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SAN MATEO COUNTY HEALTH OFFICER ORDER FOR THE CONTROL OF COVID-19 No. c19-6b (REVISED) DIRECTING INDIVIDUALS IN THE COUNTY DIAGNOSED WITH COVID-19 TO ISOLATE THEMSELVES
Date of Order: May 14, 2020

Health Officer Updates Health Orders

Please read this Order carefully. Violation of or failure to comply with this Order is a misdemeanor punishable by fine, imprisonment, or both. California Health and Saf. Code, § 120295, et seq.; Cal. Penal Code §§ 69, 148(a)(1).

SUMMARY OF THE ORDER

California is in a State of Emergency because of the Coronavirus Disease 2019 (“COVID-19”) pandemic. The spread of the novel coronavirus that causes COVID-19 is a substantial danger to the health of the public within the County of San Mateo (“County”). COVID-19 can easily spread between people who are in close contact with one another. This Order is issued based on scientific evidence and best practices as currently known and available to protect vulnerable members of the public from avoidable risk of serious illness or death resulting from exposure to COVID-19. The age, condition, and health of a significant portion of the population of the County places it at risk for serious health complications, including death, from COVID-19. There is growing evidence of transmission risk from infected persons before the onset of symptoms. Thus, all individuals who contract COVID-19, regardless of their level of symptoms (none, mild or severe), may place other vulnerable members of the public at significant risk. Currently, there are few specific treatments for COVID-19 and no vaccine available to protect against COVID-19 transmission.

To help slow COVID-19’s spread, protect vulnerable individuals, and prevent the healthcare system in the County from being overwhelmed, it is necessary for the Health Officer of the County of San Mateo to isolate persons with COVID-19. “Isolation” is the separation of persons who have been infected with COVID-19 from other persons. This Order addresses isolation requirements. “Quarantine” separates and restricts the movement of persons who, while not yet infected with COVID-19, have been exposed to COVID-19 and therefore may become infectious. San Mateo County Health Officer Order No. c19-7 concerns quarantine requirements. This Order was updated on May 14, 2020, to incorporate changes to the self-isolation protocol based on new guidance from the United States Centers for Disease Control and Prevention.

UNDER THE AUTHORITY OF SECTIONS 101040; 101085; 120130; AND 120175 OF THE CALIFORNIA HEALTH AND SAFETY CODE, THE HEALTH OFFICER OF THE COUNTY OF SAN MATEO (“HEALTH OFFICER”) ORDERS:

  1. All individuals who have COVID-19, as described in Section 2 of this Order, must isolate themselves and follow all instructions in this Order and the San Mateo County Public Health (“Public Health”) guidance documents referenced in this Order. Self-isolation is required because a person with COVID-19 can easily spread the virus to others. Isolation separates these ill individuals from others to prevent the spread of COVID-19.
  2. For purposes of this Order, an individual, other than a minor child or person with special needs who requires specialized care, becomes a “Person with COVID-19” under this Order immediately upon meeting any of the following criteria:
    1. The person is informed they have a positive lab test for the COVID-19 virus; OR
    2. The person has signs and symptoms that are consistent with COVID-19, as set forth in guidance from the Centers for Disease Control (CDC) at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html, within 14 days of knowingly being in close proximity with another person who was known or suspected to be capable of actively transmitting COVID-19 and such symptoms are not explained by another condition that preexisted such close contact; OR
    3. The person has been informed by a healthcare provider that they are likely to have COVID-19; OR
    4. The person has signs and symptoms that are consistent with COVID-19 and is awaiting results of testing for COVID-19.
  3. For purposes of this Order, a Person with COVID-19 who, at any time during their applicable Period of Isolation as set forth in Section 6, does not have access to a home or residence for the purpose of isolation shall not be deemed in violation of this Order if, upon notification of a positive COVID-19 test, such person promptly contacts the San Mateo County Emergency Operations Center Shelter & Care Branch by dialing 211 at any time, day or night, to inform of their COVID-19 status and request an isolation location, cooperates fully with EOC staff, and is otherwise compliant with this Order.
  4. This Order is issued in accordance with, and incorporates by reference, the March 4, 2020 Proclamation of a State of Emergency issued by Governor Gavin Newsom, the March 3, 2020 Proclamation by the Director of Emergency Services Declaring the Existence of a Local Emergency in the County, the March 3, 2020 Declaration of Local Health Emergency Regarding Novel Coronavirus 2019 (COVID-19) issued by the Health Officer, the March 10, 2020 Resolution of the Board of Supervisors of the County of San Mateo Ratifying and Extending the Declaration of a Local Health Emergency, the April 7, 2020, Board of Supervisors’ Resolution Further Extending the Proclamation of Local Health Emergency Until the County Takes Action to terminate the Local Emergency, the April 15, 2020 Order of the Health Officer No. c19-1b extending and revising the Order restricting visitors to skilled nursing facilities to all residential type facilities, the April 13, 2020 Order of the Health Officer No. c19-3c extending and revising the School Operations Modification Order, the March 24, 2020 Order of the Health officer No. c19-4 directing all laboratories conducting COVID-19 diagnostic tests to report COVID-19 test information, the April 29, 2020 shelter in Place Order No. c19-5c, the April 17, 2020 Order of the Health Officer No. c19-8 requiring members of the public and workers to wear face coverings, and the May 11, 2020 Order of the Health Officer No. c19-9 permitting highly regulated vehicle-based gatherings.
  5. Instructions. A Person with COVID-19 must immediately take the following actions:
    1. Isolate themselves in their home or another residence, such as a hotel or motel, for the entirety of the applicable Isolation Period as set forth in Section 6. A Person with COVID-19 who does not have access to a home or other residence should refer to Section 3, above. They may not leave their place of isolation or enter any other public or private place, except to receive necessary medical care or during an emergency that requires evacuation to protect the health and safety of the individual. See Appendix A posted at https://www.smchealth.org/post/health-officer-statements-and-orders and attached to this Order, for further guidance.
    2. Carefully review and closely follow all requirements listed in the “Home Isolation Instructions” posted at www.smchealth.org/post/health-officer-statements-and-orders and attached to this Order as Appendix B.
    3. Promptly tell their Close Contacts that they need to self-quarantine themselves and should be tested. Close Contacts who should be notified to self-quarantine are people who were in close physical proximity with them during their infectious period. For purposes of this Order, the infectious period begins 48 hours before symptoms began (or, in the absence of symptoms, on the collection date of a positive test) and ends when the applicable Period of Isolation is over (see Section 6 below). For purposes of this order, a “Close Contact” of a Person with COVID-19 as defined in Section 2 include any person who, during the infectious period of the Person with COVID-19:
      1. Lived in or stayed at the same residence as the Person with COVID-19 when the Person with COVID-19 was not following Home Isolation Instructions; OR
      2. Was an intimate sexual partner of the Person with COVID-19; OR
      3. Stayed within 6 feet of the Person with COVID-19 for 10 minutes or more while the Person with COVID-19 was not wearing a face covering; OR
      4. Had direct contact for any amount of time with the body fluids and/or secretions of the Person with COVID-19 (e.g., was coughed or sneezed on, shared utensils with, or was provided care by or provided care for them without wearing a
      5. mask, gown, and gloves).
    4. Refer their Close Contacts to the “Home Quarantine Instructions” posted at www.smchealth.org/post/health-officer-statements-and-orders which describe steps that Close Contacts must take to prevent spread of COVID-19. Close Contacts have likely been exposed to COVID-19 and if infected, can easily spread COVID-19 to others, even if they have no symptoms or only mild symptoms. Close Contacts need to be tested.
    5. Cooperate fully with Public Health concerning: i) collection, reporting and monitoring of temperature readings and other health data; ii) contact tracing and related investigations, including identification of contacts; and iii) any ongoing monitoring by Public Health, including after the Period of Isolation.
  6. A Person with COVID-19 is required to isolate for a Period of Isolation in accordance with the following: 
    1. Individuals without symptoms must isolate for ten (10) days from the date of a positive test.
    2. Individuals with symptoms must isolate until the later of the following:
      1. At least three (3) days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement of respiratory symptoms, if present (e.g., cough, shortness of breath), AND
      2. At least ten (10) days have passed since their symptoms started.  Longer isolation periods may be recommended in certain circumstances.
  7. The Health Officer may take additional action(s), which may include civil detention or requiring one to stay at a health facility or other location, to protect the public’s health if an individual who is subject to this Order fails to comply with this Order.
  8. The Order shall become effective at 12:01 am on May 16, 2020 and will continue to be in effect until it is rescinded, superseded, or amended in writing by the Health Officer.
  9. Copies of this Order shall be promptly be: (1) made available at 400 County Center, Redwood City, CA 94063; (2) posted on the County Health Services website (www.smchealth.org/post/health-officer-statements-and-orders); and (3) provided to any member of the public requesting a copy.
  10. If any provision of this Order of its application to any person or circumstance is held to be invalid, then the remainder of the Order, 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 are severable.

IT IS SO ORDERED

Scott Morrow MD, MPH
Health Office of the County of San Mateo

Dated: May 14, 2020

Appendix A: “Home Quarantine Instructions”
Appendix B: “Home Isolation Instructions”

PDFs of Health Orders

05/14/20- Health Officer Order c19-6b Revised Home Isolation
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