7TH FLOOR
SANTA ANA, CA 92701
PHONE: (714) 834-3155
FAX: (714) 834-5506
AMENDED ORDERS AND STRONG RECOMMENDATIONS
OF THE COUNTY OF ORANGE HEALTH OFFICER
[REVISED May 28, 2020]
In light of recently-issued statewide industry guidance by the California Department of Public Health and Cal-OSHA regarding places of worship and hair salons, these AMENDED ORDERS AND STRONG RECOMMENDATIONS revise the prior ORDERS AND STRONG RECOMMENDATIONS, issued by the Orange County Health Officer on May 22, 2020. The May 22, 2020 Orders and Strong Recommendations are no longer in effect as of the effective date and time of these AMENDED ORDERS AND STRONG RECOMMENDATIONS.
Pursuant to California Health and Safety Code sections 101040, 120175, and 120130, the County of Orange Health Officer ORDERS AND STRONGLY RECOMMENDS as follows:
Effective 12:00 a.m. on Friday, May 29, 2020, and continuing until further notice, the following shall be in effect in unincorporated and incorporated territories of Orange County, California:
- Self-isolation of Persons with COVID-19. All county residents who have been diagnosed with or are likely to have COVID-19, as defined below, shall immediately isolate themselves in their home or another residence under the following criteria, as applicable:
a) Individuals with COVID-19 symptoms shall isolate themselves until: (i) at least 3 days (72 hours) after they have recovered, meaning their fever has resolved without use of fever-reducing medications and their respiratory symptoms (e.g., cough, shortness of breath) have improved; AND (ii) at least 10 days has elapsed from when their symptoms first appeared.
b) Individuals who have a positive COVID-19 PCR laboratory test result and are without COVID-19 symptoms shall isolate themselves for 10 days from the date when the specimen for the positive COVID-19 PRC laboratory test result was obtained.
Unless one of the criteria, above, applies, i.e. 1.a) or 1.b), the individual may not leave his or her place of isolation except to receive necessary medical care.
A person is considered to be diagnosed with or likely to have COVID-19, if the person has:a) Received a positive COVID-19 PCR laboratory test result; and/or
b) Been informed by a physician that he or she is likely to have COVID-19 and/or;
c) Signs and symptoms that are consistent with COVID-19 (i.e., new onset of fever, cough, shortness of breath or trouble breathing).
If a more specific isolation order is issued by the County of Orange Health Officer for any county resident, that order shall be followed instead of this order.
This self-isolation order DOES NOT in any way restrict access by first responders to an isolation site during an emergency.
- Self-Quarantine of Persons Exposed to COVID-19. All county residents who know that they have been in close contact, as defined below, with a person diagnosed with or likely to have COVID-19 shall take the following actions:
a) Quarantine themselves in their home or another residence until 14 days from the last date that they were in close contact with a person that has been diagnosed with or likely to have COVID-19.
Exposed persons shall self-quarantine themselves for the entire 14-day COVID-19 incubation period, the typical time between exposure and when symptoms and signs of the disease may develop. They may not leave their place of quarantine except to receive necessary medical care or to obtain such other goods or services necessary for their basic subsistence.
Close contact refers to any person who has been within 6 feet of an infectious COVID-19 person for 15 minutes or more. A person who is diagnosed with or likely to have COVID-19 is considered infectious from 48 hours before his or her symptoms first appeared until the person is no longer required to be isolated.
If a more specific quarantine order is issued by the County of Orange Health Officer for any county resident, that order shall be followed instead of this order.
This self-quarantine order DOES NOT in any way restrict access by first responders to a quarantine site during an emergency.
This self-quarantine SHALL NOT APPLY to health care professionals and law enforcement personnel.
All businesses, industries, and entities listed on the State's website at https://covid19.ca.gov/industry-guidance/ and at https://covid19.ca.gov/roadmap-counties/ that reopen in Orange County as part of Stage 2 of the State's Resilience Roadmap shall post their corresponding industry-specific checklist at a location visible to the public at the public entrance of each property.
In addition to the foregoing industry-specific checklist, all businesses, industries, and entities shall post a document at a location visible to the public at the public entrance of each property that specifically includes an attestation by the business, industry, or entity owner and/or operator that it has:a) Performed a detailed risk assessment and implemented a site-specific protection plan;
b) Trained employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and stay home if they have them;
c) Implemented individual control measures and screenings;
d) Implemented disinfecting protocols; and
e) Implemented physical distancing guidelines.
- Cloth Face-Covering. All Orange County residents and visitors shall wear a cloth face-covering outside their home when they are not able to maintain at least 6 feet of physical distance from another person who is not a family/household member or does not reside in the same living unit.
A cloth face-covering is a device or accessory that covers the nose and mouth. It can be secured to the head with ties or straps or simply wrapped around the lower face. Cloth face-coverings can be made from a variety of materials, such as cotton, silk, or linen, and can be factory-made, sewn by hand, or improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.
The cloth face-covering order SHALL NOT APPLY to the following persons:a) Children under the age of 2;
b) Anyone who has trouble breathing, or who is unconscious, incapacitated or otherwise unable to remove the cloth face-covering without assistance; or
c) Persons with a medical or mental health condition or development disability that prevents wearing a cloth face-covering.
Effective 12:00 a.m. on Wednesday, May 27, 2020, and continuing until further notice, the following shall be in effect in unincorporated and incorporated territories in Orange County, California:
- All Orange County residents and visitors should maintain at least 6 feet of physical distance from another person who is not a family/household member or live in the same living unit, when (i) in a public place; (ii) visiting a retail, commercial or other place of business; or (iii) at work.
- All Orange County residents who are 65 years old or older; have serious underlying medical conditions (for example, chronic lung disease, moderate to severe asthma, serious heart conditions, severe obesity, diabetes, chronic kidney disease undergoing dialysis, liver disease); or have a compromised immune system should remain at home consistent with guidance provided by the California Department of Public Health (CDPH) available at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/PublicHealthGuidanceSelfIsolationforOlderAdultsandThoseWhoHaveElevatedRisk.aspx.
- All Orange County residents should avoid contact with people who are sick; not gather in groups; stay out of crowded places; avoid mass gatherings; wash hands frequently; wash face coverings frequently; cover coughs and sneezes; and clean and disinfect frequently touched surfaces daily, including tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
- This Order and Strong Recommendations shall not supersede any conflicting or more restrictive orders issued by the State of California or federal government. If any portion of this Order and Strong Recommendations or the application thereof to any person or circumstance is held to be invalid the remainder of the Order and Strong Recommendations, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect. To this end, the provisions of this Order and Strong Recommendations are severable.
- The orders contained in the Orders section may be enforced by the Orange County Sheriff or Chiefs of Police pursuant to California Health and Safety Code section 101029, and California Government Code sections 26602 and 41601. Any violation of these orders are subject to fine, imprisonment, or both (California Health and Safety Code section 120295).
REASONS FOR THE ORDER AND STRONG RECOMMENDATIONS
- On February 26, 2020, the County of Orange Health Officer declared a Local Health Emergency based on an imminent and proximate threat to public health from the introduction of a novel coronavirus disease (COVID-19) in Orange County.
- On February 26, 2020, the Chairwoman of the Board of Supervisors, acting as the Chair of Emergency Management Council, proclaimed a Local Emergency in that the imminent and proximate threat to public health from the introduction of COVID-19 created conditions of extreme peril to the safety of persons and property within the territorial limits of Orange County.
- On March 2, 2020, the Orange County Board of Supervisors adopted Resolutions No. 20-011 and No. 20-012 ratifying the Local Health Emergency and Local Emergency, referenced above.
- On March 4, 2020, the Governor of the State of California declared a State of Emergency to exist in California as a result of the threat of COVID-19.
- There is currently no vaccine to prevent COVID-19. According to the Centers for Disease Control and Prevention (CDC), the best way to prevent COVID-19 is to avoid being exposed to the novel corona virus. According to the CDC, the novel corona virus is thought to spread mainly from person-to-person due to the following: (1) between people who are in close contact with one another (within about 6 feet); (2) through respiratory droplets produced when an infected person coughs, sneezes or talks; (3) these droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs; (4) some recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.
- According to the CDC everyone should (1) wash their hands often with soap and water for at least 20 seconds (or use hand sanitizer that contains at least 60% alcohol when soap and water is not readily available) especially after having been in contact in a public place, or after blowing their nose, coughing, or sneezing; (2) avoid contact with people who are sick, stay at least 6 feet from other people, not gather in groups, stay out of crowded places, and avoid mass gatherings; (3) cover their mouth and nose with a cloth face cover when around others when they are out in public; (4) cover coughs and sneezes; and (5) clean and disinfect frequently touched surfaces daily, including tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.
- The CDC recommends that everyone wear cloth face coverings when leaving their homes, regardless of whether they have fever or symptoms of COVID-19. This is because of evidence that people with COVID-19 can spread the disease, even when they don't have any symptoms. Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated, or otherwise unable to remove the mask without assistance. See https://www.cdc.gov/coronavirus/2019-ncov/downloads/cloth-face-coverings-information.pdf.
- The CDPH also issued a Face Coverings Guidance on April 1, 2020, available at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Face-Coverings-Guidance.aspx. The Guidance provides that a face covering is a material that covers the nose and mouth; it can be secured to the head with ties or straps or simply wrapped around the lower face; it can be made of a variety of materials, such as cotton, silk, or linen; and a face covering may be factory-made or sewn by hand, or can be improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.
- According to the CDC, COVID-19 is a new disease and there is limited information regarding risk factors for severe disease. Based on currently available information and clinical expertise, older adults (65 years older and older), people who live in a nursing home or long-term care facility, and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. See https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html. According to the CDC, this at higher risk population should stay home (if possible) and practice social distancing of at least 6 feet both in and outside the home. See https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-What-You-Can-Do-High-Risk.pdf. See also https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/PublicHealthGuidanceSelfIsolationforOlderAdultsandThoseWhoHaveElevatedRisk.aspx.
- The orders and the strong recommendations contained herein are based on the fact that there is currently no vaccine to protect against COVID-19, and no proven therapeutic treatment for it; scientific evidence regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically, as well as best practices as currently known and available to protect the older adults (65 years older and older), people who live in a nursing home or long-term care facility, and people of any age who have serious underlying medical conditions from avoidable risk of serious illness or death resulting from exposure to COVID-19.
- As of May 27, 2020, there are 5,744 reported COVID-19 cases and 142 COVID-19 related deaths in Orange County (see https://occovid19.ochealthinfo.com/coronavirus-in-oc); as of May 27, 2020, there are 101,697 reported COVID-19 cases and 3,973 COVID-19 related deaths in State of California (see https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx#COVID-19%20by%20the%20Numbers); there remains a strong likelihood of a significant and increasing number of cases of community transmission; some individuals who contract the novel coronavirus have no symptoms or have only mild symptoms, and so are unaware that they carry virus and are transmitting it to others; evidence shows that the novel coronavirus can survive for hours or even days on surfaces and can be indirectly transmitted between individuals.
- The age, condition, and health of a significant portion of Orange County population place them at risk for serious health complications, including hospitalization and death, from COVID-19. Younger and otherwise healthy people are also at risk for serious negative health outcomes and for transmitting the novel coronavirus to others.
- The orders and strong recommendations contained herein are necessary preventive measures to control and reduce the spread of COVID-19 in Orange County, help preserve critical and limited healthcare capacity in Orange County, and thereby save the lives of Orange County residents.
- The California Health and Safety Code section 120175 requires the County of Orange Health Officer knowing or having reason to believe that any case of a communicable disease exists or has recently existed within the County to take measures as may be necessary to prevent the spread of the disease or occurrence of additional cases.
- The California Health and Safety Code section 101040 authorizes the County of Orange Health Officer to take any preventive measure that may be necessary to protect and preserve the public health from any public health hazard during any “state of war emergency,” “state of emergency,” or “local emergency,” as defined by Section 8558 of the Government Code, within his or her jurisdiction. “Preventive measure” means abatement, correction, removal or any other protective step that may be taken against any public health hazard that is caused by a disaster and affects the public health.
- The California Health and Safety Code section 120130 (d) authorizes the County Health Officer to require strict or modified isolation, or quarantine, for any case of contagious, infectious, or communicable disease, when such action is necessary for the protection of the public health.
County Health Officer's May 28, 2020 Amended Orders and Strong Recommendations
Orange County, California Stage 2 Re-Opening
Frequently Asked Questions
On Saturday, May 23, 2020, the County of Orange received approval by the State of California to move Orange County (OC) along the Governor's "Resiliency Roadmap" further into Stage 2. The County Health Officer also issued an County Health Officer Order (effective May 23, 2020) that applies to all of OC (both incorporated and unincorporated areas), which includes both orders and certain recommendations to help slow the spread of COVID-19 as more businesses start to re-open.
On Thursday, May 28, 2020 in light of recently-issued industry guidance by the California Department of Public Health and Cal-OSHA regarding places of worship and hair salons, the County Health Officer issued Amended Orders and Strong Recommendations that revise the May 23 orders and recommendations and are designed to help slow the spread of COVID-19 in Orange County as more businesses move toward re-opening.
We hope the following Frequently Asked Questions (FAQ) helps provide clarification related to these events:
Permitted Business Re-Opening - Stage 2:
Q: What businesses or activities are permitted to re-open/resume in Stage 2?
A: Those sectors, businesses and establishments that are listed on https://covid19.ca.gov/industry-guidance/ and on https://covid19.ca.gov/roadmap-counties/ are permitted to re-open in Orange County after owners and operators post their corresponding industry-specific checklist as published on the State website and certain attestations as specified in the County Health Officer Order at the entrance, in plain view of the public. The following are a few examples of some of the sectors, businesses and establishments listed on https://covid19.ca.gov/industry-guidance/ and https://covid19.ca.gov/roadmap-counties/. For a more complete list, please refer to the State's website.
- Essential businesses
- Restaurant takeout, delivery, and dine-in
- Office-based businesses; telework remains strongly encouraged
- Outdoor museums
- Shopping malls, strip malls
- Logistics and manufacturing
- Hair salons
- Church services, funerals, cultural services, and protests can resume
Q: Where can I find the State's guidance and checklist for my business?
Q: What shall every posted checklist include?
A: The State's website publishes specific checklist for each specific sector. For instance, for retail sector the checklist can be found at https://covid19.ca.gov/pdf/checklist-retail.pdf. Please refer to https://covid19.ca.gov/industry-guidance/ and to https://covid19.ca.gov/roadmap-counties/ for additional information and to find your own sector's checklist. The checklist must also include an attestation by the owner or operator that — prior to opening to the public —the business, sector and establishment has done all of the following:
- Performed a detailed risk assessment and implement a site-specific protection plan;
- Trained employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and stay home if they have them;
- Implemented individual control measures and screenings;
- Implemented disinfecting protocols; and
- Implemented physical distancing guidelines.
Q: What businesses are not permitted to re-open open in Stage 2?
A: According to the State website, https://covid19.ca.gov/roadmap-counties/, the following sectors, businesses, establishments, or activities are not permitted to operate in the State of California at this time:
- Personal services such as nail salons, tattoo parlors, gyms and fitness studios
- Hospitality services, such as bars, wineries, tasting rooms and lounges
- Entertainment venues, such as movie theaters, gaming, gambling, arcade venues, pro sports, indoor museums, gallery spaces, and zoos
- Community centers, public pools (even in private neighborhoods), playgrounds, and picnic areas
- Concert venues
- Live audience sports
- Theme parks
- Hotels/lodging for leisure and tourism
County of Orange - Amended Health Officer's Orders:
Q: What do the amended Orders say?
A: Community members are encouraged to read the Orders and Strong Recommendations in their entirety here as well as the OC Health Care Agency's press release here. The Order contains specific legal requirements that all OC residents and visitors must follow related to cloth face-coverings, appropriate self-quarantining and isolation related to a COVID-19 diagnosis or potential exposure, and actions that business, industry and other entity owners must take prior to re-opening under Stage 2.
Q: What is a cloth face covering?
A: A cloth face-covering is a material that covers the nose and mouth; it can be secured to the head with ties or straps or simply wrapped around the lower face; it can be made of a variety of materials, such as cotton, silk, or linen; and a face covering may be factory-made or sewn by hand, or can be improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.
Q: I'm a resident or visitor to Orange County. Where do I have to wear a face covering?
A: The cloth face-covering must be worn anytime you are out of your home and if you come within 6 feet of another person who does not live in your household/residence. This includes in public places, places of business, social events, places of worship, museums, etc. The following are a few specific examples:
- Waiting in line to go inside a store
- Shopping in a store
- Picking up food at a restaurant
- Waiting for or riding on public transportation
- Riding in a taxi or other ride service vehicle
- Seeking health care
- Going into facilities that are allowed to stay open
- While at work
- When at the beach or an outdoor museum
Q: Who is not required to wear a face covering and where am I not required to wear a face covering?
A: The face covering component of the Order does not apply to children under the age of 2; anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cloth face covering without assistance; as well as individuals with a medical condition, mental health condition or developmental disability that prevents it.
In general, as long as you maintain a 6 feet of physical distance from others (excluding your household members), you are not required to wear a face covering. That means, you are not required to wear a face covering when:
- At home
- In the car alone or with members of the household
- When walking, hiking, bicycling or running alone or with household members
Q: Why is the OC Health Care Agency requiring face coverings?
A: Many people who test positive for COVID-19 have no symptoms and could be spreading the virus to others without knowing it. A face covering blocks droplets when a person coughs, sneezes, sings or breathes. Countries that advised or require their citizens to wear face coverings in public have been shown to be more successful in their response to the COVID-19 pandemic. When compliance is high, spreading of the virus slows.
Q: What if I have questions about the self-quarantine or self-isolation components of the County Health Officer's Order?
A: Please call the OC Health Care Agency's Health Referral Line toll free at 1(800) 564-8448 or TTD (phone for the hearing impaired) at 1(800) 801-7100.