Tom Butt E-Mail Forum

	E-Mail Forum – 2020
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	March 17 Comprehensive COVID-19 Update March 18, 2020
	COVID-19 California: State of Preparedness 3/17/20 New information in blue. Control + click on the item in table of contents for easy navigation to sought after information. Contents COVID-19 Numbers at a Glance Grand Princess Cruise Ship Actions Taken by the State and Federal Government March 17 March 16 March 15 March 14 March 13 March 12 March 11 March 10 March 9 March 8 March 7 California is Prepared: How Can People Protect Themselves: About the Disease About the Tests Q&A Other Resources and Press Releases COVID-19 Numbers at a Glance As of the morning March 17, 2020 there were a total of 472 positive cases in California. 24 cases are from repatriation flights, and the other 448 confirmed cases include: 82- travel related. 75 - person-to-person. 98 - community transmissions. 193 -currently under investigation. 11 - deaths (Includes one non-California resident). Hospital Capacity (as of March 15) 74,000 hospital beds at 614 facilities. Surge capacity of 8661 beds. 11,500 ICU beds (includes pediatric and neonatal). 7587 ventilators. EMSA has additional 900 ventilators. Procured an additional several hundred ventilators. Negotiations are underway to re-open healthcare facilities to significantly increase surge capacity. A minimum of 750 new beds will be added to surge capacity by end of the week. Taskforces have been stood up by the State Operations Center (SOC) to address various COVID-19 response issues: Communications/Crisis Communications (ESF* 2/ESF 15) Transportation and Infrastructure (ESF 1/ESF 3) Housing and Social Services (ESF 6) Logistics/Commodity Movement (ESF 7) Fire/Law Enforcement (ESF 4/ESF 13) Public Health and Medical (ESF 8) Schools Task Force Economic Impact/Recovery Task Force Volunteers & Philanthropy (ESF 17) Innovation & Technology Task Force Cybersecurity (ESF 18) Corrections Facilities & Hospitals * Emergency Support Function Nationwide As of March 17, 2020, there have been 75 deaths. 4,226 cases reported in 53 jurisdictions (49 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands) 11,750+ individuals who traveled on commercial flights through SFO or LAX are self-monitoring across 49 local health jurisdictions. This is precautionary and these individuals are not displaying symptoms at this time. From the international data we have, of those who have tested positive for COVID-19, approximately 80 percent do not exhibit symptoms that would require hospitalization. Grand Princess Cruise Ship As of Saturday, March 14, state and federal officials disembarked more than 2,900 individuals from the Grand Princess which includes more than 2,400 passengers and more than 500 crew. The ship departed the Port of Oakland on Sunday, March 15. In total, 1,424 individuals were safely brought ashore during the first two days of the Grand Princess disembarkation. 613 sent to Travis Air Force Base (CA) 42 sent to Miramar Marine Corp Air Station (CA) 124 Sent to Dobbins Air Reserve Base (GA) 98 sent to Lackland Air Force Base (TX) 168 repatriated via chartered flight to United Kingdom 19 relocated to Asilomar This number will fluctuate as those who test positive for COVID-19 are relocated to Asilomar and those who test negative are relocated to federal military bases. An additional alternative quarantine site has been identified, a hotel in San Carlos owned by a private company, GRM Properties. The hotel has the capacity to house up to 120 individuals and currently has no guests. The individuals being relocated to San Carlos will not interact with the general public. Each person going to San Carlos has been screened by medical professionals, and because they have mild symptoms that do not require hospitalization, they cannot be quarantined at Travis Air Force Base. While none of these individuals are known to have contracted novel coronavirus (COVID-19), they will be tested and monitored by medical professionals. Actions Taken by the State and Federal Government March 17, 2020, the President announced on that all states can now authorize tests developed and used within their borders, in addition to the FDA. The Small Business Administration announced all California counties eligible for Economic Disaster Loans on March 17, 2020. On March 16, Governor Gavin Newsom requested that the California State Legislature take emergency action to fight Covid-19. Letter can be viewed here. The early and unanimous passage of the budget bills secured $1.1 billion in funding for COVID-19 efforts. On March 16, the President issued guidance discouraging gatherings greater than 10. On March 16, the Small Business Administration approved an Economic Injury Disaster Loan assistance declaration for California, which makes loans available to small businesses and private, non-profit organizations in designated areas of a state or territory to help alleviate economic injury caused by the Coronavirus (COVID-19). The declaration covers the following primary counties: Alameda, Calaveras, Contra Costa, Los Angeles, Sacramento, San Diego, San Francisco, San Mateo, Sonoma and Tuolumne. It also covers the contiguous counties of Alpine, Amador, El Dorado, Imperial, Kern, Lake, Madera, Marin, Mariposa, Mendocino, Merced, Mono, Napa, Orange, Placer, Riverside, San Bernardino, San Joaquin, Santa Clara, Santa Cruz, Solano, Stanislaus, Sutter, Ventura, and Yolo. Additional counties can still submit worksheets in order to be added to the declaration. Also released was guidance for older adults and those at higher risk that are self-isolating. Guidance for retail food, beverage, and other related venues was also made available and can be viewed here. Governor Gavin Newsom also issued an executive order that authorizes local governments to halt evictions for renters and homeowners, slows foreclosures, and protects against utility shutoffs for Californians affected by COVID-19. The Department of Motor Vehicles requested law enforcement exercise discretion for 60 days in their enforcement of driver license and vehicle registration expiration dates beginning March 16, 2020. The DMV is taking this action so that at-risk populations, including seniors and those with underlying health conditions, can avoid required visits to DMV field offices for driver license or vehicle registration renewals. Transactions that fall within this action include driver license renewals for those: 70 years of age and older required to take a knowledge test Individuals who are required to renew in the office (last DMV visit was 15 years prior) Individuals subject to vision testing Individuals with complex driving history On March 15, Governor Gavin Newsom announced pilot programs in Santa Clara and San Mateo counties that will begin mobile testing labs in next 24 to 48 hours. Pilot program could expand to other areas of state. The Governor also called for: Those who are older than 65 and those with chronic conditions to isolate in their homes as they face the greatest risk from COVID-19. Visitation of patients in hospitals, skilled nursing facilities, senior and assisted living homes be for “end of life” only. Bars, night clubs and wineries to close. Restaurants to cut occupancy in half. Points of access will be expanded to deliver good to people who are isolated in their homes. On March 15 Governor Gavin Newsom announced efforts to address the unsheltered homeless population: Hotels and motels will be procured to remove the homeless from the streets. 450 trailers will be sent to critical points to provide housing to the homeless. Announced forthcoming guidance for schools that plan to remain open. The CDC also announced new guidance for mass events and recommends that for the next 8 weeks, organizers cancel or postpone in-person events that consist of 50 people. March 14 , the House of Representatives passed H.R 6201, The 2nd Federal Supplemental—Coronavirus Response Act. The bill includes paid sick leave, unemployment insurance, free testing and money for food stamps, among other things. Complete summary of appropriations made in the bill can be viewed here. As of March 14, the Federal Emergency Management Agency (FEMA) has an Incident Management Assistance Team integrated into the Cal OES State Operations Center in Sacramento to support the State of California and the U.S. Department of Health and Human Services (HHS) with the coordination of federal resources. March 13 , the President issued a proclamation declaring a national emergency concerning the COVID-19 outbreak. To view the declaration, click here. The White house also released a memorandum on expanding state-approved diagnostic tests. Click here to view. State, territorial, tribal, and local government entities and certain private non-profit organizations are eligible to apply for assistance for measures taken to respond to the COVID-19 emergency at the direction or guidance of public health officials. Reimbursable activities typically include emergency protective measures such as the activation of State Emergency Operations Centers, National Guard costs, law enforcement and other measures necessary to protect public health and safety. The FEMA Region IX Office in Oakland stood up its Regional Response Coordination Center to co-coordinate with HHS for federal resources to the seven states and territories within its operational jurisdiction. CDPH issued new guidance on gambling venues, theme parks and theaters. Governor Gavin Newsom signed an Executive Order ensuring state funding for schools in event of physical closure. March 12 , Governor Gavin Newsom issued a new executive order further enhancing California's ability to respond to the COVID-19 pandemic. The Governor's order: Waives the one-week waiting period for people who are unemployed and/or disabled as a result of COVID-19; Delays the deadline for state tax filing by 60 days for individuals and businesses unable to file on time based on compliance with public health requirements related to COVID-19 filings; Directs residents to follow public health directives and guidance, including to cancel large non-essential gatherings that do not meet state criteria; Readies the state to commandeer property for temporary residences and medical facilities for quarantining, isolating or treating individuals; Allows local or state legislative bodies to hold meetings via teleconference and to make meetings accessible electronically; and Allows local and state emergency administrators to act quickly to protect public health. March 11 , Governor Newsom and state public health officials announced updated guidance on gatherings to protect public health and slow the spread of COVID-19. The state's public health experts have determined that gatherings should be postponed or canceled across the state until at least the end of March. Non-essential limited to no more than 250 people, while smaller events can proceed only if the organizers can implement social distancing of 6 feet per person. Gatherings of individuals who are at higher risk for severe illness from COVID-19 should be limited to no more than 10 people, while also following social distancing guidelines. On March 11, the World Health Organization declared COVID-19 a pandemic. March 10 Snapshot: 1017 total individuals were disembarked from the ship on March 10. 614 individuals were transported by bus to Travis Air Force Base near Fairfield, California. 124 individuals were transported via charted flight to Dobbins Air Reserve base near Marietta, Georgia. 98 individuals were transported via chartered flight to Lackland Air Force Base near San Antonio. 136 individuals were repatriated via chartered flight to the United Kingdom. 3 individuals were transported via ambulance. Up to 24 individuals who disembarked the cruise ship are being relocated to a cluster of buildings on the Asilomar State Beach and Conference Grounds in Pacific Grove. The individuals will be temporarily housed in buildings that are removed from visitors and the public, and will not interact with other Asilomar guests, employees, or the general public. All the individuals have been screened by medical professionals, and because they have mild symptoms that do not require hospitalization, they cannot be quarantined at Travis Air Force Base. While none of these individuals is known to have contracted novel coronavirus (COVID-19), they will be tested and monitored by medical professionals while at Asilomar. Following the completion of the mission, the Grand Princess Cruise Ship will be moved from dock at the Port of Oakland and temporarily anchored. Upon the ship’s departure, the Port of Oakland site will be fully remediated and decontaminated by immediately removing temporary structures and pressure washing the entire site with a bleach solution to disinfect it. CHHS and Cal OES continues partnering with federal and local governments to ensure that adequate protocols are in place to protect the health of the disembarked passengers and the public health of California and the communities surrounding Asilomar. The state worked, and continues to work closely with local agencies, including Monterey County and the City of Pacific Grove, to coordinate this mission and provide communication and information to the public. March 9 Snapshot: 407 total individuals were disembarked from the ship 173 U.S. residents 149 transported via bus to Travis Air Force Base 24 transported via ambulance 234 Canadians 232 transported for repatriation to Canada 2 transported via ambulance The first day of disembarkation focused on passengers with the greatest medical need (not necessarily related to COVID-19). Many of these passengers had limitations on their movement which required greater time and care while they de-boarded the vessel. Around noon on March 9, the Grand Princess cruise ship docked in the Port of Oakland and begin the disembarking process. Federal support teams from the Office of the Assistant Secretary for Preparedness & Response within the U.S. Department of Health and Human Services (U.S. HHS) setup disembarking screening protocols to focus first on helping those individuals who required immediate emergency medical care, not necessarily related to COVID-19 exposure. After the first cohort of individuals disembarked, the federal staff began disembarking the 962 California residents and Canadian nationals. Once all California residents were off the ship, non-Californians were transported by the federal government to facilities in other states. The crew was quarantined aboard the ship. Crew members in need of more acute medical care, were transferred to an appropriate medical facility in California. For more information regarding today’s activities in Oakland, see this press release from OESNews. March 8 , Cal OES and CDPH issued a press release giving an overview of the plan for the disembarking of the Grand Princess passengers and crew. For that release, please visit the OES News page. U.S. Department of Health and Human Services worked with state and local partners in California to support passengers returning to the U.S. on the Grand Princess cruise ship. For that release, please visit the HHS page. The ship docked temporarily in a non-passenger port in San Francisco Bay. Passengers will be transferred to federal military installations for medical screening, COVID-19 testing, and a 14-day quarantine. Nearly 1,000 passengers who are California residents will complete the mandatory quarantine at Travis Air Force Base and Miramar Naval Air Station, and residents of other states will complete the mandatory quarantine at Joint Base San Antonio Lackland in Texas or Dobbins Air Force Base in Georgia. The Department of State worked closely with the home countries of several hundred passengers to arrange for repatriation to their countries. March 7 , California officials issued updated guidance to schools, colleges and universities, event organizers and public health officials as they plan for further spread of COVID-19. On the morning of March 6, the federal government and the State of California learned that 21 of the 46 individuals who were tested for COVID-19 on the Grand Princess cruise ship tested positive. Federal and state government have been working in close collaboration overnight and throughout the day to quickly stand up a solution that meets the health needs for those on board and protects public health. The ship remains in international waters, and the mission will be a joint effort by the federal government and the State of California. On March 5, under the direction of Governor Gavin Newsom, the Department of Managed Health Care directed all commercial and Medi-Cal health plans regulated by the Department to immediately reduce cost-sharing to zero for all medically necessary screening and testing for the COVID-19. On March 5, the California Department of Insurance issued similar direction providing cost free medically necessary testing for an additional 2 million Californians. Combined these announcements ensure that 24 million more Californians are eligible to receive testing, should their health care provider deem it medically necessary. On March 5, the California Employee Development Department announced support services to individuals affected by COVID-19 in California. For faster and more convenient access to those services, the use of online options is encouraged. Individuals who are unable to work due to having or being exposed to COVID-19 (certified by a medical professional) can file a Disability Insurance claim. Californians who are unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional) can file a Paid Family Leave claim. Employers experiencing a slowdown in their businesses or services as a result of the Coronavirus impact on the economy may apply for the UI Work Sharing Program. On March 4, Governor Newsom declared a State of Emergency. The order streamlines processes to allow California to more rapidly address the impacts of suspected or confirmed COVID-19 cases throughout the state. Proclamation can be viewed here. California is Prepared: Given our connectedness to rest of the world and our sheer size, we have always understood that a fast-spreading and novel infectious disease could show up here first, in California, before anywhere else in the country. In recent years we have had a plan for a flu-like pandemic – one that has built on our knowledge and experience with previous flu-strains and infectious diseases. Our public health infrastructure and our expertise is second to none. We have been preparing for this particular virus since it was discovered last year, and we have been in deep and daily coordination with the CDC, local government and our health system as it spread. How Can People Protect Themselves: Every person has a role to play. So much of protecting yourself and your family comes down to common sense – things you learned as a kindergartner: Washing hands with soap and water. Avoiding touching eyes, nose or mouth with unwashed hands. Avoiding close contact with people who are sick. Follow guidance from public health officials. It is also important that anyone experiencing symptoms of COVID-19, call their health care provider first before seeking medical care so that appropriate precautions can be taken. Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough. About the Disease: The family of coronaviruses has been around for some time. Some coronavirus are common, like the ones that cause the common cold. Coronavirus Disease 2019, or COVID-19, is a new a kind of coronavirus. The most common symptoms include fever cough and respiratory symptoms. Our experience to date is that most people, more than 80%, have mild or no symptoms, but some have more complicated course, including pneumonia. We are learning more about its transmission, but the most common symptoms are respiratory, so its primary mode of transmission is through coughing and sneezing. About the Tests: California has 22 - labs with test kits, 21 already testing with 49 local health jurisdictions involved in self-monitoring. 9,095 – Number of tests California can perform now. 2,865 – Number of people tested in Public Health Labs Quest Lab coming online with the immediate capacity to process an additional 1,200 tests daily. 2 other commercial labs will be coming online by March 24. The CDC is providing test kits to public health labs in the U.S., including California, to detect the novel coronavirus. The test kits contain all the elements necessary for a laboratory to test and confirm the presence of the disease. Each test kit contains enough ingredients to test between 350 and 400 individuals. As of March 7, there are 25 such kits in California at various public health labs. Additional test kits have been ordered. At this time, both oral and nasal swabs are taken at a hospital or by a physician who suspects COVID 19. This is handled through regular procedures for specimen collection, much in the same way flu testing is handled. There are no special materials needed for this collection. Those specimens are delivered, again much in the same way flu specimens are delivered, to the nearest public health lab for testing. California is working closely with the CDC to request and receive more testing capacity, as needed. The CDC has fulfilled those requests on an ongoing basis and, as needs expand, California continues to request more testing capacity. Q&A: A new Q&A section is being developed. Stay tuned. Other Resources and Press Releases CDC Webpage CDPH Website Governor Newsom Asks Legislature for Emergency Legislative Action to Fight COVID-19 Small Business Administration- Disaster Loan Assistance-Declaration Details DMV allows customers to avoid coming to a DMV office for 60 days FEMA Support Under Emergency Declaration Get Your Mass Gatherings or Large Community Events Ready Federal and State Partners Provide Update on Grand Princess Cruise Ship Debarkation State Health & Emergency Officials Announce Latest COVID-19 Facts (3/15) Governor Newsom Signs Executive Order Ensuring State Funding for Schools Even in Event of Physical COVID-19 Guidance Documents Frequently Asked Questions About Use of Stockpiled N95 Filtering Facepiece Respirators for Protection from COVID-19 Interim Guidance for Protecting Health Care Workers from Exposure to 2019 Novel Coronavirus (2019-nCoV) State Health & Emergency Officials Announce Latest COVID-19 Facts Governor Newsom, State Health Officials Announce More than 22 Million Californians Now Eligible for Free Medically Necessary COVID-19 Testing Federal and State Partners Protect the Community of Oakland while Supporting the Safe Return of Passengers from the Grand Princess Cruise Ship Update on Americans Who Have Disembarked the Grand Princess Cruise Ship State Health & Emergency Officials Release Guidance to Prepare and Protect Homeless Californians and Service Providers from COVID-19 Covid-19 Public Health Guidance for Individuals With Access And Functional Needs ###
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On March 15, Governor Gavin Newsom announced pilot programs in Santa Clara and San Mateo counties that will begin mobile testing labs in next 24 to 48 hours. Pilot program could expand to other areas of state. The Governor also called for: