OC Health Officer's Orders & Recommendations

For the PDF English version, click here.
For translation, please click on the black "Translate" button on the top right to translate the same order displayed below.

OC Health Care Agency Logo

 

CLAYTON CHAU, MD, PhD, MASL
AGENCY DIRECTOR

REGINA CHINSIO-KWONG, DO
COUNTY HEALTH OFFICER
CHIEF OF PUBLIC HEALTH SERVICES

MATTHEW ZAHN, MD
DEPUTY COUNTY HEALTH OFFICER, PUBLIC HEALTH SERVICES/
MEDICAL DIRECTOR CDCD

405 W. 5TH STREET, 7TH FLOOR
SANTA ANA, CA  92701
www.ochealthinfo.com

COUNTY HEALTH OFFICER

COUNTY OF ORANGE HEALTH OFFICER'S
STRONG RECOMMENDATIONS AND ORDERS
(Revised March 24, 2023)

In light of the recent COVID-19 related guidance and orders by the California Department of Public Health (CDPH) and the State Public Health Officer, the following Orders and Strong Recommendations shall revise and replace the prior Orders and Strong Recommendations of the County Health Officer that were issued on September 23, 2022. The Orders and Strong Recommendations issued on September 23, 2022, are no longer in effect as of March 24, 2023.

Pursuant to California Health and Safety Code sections 101030, 101470, 120175, and 120130, the County Health Officer for the County of Orange orders and strongly recommends the following:

ORDERS

  1. Seasonal Flu Vaccination

    All Orange County residents and persons who work in Orange County, and who fall under one of the following categories, shall obtain the seasonal flu vaccination unless a medical or religious exemption applies:

    (i) Providers for congregate settings;
    (ii) Health care providers;
    (iii) Emergency responders.

    Nothing herein shall be construed as an obligation, on the part of employers, public or private, to require employees obtain the seasonal flu vaccination as a term or condition of employment.

    • Health care provider shall mean physicians; psychiatrists; nurses; nurse practitioners; nurse assistants; medical technicians; any other person who is employed to provide diagnostic services, preventive services, treatment services or other services that are integrated with and necessary to the provision of patient care and, if not provided, would adversely impact patient care; and employees who directly assist or are supervised by a direct provider of diagnostic, preventive, treatment, or other patient care services; and employees who do not provide direct heath care services to a patient but are otherwise integrated into and necessary to the provision those services – for example, a laboratory technician who processes medical test results to aid in the diagnosis and treatment of a health condition. A person is not a health care provider merely because his or her employer provides health care services or because he or she provides a service that affects the provision of health care services. For example, IT professionals, building maintenance staff, human resources personnel, cooks, food services workers, records managers, consultants, and billers are not health care providers, even if they work at a hospital of a similar health care facility.
    • Emergency responder shall mean military or national guard; law enforcement officers; correctional institution personnel; fire fighters; emergency medical services personnel; physicians; nurses; public health personnel; emergency medical technicians; paramedics; emergency management personnel; 911 operators; child welfare workers and service providers; public works personnel; and persons with skills or training in operating specialized equipment or other skills needed to provide aid in a declared emergency; as well as individuals who work for such facilities employing these individuals and whose work is necessary to maintain the operation of the facility.
  2. Face Mask Use During Times of COVID-19 Outbreaks

    3. All employers in Orange County that are subject to Cal/OSHA Standards shall follow applicable Cal/OSHA requirements during COVID-19 Outbreaks.

    Further details about Cal/OSHA COVID-19 Prevention Non-Emergency Regulation Standards can be found at: https://www.dir.ca.gov/dosh/coronavirus/Non_Emergency_Regulations/

STRONG RECOMMENDATIONS

  1. Self-Isolation for Persons with COVID-19
    • If you start having COVID-19 symptoms (Day 0) or test positive (Day 0), you should isolate in your home or another suitable place for at least 5 days.
      • You may end isolation after day 5, if:
        • You are fever-free for at least 24 hours without taking fever reducing treatments, AND
        • Your symptoms are not present, or mild and improving.
      • If fever is present, you should continue to isolate until 24 hours after fever resolves.
      • If symptoms, other than fever, are not improving, you should continue to isolate through Day 10 or until symptoms are improving.
      • If you have severe symptoms or are at high risk of serious disease or have questions concerning care, you should contact a health care provider for available treatments.
      • Per CDPH masking guidance, infected persons should wear a well-fitting mask around others for a total of 10 days, especially in indoor settings.
      • After you have ended isolation, if your symptoms recur or worsen, you should test again; if you test positive, you should isolate as stated above.
      • For additional details on COVID-19 isolation recommendations see:
  2. Guidance for Persons Exposed to COVID-19
    • If you have been exposed to COVID-19 (regardless of vaccination status, prior disease, or occupation), you should:
      • Test within 3-5 days after last exposure;
      • Per CDPH masking guidance, you should wear a well-fitting mask around others for a total of 10 days, especially in indoor settings and when near those at higher risk for severe COVID-10 disease;
      • You should consider obtaining COVID-19 vaccination, if you have not already been vaccinated;
      • If you develop symptoms, get tested, and stay home per Section I, above; AND
      • If your test results are positive for COVID-19, you should follow the isolation recommendations stated in Section I, above.
      • For additional information see: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Guidance-on-Isolation-and-Quarantine-for-COVID-19-Contact-Tracing.aspx
  3. Face Mask Guidance

    4. To help prevent the spread of droplets containing COVID-19, all county residents and visitors should refer to the CDPH’s Guidance for the Use of Face Masks. The Guidance will be updated on April 3, 2023, utilizing personal risk, local COVID-19 transmission, and the Centers for Disease Control & Prevention (CDC) COVID-19 Community levels to guide the use of face masks. The Guidance, effective April 3, 2023 provides recommendations which apply to the following groups:

    • General public
    • Individuals who are vulnerable to severe COVID-19 disease
    • Staff, residents, or patients in high-risk settings including:
      • Health Care Settings
      • Long Term Care Settings
      • Adult and Senior Care Facilities
      • Homeless shelters, Emergency shelters and cooling and heating centers
      • State and local correctional facilities and detention centers
    • The CDPH’s Guidance for the Use of Face Masks is attached herein as Attachment "A" and can be found at:
      https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx

    Face Mask Use and Skilled Nursing Facilities

    To further protect the most vulnerable at Skilled Nursing Facilities (SNF), all staff, residents, and visitors of a skilled nursing facility should adhere to the CDPH Guidance for use of Face Masks. Universal use of face masks is strongly recommended in these settings when two or more cases of COVID-19 are identified in residents within a seven-day period in that facility. Universal use of face masks is strongly recommended until seven days after the last case is identified. This is exclusive of residents who are COVID-19 positive on admission or identified with infection within 72 hours of admission. 
  4. COVID-19 Vaccination
  5. Seasonal Flu Vaccination for County Residents

All county residents who are six months of age or older are strongly recommended to obtain the seasonal flu vaccination unless a medical or religious exemption applies.

GENERAL PROVISIONS

  1. The Orders and Strong Recommendations, above, shall not supersede any conflicting or more restrictive orders issued by the State of California or federal government. If any portion of this document or the application thereof to any person or circumstance is held to be invalid, the remainder of the document, 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 the Orders and Strong Recommendations, above, are severable.
  2. The Orders contained in this document 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. A violation of a health order is subject to fine, imprisonment, or both (California Health and Safety Code section 120295).

REASONS FOR THE ORDERS AND STRONG RECOMMENDATIONS

  1. On February 26, 2020, the County of Orange Health Officer and the Chairwoman of the Board of Supervisors declared a Local Health Emergency and Local Emergency, respectively, based on an imminent and proximate threat to public health from the introduction of COVID-19 in Orange County. On March 2, 2020, the Orange County Board of Supervisors ratified both declarations.
  2. 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.
  3. With the burden of COVID-19 disease abating and a large proportion of the population vaccinated, the Governor of the State of California terminated the state’s COVID-19 State of Emergency on February 28, 2023. The Orange County Board of Supervisors also terminated the Local Health Emergency and Local Emergency on February 28, 2023.
  4. The Orders and the Strong Recommendations contained in this document are based on the following facts: (i) As of March 22, 2023, the County has reported a total of 715,259 recorded confirmed COVID-19 cases and 8,009 COVID-19 related deaths; (ii) Safe and effective Food and Drug Administration authorized COVID-19 vaccines have been widely available, but certain populations have been slow to getting vaccinated or boosted; (iii) the current consensus among public health officials for avoiding severe illness caused by COVID-19 is for persons to complete a COVID-19 vaccination series and receive an updated (bivalent) booster if eligible, wear a well-fitted face mask in indoor settings when around others outside of their household, practice distancing, and frequently wash hands; (iv) some individuals who contract COVID-19 have no symptoms or have only mild symptoms and so are unaware that they carry the virus and are transmitting it to others; (v) current evidence shows that the novel coronavirus can survive on surfaces and can be indirectly transmitted between individuals; (vi) older adults and individuals with medical conditions are at higher risk of severe illness; (vii) sustained COVID-19 community transmission continues to occur; (viii) the age and health status of a portion of Orange County's residents place them at risk for serious health complications, including hospitalization and death, from COVID-19; (ix) younger and otherwise healthy people are also at risk for serious health outcomes and for transmitting the novel coronavirus to others.
  5. The strong recommendation for universal masking at skilled nursing facilities when two or more COVID-19 cases are identified in a facility is based on the disproportionate burden of serious disease and death caused by COVID-19 in these facilities’ residents throughout the pandemic. More than 6,500 staff infections at skilled nursing facility have occurred throughout the course of the COVID-19 pandemic. More than 8,000 COVID-19 cases leading to more than 1,500 deaths have occurred in Orange County skilled nursing facility residents. Eighteen percent of all COVID-19 county resident deaths have occurred in SNF residents.
  6. The Orders and Strong Recommendations contained in this document are necessary and the least restrictive preventive measures to control and reduce the spread of COVID-19 in Orange County, help preserve critical and limited health care capacity in Orange County and save the lives of Orange County residents.
  7. 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.
  8. The California Health and Safety Code sections 101030 and 101470 require the County Health Officer to enforce and observe in the unincorporated territory of the county and within the city boundaries located within a county all of the following: (a) Orders and ordinances of the Board of Supervisors, pertaining to the public health and sanitary matters; (b) Orders, including quarantine and other regulations, prescribed by the department; and (c) Statutes relating to public health.
  9. The California Health and Safety Code section 120130 (d) authorizes the County of Orange 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.

 

 

IT IS SO ORDERED:

Date: March 24, 2023

Order Bottom

Regina Chinsio-Kwong, DO
County Health Officer
Chief of Public Health Services
County of Orange