DATE OF ORDER: September 3, 2021
Please read this Order carefully. Violation of or failure to comply with this Order is a misdemeanor and may be punishable by fine, imprisonment, or both. (California Health and Safety Code § 120275, et seq.)
UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 101040, 101085, AND 120175, THE HEALTH OFFICER OF THE COUNTY OF SONOMA (“HEALTH OFFICER”) ORDERS:
1. Summary. This Order of the Health Officer requires businesses and governmental entities with personnel who are home health care workers or pharmacists to require their personnel to get tested weekly for the virus that causes Coronavirus Disease 2019 (“COVID-19”) or produce satisfactory evidence, as defined in this Order, that they are fully vaccinated against COVID-19.
2. Effective Date: This Order takes effect at 12:01 a.m. on September 24, 2021.
3. Basis for Order. On July 26, 2021, the California Department of Public Health issued an order requiring employers of high-risk health care and congregate settings to verify the vaccine status of all workers and requiring that unvaccinated or unverified workers undergo routine surveillance testing (https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Order-of-the-State-Public-Health-Officer-Unvaccinated-Workers-In-High-Risk-Settings.aspx). I have reviewed the Order and determined that it leaves out an important group that interacts with persons especially vulnerable to the COVID-19 virus and that should also undergo regular surveillance testing if they cannot show proof of vaccination. That group consists of persons that go into homes to deliver health care and persons working in a pharmacy.
This Order is being issued in light of SARS-CoV-2 Delta variant which has become the dominant strain of the SARSCoV-2 virus in the United States, including the County. This variant is more contagious and causes more severe illness than previous strains of SARS-CoV-2. With the easing of COVID-19 prevention restrictions since June 15, people have more exposure risk outside the workplace and can therefore more easily bring the virus into the workplace.
Vaccination against COVID-19 is the most effective means of preventing infection with the COVID-19 virus, with the risk of infection reduced by between 70 percent and 95 percent. Vaccination also appears to reduce the chance of transmission by an infected vaccinated person by between 40 percent and 60 percent. The combination of reduced infection risk plus reduced transmission risk provides a very high level of protection for persons who are in close proximity to each other. In contrast, the wearing of face coverings reduces transmission by an infected person by about 70 percent; however, the combination of wearing face coverings and regular testing, followed by isolation of individuals who test positive, may approach the level of efficacy vaccination provides in terms of reduction of transmission risk.
Cal/OSHA Regulations generally allow documentation of vaccination status by self-attestation. I have determined that, for purposes of this Order, documentation of the vaccination status of home health care workers and pharmacists, as defined in this Order, be based on more reliable documentation than a self-attestation. I have also determined that public health and safety demands that home health care workers and pharmacy staff who cannot show proof of being fully vaccinated must be tested at least weekly for the presence of the SARS-CoV-2 virus in order to continue to interact with patients/clients in their work setting.
4. COVID-19 Test Requirements. Except as set forth in Section 5 of this Order, Businesses, as defined below, and governmental entities with Personnel who are Home Health Care Workers or Pharmacists shall:
a. Receive a COVID-19 Test at least once a week; and
b. Unless test results are sent directly to the Business or governmental entity by the test provider, promptly provide the results of each COVID-19 test to their employer for record-keeping.
Businesses and governmental entities may require a confirmatory nucleic acid amplification test (“PCR test”) following a positive antigen test. The Business or governmental entity must exclude from the workplace any Personnel who receives a positive antigen test until the Business or governmental entity receives results from a confirmatory PCR test.
5. Fully Vaccinated Personnel. A Business or governmental entity may exempt an individual member of its Personnel from the COVID-19 Test requirements set forth in Section 4 of this Order if the individual first presents to the Business or governmental entity one of the following:
a. COVID-19 Vaccination Record Card (issued by the CDC or WHO Yellow Card) which includes name of person vaccinated, type of vaccine provided and date last dose administered); or
b. a photo of a Vaccination Record Card as a separate document; or
c. a photo of the client’s Vaccination Record Card stored on a phone or electronic device; or
d. documentation of COVID-19 vaccination from a health care provider; or
e. digital record that includes a QR code that when scanned by a SMART Health Card reader displays to the reader client name, date of birth, vaccine dates and vaccine type. The QR code must also confirm the vaccine record as an official record of the state of California; or
f. documentation of vaccination from another employer or agency that is also subject to this Order.
In the absence of knowledge to the contrary, a Business or governmental entity may accept the documentation presented as valid.
Personnel who are not Fully Vaccinated as defined below, or for whom vaccine status is unknown or documentation is not provided, must be considered not Fully Vaccinated and are subject to the COVID-19 Test requirements in Section 4 of this Order.
6. Record-Keeping Requirements. A Business or governmental entity must keep and maintain a record of the following information for the purpose of inspection by an authorized representative of the Health Officer:
a. For Personnel who provide the Business or governmental entity with documentation of Fully Vaccinated status in accordance with Section 5 of this Order: (1) Full name and date of birth; (2) COVID19 Vaccine manufacturer; and (3) date of COVID-2 Vaccine administration (first dose, and if applicable, second dose).
b. For other Personnel: COVID-19 Test results.
7. Face Covering Requirement. Businesses and governmental entities subject to this Order shall require all of its Personnel to comply with the Order of the Health Officer (C19-25). Personnel who are not Fully Vaccinated, or for whom vaccine status is unknown or documentation is not provided, must wear FDA-cleared surgical masks or respirators in indoor work settings, unless exempted from wearing a face covering under Cal/OSHA COVID-19 Emergency Temporary Standards and/or the Cal/OSHA Aerosol Transmissible Diseases Standards.
8. Definitions. For purposes of this Order, the following terms have the meanings given below.
a. “Business” includes any for-profit, non-profit, or educational entity, whether a corporate entity, organization, agency, partnership or sole proprietorship, and regardless of the nature of the service, the function it performs, or its corporate or entity structure.
b. “CDC” means the U.S. Centers for Disease Control and Prevention.
c. “COVID-19 Test” means a nucleic acid amplification or antigen test to detect infection of a person with SARS-CoV-2, the virus that causes COVID-19.
d. “COVID-19 Vaccine” means a vaccine to prevent COVID-19 that is (1) administered under an emergency use authorization from the FDA; (2) approved by the FDA; or (3) listed for emergency use by the World Health Organization.
e. “FDA” means the U.S. Food and Drug Administration.
f. “Fully Vaccinated” means a person’s status two weeks following the person’s receipt of a single-dose COVID-19 Vaccine or the second dose of a two-dose COVID-19 Vaccine.
g. “Home Health Care Worker” means a health care service provider providing care in the patient’s home, including but not limited to physical, speech, and occupational therapists, and does not include social service providers such as In Home Support Services workers, social workers, teachers and tutors.
h. “Personnel” means the following people who provide services to a Business or governmental entity: employees, contractors or sub-contractors; independent contractors; volunteers; and other individuals who regularly provide services at the request of the Business or governmental entity.
i. “Pharmacist” means Pharmacists, Pharmacy Technicians, and Pharmacy Assistants.
j. “WHO” means the World Health Organization.
IT IS SO ORDERED:
Sundari R. Mase, MD, MPH Date