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"Californians heard the urgent message to stay home as much as possible and accepted that challenge to slow the surge and save lives," said Dr. Tomás Aragón, CDPH director and state public health officer. "Together, we changed our activities knowing our short-term sacrifices would lead to longer-term gains. COVID-19 is still here and still deadly, so our work is not over, but it's important to recognize our collective actions saved lives and we are turning a critical corner." Early last year, the state developed a system of color-coded tiers that dictated the level of restrictions on businesses and individuals based on virus conditions in each of California's 58 counties. Most counties will now go back to the most restrictive purple tier, which allows for outdoor dining, hair and nail salons to be open, and outdoor church services. The Health and Human Services Agency, in consultation with counties and labor organization and consumers, shall leverage existing services and programs to support home isolation of vulnerable Californians, including seniors and those with serious chronic underlying health conditions.
The huge Southern California region, the most populous, remains at zero ICU capacity. "We are in a position, projecting four weeks forward, with a significant decline in the case rates, positivity rates, we are anticipating decline still more decline in hospitalizations and more declines in ICUs and that's why we are lifting that stay-at-home order effective immediately today," he said. Late last week, the stateissued a travel advisory, along with Oregon and Washington, urging people entering the state or returning home from travel outside the state to self-quarantine to slow the spread of the virus.
California Tobacco Control
The most recent order was issued yesterday, March 24, to address reducing the spread of COVID-19 in corrections facilities. Public health leaders implemented a statewide order to make it easier to transfer patients from over-crowded hospitals to those with more space and staff. The state provided assistance within hospitals in the form of personal protective equipment, ventilators and help with oxygen supply. Dr. Monica Gandhi, an infectious disease expert at UCSF, told CBS San Franciscothat she was encouraged by the region's ICU availability. She is seeing hospitalizations drop first-hand at Zuckerberg San Francisco General, where she also works.
The travel advisory urges against non-essential out-of-state travel, asks people to self-quarantine for 14 days after arriving from another state or country, and encourages residents to stay local. Enforcement activities shall focus where there are allegations of the most serious violations impacting health and safety. "We are actively calculating some of the information from the last 24 hours and may be updating you in the next hours and certainly by tomorrow if any one of these regions does indeed emerge out of that regional stay-at-home order," said Ghaly. This order authorizes local governments to take measures to halt evictions and protect against utility shutoffs, and sets forth guidance for any jurisdiction looking to do so. This order establishes guidance for state licensed facilities that house populations most vulnerable to COVID-19. California also helped hospitals expand their capacity by opening 16 alternate care sites, lower-acuity facilities where COVID-19 patients get a bridge from hospital to home as they are recovering.
Timeline of California’s COVID-19 Executive Orders
The state must focus on protecting the health and safety of the most vulnerable in licensed facilities. Ghaly said for now, the orders would remain but that health officials were still running the numbers on ICU projections for all the regions and there could be updates later Tuesday or by Wednesday. Because case rates remain high across most of the state, the state's Hospital Surge Order remains in place to prevent hospitals from becoming overwhelmed. The Limited Stay at Home Order, which limits non-essential activities between the hours of 10 p.m. California deployed more than 4,100 medical professionals to facilities across the state to ease the burden on frontline health care workers.
The state shall redirect resources and provide technical and compliance support to protect caregivers and those they care for. The governor also gave more details about the state’s vaccine verification system, which will be electronic vaccine cards that can be kept on phones, SFGate reports. San Francisco will require employees to be vaccinated at high-risk workplaces, like hospitals and nursing homes, and will enforce stricter rules for large events, The San Francisco Chronicle reports. But the lifting of nearly all of the state’s remaining pandemic restrictions is a significant emotional and psychological milestone for residents of a state that has experienced some of the nation’s most enduring lockdowns. Since Governor Newsom declared a State of Emergency on March 4, 2020, he has signed 11 Executive Orders addressing various aspects of the COVID-19 pandemic. As a result of many conversations between the Governor’s office and CSAC, many of these orders have addressed issues that affect counties greatly.
Center for Infectious Diseases
According to the state COVID-19 website, as of Tuesday, both the San Joaquin Valley and Southern California hospital regions remained at zero percent ICU capacity. The Bay Area region's ICU capacity had risen several points from only 0.7% to 4.7%, while the Greater Sacramento region was at 9.4%. The Northern California hospital region was still above 15%, but had dropped to its lowest point yet at 17.6%. Broadly it applies work hours exemptions (laid out in N-25-20) to local governments, suspends local ordinances that interfere with essential activities, further clarifies and expand Brown Act exemptions, and extends deadlines and relaxes requirements for a number of statues. The Governor is also continuing the wind down of executive actions put in place since March 2020 to help facilitate a coordinated response to the pandemic and ensure the state could quickly and efficiently respond to the impacts of the pandemic.
One county supervisor in Los Angeles, home to 10 million people, expressed support for opening more businesses in the country. Republican Supervisor Kathryn Barger said the state must balance public health with "devastating social, emotional and economic impacts of this virus." On Monday, the state pulled an emergency brake in theBlueprint for a Safer Economyputting more than 94 percent of California’s population in the most restrictive tier.
Director / State Public Health Officer
The Salton Sea also experienced three dozen earthquakes up to 3.2 magnitude within 24 hours on Monday, The San Luis Obispo Tribune reports. Workers will still have to wear masks, even if they’re vaccinated, for at least part of this week. As my colleagues and I reported, the reactions to today’s reopening have varied widely, from outright jubilation to continued frustration with Gov. Gavin Newsom for keeping orders in place for so long. "I don't want to think that we're out of the woods in any measure," Ghaly said, adding later that "We're in the early parts of that holiday surge. It looks encouraging at the moment." "This is promising news, of course. We've been talking about hope that we'd see lower post-holiday surge than we did see post-Thanksgiving," said Ghaly. However, despite those numbers and what Ghaly said during the Tuesday briefing, the stay-at-home order was later lifted for the Greater Sacramento region.
COVID-19 case rates increased by approximately 50 percent in California during the first week of November. As a result, Governor Newsom and California’s public health officials have announced a list of measures to protect Californians and the state’s health care system, which could experience an unprecedented surge if cases continue their steep climb. The order directs state health and social services agencies to redirect resources and staff to the facilities, focusing on providing technical assistance and supporting compliance with core health and safety requirements for caregivers and the cared for.
The county-by-county tier system uses various metrics to determine the risk of community transmission and apply a color code - purple, red, orange or yellow - which correspond to widespread, substantial, moderate and minimal, respectively. The decision comes with improving trends in the rate of infections, hospitalizations and intensive care unit capacity as well as vaccinations. See the Center for Disease Control and Prevention’s guidance regarding the prevention of disease in homes and residential communities. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick. Have supplies on handContact your healthcare provider to ask about obtaining extra necessary medications to have on hand.
Ghaly said in his afternoon briefing that Gov. Gavin Newsom has directed health officials to meet Tuesday to evaluate the new federal guidance. Once a region emerges from the order, Ghaly said the counties contained in the region would fall under the previous colored tier system based on its test positivity and case rate. Most California counties, including all Bay Area counties, are currently under the Purple Tier indicating widespread infection rate, three counties are in the Red Tier, one county in the Orange Tier and no counties in the Yellow Tier.
Failure to comply with this and other public health orders issued by CDPH may result in disciplinary action against the ABC license. Licensees should refer to the Blueprint and the Order for further information. Please consult with your local Department of Public Health to determine if more restrictive directives exist in your area. Today the California Department of Public Health released anew state public health officer orderthat goes into effect on June 15. The action supports the full and safe reopening of the state, while maintaining focused public health requirements that address the risk posed by variants as some regions across the nation and world continue to experience high levels of transmission. "California is slowly starting to emerge from the most dangerous surge of this pandemic yet, which is the light at the end of the tunnel we've been hoping for," said California Health and Human Services Secretary Dr. Mark Ghaly.
In the purple tier, bars, breweries, and distilleries in which no meals are served are required to be closed to both indoor and outdoor operations. Wineries and restaurants are required to close indoor operations but may operate outdoors with certain modifications. These restrictions and operational directives are detailed more fully in the Blueprint and in prior advisories issued by the Department.
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