COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 1 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
RESPONDING TOGETHER AT WORK AND IN THE COMMUNITY
COMMUNITY MONITORING OF COVID-19 AND CONTINUED RESPONSE MEASURES Issue Date: Thursday, September 22, 2022
Effective at 12:01am on Friday, September 23, 2022
Brief Highlights (Changes highlighted in yellow):
9/22/2022
• Revised to strongly recommend, but no longer require, masking for all persons using public transit or at indoor transportation hubs. Transit agencies may elect to continue requiring masking. • Revised to align with the State Public Health Officer’s September 20, 2022 guidance regarding masking in the following high-risk settings: correctional facilities, homeless shelters, emergency shelters, and cooling and heating centers.
• Continues to require masking at all indoor healthcare settings. • Revised to update Appendix T1: Protocols for K-12 Schools to align with the State and retire the requirement for schools to conduct routine testing of unvaccinated school staff.
Please read this Order carefully.
The County of Los Angeles is now experiencing both a Low Community Level, as measured by the Centers for Disease Control and Prevention’s (CDC) COVID-19 Community Level Framework, and a weekly COVID-19 transmission rate that is lower than 100 cases per 100,000 residents. This Health Officer Order is updated to closely align with the State Public Health Officer’s recent guidance regarding the requirement to wear a face mask in the following higherrisk settings: correctional facilities; homeless shelters, emergency shelters and cooling centers.
This Order also revises the masking requirement on public transportation and indoor transportation hubs from required to strongly recommended given the current lower rate of COVID-19 transmission within Los Angeles County. Public Health will continue following the County’s COVID-19 Response Plan to recommend or require future mitigation measures should the County’s designation on the CDC’s Community Level framework increase to Medium or High and the County’s COVID-19 transmission level substantially increases in the future. Local health jurisdictions may implement additional protective measures based upon local conditions.
This Order’s primary intent continues to be to reduce the transmission risk of COVID-19 in the County for those in higher transmission risk settings and protect those persons at elevated risk for severe health outcomes due to COVID-19 infection. It is very likely that there will be additional and unpredictable waves of infections and hospitalizations that will require monitoring and may require implementing different strategies to meet changing mitigation needs. The County will need to be ready to meet those challenges should they arise.
This Order may 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
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 2 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
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 protective than those of the State Public Health Officer.
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, September 23, 2022.
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 those at greater risk, including those at risk of experiencing elevated rates of illness, hospitalization, and death, from COVID-19; safeguard the functioning of hospitals and the health care system; prevent the spread of and significant illness due to COVID-19; and encourage persons to be up-to-date with their COVID-19 vaccinations, including the Fall 2022 updated Pfizer or Moderna (bivalent) COVID-19 booster, so that the whole community is safer. Failure to comply with any of the Order’s provisions may constitute 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 protective 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) Face Masks at Healthcare Indoor Settings. This Order requires that all persons 2 years of age and older, regardless of vaccination status, wear a face mask or respirator that covers their mouth and nose at healthcare (including long term care facilities and adult and senior care facilities) indoor settings. This requirement applies to all health care settings, including those that are not covered by the State Health Officer Order issued on July 26, 2021. a) Operators of healthcare facilities or settings where face masks are required to be worn indoors, shall take the following actions:
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 3 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
i) Require employees and workers to wear a well-fitting medical mask or respirator that covers their mouth and nose while working indoors with others and in vehicles with more than one person.
ii) Provide information to all patrons, guests, and attendees regarding masking requirements for all persons 2 years of age and older, regardless of vaccination status.
iii) Post conspicuous signage at the entrance and other places within the facility to clearly communicate the indoor masking requirement to all persons coming into the indoor portion of the premises.
iv) Remind all patrons, employees, and workers to wear masks that covers their mouth and nose while indoors.
4) Face Masks on Public Transportation and in Transportation Hubs. a) The Health Officer strongly recommends, but no longer requires, that persons continue to mask while in:
i) Public transit (examples: ships, ferries, commuter trains, subways, buses, taxis, and ride- shares).
ii) Transportation hubs (examples: airport and bus terminals, marina, train and subway stations, seaport or other ports, or any other area that provides transportation).
Please note that transit providers may elect to continue requiring masking in their transportation hubs and on their conveyances.
5) Face Masks in Specified High-Risk Settings
a) In the following non-healthcare indoor settings, facilities may use the CDC COVID-19 Community Levels to determine the level of masking requirements within their facility:
i) State and local correctional facilities and detention centers. ii) Homeless shelters, emergency shelters, and cooling and heating centers. b) When the COVID-19 Community Levels is Low, masking may be based on individual preference:
i) Only in non-clinical areas (such as housing units, communal dining areas, visitation areas, and in administrative areas where only staff may have access), and
ii) When there have been no outbreaks (defined as three suspected, probable, or confirmed COVID-19 cases within a 14-day period among epidemiologically linked residents and/or staff) in the entire facility or within separated, closed subunits that do not allow for mixing of those residents or staff with the general population.
c) When the COVID-19 Community Level is low, facilities must make surgical masks or higher-level respirators (e.g., N95s, KN95s, KF94s) with good fit available at all
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 4 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
times to any residents and staff who would like to use them based upon their personal preferences
d) When the COVID-19 Community Level is Medium or High, facilities must maintain or reinstate universal masking for all staff and residents, regardless of if there are no outbreaks within the facility.
i) Universal masking of all staff and residents, regardless of vaccination status and Community Level, is required in all clinical areas (or when any healthcare is being delivered), including isolation and quarantine areas, or any other areas that are covered by other specified high-risk settings. *In certain healthcare situations or settings surgical masks (or higher filtration masks) are required. In workplaces, employers and employees are subject to either the Cal/OSHA COVID-19 Emergency Temporary Standards (ETS) or the Cal/OSHA Aerosol Transmissible Diseases Standard and should consult those regulations for additional applicable requirements. 6) Additional Masking Requirements.
a) No person can be prevented from wearing a mask as a condition of participation in an activity or entry into a business or venue, including K-12 Schools and childcare settings.
b) Regardless of the CDC’s COVID-19 Community Level, employers are required to offer well-fitting medical masks and respirators, such as an N95, KN95 or KF94, at no cost to their employees who work indoors and have contact with other workers, customers, or members of the public, or in vehicles with more than one person. Respirators must be offered at no cost to workers in indoor settings where customers may spend time unmasked.
c) In workplaces, employers and employees are subject to either the Cal/OSHA COVID19 Emergency Temporary Standards or the Cal/OSHA Aerosol Transmissible Diseases Standard and should consult those regulations for additional applicable requirements.
d) The following individuals are exempt from wearing masks at all times:
i) Persons younger than two years old. Very young children must not wear a mask because of the risk of suffocation.
ii) Persons with a medical condition, mental health condition, or disability that prevents wearing a mask. This includes persons with a medical condition for whom wearing a mask could obstruct breathing or who are unconscious, incapacitated, or otherwise unable to remove a mask without assistance. iii) Persons who are hearing impaired, or communicating with a person who is hearing impaired, where the ability to see the mouth is essential for communication.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 5 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
iv) Persons for whom wearing a mask would create a risk to the person related to their work, as determined by local, state, or federal regulators or workplace safety guidelines.
7) Mandatory Reporting by Businesses and Governmental Entities. Persons and businesses within the County of Los Angeles Public Health Jurisdiction must continue to report clusters of confirmed or suspected COVID-19 cases to the County Department of Public Health.
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 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 follow Cal/OSHA requirements for workers who were exposed to the COVID-19 case(s).
8) Sectors that Require Specific Mitigation and COVID-19 Response Measures. The following sectors must operate subject to the following conditions listed:
a) Day camps. Day camp owners and operators must review, implement, and post the 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 must review, implement, and post the Protocols for K-12 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) Overnight Organized/ Children’s Camps. The owner or operator of an Overnight Organized/ Children’s Camp must review, implement and post the Protocol for Overnight Organized / Children’s Camps, attached to this Order as Appendix K-1. d) 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 Protocol for Organized Youth Sports, attached to this Order as Appendix S.
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 6 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
REASONS FOR THE ORDER
9) This Order is based upon the following determinations:
Evidence that the County of Los Angeles has receded to a Low COVID-19 Community Level as determined by the CDC and receded to a weekly rate of current COVID-19 transmission that is below 100 new cases per 100,000 people. Public Health continues urging individuals to continue taking common sense precautions, such as, being up to date on their vaccinations, including obtaining the Fall 2022 bivalent COVID-19 booster; that persons at elevated risk for severe illness continue to mask at indoor public spaces, that persons continue to mask at indoor transportation hubs and while on public transportation, including ride shares and shuttles; test prior to gathering with others who are at an elevated risk for severe illness; and increase ventilation at indoor settings.
10)The Health Officer will continue monitoring epidemiological data and indicators to determine the need for potential community mitigation measures. 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.
c) New COVID-19 hospital admissions per 100,000 population (7-day total). d) Proportion of staffed hospital inpatient beds occupied by COVID-19 patients (7-day average).
e) The percentage of COVID-19 tests reported that are positive. f) The availability of COVID-19 vaccines and the percentage of eligible County residents vaccinated against COVID-19.
g) The number of fully vaccinated people who get sick, are hospitalized, or die from COVID-19.
h) The sufficient supply and wide availability of effective therapeutics. i) The presence of Variants of Concern, such as, Omicron and its subvariants, and their impact on indicators (a) – (g).
ADDITIONAL TERMS
11)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.
12) 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
COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC HEALTH
ORDER OF THE HEALTH OFFICER
Responding Together at Work and in the Community, Page 7 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
decision of a court of competent jurisdiction, then such decision will not affect the validity of the remaining portions or applications of this Order.
13) 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. 14) 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. 15) This Order is issued pursuant to Health and Safety Code sections 101040, 101085, and 120175.
16) This Order shall become effective at 12:01am Friday, September 23, 2022 and will continue to be until it is revised, rescinded, superseded, or amended in writing by the Health Officer.
IT IS SO ORDERED:
9/22/2022
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 Community, Page 8 of 8 Community Monitoring of COVID-19 and Continued Response Measures Revised 9/22/2022
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
Appendix K-1: Reopening Protocol for Overnight Organized/ Children’s Camps Appendix S: Protocol for Organized Youth Sports
Appendix T1: Reopening Protocols for K-12 Schools
Appendix T2: Protocol for COVID-19 Exposure Management Plan in K-12 Schools