At a noon- hour briefing, L.A. County Dir. of Public Health Barbara Ferrer, PhD MPH, MEd, added the County agency recommends that people with underlying health conditons, pregnant women and elderly persons should adopt some social distancing practices immediately including avoiding non-essentioal travel, avoiding public gatherings or places where large groups of people are congreating and avoiding event venues. She said this applies to these three groups of people because they face the possibility of more serious illness if they if they become infected with COVID-19.

[Scroll down for further.]

Less than 24 hours ago, a March 8 guidance by the CA Dept. of Public Health (reported as breaking by LBREPORT.com) said that in counties with no evidence of community transmission, the agency doesn't recommend cancelation of community events "at this time if no COVID-19 cases exist within the community."

However, the state agency said in counties with "evidence of commmunity transmission" it recommends event organizers of mass gatherings and large community events "should aniticpate that some non-essential events made need to be modified (e.g., conducted as a video webinar), canceled, or postponed."

The state agency also recommeded that event organizers "Consider canceling non-essential events primarily for or attended by older adults and people with chronic medical conditions at higher risk for severe illness." (A footnote stated: "Current evidence indicates that the risk of severe illness increases with age. The median age of reported cases has been 59 years and the median age of critically ill cases has been 66 years. People with underlying medical problems, including cardiovascular disease, diabetes, cancer, chronic lung disease, and immunosuppression, are also likely at higher risk for severe illness.")

The CA Dept. of Health guidance said "mass gatherings" are "events, including religious services, where large numbers of people are within an arm's length of one another. They do not include typical office environments or stores."] It notes that "large community events bring people from multiple communities into close contact with each other and have the potential to increase COVID-19 transmission. One method to slow the spread of respiratory virus infections, including COVID-19, is by increasing social distancing (reduce close contact)."

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The CA Dept. of Public Health said the goals of its guidance "are: (1) to protect people attending and working at the event and the local community from COVID-19 infection; and (2) to reduce community transmission and introductions of COVID-19 into new communities."

The CA Dept. of Health Guidance states that if a mass gathering does take place, it recommends that event organizers should:

• Instruct any participants or event staff to not attend if they have any respiratory symptoms (cough or runny nose) or fever regardless of the presumed cause.
• Remind participants and staff to not attend if they have travelled within the past 14 days to an area identified by the CDC as having a Level 3 Travel Health Notice due to COVID-19.
• Recommend that participants and staff at higher risk of severe illness not attend.
• Ensure that event venues are well ventilated and are adequately equipped with facilities for hand washing and supplies including hand sanitizer that contains at least 60% alcohol, tissues, and trash baskets.
• Increase the frequency of cleaning commonly used areas with detergent and water followed by a disinfectant that is EPA-approved for emerging viral pathogens.

  List N: Disinfectants for Use Against SARS-CoV-2

• Encourage participants to minimize close contact (e.g., recommend no hand shaking or hugging).
• Maintain a registration list of participants and staff; this will significantly assist local public health in contact tracing in the event a COVID-19 case should later be identified as having attended the event.
• Promote messages that discourage people who are sick from attending events. Create refund policies that permit participants the flexibility to stay home when they are sick, need to care for sick household members, or are at high risk for complications from COVID-19.
• Isolate staff or participants in a designated space who become ill with symptoms consistent with COVID-19 at the event and provide a clean disposable procedure facemask to wear for those who may become ill. It is not necessary to distribute masks to healthy participants. Establish procedures to help sick participants or staff leave the event as soon as possible without use of public transportation, shared rides, or taxis.
• Provide alternative options for attending the event via phone, video, or web

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Some of these measures shouldn't be a surprise. In Scenario I, for "mass gatherings and large community events in counties without evidence of community transmission," the CA Dept. of Public Health recommended these measures:

• As the COVID-19 situation is evolving, event organizers should create an emergency contingency plan for how to modify, cancel, or postpone their mass gathering or large community event if a COVID-19 outbreak occurs in their community.
• Events may still need to be modified, canceled, or postponed if participants are traveling from communities with COVID-19 outbreaks.
• Event organizers should:
  • Collaborate and coordinate with community partners including the local public health department, hotels where participants are staying, airlines, the event venue, and other partners.
  • Use event messaging and communications to promote everyday preventive health messages to your participants and staff, which include:
    • Stay home when you are sick, except to get medical care.
    • Cover your coughs and sneezes with a tissue or sleeve, then throw the tissue in the trash.
    • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
    • Avoid touching your eyes, nose, and mouth with unwashed hands.
    • Clean frequently touched surfaces and objects daily.
    • Recommend that participants minimize close contact (e.g., recommending no hand shaking or hugging)
    • Promote messages that discourage people who are sick from attending events. Create refund policies or remote participation capability such as live stream that permit participants the flexibility to stay home when they are sick, need to care for sick household members, or are at high risk for complications from COVID-19.
  • Provide COVID-19 prevention supplies at your events, to the extent supplies are available. Plan to have extra supplies on hand for event staff and participants, including sinks with soap, hand sanitizers, and tissues. Promote proper and frequent hand hygiene.
  • Isolate staff or participants in a designated space who become ill with symptoms consistent with COVID-19 at the event and provide a clean disposable procedure facemask, to the extent available, to wear for those who become ill. It is not necessary to distribute masks to healthy participants.
  • Implement a strategy to prevent the theft of prevention supplies.
  • CDPH does not recommend cancelation of community events at this time if no COVID-19 cases exist within the community.

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The CA Dept. of Public Health stated the "complete clinical picture with regard to COVID-19 is not fully understood. Reported illnesses have ranged from mild to severe, including illness resulting in death. Older people and people with certain underlying health conditions like heart disease, lung disease and diabetes, for example, seem to be at greater risk of serious illness."

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As to how people can protect themselves, the CA Dept of Public Health says "so much of protecting yourself and your family comes down to common sense:"

• Washing hands with soap and water.
• Avoiding touching eyes, nose or mouth with unwashed hands.
• Avoiding close contact with people who are sick.
• Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough.
• Following guidance from public health officials.

What to Do if You Think You're Sick:

[CA Dept. of Public Health text]

Call ahead: If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care so that appropriate precautions can be taken.

Continuing coverage on LBREPORT.com.

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