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Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith Thursday, March 12, 2020 Time to Hunker Down* * “Hunker down”: to stay in a place for a period of time Merriam-Webster.com Dictionary, Merriam-Webster, Accessed 12 Mar. 2020. In order to protect the public’s health and slow the rate of transmission of COVID-19, we recommend that gatherings as described below should be postponed or canceled until further notice. In addition, Alpine County CAO Nichole Williamson orders that all county sponsored events involving seniors and those with underlying medical conditions be postponed or canceled. - Large gatherings that include 250 people or more should be postponed or canceled, including gatherings such as concerts, conferences, and professional, college, and school sporting events. - Smaller gatherings held in venues that do not allow social distancing of six feet per person should be postponed or canceled, including gatherings in crowded auditoriums, rooms or other venues, including houses of worship. - Gatherings of individuals who are at higher risk for severe illness from COVID-19 should be limited to no more than 10 people, including gatherings such as support groups for people with health conditions. A “gathering” is any event or convening that brings together people in a single room or single space at the same time, such as an auditorium, stadium, arena, large conference room, meeting hall, cafeteria, or any other indoor or outdoor space. This applies to all non-essential professional, social, and community gatherings regardless of their sponsor. Gatherings that do not meet the aforementioned criteria should only be conducted when they are essential— that is, if the activity is essential and could not be postponed or achieved without gathering, meaning that some other means of communication could not be used to conduct the essential function. 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 Numbers Dr. Johnson’s cell: (760) 914-0496 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: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith What can be done to a make a gathering safer if it is essential or small? - Stagger activities. - Add frequency of an event to spread out attendance, e.g. hold more, smaller gatherings. - Add distance between where individuals sit or stand around tables. - Add additional hand washing stations and restrooms. - Limit the number of people in lines. - Avoid direct physical contact, such as shaking hands, holding hands, and hugging. - Extend hours to allow for staggering of attendance or participation. - Use phones, videos or video conferencing to reduce the need for close interactions. - Consider ways to encourage anyone with fever and respiratory to stay home when sick, such as: o Offering refunds or support reselling of tickets for persons who become ill. o Placing messages on websites, tickets, and venue entrances reminding people to protect one another by staying home if sick. The goal of this recommendation is to prevent people physically coming together unnecessarily, where people who have the infection can easily spread it to others. This guidance does not apply to activities such as: - attendance at regular school classes, work, or essential services. - public transportation, airport travel, or shopping at a store or mall. - congregate living situations, including dormitories. Who is at “high risk” for serious disease or death from COVID-19 infection? - Older adults, defined as adults >59 years of age - Persons with underlying chronic medical conditions of any age: • Heart disease • High blood pressure • Lung disease • Diabetes • Obesity • Compromised immune systems • Pregnant females ---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: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith Measures for High-Risk Individuals Individuals and caregivers can take steps now to slow the spread of respiratory infectious diseases, including COVID-19. We recommend implementing the following steps: • Review and update your personal emergency plan. A Personal Emergency Plan for people with access and functional needs is available on the California Health and Human Services Agency’s website. • Avoid crowds, mass gatherings or large events, and public transit, and stay home as much as possible. • Stay home when sick. o If you have an elevated temperature, remain at home until fever has been gone for at least 24 hours without the use of fever-reducing medicines. o Seek immediate medical care if become more severe, e.g., high fever or difficulty breathing. • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones). o See the Center for Disease Control and Prevention’s guidance regarding the prevention of disease in homes and residential communities. • Use “respiratory etiquette.” o Cover cough with a tissue or sleeve. See CDC’s Cover Your Cough page. • Wash hands frequently for at least 20 seconds. o Encourage hand washing by caregivers, family, and friends. o Provide alcohol-based hand sanitizers to supplement hand washing. o Routinely clean frequently touched surfaces. o Avoid touching eyes, nose, or mouth with unwashed hands. • Have supplies on hand o Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time. ---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: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith o If you cannot get extra medications, consider using mail-order for medications. o Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other Most people will be able to recover from COVID-19 at home. • Have a plan for if you get sick: o Consult with your health care provider for more information about monitoring your health for suggestive of COVID-19. o Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick. o Determine who can provide you with care if your caregiver gets sick. • Watch for and emergency warning signs o Pay attention to potential COVID-19 including fever, cough and shortness of breath. If you develop call your doctor, clinic, urgent care, or emergency department. Please do not show up unannounced!! o If you develop emergency warning signs for COVID-19, get medical attention immediately. In adults, emergency warning signs* include: ▪ Difficulty breathing or shortness of breath ▪ Persistent pain or pressure in the chest ▪ New confusion or inability to arouse ▪ Bluish lips or face *This list is not all inclusive. Please consult your medical provider for any other that is severe or concerning. Family and Caregiver Support • Know what medications your loved one or client is taking and see if you can help them have extra on hand. • Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan. • Stock up on non-perishable food items to have on hand in your home to minimize trips to stores. • If a loved one lives in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak. For up-to-date information, go to: