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Accelerating our Reopening; Statewide Stay at Home Order Still in Effect

Lake County, CA (May 18, 2020) – Recent changes to the State’s “Stay at Home” Order offered the opportunity for Lake County to assume greater local control, as we move to reopen our economy.  Over the past 10 days, I have collaborated with a broad set of local and State-level stakeholders to evaluate our preparedness.  In meetings with healthcare professionals, a cross-section of business leaders, members of all of Lake County’s local governments, school officials, and many others, I was encouraged to find numerous partners that truly understand the risks we face, and also share a commitment to moving our County forward in a responsible manner.

Today, I presented a “Local Variance” plan to the Board of Supervisors, to accelerate reopening of eligible local businesses.  I am grateful to the Board, our local hospital systems, and the Councils of the Cities of Clearlake and Lakeport, for recognizing the great community efforts that went into this proposal, and formally supporting our submitting it to State Public Health officials, for review.

Reopening of Some Lake County Businesses Expected May 21
Once our Local Variance documents are approved by the State, I will gain authority to reopen businesses that are considered “Low risk” under the Governor’s Resilience Roadmap.  Following this morning’s discussion with the Board, I have decided to move forward with a plan to reopen eligible businesses May 21, pending approval by the State.

We have already attended pre-meetings with State Public Health Officials, and it is probable our plan will be approved.  To enable local residents and businesses to prepare, I want to share key details of that plan now.  The following changes are expected to take effect Thursday, May 21:
• Childcare will no longer be restricted to children of essential workers, only, but accessible to all families, in stable groups of 10 kids or fewer, with proper precautions and disinfection.
• Outdoor dining will be permitted at restaurants (excluding gaming areas and bars), with limited seating to promote social distancing and other precautions.
• Low-risk retail establishments will be able to receive in-person customers, with a plan in place to maintain the health safety of workers and patrons.
• Some personal services will be available, including car washes, pet grooming, tanning facilities, and landscape gardening.
• Outdoor museums and open gallery spaces will be permitted to reopen, as well.
• To keep all residents safe, and particularly those most vulnerable to severe complications, face coverings (masks) will be required when entering all Lake County businesses, for workers and patrons, alike, with the following exceptions:
     o People that have medical conditions leading to difficulty breathing with masks should get a note from their medical provider, excusing them from wearing one. 
     o Children younger than two must not wear face coverings due to risk of suffocation.
     o Face coverings are not recommended for children six years or under.
     o Masks may not be appropriate for individuals who would have difficulty removing the covering without assistance.

If the Situation Remains Stable, More Reopening Will Occur 10-14 days Later
As with other steps we have taken to loosen restrictions, we will then have to monitor COVID-19 activity in Lake County’s communities for a period of 10-14 days.  If there is no significant increase in infections, and local healthcare partners remain well prepared for any potential surge in cases, we will take additional steps, likely Thursday, June 4, including:
• Indoor dining at restaurants, with appropriate disinfection, social distancing, and other precautions; and
• Reassignment of “day camp” activities and after school programs (carried out in stable groups of 10 or fewer, without changes from one group to another) to the permitted childcare activities category, facilitating much needed relatively low-risk group activities for children.

Reopening Plans are Required
Prior to reopening, all businesses must complete a reopening business plan, social distancing plan and a self-certification attestation form.  All of these are available here:
http://health.co.lake.ca.us/Coronavirus/Businesses.htm

Because business owners are the experts on their own spaces and the activities associated with their work, we expect businesses will take the most appropriate precautions to keep their employees and customers safe.  If complaints are received, local officials will take action to make conditions safer.  The goal is to keep everyone healthy, and not further burden local business owners, so education and correction of any problems that emerge will be our primary objectives.  Eventually, we would consider issuing fines, if necessary.

Statewide guidance by industry is published here:
https://covid19.ca.gov/industry-guidance/

Please also Follow the County of Lake Facebook page, https://www.facebook.com/lakecountycagov/, as a YouTube video will soon be posted, to help guide businesses on how to navigate new requirements.

If COVID-19 Activity Significantly Increases, Restrictions May Tighten Again
There was much discussion during this morning’s Board meeting regarding triggers that may cause us to pause advancement of reopening, or even add restrictions back in.  The situation will be continually evaluated, and no one factor will entirely drive our decision-making.  However the following events would suggest concern:
• Increasing confirmed cases of COVID-19, particularly if testing/containment capacity becomes strained.
• Clusters of cases, indicating community spread, and the probability further undocumented infections are present in significant numbers.
• Deaths or other severe complications in significant numbers, particularly if the health care system is unable maintain capacity to respond.

Statewide Stay at Home Order is in Effect Until Further Notice
The Statewide Stay at Home Order sets a baseline for what business-related and other activities are allowed.  All California residents are currently required to stay home, unless leaving to engage in permitted activities.

COVID-19 Remains a Significant Threat to Public Health in Lake County
As reported over the weekend, two further cases were documented in Lake County, and this is a clear reminder that we are not out of the woods yet.  Cross-county travel, both into and out of Lake County, is very common, and active cases in neighboring Counties may result in secondary infections of Lake County residents.

Particularly as we begin to further reopen, and movement in our communities increases, it is very likely we will see an increase in confirmed cases.  Because testing capacity in Lake County was so limited early on, and has now markedly improved, more confirmed positive cases does not necessarily indicate an elevated level of concern, but it does serve as a reminder that the virus remains very active in our region.

This weekend’s cases appear to have stemmed from a live streamed Mother’s Day event produced by a community organization in inland Mendocino County.  At least one Mendocino County resident and two Lake County residents have now tested positive for COVID-19.  All were present at the venue for the event; they were not merely watching a Zoom presentation from home, as has been rumored.

Two participated in the presentation, which included singing.  Congregate singing, particularly in an enclosed space and in close proximity, is a high-risk activity, as detailed in this recent CDC report:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm?fbclid=IwAR2_KHgM-1hrs1KS8bVufJ0n5tARyyaEBk_IWBKKYn-Du_6u8ZAryNrWS8Y

The two Lake County residents who tested positive were from the same family, and there are indications that others who came into close contact with these individuals were actively moving about in the community for some period of time.  While Contact Tracing and investigations remain ongoing, only the two cases previously reported have been confirmed, to date.  Mendocino County reported over the weekend one of the Lake County residents that tested positive was hospitalized at a Mendocino County facility.

COVID-19 Testing by Verily
Testing is only more critical as we take additional steps toward reopening.  Thanks to the tremendous efforts of County Public Health staff, local leadership, Senator McGuire, Assemblymember Aguiar-Curry, and the California COVID-19 Testing Task Force, Verily’s Project Baseline has now made drive-thru COVID-19 testing more robustly available in Lake County.  Those with any concern they may have been exposed are strongly encouraged to visit https://www.projectbaseline.com/study/covid-19/ to complete the screening process and schedule Drive-Thru testing.

Frequently Asked Questions on Drive-Thru Testing are available here:
http://health.co.lake.ca.us/Assets/Departments/Health/Public+Health+Division/COVID-19/Testing/TestingFacts.pdf

More Resources
For Lake County-specific Coronavirus information, please continue to visit the Health Services Department’s website, http://health.co.lake.ca.us.

The Lake County Coronavirus Response Hub has additional valuable resources: https://lake-co-ca-coronavirus-response-lakecoca.hub.arcgis.com/

Public Health can be reached by email, MHOAC@lakecountyca.gov, or by phone, during business hours: 707-263-8174.

Up-to-date information on what businesses are open and closed, statewide, is available here:
https://covid19.ca.gov/stay-home-except-for-essential-needs/#top

The most recent formal update to the State’s Stay at Home Order, from Sonia Angell, MD, MPH, can be found here:
https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID-19/SHO%20Order%205-7-2020.pdf

California’s COVID-19 Response “Resilience Roadmap,” describing the like progression of reopening of industries and business sectors, is available here:
https://covid19.ca.gov/roadmap/

Thank you for continuing to exercise appropriate precautions
• Maintain social distancing and keep good hygiene
• It remains strongly recommended that people wear masks when out.
• Vulnerable populations (over 65 and/or with chronic medical conditions) should continue to stay safe at home.
• We discourage people from crossing county lines, since this is an important way that the virus spreads.

Gary Pace, MD, MPH

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Coronavirus
5 New Cases

There has been a general increase in social mobility. It is therefore concerning, but not entirely surprising, that new cases of COVID-19 continue to be identified.

Case info