Full Text
Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: January Riddle, District 2: Ron Hames, District 3: Irvin Jim, District 4: Terry Woodrow, District 5: David Griffith Tuesday September 21, 2021 Public Health Officer Order: COVID-19 VACCINATION REQUIRED FOR ALL ALPINE COUNTY WORKERS The COVID-19 pandemic remains a significant challenge in Alpine County (hereinafter referred to as “the County”). Nationally, there is a >300% increase in cases as compared to the Labor Day weekend of 2020. California is currently experiencing a surge in cases threatening to overwhelm our healthcare system, especially in rural counties. The County has experienced infection among its workers in 6 different departments, resulting in workers ordered to isolate or quarantine according to official California Department of Public Health (CDPH) and Centers for Disease Control and Prevention (CDC) definitions. Our worker pool is not deep, with limited ability to replace workers not able to work during these times. The Delta variant is highly transmissible and may cause more severe illness. In fact, recent data suggests that viral load is roughly 1,000 times higher in people infected with the Delta variant than those infected with the original coronavirus strain, according to a recent study. The Delta variant is currently the most common variant causing new infections in California. The longer our population is inadequately vaccinated, the greater the risk of newer and more potent variants developing. COVID-19 vaccines are effective in reducing infection and serious disease, including that cause by the Delta variant. At present, the County has a high percentage of residents over the age of 17 who are partially or completely vaccinated. Unvaccinated Public Health Brief Richard O. Johnson, M.D., MPH Nichole Williamson Public Health Officer HHS Director Office: [PHONE REDACTED], Ext 249 Office: [PHONE REDACTED] e-mail: [EMAIL REDACTED] 24/7/365 Emergency Contact Number Dispatch: [PHONE REDACTED], Ext 330 ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: January Riddle, District 2: Ron Hames, District 3: Irvin Jim, District 4: Terry Woodrow, District 5: David Griffith persons are more likely to get infected and spread the virus, which is transmitted through the air. Most current hospitalizations and deaths are among unvaccinated persons. Additional measures are necessary to protect particularly vulnerable populations, and ensure a sufficient, consistent supply of workers in the county setting. Vulnerable populations may include our co-workers, the public that we serve, and our kids who are not yet eligible for vaccination. COVID-19 outbreaks can have severe consequences for vulnerable populations including hospitalization, severe illness, and death. County facilities share several features. There is frequent exposure to co-worker and highly vulnerable persons, including elderly, chronically ill, and disabled persons. In addition, workers go home each workday and interact with family and friends who may unintentionally share an infection with them, and vice versa. In addition, many county workers have children in their homes who are unprotected and at increased risk of acquiring infection in the school setting. Vaccinations have been available in California from December 2020 to the present, and from January 1, 2021, to July 12, 2021, a total of 9,371 confirmed COVID-19 outbreaks and 113,196 outbreak-related cases were reported to CDPH. Increasing numbers of county workers are among the new positive cases, despite vaccinations being prioritized for this group in the County when vaccines initially became available. Recent cases in county settings have been traced to unvaccinated workers. Vaccination against COVID-19 is the most effective means of preventing infection with the COVID-19 virus, and subsequent transmission and outbreaks. As we respond to the dramatic increase in cases, all workers must be vaccinated to reduce the chance of transmission to vulnerable populations. For these reasons, COVID-19 remains a concern to public health. To prevent its further spread in county workplace settings, new public health requirements are necessary. NOW, THEREFORE, I, as Public Health Officer of the County of Alpine, order: 1. All workers who provide services or work in county facilities have their first dose of a one-dose regimen or their second dose of a two-dose regimen by October 29, 2021: a. Two-dose vaccines include: Pfizer-BioNTech or Moderna. The one-dose vaccine is: Johnson and Johnson [J&J]/Janssen. All COVID-19 vaccines that are currently approved or authorized for emergency use can be found at the following link: ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: January Riddle, District 2: Ron Hames, District 3: Irvin Jim, District 4: Terry Woodrow, District 5: David Griffith US Food and Drug Administration (FDA), are listed at the FDA COVID-19 Vaccines webpage. b. "Worker" refers to all paid and unpaid individuals who work in county owned or operated settings, including employees, contractors, and volunteers. 2. Workers may be exempt from the vaccination requirements under section only upon providing Alpine County Human Resources a declination form, signed by the individual stating either of the following: the worker is declining vaccination based on Religious Beliefs, or the worker is excused from receiving any COVID-19 vaccine due to Qualifying Medical Reasons. Request for declinations based upon Religious Beliefs must be approved by Alpine County Human Resources Department. a. To be eligible for a Qualified Medical Reasons exemption the worker must also provide to Alpine County Human Resources a written statement signed by a physician, nurse practitioner, or other licensed medical professional practicing under the license of a physician stating that the individual qualifies for the exemption (but the statement should not describe the underlying medical condition or disability) and indicating the probable duration of the worker’s inability to receive the vaccine (or if the duration is unknown or permanent, so indicate). All requests for exemptions based on Qualified Medical Reasons must be approved by the Public Health Officer. 3. If the County deems a worker to have met the requirements of an exemption pursuant to section the unvaccinated exempt worker must meet the following requirements when entering or working in any county setting: a. Test for COVID-19 with either PCR or antigen test that either has Emergency Use Authorization by the U.S. Food and Drug Administration or be operating per the Laboratory Developed Test requirements by the U.S. Centers for Medicare and Medicaid Services. Testing must occur at the beginning of each work week. Testing will be performed under the direction of Public Health at the expense of the county. b. Wear a surgical mask or higher-level respirator approved by the National Institute of Occupational Safety and Health (NIOSH), such as an N95 filtering facepiece respirator, at all times while indoors in any county facility or vehicle while not alone. 4. Consistent with applicable privacy laws and regulations, the County must maintain records of workers’ vaccination or exemption status. If the worker is exempt pursuant ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: January Riddle, District 2: Ron Hames, District 3: Irvin Jim, District 4: Terry Woodrow, District 5: David Griffith to section the County then also must maintain records of the workers’ testing results pursuant to section a. The County must provide such records to the Alpine County Public Health Officer or his designee upon request, and in any event no later than the next business day after receiving the request. b. The County is subject to the requirement under section and must maintain records pursuant to the CDPH Guidance for Vaccine Records Guidelines & Standards with the following information: full name and date of birth; vaccine manufacturer; and date of vaccine administration (for first dose and, if applicable, second dose). c. For unvaccinated workers: signed declination forms with written health care provider’s statement where applicable, as described in section above. Testing records pursuant to section must be maintained. 5. Nothing in this Order limits otherwise applicable requirements related to Personal Protective Equipment, personnel training, and infection control policies and practices. 6. The County is encouraged to provide onsite vaccinations, easy access to nearby vaccinations, and education and outreach on vaccinations, including: a. access to physicians, and other counselors who can answer questions or concerns related to vaccinations and provide culturally sensitive advice; and b. access to online resources providing up to date information on COVID-19 science and research. 7. This Order shall take effect on September 21, 2021, and the County must be in full compliance with the Order by October 29, 2021. 8. This Order is issued pursuant to Health and Safety Code sections 120125, 120140, 120175, and 120195, and other applicable law. Richard O. Johnson, M.D., MPH, Health Officer, Alpine County