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(This information is being shared on behalf of the Alameda County Public Health Department.)

Alameda County Public Health Department Confirms Third Positive Case of COVID-19; Announces New Recommendations and Guidance to Protect Alameda County Residents from COVID-19

ALAMEDA COUNTY, CA – Alameda County Public Health Department reported a third case of the Coronavirus Disease 2019 (COVID-19).

The individual is the spouse of the second confirmed case, and is an older adult, who had disembarked from the Grand Princess cruise ship in February (11^th-21^st). This individual had already been quarantined at home and remains isolated; we are monitoring this new case’s condition and no additional contacts were identified.

Alameda County will not be sharing any additional information about this case.

ACPHD has reached out to other Alameda County residents who were aboard that Grand Princess Cruise during its February trip, and we recommend that those who experienced symptoms (fever, cough or difficulty breathing) after the cruise and prior to March 6th be tested for COVID-19 by their healthcare provider.

Patients with confirmed COVID-19 infection have experienced mild to severe respiratory illness with symptoms such as fever, cough, and shortness of breath. Over eighty percent of individuals have mild disease.

Princess Cruise Ship
Alameda County leadership and the Health Care Services Agency are in close contact with the California Department of Health and Human Services, as well as local, regional, and federal partners. The disembarking of passengers from the Grand Princess Cruise Ship is being led by the state and federal governments, with Alameda County and the City of Oakland providing support as needed.

• The passengers will not be released into the general public. California residents aboard the ship will be taken to federal facilities for isolation and quarantine, while non-California residents will be transported to federal facilities in other states.
• Anyone with immediate health care needs upon disembarkation may be transported to local or regional health facilities to receive care.

“As the state and federal governments manage transfer of passengers from the cruise ship to their respective destinations, we want to assure our community that all entities are working to minimize the impact in Oakland. Our highest priority is to safeguard the health of people living, working in, or visiting Alameda County,” said Colleen Chawla, Director of Alameda County Health Care Services Agency.
 
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March 10, 2020: ACPHD Announces New Recommendations and Guidance to Protect Alameda County Residents from COVID-19

Alameda County Public Health Department is taking proactive steps to protect the health of county residents by making recommendations intended to slow the spread of Coronavirus Disease 2019 (COVID-19) in our community and protect the most vulnerable among us from severe illness. These recommendations are effective immediately and will be reassessed periodically as this COVID-19 outbreak evolves.

“There is evidence of increasing circulation of COVID-19 in our region. These recommendations are meant to slow the spread of the virus in order to protect the health of Alameda County residents, particularly the elderly and people who have underlying medical conditions,” said Dr. Erica Pan, Health Officer for Alameda County. “To limit the impact of COVID-19 and reduce the number of people infected, we must reduce the number of opportunities the virus has to spread from person-to-person. This means limiting the times and places people come together.”

New Guidance for Persons Hosting Mass Gatherings and Large Community Events
ACPHD offers this guidance to help people planning or attending large gatherings to make informed decisions. We have seen evidence of community transmission of COVID-19 across the Bay Area, and we have weighed the potential benefits to our community’s health alongside the potential for disruptive impacts on event organizers and attendees.

The goals of this 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, decrease the introduction of COVID-19 into new communities, and slow and decrease the spread of the virus.

Guidance for Persons at Higher Risk
Older people and people with certain underlying health conditions like heart disease, lung disease and diabetes, for example, may be at greater risk of serious illness. Persons at higher risk of severe illness from COVID-19 should stay home and away from crowded social gatherings as much as possible. These types of gatherings include, but are not limited to parades, conferences, sporting events, and concerts where large numbers of people are within arm’s length of one another.

Those considered at higher risk include:

• People over 60 years of age. The risk increases significantly thereafter and escalates with age, with persons over age 80 in the highest risk category.

People, regardless of age, with underlying health conditions including cardiovascular disease, diabetes, cancer, heart disease, or chronic lung diseases like COPD, as well as those with severely weakened immune systems.

Guidance for Event Organizers
At this time, we recommend postponing or canceling non-essential mass gatherings and large community events where large numbers of people are within arm’s length of one another. Mass gatherings do not include typical office environments or stores.

• As the COVID-19 situation continues to evolve, community event calendars should be assessed on a rolling 30-day basis.

• Large events (more than 1000 people): Cancel or postpone

• Medium events (100-1000 people):  Consider the following recommendations when determining event cancellation or postponement:
  • Size: Smaller is better. The risk of getting the virus increases as the size of the crowd increases.
  • Duration: Shorter is better. The risk of getting the virus increases as the duration of the event increases (e.g., a 2-hour meeting is lower risk than a 2-day conference).
  • Density: Risk of getting the virus increases in crowded settings. If the venue or setting doesn’t enable people to keep social distance (more than arm’s length of one another), the risk of spreading the virus increases. People should avoid crowded places where large numbers of people are within arm’s length of one another.
  • Geographic reach: Mixing of people across regions, states, and countries
• Small events (<100 people):  Cancel smaller community events where people at increased risk of severe illness (older adults and those with chronic medical conditions) will be congregating.

If you can’t avoid bringing groups of people together:

• Urge anyone who is sick to not attend.
• Encourage those who are at higher risk for serious illness to not attend.
• Find ways to give people more physical space and reduce close contact as much as possible.
• Encourage attendees to follow increased hygiene, such as:
  • Washing their hands often with soap and water for at least 20 seconds
    • If soap and water are not available, alcohol-based hand sanitizer can be used
  • Avoid close contact with other people
  • Avoid touching your eyes, nose, and mouth
  • Covering their cough or sneeze with a tissue - if available - or into their elbow
• Clean surfaces with standard cleaner.
• Provide alternative options for attending the event via phone, video, or web applications.
• Maintain a registration list of participants and staff; this will assist local public health officials in contact tracing in the event a COVID-19 case is later identified as having attended the event.

• Ensure that event venues are well ventilated.
• Use event messaging and communications to provide COVID-19 updates and promote everyday preventive health messages to your participants and staff.
• For additional recommendations and resources, please see:
  • CDC: https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/mass-gatherings-ready-for-covid-19.html
  • CDPH: https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/CDPH%20Guidance%20for%20Mass%20Gatherings%20and%20Large%20Community%20Events_ADA%20Compliant.pdf

In deciding whether to hold an event, organizers should stay informed:

• https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx
• https://www.acphd.org

 
Guidance for schools
Consider alternates to congregate or group programming within the school including any large or communal activities such as assemblies. Alternate approaches which limit close contact may include conducting assemblies via webcasts or intercom announcements.

The Alameda County Public Health Department is not recommending closing schools at this time. If a significant COVID-19 exposure occurs on a school site, ACPHD will work closely with school and school district administration to evaluate risk and determine steps to protect students, staff, and families by preventing the spread of disease.

Closing a school is a serious decision that requires balancing the safety of students and staff and the disruption caused to parents, guardians and the community. While health officials can recommend or order school dismissals to prevent the spread of disease or to protect the health of the community, school administrators hold the responsibility for decisions regarding school dismissal and closures.

We encourage all school officials to carefully review ACPHD’s guidance for K-12 schools and childcare centers, as well as the California Department of Public Health’s guidance for schools.
 
Guidance for homelessness services providers
The Alameda County Public Health Department and Health Care for the Homeless program have developed guidance for shelters and other transitional housing sites for staff who visit encampments, and for individuals experiencing homelessness. For more information, visit https://www.achch.org/coronavirus.html.
 
Guidance for the general public
The general public should continue to take these precautions to stop the spread of germs and prevent respiratory illnesses:

• Practice good personal hygiene habits;
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing;
• Refrain from touching your eyes, nose and mouth;
• Stay home when you are sick and away from others in your home;
• Clean frequently touched surfaces and objects using normal household cleansers;
• Try alternatives to shaking hands, like an elbow bump or wave
• Plan for the possibility of school dismissals, cancellations of large gatherings, and other ways to reduce contact between people;
• Get a flu shot to protect yourself and others from the flu, which has similar symptoms to COVID-19.

The CDC continues to provide and update guidance for preventing the spread of COVID-19 in communities. For additional information visit https://www.cdc.gov/coronavirus/2019-ncov/community/index.html.