COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 1 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
RESPONDING TOGETHER AT WORK AND IN THE COMMUNITY
BEYOND THE BLUEPRINT FOR A SAFER ECONOMY, POST WINTER SURGE, HIGH TRANSMISSION—ENCOURAGING COVID-19 VACCINATION AND BOOSTER DOSE
COVERAGE WITH RISK REDUCTION MEASURES
Issue Date: Wednesday, February 23, 2022
Effective at 12:01am on Friday, February 25, 2022*
Brief Highlights (Changes highlighted in yellow):
2/23/2022:
• In light of decreasing case and test positivity rates and hospitalizations, this Order creates elective criteria for establishments, businesses, and venues to voluntarily implement to exempt either of the following from the indoor masking requirement: Option #1— all fully vaccinated customers, visitors and onsite workers or Option #2—just fully vaccinated customers and visitors. Unvaccinated or partially vaccinated persons must continue to wear a well-fitting mask in public indoor settings.
Please read this Order carefully.
SUMMARY OF THE ORDER: Based on the federal Centers for Disease Control and Prevention (CDC) indicators, as of February 22, 2022 the County of Los Angeles had 133.27new cases of COVID-19 per 100,000 persons in the past 7 days. According to the CDC’s threshold of 100 or more new cases of COVID-19 per 100,000 persons, the County remains at a High rate but is moving steadily downward toward a Substantial rate of community transmission of COVID-19.
The CDC’s threshold for a Substantial rate of COVID-19 transmission is 50-99.99 new cases of COVID-19 per 100,000 persons in the past 7 days. As a result, and in anticipation of a continued consistent downward trend of cases and hospitalizations, this Order revises certain protective measures.
This Order mainly aligns with the State Public Health Officer Orders of June 11, 2021, December 13 & 31, 2021, and February 7. It continues to place certain safety requirements on individuals consistent with federal and state rules. Further, this Order incorporates by reference the July 26, 2021, and December 22, 2021 Order of the State Public Health Officer, which requires specific transmission prevention measures to be taken by Acute Health Care and Long-Term Care settings, High-Risk Congregate settings, and Other Health Care settings. In addition, this Order continues to require that all persons, 2 years of age and older, wear face masks while in indoor public settings and businesses, with limited exceptions, as a protective measure with this High level of community transmission. On July 28, 2021, the CDC, and the California Department of Public Health each issued new guidance validating the universal indoor masking requirements of this Order. The CDC’s Interim Public Health Recommendations for Fully Vaccinated1 People advises that “preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others” and therefore recommends that 1 People are considered “fully vaccinated” against COVID-19 two weeks or more after they have received the second dose in a 2-dose series (e.g., Pfizer-BioNTech or Moderna) or 2 weeks or more after they have received a single-dose vaccine (e.g., Johnson and Johnson [J&J]/Janssen).
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 2 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
fully vaccinated people should wear a mask in indoor settings if they are in a [geographic] area where there is Substantial or High rates of COVID-19 community transmission. Although beginning February 16, 2022, the State Public Health Officer recommends that fully vaccinated individuals to continue indoor masking and continues to require masking indoors for unvaccinated individuals in indoor public settings and businesses, this Order continues to require indoor masking regardless of vaccination status.
In recognition of the recent and consistent decline of case and test positivity rates and hospitalizations, the Order establishes two voluntary verification options for establishments, businesses or other venues that are not subject to a federal or state requirement that requires everyone to wear a mask, to implement, so that persons who are up to date2 with their COVID19 vaccines or fully vaccinated may be unmasked while indoors within their facility. Persons who are not fully vaccinated must continue to wear a well-fitting mask while indoors. This is an interim step until the County reaches a Moderate3 rate of community transmission, and it permits establishments, businesses and venues which meet the specific criteria to allow fully vaccinated persons to remain unmasked while indoors. See Paragraph 4(c) for criteria requirements.
COVID-19 daily cases and community transmission of COVID-19 remain at a high level.
Thankfully, since mid-January 2022, cases, test positivity, and hospitalization rates are consistently decreasing. Further, based upon federal CDC indicators and thresholds, community transmission of COVID-19 within the County of Los Angeles continues to be at a High level.
Even though more people in Los Angeles County and the region are vaccinated against the virus that causes COVID-19, there remains a risk that when outside of their residence people may come into contact with others who may have COVID-19. There are millions of people in Los Angeles County who are not yet vaccinated against COVID-19, including children under 5 years of age who are not currently eligible to be vaccinated, and people who are immunocompromised and may be particularly vulnerable to infection and disease. Most COVID-19 infections are spread by people who have no or mild symptoms of infection. The Omicron variant, currently the predominant strain in Los Angeles County, spreads more easily than the original virus that causes COVID-19. In the absence of physical distancing requirements for the public and capacity limits for indoor settings, unvaccinated and partially vaccinated persons are more likely to get infected and spread the virus, which is transmitted through the air and concentrates in indoor settings. Additionally, we continue to see COVID-19 infections among fully vaccinated persons, albeit at a significantly lower rate than those among persons who are not fully vaccinated.
Current vaccines lower the risk of infection and, if infected, help protect against severe illness, hospitalizations, and deaths due to infection with the Omicron variant. However, breakthrough infections in people who are vaccinated can occur. People who are up to date (up to date means fully vaccinated and received a booster dose or fully vaccinated but not yet booster-eligible) with their COVID-19 vaccines and get COVID-19 are less likely to develop severe illness, be hospitalized, or die than those who are unvaccinated and get COVID-19. Although no vaccine is 100 percent effective at preventing illness in vaccinated people, the currently authorized 2 Up to date means a person is fully vaccinated and has received a booster dose or is fully vaccinated but not yet booster-eligible. 3 A Moderate level of transmission is defined by the CDC as 10-49.99 new cases of COVID-19 per 100,000 persons in the past 7 days.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 3 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
COVID-19 vaccines, including the primary series, booster shots and additional doses for those who need them, remain the best form of protection against COVID-19 infection, hospitalization, and death. Vaccinations are widely available to those 5 years and older. Booster doses are available for everyone 12 years and older.
The best way to reduce the current level of community transmission, reduce the likelihood of new variants emerging, and to prevent future surges is for everyone who is eligible, including those who have recovered from a COVID-19 infection, to get fully vaccinated and be up to date on their vaccines as soon as possible. People at risk for severe illness with COVID-19, such as unvaccinated older adults and unvaccinated individuals with health risks, and members of their households, are strongly urged to get vaccinated against COVID-19 as soon as they can if they have not already done so. And all persons who are fully vaccinated should also receive a booster dose of the COVID-19 vaccine as soon as they are eligible since studies show the protection from the primary COVID-19 vaccination may decrease over time. With an increased immune response, people should have improved protection against getting infected with and seriously ill from COVID-19, including the variants. Those who are not fully vaccinated are urged to adhere to both the required and recommended risk reduction measures.
We must remain vigilant against variants of the virus that causes COVID-19, especially given High levels of transmission here and in other parts of the country and world. It is, therefore, prudent to require continued indoor masking for all as an effective public health measure to reduce transmission between people until we reach lower rates of community transmission. We believe that if people who live and work in Los Angeles County continue taking common sense measures to prevent the spread of COVID-19, we will continue to experience the current consistent rate of declines in case, test positivity rates, and hospitalizations, and the County may reach a Moderate rate of community transmission in March 2022. A Moderate level of transmission is defined by the CDC as 10-49.99 new cases of COVID-19 per 100,000 persons in the past 7 days.
This Order is issued to continue to help slow and decrease the level of community transmission of COVID-19, so we can quickly reach a Moderate level of transmission here in Los Angeles County.
This Order’s primary intent is to reduce the transmission risk of COVID-19 in the County for all, especially those who are not fully vaccinated and fully vaccinated but immunocompromised persons, in the absence of other protective measures, like physical distancing requirements and capacity limits. Accordingly, this Order allows Businesses, schools, and other activities to remain open while at the same time putting in place certain requirements designed to (1) limit transmission risk of COVID-19 and (2) reduce the risk of any COVID-19 outbreaks.
This Order will be revised in the future, if needed, to reflect the State Executive Orders, California Division of Occupational Safety and Health’s (better known as Cal/OSHA) worksite requirements, State Public Health Officer Orders and guidance, and CDC recommendations.
Should local COVID-19 conditions warrant, the County Health Officer may, after consultation with the Board of Supervisors, issue Orders that are more restrictive than those of the State Public Health Officer.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 4 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
This Order is effective within the County of Los Angeles Public Health Jurisdiction, defined as all cities and unincorporated areas within the County of Los Angeles, except for the cities of Long Beach and Pasadena that must follow their respective City Health Officer orders and guidance. This Order is effective at 12:01 am on Friday, February 25, 2022 and
UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND
SAFETY CODE SECTIONS 101040, 101085, AND 120175,
THE COUNTY OF LOS ANGELES HEALTH OFFICER ORDERS:
1) This Order supersedes the Health Officer's Prior Order. 2) This Order’s intent is to continue to protect the community from COVID-19 and to also increase vaccination and booster dose rates to reduce transmission of COVID-19 long-term, so that the whole community is safer, and the COVID-19 health emergency can come to an end.
4 Failure to comply with any of the Order’s provisions constitutes an imminent threat and menace to public health, and a public nuisance, and is punishable by citation or fine. a) This Order does not supersede any stricter limitation imposed by a local public entity within the County of Los Angeles Public Health Jurisdiction. The Order is consistent with existing authority that local health jurisdictions may implement or continue more restrictive public health measures if the jurisdiction’s Local Health Officer determines that health conditions in that jurisdiction warrant such measures. Where a conflict exists between this Order and any State Public Health Officer Order related to controlling the spread of COVID-19 during this pandemic, the most restrictive provision controls, unless the County of Los Angeles is subject to a court order requiring it to act on, or enjoining it from enforcing, any part of this Order. 3) All persons living and working within the County of Los Angeles Public Health Jurisdiction should continue to always practice required and recommended COVID-19 infection control measures and when among other persons when in community, work, social or school settings, especially when multiple unvaccinated persons from different households may be present and in close contact with each other, and especially when in indoor or crowded outdoor settings.
All persons in the general public diagnosed with COVID-19 must review and comply with the requirements for isolation provided in the Health Officer Public Health Emergency Isolation Order. And those who were exposed to someone who tested positive for COVID-19 while the positive person was infectious must review and comply with the quarantine requirements provided in the Health Officer Public Health Emergency Quarantine Order. Separate isolation and quarantine requirements are outlined in the Coronavirus Disease 2019: Infection Prevention Guidance for Healthcare Personnel and in Appendix T1: Reopening Protocols for K-12 Schools for students in K-12 School Settings.
5 4 People are considered “fully vaccinated” against COVID-19 two weeks or more after they have received the second dose in a 2-dose series (e.g., Pfizer-BioNTech or Moderna) or 2 weeks or more after they have received a single -dose vaccine (e.g., Johnson and Johnson [J&J]/Janssen).
5 An antigen test, nucleic acid amplification test (NAAT) or LAMP test are acceptable; however, it is recommended that persons use an antigen test for ending isolation.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 5 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
4) Face Masks. All individuals must follow the requirements of this Order. a) These requirements are aligned with July 28, 2021 recommendations issued by the CDC. The CDC recommendations provide information about both indoor and higher risk settings where masks are required or recommended to prevent transmission to:
i) Persons with a higher risk of infection (e.g., unvaccinated or immunocompromised persons),
ii) Persons with prolonged, cumulative exposures (e.g., workers), or iii) Persons whose vaccination status is unknown.
When people wear a mask correctly, they protect others as well as themselves.
Consistent and correct mask use is especially important indoors when in close contact with (less than six feet from) others who are not fully vaccinated against COVID-19 or whose vaccination status is unknown.
b) Masks are required to be worn by everyone, 2 years of age and older, regardless of COVID-19 vaccination status, in the following settings:
i) On public transit (examples: airplanes, ships, ferries, trains, subways, buses, taxis, and ride-shares),
ii) In transportation hubs (examples: airport, bus terminal, marina, train station, seaport or other port, subway station, or any other area that provides transportation),
iii) Indoors in K-12 schools, childcare and other youth settings (See, Appendix T1 for K-12 School masking requirements),
iv) Healthcare settings (including long term care facilities), v) State and local correctional facilities and detention centers, vi) Homeless shelters, emergency shelters, and cooling centers, and vii) All indoor public settings, venues, gatherings, and public and private businesses (some examples: offices, manufacturing, warehouses, retail, food and beverage services, theaters, family entertainment centers, meetings, and state and local government offices serving the public, and Indoor Mega Events, among others. Operators of these settings outlined in Paragraph 4(b)(vii) may elect to meet the criteria for either of the two options in Paragraph 4(c) if they want to allow fully vaccinated persons to choose to be exempt from the indoor masking requirement.
c) An establishment, business, or venue listed in Paragraph 4(b)(vii) may elect to fulfill and operationalize one of the requirements listed below to allow fully vaccinated persons, ages 5 and older, to choose to be exempt from the indoor masking requirement.
i) Option #1—To allow both fully vaccinated customers/visitors and fully vaccinated onsite workers to unmask while indoors, the operator must:
(a) Verify proof of either full vaccination against COVID-19 or a recent negative COVID-19 viral test result for all
customers/visitors (age 5 years or older) AND all onsite workers,
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 6 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
prior to entry. A customer’s or visitor’s test results must have been taken within 2 days of entry if a PCR test or 1 day if an antigen test. Onsite workers who are not fully vaccinated may submit a negative COVID-19 viral test result prior to work onsite, every 3 days. No cost testing must be made available to onsite workers. (i) Proof of full vaccination status prior to entry requires review of:
1. Both the individual’s photo identification; and
2. The individual’s vaccination card (which includes
name of person vaccinated, type of COVID-19
vaccine provided, and date last dose administered)
OR a photo of a vaccination card as a separate
document OR a photo of the attendee's vaccine
card stored on a phone or electronic device OR
documentation of the person’s full vaccination
against COVID-19 from a healthcare provider OR
their COVID-19 digital vaccine record. The vaccine
card or record must include the name of person
vaccinated, type of COVID-19 vaccine provided,
and date each dose was administered.
(ii) Proof of a recent negative COVID-19 viral test prior to entry requires review of:
1. Both the individual’s photo identification (for
persons 18 years of age and older); and a printed
document from the test provider or laboratory OR
an email or text message displayed on a phone
from the test provider or laboratory. The test result
information needs to include the person's name,
date of test, type of test performed, and negative
test result.
2. Results from over the counter (OTC) self-test kits
are not an acceptable form of proof for customers.
Workplaces may accept negative test result from
COVID-19 OTC self-test kits for employees if used
per Cal-OSHA requirements.
(b) For persons who ARE fully vaccinated to be exempt from the indoor public setting masking requirement, persons who are not fully vaccinated or do not show proof of vaccination status must:
(i) Provide a negative COVID-19 viral test result prior to entry or, if a worksite staff member, every 3 days (as above), AND
(ii) Continue to wear a well-fitting mask while indoors, except when actively eating or drinking.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 7 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
ii) Option #2—To allow fully vaccinated customers and visitors to unmask while indoors, while all onsite workers, including contractors, remain masked, they must:
(a) Verify proof of either full vaccination against COVID-19 or a recent negative COVID-19 viral test result for all
customers/visitors (age 5 years or older). All onsite workers remain masked while indoors. A customer or visitor test results must have been taken within 2 days of entry if a PCR test or 1 day if an antigen test.
(b) Adhere to the following regarding customers and masking:
(i) Only fully vaccinated customers and guests may be
unmasked in the indoor setting.
(ii) Customers and guests that are not fully vaccinated must continue to wear a well-fitting mask while indoors (as
required by the state) except when actively eating or
drinking.
(iii) Onsite worksite staff, regardless of their vaccination status, are required to remain masked while indoors.
iii) Establishments, businesses, and venues that elect to meet this criterion and permit fully vaccinated customers, guests and/or worksite staff to be unmasked, must offer, at no cost to all employees, a well-fitting respirator (e.g., N95/KN95/KF94) to maximize their protection in an unmasked indoor environment.
iv) Individuals do not need to meet the vaccination/negative viral test verification requirements to enter the indoor portion of the facility in the following situations, as long as they wear a well-fitted mask:
(a) As part of their employment to make a delivery or pick-up, provide a service or repair to the facility, or for an emergency or regulatory purpose;
(i) To get to the outdoor portion of the facility;
(ii) To use an indoor restroom, or
(iii) To order, pick-up, or pay for food or drink “to go.” d) Recommendation for higher level of protection: In indoor public and private settings where there is close contact with other people who may not be fully vaccinated, individuals should consider wearing a higher level of protection, such as wearing two masks (“double masking”) or a wearing a respirator (e.g., KN95 or N95). This is particularly important if an individual is not fully vaccinated and is in an indoor or crowded outdoor setting.
e) Individuals, businesses, venue operators or hosts of public indoor settings, venues, gatherings, and businesses must:
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 8 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
i) Require all patrons, customers, and guests to wear masks when inside at all indoor settings, regardless of their vaccination status; and ii) Post clearly visible and easy to read signage, with or without having an employee present, at all entry points for indoor settings to communicate the masking requirements for patrons, customers, and guests. f) For clarity, patrons, customers, or guests at public indoor settings, venues, gatherings, and public and private businesses are required to wear a face mask except while:
i) Actively eating or drinking, which is the limited time during which the mask can be removed briefly to eat or drink, after which it must be immediately put back on. Patrons, customers, or guests must be seated at a table or positioned at a stationary counter, ticketed seat, or place while actively eating or drinking.
Except, all persons must wear masks at all times while indoors at Cardrooms, except when actively consuming food and beverages in a designated dining area.
Further, it is a strong recommendation that at Indoor Mega Events, Performance Venues, Movie Theatres and Entertainment Venues, food and drink only be consumed, where possible, in designated dining areas. In addition, Indoor Mega Events, Performance Venues, Movie Theatres and Entertainment Venues are responsible for messaging, signage, and compliance with masking requirement unless spectators/customers are actively eating or drinking.
ii) Showering or engaging in personal hygiene or a personal care service that requires the removal of the face mask;
iii) Alone in a separate room, office or interior space; g) Special considerations are made for people with communication difficulties or certain disabilities. Clear masks or cloth masks with a clear plastic panel that fit well are an alternative type of mask for people who interact with: people who are deaf or hard of hearing, children or students learning to read, people learning a new language, and people with disabilities.
h) All businesses, venue operators or hosts must implement measures to clearly communicate to non-employees the masking requirements on their premises. i) No person can be prevented from wearing a mask as a condition of participation in an activity or entry into a business.
j) The categories of persons who are exempt from mask requirements remain unchanged at this time and can be found at
http://publichealth.lacounty.gov/acd/ncorona2019/masks/#notwear. In workplaces, certain employees may be exempt from wearing a mask when performing specific tasks which cannot feasibly be performed while wearing a mask. This exception is limited to the period of time in which such tasks are actually being performed.
Workers who cannot feasibly wear a mask while performing their work, and who are either unvaccinated or fully vaccinated and eligible for a dose of COVID-19 vaccine but have not yet received it, must be tested for COVID-19 at least twice per week.
Fully vaccinated persons who cannot feasibly perform their job while wearing a
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 9 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
mask, and who have received their booster dose of COVID-19 vaccine or who are not yet eligible for a booster should test at least once per week. k) In workplaces, most employers and businesses are subject to the Cal/OSHA COVID19 Emergency Temporary Standards (ETS) and some to the Cal/OSHA Aerosol Transmissible Diseases Standards, and should consult those regulations for additional applicable requirements. The ETS allow local health jurisdictions to require more protective mandates. This County Health Officer Order, which requires masking of all individuals at indoor public settings and businesses, regardless of vaccination status, is a such a mandate in Los Angeles County, and overrides the more permissive ETS regarding employee6 masking.
i) In establishments and settings with active outbreaks, quarantine and isolation may be extended for additional days by County Public Health outbreak investigators to help lower the risk of ongoing transmission at the site. ii) Healthcare personnel in any setting must comply with the State’s Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2 and Return to Work for HCP with COVID-19, as described in AFL-21-08.7.
All employers and businesses subject to Cal/OSHA must review and comply with the active Cal/OSHA COVID-19 Prevention Emergency Temporary Standards (ETS). As approved and effective, the full text of the COVID-19 Prevention emergency standards will be listed under Title 8, Subchapter 7, sections 3205-3205.4 of the California Code of Regulations. All businesses or employers with independent contractors should also review the State Labor Commissioner’s Office webpage entitled, “Independent contractor versus employee”, which discusses the “employment status” of persons hired as independent contractors, to ensure correct application of the ETS. As soon as possible, but no later than January 17, 2022, employers are required to provide at no cost to their employees with and require them to wear a well-fitting medical grade mask, surgical mask or higher-level respirator, such as an N95 filtering facepiece respirator or KN95, at all times while indoors at the worksite or facility. Given the contagiousness of the Omicron variant, this provision is to lower the risk of transmission to workers who work in close contact with others or with the public.
5) Mandatory Reporting by Businesses and Governmental Entities. Persons and businesses within the County of Los Angeles Public Health Jurisdiction must continue to follow the COVID-19 infection control protocols and guidance provided by the County Department of Public Health regarding isolation of persons confirmed or suspected to be infected with the virus that causes COVID-19 disease or quarantine of those exposed to and at risk of infection from COVID-19. In instances where the County has not provided a specific guidance or protocol, specific guidance or protocols established by the State Public Health Officer shall control.
a) In the event that an owner, manager, or operator of any business knows of three (3) or more cases of COVID-19 among their employees, assigned or contracted workers 6 Some independent contractors are considered as employees under the State Labor Code. For more details, check the California Department of Industrial Relations’ Independent contractor versus employee webpage.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 10 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
or volunteers within a span of 14 days, the employer must report this outbreak to the Department of Public Health at (888) 397-3993 or (213) 240-7821, or online at www.redcap.link/covidreport.
b) In the event that an owner, manager, or operator of any business is informed that one or more employees, assigned or contracted workers, or volunteers of the business has tested positive for, or has symptoms consistent with COVID-19 (case), the employer must have a protocol to require the case(s) to isolate themselves at home and require the immediate self-quarantine of all employees that had a workplace exposure to the case(s).
6) LACDPH Best Practice Guidance. All individuals and Businesses are strongly urged to follow the LACDPH Best Practice Guidance, containing health and safety recommendations for COVID-19.
7) Considerations for Persons at Higher Risk for Negative Health Outcomes: At this time, people at risk for severe illness or death from COVID-19—such as unvaccinated older adults and unvaccinated individuals with health risks—and members of their household, should defer participating in activities with other people outside their household where taking protective measures, including wearing face masks and social distancing, may not occur or will be difficult, especially indoors or in crowded spaces. For those who are not yet fully vaccinated, staying home or choosing outdoor activities as much as possible with physical distancing from other households whose vaccination status is unknown is the best way to prevent the risk of COVID-19 transmission.
8) Encourage Activities that Can Occur Outdoors. All Businesses and governmental entities are urged to consider moving operations or activities outdoors, where feasible and to the extent allowed by local law and permitting requirements, because there is generally less risk of COVID-19 transmission outdoors as opposed to indoors. 9) Ventilation Guidelines. All Businesses and governmental entities with indoor operations are urged to review the Ventilation Guidelines and implement ventilation strategies for indoor operations as feasible. See California Department of Public Health Interim Guidance for Ventilation, Filtration and Air Quality in Indoor Environments for detailed information. Nothing in this Order limits any ventilation requirements that apply to particular settings under federal, state, or local law.
10)High-Risk Health Care and Congregate Settings. This Order incorporates by reference the State Public Health Officer Order of July 26, 2021, which requires additional statewide facility-directed measure to protect particularly vulnerable populations. The Order is found here: State Public Health Officer Order issued July 26, 2021 11)Sectors that Continue to Require Additional Risk Reduction Measures. The following sectors serve persons and populations that have lower rates of vaccination, who are at higher risk of being infected, or who are not yet eligible to be vaccinated. As such, these sectors continue to require additional risk reduction measures and must operate subject to the
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 11 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
following conditions listed below and those specified in the County sector-specific reopening protocol(s) located at http://publichealth.lacounty.gov/media/Coronavirus/index.htm:
a) Day camps. Day camp owners and operators must implement and post the required Los Angeles County Department of Public Health Reopening Protocol for Day Camps, attached to this Order as Appendix K.
b) Schools (K-12) and School Districts. All public and private schools (K-12) and school districts within the County of Los Angeles may open for in-person classes. Educational facilities serving students at any grade level must prepare, implement, and post the required Los Angeles County Department of Public Health Reopening Protocols for K12 Schools, attached to this Order as Appendix T1, and must follow the Protocol for COVID-19 Exposure Management Plan in K-12 Schools, attached to this Order as Appendix T2.
c) Mega Events (Outdoor and Indoor). Beginning February 16, 2022, the attendance thresholds for Mega Events are returned to 1,000 attendees for Indoor Mega Events and to 10,000 attendees for Outdoor Mega Events. Mega Events include conventions, conferences, expos, concerts, shows, nightclubs, sporting events, live events and entertainment, fairs, festivals, parades, theme parks, amusement parks, water parks, large private events or gatherings, marathons or endurance races, and car shows. Mega Events may have either assigned or unassigned seating, and may be either general admission or gated, ticketed and permitted events. These events are considered higher risk for COVID-19 transmission.
i) Indoor Mega Events: Indoor Mega Events remain open to the public. In addition to the public health recommendations, Indoor Mega Event operators must verify the full vaccination status7 or pre-entry negative COVID-19 viral test8 result of all attendees ages 2 and older. For those attendees who cannot provide proof of full vaccination, pre-entry COVID-19 testing must be conducted within one day for antigen tests and within two days for PCR tests. Attendees, who are not fully vaccinated, must wear a well-fitting mask while indoors at an Indoor Mega Event. Operators are required to cross-check proof of full vaccination or negative COVID-19 viral test result against a photo identification for all attendees who are 18 years of age or older. Indoor Mega Event operators must prominently place information on all communications, including reservation and ticketing systems, to ensure guests are aware of the proof of pre-entry negative testing or full vaccination status, including masking requirements, and acceptable modes of verification. Self-attestation may not 7 The following are acceptable as proof of full vaccination status: 1) A photo identification of the attendee and 2) their vaccination card (which includes name of person vaccinated, type of COVID-19 vaccine provided, and date last dose administered) OR a photo of a vaccination card as a separate document OR a photo of the attendee's vaccine card stored on a phone or electronic device OR documentation of the person’s full vaccination against COVID-19 from a healthcare provider. 8 Pre-entry negative COVID-19 viral testing is testing that must be conducted before entry into the event or venue (both PCR and antigen are acceptable). Results of the test must be available and provided to the operator prior to entry into the event or venue. The f ollowing is required as acceptable proof of a negative COVID-19 viral test result: 1) A photo identification of the attendee (for attendees 18 years of age and older) and 2) a printed document from the test provider or laboratory OR an email or text message displayed on a phone from the test provider or laboratory. The test result information needs to include the person's name, date of test, type of test performed, and negative test result. To be considered a valid pre-entry negative COVID-19 viral test result that permits entry into the event or venue, an antigen test must be condu cted within one day and PCR test must be conducted within two days prior to event entry.
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ORDER OF THE HEALTH OFFICER
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be used as a method to verify an attendee’s status as fully vaccinated or as proof of a negative COVID-19 test result.
ii) Outdoor Mega Events: Outdoor Mega Events remain open to the public.
Outdoor Mega Event operators of events or venues that are ticketed or held in a defined space with controlled points of public entry must verify the full vaccination status (see footnote 7) or pre-entry negative COVID-19 viral test (see footnote 8) result of all attendees, ages 5 and older, prior to entry to the event. For those attendees who cannot provide proof of full vaccination, preentry COVID-19 testing must be conducted within one day for antigen tests and within two days for PCR tests. Outdoor Mega Event operators must prominently place information on all communications, including reservation and ticketing systems, to ensure guests are aware of both the County Health Officer’s Order that all attendees, ages 5 and older, either be fully vaccinated against COVID-19 or obtain a negative COVID-19 viral test prior to attending the event. Operators are required to cross-check proof of full vaccination or negative COVID-19 viral test result against a photo identification for all attendees who are 18 years of age or older. Operators are to make face masks available for all attendees.
iii) Additional Recommendations for Both Outdoor and Indoor Mega Events: Mega Event operators are encouraged to follow these additional recommendations:
iv) Assign staff to remind all guests to wear face masks while on the premises or location
(a) Encourage everyone to get vaccinated and receive a COVID-19 booster when eligible.
(b) Facilitate increased ventilation of indoor spaces (i.e., open all windows and doors to increase natural air flow), following California Department of Public Health Interim Guidance for Ventilation, Filtration and Air Quality in Indoor Environments. (c) Encourage everyone to sign up for CA Notify as an added layer of protection for themselves and the community to receive alerts when they have been in close contact with someone who tests positive for COVID-19.
(d) Convey the risk of attending large, crowded events where the vaccine status of other attendees may be unknown to the individuals.
(e) Convey the risk of attending large, crowded events for populations that may not currently be eligible for vaccination or may be immunocompromised and whose vaccine protection may be incomplete.
d) Overnight Organized / Children’s Camps. An organized camp is a site with program and facilities established for the primary purpose of providing an overnight outdoor group living experience for recreational or other purposes for five days or more during one or
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ORDER OF THE HEALTH OFFICER
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more seasons of the year. A Notice of Intent to Operate must be submitted by the Camp operator to the Environmental Health Division [email protected] prior to operation. The owner or operator of an Overnight Organized/ Children’s Camp must prepare, implement, and post the required Los Angeles County Public Health Protocols for Overnight Organized / Children’s Camps, attached to this Order as Appendix K-1. e) Organized Youth Sports Activities. Organized youth sports include all school (TK-12 Grades) and community-sponsored programs and recreational or athletic activities and privately organized clubs and leagues. Organized Youth Sport Protocols do not apply to collegiate or professional sports. This Protocol provides direction on outdoor and indoor youth sports activities to support an environment that presents less risk for participants of these sports. The organizers and operators of Organized Youth Sport Activities must review, implement, and post the required Los Angeles County Public Health Protocol for Organized Youth Sports, effective September 1, 2021, attached to this Order as Appendix S.
f) Bars, Breweries, Wineries and Distilleries. Effective October 7, 2021, bars that have a low-risk food facility public health permit and breweries, wineries, and distilleries with a #1, #2, #4, #23 and/or #74 state alcohol license that do not possess or that are not required to have a public health permit to operate must require patrons, who are 12 years of age or older, to provide proof of their COVID-19 vaccination status for entry. Between October 7 and November 3, 2021, all patrons must provide proof they have received at least one dose of COVID-19 vaccination for entry into the facility to obtain indoor service at a bar, brewery, winery, or distillery. Beginning November 4, 2021, all bars, breweries, wineries, and distilleries must require patrons, who are 12 years of age or older, to provide proof of full vaccination against COVID-19 for entry into the facility to obtain indoor service. Patrons who do not provide proof of vaccination against COVID-19, as specified, may be served in and use the outdoor portions of the facility, where the risk of exposure to the virus that causes COVID-19 is less likely when compared to being indoors. See paragraph 11.i for further clarification. Bars, breweries, wineries, and distilleries must comply with the Guidance for Verifying Proof of COVID-19 Vaccination and Guidance for Verifying Proof of a Negative COVID-19 Test attached to this Order.
In addition, by November 4, 2021, all on-site employees must provide their employer with proof of full vaccination against COVID-19.9
9 On-site employees of the bars, breweries, wineries, distilleries, nightclubs and lounges may be exempt from the vaccination requirements only upon providing their employer, a declination form, signed by the individual stating either of the following: (1) the worker is declining vaccination based on sincerely held religious beliefs, or (2) the individual is excused from receiving any COVID-19 vaccine due to Qualifying Medical Reasons.
a. To be eligible for a Qualified Medical Reasons exemption the individual must also provide to their employer a written stateme nt 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).
See the most updated version of the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines guidance. b. If an operator of a bar, brewery, winery, distillery, nightclub or lounge deems its on-site employee to have met the requirements of an exemption, the unvaccinated exempt employee must meet the following requirements when entering or working in such facility:
a. Test for COVID-19 at least once per week with either polymerase chain reaction (PCR) or antigen test that either has Emergency Use Authorization (EUA) 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. 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 in the bar, brewery, winery, distillery, nightclub or lounge.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 14 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
g) Nightclubs and Lounges. Effective October 7, 2021, nightclubs and lounges10 that are open only to persons 18 years of age or older, must require patrons and on-site personnel to provide proof of their COVID-19 vaccination status for entry. Between October 7 and November 3, 2021, patrons must provide proof they have received at least one dose of COVID-19 vaccination for entry into the facility to obtain indoor service at a nightclub or lounge. Beginning November 4, 2021, all nightclubs and lounges must require patrons to provide proof of full vaccination for entry into the facility to obtain indoor service. Patrons who do not provide proof of full vaccination against COVID-19 may be served in outdoor portions of the facility, where the risk of exposure to COVID-19 is less likely when compared to indoors. Nightclubs and lounges must comply with the Guidance for Verifying Proof of COVID-19 Vaccination and Guidance for Verifying Proof of a Negative COVID-19 Test attached to this Order. In addition, by November 4, 2021, all on-site employees must provide their employer with proof of full vaccination against COVID-19 (see footnote 7).
h) Restaurants. These indoor venues serve food or drink indoors and are required to maintain a valid public health permit to operate. Due to the continued increased risk of transmission at places where persons are indoors and unmasked, the County Health Officer strongly recommends that the operators of these venues reserve and prioritize indoor seating and service for patrons who are fully vaccinated against COVID-19. They should verify the full vaccination status of all patrons, 12 years of age or older, who will be seated indoors for food or beverage service. Patrons who cannot provide proof of full vaccination against COVID-19 should be served in outdoor portions of the facility, where the risk of exposure to the virus that causes COVID-19 is less likely when compared to being indoors. See paragraphs 11.i.a through 11.i.c for further clarification. i) For clarity, individuals who do not provide proof of partial or full vaccination at bars, breweries, wineries, distilleries, nightclubs and lounges, may use the outdoor portions of the facility, but may not remain inside the facility except as solely provided in the subsections below:
a. The individual, who is wearing a well-fitted mask, may enter the indoor portion of the facility as part of their employment to make a delivery or pick-up, provide a service or repair to the facility, or for an emergency or regulatory purpose. b. The individual, who is wearing a well-fitted mask, may enter the indoor portion of the facility to get to the outdoor portion of the facility or to use the restroom. c. The individual, who is wearing a well-fitted mask, may enter the indoor portion of the facility to order, pick-up, or pay for food or drink “to go.” j) Cardrooms. Cardroom operators may only allow indoor dining and/or drinking within designated areas of the facility only. Food and beverages may not be consumed outside of those areas or while patrons are playing or gaming within the facility. Patrons must wear masks indoors at all times while not actively eating or drinking in a designated indoor dining area.
10 Nightclub means a commercial establishment dispensing beverages for consumption on the premises and in which dancing is permitted or entertainment is provided, and/or has as its primary source of revenue (a) the sale of alcohol for consumption on the premise s, (b) cover charges, or (c) both. A lounge is defined as a business that operates primarily for the preparation, sale, and service of beer, wine, or spirits. Minors are not allowed in a lounge.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 15 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
REASONS FOR THE ORDER
12)This Order is based upon the following determinations: continued evidence of High community transmission of COVID-19 within the County; documented asymptomatic transmission; scientific evidence and best practices regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically; evidence that millions of people in the County population continue to be at risk for infection with serious health complications, including hospitalizations and death from COVID-19, due to age, pre-existing health conditions, being unvaccinated or not eligible for vaccination, and the dominance of the more infectious Omicron variant of the virus that causes COVID-19; and limited availability of effective therapeutics. The Order’s intent is to continue to reduce the risk of COVID-19 infection for all, especially those who are not or cannot be fully vaccinated against COVID-19 in the County.
13)Existing community transmission of COVID-19 in Los Angeles County remains High and continues to present a high risk of infection and harm to the health of those who are not or cannot be vaccinated against COVID-19. COVID-19 vaccinations are widely available to those 5 years and older. The Omicron variant of the virus spreads more easily and has caused a significant amount of severe illness and deaths in our county during the winter surge and remains a risk for both those who are fully vaccinated as well as those who not vaccinated against COVID-19. As of, February 21, 2022, there have been at least 2,784,276 cases of COVID-19 and 30,376 deaths reported in Los Angeles County. As of February 15, 2022, Los Angeles County is also reporting a 7-day average daily case rate of 29.7 cases per 100,000 people. Making the risk of community transmission worse, some individuals who contract the COVID-19 virus have no symptoms or have only mild symptoms, and so are unaware that they carry the virus and are transmitting it to others. Because even people without symptoms can transmit the virus, and because evidence shows the infection is now more easily spread, universal indoor masking is a risk reduction measure that is proven to reduce the risk of transmitting the virus. The continuation of this safety measure is intended to help the County reach a Moderate rate of community transmission as quickly as possible. 14)Epidemiologic evidence demonstrates that the rate of community transmission, after peaking in mid-January 2022, is now declining at a consistent rate. Although more than 17.7 million vaccine doses have been administered and nearly 7.2 million residents ages 5 and older are fully vaccinated against COVID-19 in Los Angeles County, COVID-19 infection remains a significant health hazard to all residents.
In line with the State Public Health Officer, the Health Officer will continue to monitor scientific evidence and epidemiological data within the County.
15)The Health Officer will continue monitoring epidemiological data to assess the impact of lifting restrictions and fully re-opening sectors. Those Indicators include, but are not limited to:
a) The number of new cases, hospitalizations, and deaths among residents in areas in the lowest Healthy Places Index (HPI) quartile and by race/ethnicity. b) The COVID-19 case rate.
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ORDER OF THE HEALTH OFFICER
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c) The percentage of COVID-19 tests reported that are positive. d) The availability of COVID-19 vaccines and the percentage of eligible County residents vaccinated against COVID-19.
e) The number of fully vaccinated people who get sick, are hospitalized, or die from COVID-19.
f) The sufficient supply and wide availability of effective therapeutics. g) The presence of Variants of Concern, such as, Omicron and Subvariant BA.2, and their impact on indicators (a) – (f).
ADDITIONAL TERMS
16)The County shall promptly provide copies of this Order by: (a) posting it on the Los Angeles Department of Public Health’s website (www.publichealth.lacounty.gov), (b) providing it to any member of the public requesting a copy, and (c) issuing a press release to publicize the Order throughout the County.
a) The owner, manager, or operator of any facility that is likely to be impacted by this Order is strongly encouraged to post a copy of this Order onsite and download, review and implement all applicable Best Practice Guidance.
b) Because guidance may change, the owner, manager, or operator of any facility that is subject to this Order is encouraged to consult the Los Angeles County Department of Public Health’s website (www.publichealth.lacounty.gov) daily to identify any modifications to this Order and the Best Practice Guidance and continue to implement these important and necessary infection control protocols. 17)If any subsection, sentence, clause, phrase, or word of this Order or any application of it to any person, structure, gathering, or circumstance is held to be invalid or unconstitutional by a decision of a court of competent jurisdiction, then such decision will not affect the validity of the remaining portions or applications of this Order.
18)This Order incorporates by reference, the March 4, 2020 Proclamation of a State of Emergency issued by Governor Gavin Newsom and the March 4, 2020 declarations of a local and public health emergency issued by the Los Angeles County Board of Supervisors and Los Angeles County Health Officer, respectively, and as they may be supplemented. 19)This Order may be revised in the future as the State Public Health Officer amends its guidance to reflect evolving public health conditions and recommendations issued by the federal CDC and other public health authorities. Should local COVID-19 conditions warrant, the Health Officer may, after consultation with the Board of Supervisors, issue orders that are more restrictive than the guidance and orders issued by the State Public Health Officer. 20)This Order is consistent with the provisions in the Governor’s Executive Order N-60-20 and the State Public Health Officer’s May 7, 2020 Order, that local health jurisdictions may implement or continue more restrictive public health measures in the jurisdiction if the local health officer believes conditions in that jurisdiction warrant them. Where a conflict exists
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ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 17 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
between this Order and any state public health order related to controlling the spread of COVID-19 during this pandemic, the most restrictive provision controls. Consistent with California Health and Safety Code section 131080, except where the State Health Officer may issue an order expressly directed at this Order or a provision of this Order and based upon a finding that a provision of this Order constitutes a menace to the public health, any more restrictive measures in this Order may continue to apply and control in the County of Los Angeles Public Health Jurisdiction.
21)Pursuant to Sections 26602 and 41601 of the California Government Code and Section 101029 of the California Health and Safety Code, the Health Officer requests that the Sheriff and all chiefs of police in all cities located in the Los Angeles County Public Health Jurisdiction ensure compliance with and enforcement of this Order. The violation of any provision of this Order constitutes an imminent threat and menace to public health, constitutes a public nuisance, and is punishable by fine, imprisonment or both. 22)This Order is issued pursuant to Health and Safety Code sections 101040, 120175, and 120295.
23)This Order shall become effective at 12:01 am on Friday, February 25, 2022 and will continue to be until it is revised, rescinded, superseded, or amended in writing by the Health Officer.
IT IS SO ORDERED:
2/23/2022
Muntu Davis, M.D., M.P.H.
Health Officer,
County of Los Angeles
Issue Date
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the CommunityBeyond The Blueprint For A Safer Economy, Page 18 of 18 POST WINTER SURGE, High Transmission—Encouraging COVID-19 Vaccination and Booster Dose Coverage with Risk Reduction Measures Revised 2/23/2022
Appendices At-A-Glance
Businesses and customers should continue reviewing best practice documents and sector-specific protocol for designated areas on a regular basis to ensure they are complying with the latest health protection and prevention measures.
All DPH protocol and best practice documents are available at:
http://publichealth.lacounty.gov/media/Coronavirus/index.htm Appendix K: Reopening Protocol for Day Camps [Revised 6/23/2021] Appendix K-1: Reopening Protocol for Overnight Organized/ Children’s Camps [Revised 6/14/2021]
Appendix S: Protocol for Organized Youth Sports [Revised 2/17/2022] Appendix T1: Reopening Protocols for K-12 Schools [Revised 2/17/2022] Appendix T2: Protocol for COVID-19 Exposure Management Plan in K-12 Schools [Revised 1/30/2022]