Pursuant to California Health and Safety Code Sections 101040, 120175 and 120175(b), the health officer of the County of Madera orders as follows:
1. The order is issued as a result of the World Health Organization’s declaration of the worldwide pandemic of Coronavirus Disease (COVID-19). COVID-19 is a respiratory illness that can spread from person to person. COVID-19 is contained in the droplets that can be sneezed, coughed or exhaled into the air by infected individuals.
2. As of today, there are more than 230,700 cases in the world and more than 9,390 deaths. In California, there are 917 confirmed cases and 17 deaths. We can expect the number of cases to increase significantly should action not be taken to decrease the spread of the disease.
3. There currently is no available treatment, however, transmission of the disease can be done through community mitigation measures that decrease the likelihood of being exposed to the droplets of an infected person.
These measures include limiting large-scale events and mass gatherings, and practicing social distancing.
Aggressive containment operations, including isolating suspect cases and persons under investigation, and quarantining their contacts can limit the spread of the disease, reduce the impacts on society, and avoid more stringent measures that would cause further detriment to society.
4. Within the public health system, every person who meets the Center for Disease Control criteria for disease within Madera County has been and will be tested. However, both locally and nationally, there are limited testing capabilities due to availability and number of laboratory test kits and specimen collection kits.
5. Effective 5 p.m. on Thursday, March 19, and continuing until Thursday, April 30, the following will be in effect for Madera County:
a. Health Care Providers shall:
i. On a daily basis, report to the health department/public health branch Health and Human Services Agency all patients seen in their practice with a febrile respiratory illness.
ii. The patient information will include demographic information, including age, as well as residential address and clinical status, indicate whether rapid point of care testing was performed and their results, indicate if COVID-19 testing was done.
iii. Direct the patient, if no exclusionary diagnosis is found, to isolate him/herself for seven days after onset of symptoms or three days after cessation of fever without the use of fever-reducing medications AND notify all close contacts to quarantine themselves for 14 days from the last known contact with the patient.
b. All employers shall:
i. On a daily basis, while conducting business, screen all employees for febrile respiratory illness.
ii. Exclude from work all employees that report symptoms of respiratory illness for seven days from the day they are identified as having symptoms.
iii. Direct employees excluded from work to isolate at home AND notify their close contacts to quarantine.
c. All residents shall:
i. Self-monitor for signs and symptoms of COVID-19.
ii. Isolate themselves if they have signs and symptoms and should they not require further medical attention for seven days after onset of symptoms.
6. For the purposes of this order:
a. Febrile respiratory illness is defined as “a new or worsening episode of either cough or shortness of breath, presenting with fever (temperature 38 degrees Celsius or 100.4 degrees F or higher) or chills in the previous 24 hours.
b. Isolation is defined as “separation of sick people with a contagious disease from people who are not sick.”
c. Quarantine is defined as “separation and restricts the movement of people who were exposed to a contagious disease to see if they become sick.”
d. Social distancing is defined as “maintain a six-foot separation from all persons, except for family members.”
e. Symptoms of COVID-19:
iii. Shortness of breath.
7. The California Department of Public Health and the Centers for Disease Control may recommend further guidance.
I, as Health Officers for the County of Madera, encourage voluntary compliance with this Health Officer’s Order. However, violation of this order is subject to fine, imprisonments or both (California Health and Safety Code Section 120295).
— Eric Sergienko, MD, MPH,