Yesterday, we reported on the latest Safer at Home order issued by Los Angeles Mayor Eric Garcetti. Later on Thursday, to help deal with the worsening COVID-19 surge at the state level, California Governor Gavin Newsom chimed in with his own new order, which would enact new regional restrictions, beginning at 12:50 p.m. on December 5, if the availability of ICU beds in that region of the state falls below 15%. (For the purposes of the order, the state will be divided into five regions: Northern California, Bay Area, Greater Sacramento, San Joaquin Valley, and Southern California. Los Angeles is part of the Southern California region.)
According to yesterday’s announcement, no region currently meets the threshold that would trigger the new restrictions, but some are expected to qualify “within the next week.”
In general, said the announcement:
“Regional Stay at Home Orders will require Californians to stay at home as much as possible, close operations for certain sectors and require 100 percent masking and physical distancing in all others.
Schools currently open can remain open and retailers can operate indoors at no more than 20 percent capacity to reduce exposure risk.”
Also:
“Residents are required to stay at home as much as possible and minimize mixing to reduce unnecessary exposure, while still being able to do important things like go to the doctor, buy groceries, pick up take out, go on a hike, or worship outdoors. K-12 schools that are already open can remain open and retailers can operate indoors at no more than 20 percent capacity to reduce exposure risk.”
In many ways, the order is very similar to the local order for the City of Los Angeles that Mayor Garcetti announced earlier this week, but there are some small differences.
Here are the major requirements that will be put into effect under Newsom’s order (differences from the Los Angeles city ordinance are noted in parentheses):
In any region that triggers a Regional Stay at Home Order because it drops below 15 percent ICU capacity, all operations in the following sectors must be closed:
- Indoor and Outdoor Playgrounds
- Indoor Recreational Facilities
- Hair Salons and Barbershops (the LA city order currently allows these to operate at 20% capacity)
- Personal Care Services (the LA City order currently allows these to operate at 20% capacity)
- Museums, Zoos, and Aquariums (outdoor areas at these facilities are currently still allowed to open under the city order)
- Movie Theaters
- Wineries
- Bars, Breweries and Distilleries
- Family Entertainment Centers
- Cardrooms and Satellite Wagering
- Limited Services
- Live Audience Sports
- Amusement Parks
The following sectors will have additional modifications in addition to 100 percent masking and physical distancing:
- Outdoor Recreational Facilities: Allow outdoor operation only without any food, drink or alcohol sales. Additionally, overnight stays at campgrounds will not be permitted.
- Retail: Allow indoor operation at 20 percent capacity with entrance metering and no eating or drinking in the stores. Additionally, special hours should be instituted for seniors and others with chronic conditions or compromised immune systems. (The 20% capacity will include grocery stores, which do not currently have such a limit in the city of Los Angeles.)
- Shopping Centers: Allow indoor operation at 20 percent capacity with entrance metering and no eating or drinking in the stores. Additionally, special hours should be instituted for seniors and others with chronic conditions or compromised immune systems.
- Hotels and Lodging: Allow to open for critical infrastructure support only.
- Restaurants: Allow only for take-out or pick-up.
- Offices: Allow remote only except for critical infrastructure sectors where remote working is not possible.
- Places of Worship: Allow outdoor services only.
- Entertainment Production including Professional Sports: Allow operation without live audiences. Additionally, testing protocol and “bubbles” are highly encouraged.
The Order does not modify existing state guidance regarding K-12 schools.
The following sectors are allowed to remain open when a remote option is not possible with appropriate infectious disease preventative measures including 100 percent masking and physical distancing:
- Critical Infrastructure
- Non-urgent medical and dental care
- Child care and pre-K
The order would remain in place for at least three weeks, and at that point restrictions could:
“End for a county in a region if the region’s ICU capacity projected out four weeks (from three weeks since the Stay-at-Home Order started) is above or equal to 15 percent. Each county in the region would be assigned to a tier based on the Blueprint for a Safer Economy.
Remain in effect in a county if the region’s ICU capacity projected out four weeks (from three weeks since the Stay-at-Home Order started) is less than 15 percent. The order would remain in effect until the region’s ICU capacity meets criteria (1) above. This would be assessed on a weekly basis.”
When news first broke of the Los Angeles city order, some people were confused about whether they could go out for walks and other exercise, a point clarified in a later posting of the order, which states that individual exercise, or moving around with members of your own household, is still allowed; it’s just gatherings of people from different households that will be restricted.
And the state’s order, too, clarifies that personal exercise is still allowed with appropriate social distancing:
“Members of the same household are encouraged to maintain physical and mental health by safely going to a park, hike, walk or bike ride when safe to do so and socially distanced. Californians are also encouraged to keep connected with loved ones virtually.”
Some questions remain, however, before the new ICU-based order can be put into effect. These include how ICU beds are counted and how ICU availability is calculated.
In a press briefing yesterday, LA County Department of Public Health representative Tim Gilman, LA County Health Officer Dr. Muntu Davis and Dr. Christina Ghaly, Director of the LA County Department of Health Services, fielded several questions on this topic. The officials explained that the total number of “ICU beds” generally includes adult and pediatric beds, but not those in neo-natal intensive care units, because those beds are too small to be repurposed for older patients. (Pediatric ICU beds, on the other hand, are usually large enough for adults, so they are included in the total number of existing beds.)
Also, because hospitals many not maintain staff for all their ICU beds at the same time, beds without staff assigned may not be counted in the number of “available” beds at any given time, and that definition could differ from facility to facility. Ghaly said in the briefing that LA County will be trying to clarify numbers and definitions in the next few days, to make it easier to calculate the number of beds available, and when the state restrictions might begin to apply.
You can watch the full video of Newsom’s announcement yesterday at https://www.facebook.com/CAgovernor/videos/1281284502254508
