San Andreas, CA…On Friday, September 10, 2021, the Calaveras County Health Officer upgraded the guidance for youth extracurricular activities and youth sports released on August 23, 2021 to an order. The order comes at a time when COVID-19 cases have surged in the county, including the quarantine of a local school sports team stemming from a recent exposure to COVID-19. The order was done in collaboration with the Calaveras County Superintendent of Schools and other school partners. The order goes into effect starting Monday, September 13, and will remain in effect until it is rescinded. Adherence to the order applies to all extracurricular and organized youth activities that occur before or after school, on school campuses or in the community, public or private.

Late last month, the Calaveras County Health Officer issued voluntary guidance for youth sports and other extracurricular youth activities in hopes that any risk of COVID-19 infections would be avoided. Since the guidance was issued, COVID-19 has surged, more COVID-19 patients have required hospital care, and the County’s only hospital, Mark Twain Medical Center recently reported that they were nearing capacity.

Calaveras County is also seeing a concerning uptick in cases among children under the age of eighteen. Local public health officials are also worried about serious infections, hospitalizations, and deaths involving children becoming increasingly common both statewide and nationwide.

“We have seen a dramatic rise in Calaveras County students being quarantined or in isolation because they tested positive for COVID-19 or were exposed to someone who was,” said Dr. René Ramirez, Calaveras County Health Officer. “The county’s low vaccination rate coupled with mask refusal leaves Calaveras children more vulnerable to COVID-19 infection. This order outlines what schools must adhere to so that we prevent the further spread of COVID-19 in our schools and communities and to avoid cancellation of sports altogether,” added Dr. Ramirez.

Vaccination is strongly recommended for all eligible people. Extracurricular activities should take place outdoors and/or distanced when feasible. Masks are required indoors for all individuals in K-12 schools. This applies to all teachers, staff, students, game officials, and visitors to schools, regardless of vaccination status. Masks are not required when actively participating in sports or extracurricular activity when a mask cannot be worn.

Under the local order, masks are required during outdoor events for all individuals, regardless of vaccination status, when there is sustained contact of 3 feet or less for a duration of 15 minutes or more.

In areas of high transmission, the CDC recommends canceling high risk sports and extracurricular activities. Under the local order, testing is required in lieu of cancelling these activities. Routine testing will be required for participants, regardless of vaccination status.

Schools will continue to follow CDPH Guidance for K-12 Schools which outlines what youth and adults should do if they have symptoms of COVID-19, quarantine and isolation instructions if exposed to someone with COVID-19 or if they test positive for COVID-19, hand hygiene, cleaning and disinfecting surfaces, and vaccine verification.

Local schools in collaboration with Public Health staff continue to investigate new cases to determine any possible students who may have had close personal contact with positive individuals. The current COVID-19 surge is likely caused by factors such as an increase of the Delta variant, mask refusal, communities with low vaccination rates, and easing of prevention and control measures. According to the CDC, most hospitalizations and deaths have been among the unvaccinated. The best protection there is against COVID-19 is to get fully vaccinated. People can schedule a free COVID-19 vaccine appointment by visiting myturn.ca.gov.

Calaveras Public Health encourages the community to stay safe by taking some simple
precautions, such as:
 Getting vaccinated
 Wearing a mask
 Getting tested for COVID-19
 Staying at least 6 feet from others
 Avoiding crowds and poorly ventilated spaces
Symptoms of COVID-19 may appear 2-14 days after exposure to the virus. People with
these symptoms may have COVID-19:
 Fever or chills
 Cough
 Shortness of breath or difficulty
breathing
 Fatigue
 Muscle or body aches
 Headache
 New loss of taste or smell
 Sore throat
 Congestion or runny nose
 Nausea or vomiting
 Diarrhea

Look for emergency warning signs for COVID-19. If someone is showing signs, seek
emergency care immediately:
 Trouble breathing
 New confusion or weakness
 Bluish lips or face
 Persistent pain or pressure in the
chest
 Inability to wake or stay awake

For information about testing and vaccination visit the Calaveras County COVID-19
website. https://covid19.calaverasgov.us/
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Calaveras County Public Health Officer Order
ORDER OF THE HEALTH OFFICER OF THE COUNTY OF CALAVERAS ISSUING MANDATORY ADHERENCE TO THE GUIDANCE FOR YOUTH EXTRACURRICULAR ACTIVITIES AND YOUTH SPORTS
Order: September 13, 2021

SUMMARY OF THE ORDER
The guidance attached to this order provides a combination of mandatory requirements and general public health recommendations for extracurricular and organized youth activities in an effort to protect against COVID-19, including all types of programs (e.g. before or after school, on school campuses or in the community, public or private) and all types of activities (e.g., sports [school-affiliated, community or private club], dance, choir, band, theater, etc.) that are not part of a required educational curriculum. The state guidance is being elevated to a local Health Officer Order which establishes mandatory adherence to any and all guidance established for extracurricular and organized youth activities in an effort to protect against COVID-19. This Order supersedes recommendations established on August 24, 2021 and is issued in lieu of cancelling extracurricular and organized youth activities altogether in an effort to protect against COVID-19 spread.

FINDINGS RESULTING IN THE NEED FOR THE ORDER
1. The County remains under a state of Local Health Emergency due to the COVID-19 pandemic.
2. The State of California remains under a Public Health Emergency due to the COVID-19 pandemic.
3. As of August 23, 2021, Calaveras County has 2,660 confirmed COVID-19 cases, 97 of which are currently active, and 61 deaths from COVID-19.
4. Hundreds of children aged 0-17 in Calaveras County have had confirmed COVID-19 infections and children continue to test positive for COVID-19 on a near daily basis.
5. It has been determined that COVID-19 is an airborne virus, meaning that close contact to other people’s exhalations increases the risk of transmission.
6. It has been determined the transmissibility of COVID-19 increases when groups of people are exhaling in indoor environments than when they are doing so in outdoor environments.
7. It has been determined that wearing properly constructed facemasks reduces the transmission of airborne viruses, including COVID-19.
8. Since mid-June 2021, the SARS-CoV-2 B.1.617.2 (Delta) variant has been circulating in Calaveras County. This variant is highly transmissible and requires multi-component prevention strategies to reduce spread. Given the modest vaccination rates, Calaveras County is experiencing high levels of community transmission due to the Delta variant. While most COVID-19 cases are among unvaccinated residents, the proportion of breakthrough cases is increasing. Hospitalizations have also increased, primarily among unvaccinated persons. Calaveras County is seeing a concerning uptick in cases among children under the age of eighteen, and serious infections, hospitalizations, and deaths involving children becoming increasingly common both statewide and nationwide.
9. Hospitals in the State of California are increasingly overwhelmed by patients being admitted with COVID-19 symptoms.
10. It has been shown that there is an inverse relationship between vaccination rates and the number of new COVID-19 cases, meaning that in places where a greater percentage of the population received COVID-19 vaccinations, the number of new COVID-19 cases is reduced.
11. In the State of California as a whole as of August 24, 2021, the vaccination rate is 66.5% but the vaccination rate in Calaveras County is 43.25%, leaving children in Calaveras County at higher risk of COVID-19 infection than the State of California as a whole.
12. With the Governor’s stay-at-home order lifted and children returning to school, participation in organized before/after-school sports and other activities will resume precisely at the time that youth are becoming increasingly susceptible to serious COVID-19 illness—particularly in Calaveras County, where the vaccination rate is lower.
13. On August 24, 2021, the Calaveras County Health Officer issued voluntary but strongly recommended Guidance for extracurricular youth sports and other extracurricular youth activities, hoping that participants in the activities and other local circumstances would coalesce in a way that the local health risks posed by the virus would be abated without need for a formal order.
14. Unfortunately, since the Guidance was issued, COVID-19 has surged, more COVID-19 patients have required hospital care, and the County’s only hospital, Mark Twain Medical Center, has been at or near capacity. As of Thursday, August 27, 2021, the vast majority of admitted COVID-19 patients utilizing beds at Mark Twain were unvaccinated, and County vaccination rates remain below the statewide average. The surge of inpatient care required at Mark Twain Medical Center is occurring simultaneously with a staffing shortage at the hospital, putting a severe strain on the existing staff in its efforts to appropriately meet all patients’ needs. The surge of inpatient care is also occurring at a time when other regional hospitals are experiencing a similar surge of patients and low availability of ICU beds, making them far less available to receive extra patients from Mark Twain Medical Center.
15. Unfortunately, since the Guidance was issued, a student participating in the type of youth sports and activities covered by the Guidance refused to voluntarily wear a mask while engaged in the team activity, later tested positive for COVID-19, and, as a result, all members of the team activity were unnecessarily exposed to the virus and had to be quarantined.
16. For all of the above reasons, community transmission of COVID-19 within Calaveras County remains a significant and increasing threat to the public health in the community, and the Health Officer finds that the issuance of the August 24, 2021 Guidance has not been adequate to mitigate the increasing threat posed by COVID-19.

ORDER
Pursuant to California health and Safety Code sections 101040, 120175, 120175.5(b), 101085, and 120130, the Health Officer of Calaveras County, as part of a strategy to support the continued operations of businesses, activities, and schools, HEREBY ORDERS AS FOLLOWS:
1. The attached “Guidance—Youth Extracurricular Activities and Youth Sports”, which is incorporated by reference into this Order, shall be ordered and shall apply to all youth extracurricular activities and youth sports in Calaveras County that are not part of a required educational curriculum.
2. This Order shall go into effect immediately, shall supersede any conflicting orders related to extracurricular youth sports and activities, and shall continue in effect until rescinded.
3. This Order shall be reviewed by the Calaveras County Health Officer for possible amendment or rescission in the event updated Youth Sports and Extracurricular Activities Guidance is issued by the California Department of Public Health (CDPH).
4. Copies of this Order shall promptly be: (1) made available at 891 Mountain Ranch Rd., San Andreas, CA 95249; (2) posted on the County Public Health website [ADD LINK]; and (3) provided to any member of the public requesting a copy.
5. If any provision of this Order or its application to any person or circumstance is held to be invalid, then the reminder of the Order, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect. To this end, the provisions of this Order are severable.
IT IS SO ORDERED:
_____________________________
Rene Ramirez, M.D. Date: 09/09/2021
Calaveras County Health Officer