OC Health Officer's Orders & Recommendations

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OC Health Care Agency Logo

CLAYTON CHAU, MD PhD
DIRECTOR/COUNTY HEALTH OFFICER

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

COUNTY OF ORANGE HEALTH OFFICER'S ORDERS AND STRONG RECOMMENDATIONS

(Revised November 20, 2020)

In light of the revised Guidance for the Use of Face Coverings, issued by the State Public Health Officer on November 16, 2020, the assignment of Orange County to Tier 1 (Purple) of California’s Blueprint for a Safer Economy on November 17, 2020, and issuance of the Limited Stay At Home by the State Public Health Officer, effective November 21, 2020 at 10:00 pm PST, 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 8, 2020. The Orders and Strong Recommendations issued on September 8, 2020 are no longer in effect as of November 20, 2020.

Pursuant to California Health and Safety Code sections 101030, 101040, 101470, 120175, and 120130, the County of Orange’s Health Officer orders and strongly recommends the following:

ORDERS

Effective immediately, and continuing until further notice, the following shall be in effect in unincorporated and incorporated territories of Orange County, California:

  1. Business and Activities: Who May and May Not Open. Only those businesses and activities allowed to open under the tier assigned to Orange County may open, provided that such businesses and activities comply with all applicable restrictions for that tier. As of November 17, 2020, Orange County is assigned to the Tier 1 (Purple). See the following link for the list business and activities that may open under each tier and the restrictions that apply to each tier: https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID-19/Dimmer-Framework-September_2020.pdf.
  2. Business and Activities: Comply with Applicable Industry Guidance. In addition, all businesses and activities allowed to open under order #1, above, shall operate in accordance with their applicable industry guidance. See the following link for a list of the industry guidance: https://covid19.ca.gov/industry-guidance/.
  3. Business and Activities: Comply with Certain Criteria Before Re-Opening. In addition, all businesses and activities that are allowed to open under #1, above, must post a separate document at a location visible to the public at the public entrance of the property that specifically includes a signed and dated attestation by the business or activity owner and/or operator that it has done all the following prior to reopening:
     
    1. Completely reviewed the industry guidance that applies to your business or activity;
    2. Performed a detailed risk assessment and created a worksite-specific protection plan;
    3. Trained employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and when to stay home;
    4. Set up individual control measures and screenings;
    5. Put disinfection protocols in place;
    6. Established physical distancing guidelines;
    7. Established universal face covering requirements (with allowed exceptions) in accordance with CDPH guidelines at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx.
  4. Self-isolation of Persons with COVID-19. All Orange County residents and visitors 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:
     
    1. Individuals with COVID-19 symptoms shall isolate themselves until: (i) at least 24 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.
    2. Individuals who have a positive COVID-19 PCR or rapid antigen laboratory test result and are without COVID-19 symptoms shall isolate themselves for 10 days from the date when the first specimen for the positive COVID-19 laboratory test result was collected/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:
     
    1. Received a positive COVID-19 PCR or rapid antigen laboratory test result; and/or
    2. Been informed by a physician that he or she is likely to have COVID-19 and/or;
    3. 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 Health Officer for any county resident, the specific order shall be followed instead of this order # 4.   This self-isolation order DOES NOT in any way restrict access by emergency responders to an isolation site during an emergency. See the U.S. Department of Labor’s Families First Coronavirus Response Act Q&A (Question 57 available at https://www.dol.gov/agencies/whd/pandemic/ffcra-questions) for a definition of emergency responder.
  5. Self-Quarantine of Persons Exposed to COVID-19. All Orange County residents and visitors 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.

    For the purposes of this Order, “close contact” means someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more, over a 24-hour period, starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.  A person who is diagnosed with or likely to have COVID-19 is considered infectious from 48 hours before the moment his or her symptoms first appeared until that time when the person is no longer required to be isolated.  A person who is diagnosed with COVID-19 but has no symptoms is considered infectious from 48 hours prior to the date the person was tested until 10 days after that date.  

    If a more specific quarantine order is issued by the County Health Officer for any county resident, that order shall be followed instead of this order #5.  

    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 providers and emergency responders, as defined by the U.S. Department of Labor’s Families First Coronavirus Response Act Q&A (see Questions 56 and 57, respectively, available at https://www.dol.gov/agencies/whd/pandemic/ffcra-questions).
  6. Wear a Cloth Face-Covering. To help prevent the spread of droplets containing COVID-19, all County residents and visitors shall wear face coverings when outside of the home (with certain individuals exempted), as required by the Guidance for the Use of Face Coverings issued by California Department of Public Health (CDPH) on November 16, 2020. The Guidance is attached as Exhibit A and also available at: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx.

     Please refer to this link or Exhibit A for a list of individuals who are exempt from wearing a face covering.  
  7. Limited Stay at Home Order. To help prevent the spread of COVID-19 virus, all County residents and visitors shall comply with the Limited Stay At Home Order, issued by CDPH and effective November 21, 2020 10:00 pm PST. The Limited Stay At Home Order is attached as Exhibit B and also available at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/limited-stay-at-home-order.aspx.
  8. Seasonal Flu Vaccination for Certain County Residents and Visitors. All County residents and visitors who fall under one of the following categories shall obtain the seasonal flu vaccination unless a medical or religious exemption applies: (i) current providers for congregate settings; (ii) current health care providers; and (iii) current emergency responders. See the U.S. Department of Labor’s Families First Coronavirus Response Act Q&A (Questions 56 and 57, respectively, available at https://www.dol.gov/agencies/whd/pandemic/ffcra-questions) for definitions of health care provider and emergency responder. However, 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.

STRONG RECOMMENDATIONS

Effective immediately, and continuing until further notice, the following shall be in effect in unincorporated and incorporated territories in Orange County, California:

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

GENERAL PROVISIONS

  1. 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 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 declared a Local Health Emergency based on an imminent and proximate threat to public health from the introduction of a novel coronavirus disease (COVID-19) in Orange County.
  2. On February 26, 2020, the Chairwoman of the Board of Supervisors, acting as the Chair of Emergency Management Council, proclaimed a Local Emergency in that the imminent and proximate threat to public health from the introduction of COVID-19 created conditions of extreme peril to the safety of persons and property within the territorial limits of Orange County.
  3. On March 2, 2020, the Orange County Board of Supervisors adopted Resolutions No. 20-011 and No. 20-012 ratifying the Local Health Emergency and Local Emergency, referenced above.
  4. On March 4, 2020, the Governor of the State of California declared a State of Emergency to exist in California as a result of the threat of COVID-19.
  5. There is currently no vaccine available to the public 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 breathes, signs, or talks; (3) respiratory droplets cause infection when they are inhaled or deposited on mucous membranes, such as those that line the inside of the nose and mouth; (4) people who are infected but do not have symptoms can also spread the virus to others. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.
  6. According to the CDC everyone should (1) wash their hands often; (2) avoid close contact; (3) cover their mouth and nose with a make when around others; (4) cover coughs and sneezes; (5) clean and disinfect; and (6) monitor their health daily. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html for more detailed information and recommendations for how to accomplish the above listed items.
  7. The CDC recommends that people wear masks in public settings, like on public and mass transportation, at events and gatherings, and anywhere they will be around other people. See https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html.
  8. The CDPH also issued a Guidance for the Use of Face Coverings on November 16, 2020, available at: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx. The Guidance requires people in California to wear face coverings at all times when outside of the home, and provides a number of exemptions, as well as providing a description of what is a face covering.
  9. According to the CDC and CDPH, older adults and individuals with medical conditions are at higher risk of severe illness from See https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html; see also https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/PublicHealthGuidanceSelfIsolationforOlderAdultsandThoseWhoHaveElevatedRisk.aspx.
  10. The orders and the strong recommendations contained herein are based on the fact that there is currently no vaccine to protect against COVID-19, and limited approved therapeutic treatment for it; scientific evidence regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically, as well as best practices as currently known and available to protect the older adults (65 years older and older), people who live in a nursing home or long-term care facility, and people of any age who have serious underlying medical conditions from avoidable risk of serious illness or death resulting from exposure to COVID-19.
  11. There remains a strong likelihood of a significant and increasing number of cases of community transmission; some individuals who contract the novel coronavirus have no symptoms or have only mild symptoms, and so are unaware that they carry virus and are transmitting it to others; evidence shows that the novel coronavirus can survive for hours or even days on surfaces and can be indirectly transmitted between individuals.
  12. The age, condition, and health of a significant portion of Orange County population place them at risk for serious health complications, including hospitalization and death, from COVID-19. Younger and otherwise healthy people are also at risk for serious negative health outcomes and for transmitting the novel coronavirus to others. As of November 20, 2020, the cumulative COVID-19 case count to date in Orange County is 67,167, including 1,537 COVID-19 related deaths.
  13. The orders and strong recommendations contained in this document are necessary and lest restrictive 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 save the lives of Orange County residents.
  14. The California Health and Safety Code section 120175 requires the County of Orange Health Officer knowing or having reason to believe that any case of a communicable disease exists or has recently existed within the County to take measures as may be necessary to prevent the spread of the disease or occurrence of additional cases.
  15. The California Health and Safety Code 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 with 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.
  16. 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.
  17. 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: November 20, 2020

Order Bottom

Clayton Chau, MD, PhD
County Health Officer
County of Orange


 

Orange County's Health Officer November 20, 2020
Revised Orders and Strong Recommendations

Frequently Asked Questions

On November 20, 2020, the Orange County’s Health Officer, Dr. Clayton Chau, issued certain orders and strong recommendations (hereinafter “Revised Order”) that apply to all of Orange County (both incorporated and unincorporated) areas. Under the Revised Order only those businesses and activities allowed to open under the new State tier system may open, provided they comply with all applicable restrictions for that tier. As of November 17, 2020, Orange County is assigned to the Tier 1 (Purple).

The Revised Order changes the previous face covering order to requiring that, with certain exceptions, all County residents and visitors when outside their home must wear face covering at all times. Because Orange Count is now assigned to Tier 1 (Purple), the Revised Order mandates that all County residents to comply with the CDPH’s Limited Stay At Home Order.

As before, the Revised Order continues to mandate appropriate self-quarantining and isolation related to a COVID-19 diagnosis or potential exposure; that certain actions that business and sector owners/operators to take prior to re-opening; and, that all county residents and visitors who are providers for congregate settings, health care providers, or emergency responders in Orange County to obtain the seasonal flu vaccination unless a medical or religious exemption applies. The vaccination is strongly recommended for all other County residents.

We hope the following Frequently Asked Questions (FAQ) helps provide clarification related to these events:

Q: Which businesses and activities are allowed to re-open or stay open under the Revised Order?

A: Only those businesses and activities allowed to open under the tier assigned to Orange County may open, provided that such businesses and activities comply with all applicable restrictions for that tier. As of November 20, 2020, Orange County is assigned to the Tier 1 (Purple), the most restrictive tier under the California’s Blueprint for a Safer Economy. See the following link for the list business and activities that may open under each tier and the restrictions that apply to each tier:

https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID-19/Dimmer-Framework-September_2020.pdf

Q: What else are businesses and activities that are allowed to open under the Revised Order to do?

A: All businesses and activities allowed to open under the Revised Order must operate in accordance with their applicable industry guidance. See the following link for a list of the industry guidance: https://covid19.ca.gov/industry-guidance/. For public and HOA swimming pool industry-specific checklist posting requirements, please visit https://www.ochealthinfo.com/eh/water/pool.

In addition, they must post a separate document at a location visible to the public at the public entrance of the property that specifically includes a signed and dated attestation by the business or activity owner and/or operator that it has done all the following prior to reopening:

  1. Completely reviewed the industry guidance that applies to your business or activity;
  2. Performed a detailed risk assessment and created a worksite-specific protection plan;
  3. Trained employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and when to stay home;
  4. Set up individual control measures and screenings;
  5. Put disinfection protocols in place;
  6. Established physical distancing guidelines;
  7. Established universal face covering requirements (with allowed exceptions) in accordance with CDPH guidelines at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx.

Q: Who MUST to obtain the seasonal flu vaccination?

A: All county residents and visitors who are providers for congregate settings, health care providers, or emergency responders in Orange County must obtain the seasonal flu vaccination unless a medical or religious exemption applies. See the U.S. Department of Labor’s Families First Coronavirus Response Act Q&A (Questions 56 and 57, respectively, available at https://www.dol.gov/agencies/whd/pandemic/ffcra-questions for definitions of health care provider and emergency responder.

However, this order does not create 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.

Q: Who should obtain the seasonable flu vaccination?

A: All County residents unless a medical or religious exemption applies.

Q: Is there a template businesses may use to attest that they have completed the check list required to re-open and can post inside their business for customers?

A: Yes, here is the template.

Q: Do I need to submit my re-opening plan or any other document to the OC Health Care Agency for approval?

A: No, businesses and sectors are not required to submit an individual re-opening plan or any other document to OC Health Care Agency for review or approval.

Q: What businesses and activities are not permitted to re-open in Orange County under the Revised Order?

A: Please go to the following website and enter Orange County in the first field and the name of the category of your sector (e.g. restaurant, museum, etc.) in the second field and see if you may open in Orange County.

https://covid19.ca.gov/safer-economy/

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: Who must wear a face covering and who is exempt from wearing a face covering?

A: All County residents and visitors must wear face covering at all times when outside of their home. There are some exceptions, however, as stated below.

Individuals are exempt from wearing face coverings in the following specific settings:

  • Persons in a car alone or solely with members of their own household.
  • Persons who are working in an office or in a room alone.
  • Persons who are actively eating or drinking provided that they are able to maintain a distance of at least six feet away from persons who are not members of the same household or residence.
  • Persons who are outdoors and maintaining at least 6 feet of social distancing from others not in their household. Such persons must have a face covering with them at all times and must put it on if they are within 6 feet of others who are not in their household.
  • Persons who are obtaining a service involving the nose or face for which temporary removal of the face covering is necessary to perform the service.
  • Workers who are required to wear respiratory protection.
  • Persons who are specifically exempted from wearing face coverings by other CDPH guidance.

The following individuals are exempt from wearing face coverings at all times:

  • Persons younger than two years old. These very young children must not wear a face covering because of the risk of suffocation.
  • Persons with a medical condition, mental health condition, or disability that prevents wearing a face covering. This includes persons with a medical condition for whom wearing a face covering could obstruct breathing or who are unconscious, incapacitated, or otherwise unable to remove a face covering without assistance. Such conditions are rare.
  • Persons who are hearing impaired, or communicating with a person who is hearing impaired, where the ability to see the mouth is essential for communication.
  • Persons for whom wearing a face covering would create a risk to the person related to their work, as determined by local, state, or federal regulators or workplace safety guidelines.

Note: Persons exempted from wearing a face covering due to a medical condition who are employed in a job involving regular contact with others must wear a non-restrictive alternative, such as a face shield with a drape on the bottom edge, as long as their condition permits it.

Please visit https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx for additional information on face covering.

Q: What is the Limited State At Home Order?

A: Because Orange County is now assigned to Tier 1 (Purple), therefore, according to the State Public Health Officer’s Order, all gatherings with members of other households and all activities conducted outside the residence, lodging, or temporary accommodation with members of other households must cease between 10:00pm PST and 5:00am PST, except for those activities associated with the operation, maintenance, or usage of critical infrastructure or required by law. This order does not apply to persons experiencing homelessness. Nothing in this order prevents any number of persons from the same household from leaving their residence, lodging, or temporary accommodation during the stated hours, 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.

For additional information please visit https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/limited-stay-at-home-order.aspx.

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 COVID-19 Hotline at (714) 834-2000 or email ETeam@ochca.com. Community members with questions or concerns about businesses operating in non-compliance may contact their local law enforcement’s non-emergency line.


Click to read general COVID-19 FAQs