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Director’s Order from the Office of the Ohio Department of Health (Regarding COVID-19)

March 13, 2020

“Below you will find the latest guidance from Dr. Amy Acton, Director of The Ohio Department of Health.  Governor DeWine and Dr. Acton presented this at a news conference Thursday, March 12.  We understand that these are challenging times.  We thank you for doing your part in helping to keep Hamilton County safe and healthy.  The Ohio Department of Health has opened a call center for COVID-19 questions.  You may call 1-833-4-ASK-ODH (1-833-427-5634) 7-days-a-week, 9 a.m. to 8 p.m.”

-Greg Kesterman, Interim Hamilton County Health Commissioner

Director’s Order from the office of the Ohio Department of Health:
In Re: Order to Limit and/or Prohibit Mass Gatherings in the State of Ohio

I, Amy Acton, MD, MPH, Director of the Ohio Department of Health (ODH), pursuant to the authority
granted to me in R.C. 3701.13 to “make special orders … for preventing the spread of contagious or
infectious diseases” Order the following to prevent the spread of COVID-19 into the State of Ohio:

  1. Mass gatherings are prohibited in the State of Ohio.
  2. Mass gatherings are defined as any event or convening that brings together one hundred (100) or
    more persons in a single room or single space at the same time, such as an auditorium, stadium,
    arena, large conference room, meeting hall, theater, or any other confined indoor or outdoor space.
    This would also include parades, fairs and festivals.
  3. For the purpose of clarity, a mass gathering does not include normal operations at airports, bus and
    train stations, medical facilities, libraries, shopping malls and centers, or other spaces where 100
    or more persons may be in transit. It also does not include typical office environments, schools,
    restaurants, factories, or retail or grocery stores where large numbers of people are present, but it
    is unusual for them to be within arm’s length of one another.
  4. A mass gathering also does not include athletic events that exclude spectators. Athletic and other
    events do not need to be cancelled or postponed if spectators and other attendees are excluded.
  5. This Order does not apply to and/or excludes immediate family members of participants in the
    athletic or other event, as well as anyone necessary for the event to take place.
  6. This Order does not apply to and/or excludes members of the media.
  7. This Order does not apply to and/or exclude religious gatherings, gatherings for the purpose of
    the expression of First Amendment protected speech, weddings and funerals.
  8. This Order shall take effect immediately and remain in full force and effect until the State of
    Emergency declared by the Governor no longer exists, or the Director of the Ohio Department of
    Health rescinds or modifies this Order.
  9. To the extent any public official enforcing this order has questions regarding the definition of mass
    gathering under this Order, the Director of Health hereby delegates to local health departments the
    authority to answer questions in writing and consistent with this Order.
  10. Regardless of whether an event or gathering falls within the definition of mass gathering, all
    persons are urged to maintain social distancing (approximately six feet away from other people)
    whenever possible and to continue to wash hands, utilize hand sanitizer and practice proper
    respiratory etiquette (coughing into elbow, etc.)

COVID-19 is a respiratory disease that can result in serious illness or death, is caused by the SARS-CoV2
virus, which is a new strain of coronavirus that had not been previously identified in humans and can
easily spread from person to person. The virus is spread between individuals who are in close contact
with each other (within about six feet) through respiratory droplets produced when an infected person
coughs or sneezes. It may be possible that individuals can get COVID-19 by touching a surface or object
that has the virus on it and then touching their own mouth, nose or eyes.

Currently, the Centers for Disease Control and Prevention (CDC) lists over 110 countries with confirmed
cases of COVID-19. The World Health Organization reports over 118,000 diagnosed cases worldwide
with 4,200 deaths reported worldwide. The CDC has announced 1,215 confirmed and presumptive
positive cases, with 36 deaths reported from the disease in the United States.

On January 23, 2020, the Ohio Department of Health issued a Director’s Journal Entry making COVID-19
a Class A reportable disease in Ohio.

On January 28, 2020, the Ohio Department of Health hosted the first statewide call with local health
departments and healthcare providers regarding COVID-19.

On January 30, 2020, the International Health Regulations Emergency Committee of the World Health
Organization declared the outbreak of COVID-19 a public health emergency of international concern.

On January 31, 2020, Health and Human Services Secretary, Alex M. Azar II, declared a public health
emergency for the United States to aid the nation’s healthcare community in responding to COVID-19.

On February 1 ,2020, the Ohio Department of Health issued a statewide Health Alert Network to provide
local health departments and healthcare providers with updated guidance for COVID-19 and revised
Person Under Investigation (PUI) criteria.

On February 3, 2020, the Ohio Department of Health trained over 140 personnel to staff a call center for
COVID-19, in the event it was needed.

On February 5, 2020, the Ohio Department of Health began updating and notifying the media of the
number of PUIs in Ohio every Tuesday and Thursday.

On February 6, 2020, the Ohio Department of Health updated all agency assistant directors and chiefs of
staff on COVID-19 preparedness and status during the Governor’s cabinet meeting.

On February 7, 2020, the Ohio Department of Health and the Ohio Emergency Management Agency met
to conduct advance planning for COVID-19.

On February 13, 2020, the Ohio Department of Health conducted a Pandemic Tabletop Exercise with
State agencies to review responsive actions should there be a pandemic in Ohio

On February 14, 2020, the Ohio Department of Health held a conference call with health professionals
across the state. The purpose of the call was to inform and engage the healthcare community in Ohio.
Presentations were provided by the Department of Health, Hamilton County Public Health, and the Ohio
State University.

On February 27, 2020, the Ohio Department of Health and the Ohio Emergency Management Agency
briefed the directors of State agencies during the Governor’s cabinet meeting regarding preparedness and
the potential activation of the Emergency Operations Center.

On February 28, 2020, the “Governor DeWine, Health Director Update COVID-19 Prevention and
Preparedness Plan” was sent to a broad range of associations representing healthcare, dental, long-term
care, K-12 schools, colleges and universities, business, public transit, faith-based organizations, non-profit
organizations, and local governments.

On March 2, 2020, the Ohio Department of Health activated a Joint Information Center to coordinate
COVID-19 communications.

On March 5, 2020, the Ohio Department of Health hosted the Governor’s Summit on COVID-19
Preparedness, a meeting with the Governor, cabinet agency directors, local health department
commissioners, and their staff.

On March 6, 2020, the Ohio Department of Health opened a call center to answer questions from the
public regarding COVID-19.

On March 9, 2020, testing by the Department of Health confirmed that three (3) patients were positive for
COVID-19 in the State of Ohio. This confirms the presence of a potentially dangerous condition which
may affect the health, safety and welfare of citizens of Ohio.

On March 9, 2020, the Ohio Emergency Management Agency activated the Emergency Operations
Center.

On March 9, 2020, the Governor Declared a State of Emergency in Executive Order 2020-O1D.

On March 11, 2020, the head of the World Health Organization declared COVID-19 a pandemic.

On March 11, 2020, testing by the Ohio Department of Health confirmed that one (1) more patient was
positive for COVID-19 in the State of Ohio.

On March 11,2020, the Ohio Departments of Health and Veterans Services issued a Joint Directors’ Order
to limit access to Ohio nursing homes and similar facilities.

Multiple areas of the United States are experiencing “community spread” of the virus that causes COVID-19.
Community spread, defined as the transmission of an illness for which the source is unknown, means
that isolation of known areas of infection is no longer enough to control spread.

The CDC reports that people are most contagious when they are most symptomatic (the sickest) however
some spread might be possible before people show symptoms although that is not the main way the virus
spreads

Mass gatherings (100 or more persons) increase the risk of community transmission of the virus COVID-19.

Accordingly, to avoid an imminent threat with a high probability of widespread exposure to COVID-19
with a significant risk of substantial harm to a large number of people in the general population, including
the elderly and people with weakened immune systems and chronic medical conditions, I hereby ORDER
that mass gatherings are prohibited in the State of Ohio. Mass gatherings are defined as any event or
convening that brings together one hundred (100) or more persons in a single room or single space at the
same time, such as an auditorium, stadium, arena, large conference room, meeting hall, theater, or any
other confined indoor or outdoor space. This would also include parades, fairs and festivals. For the
purpose of clarity, a mass gathering does not include normal operations at airports, bus and train stations,
medical facilities, libraries, shopping malls and centers, or other spaces where 100 or more persons may
be in transit. It also does not include typical office environments, schools, restaurants, factories, or retail
or grocery stores where large numbers of people are present, but it is unusual for them to be within arm’s
length of one another. A mass gathering also does not include athletic events that exclude spectators.
Athletic and other events do not need to be cancelled or postponed if spectators and other attendees are
excluded. This Order does not apply to and/or excludes immediate family members of participants in the
athletic or other event, as well as anyone necessary for the event to take place. This Order does not apply
to and/or excludes members of the media. This Order does not apply to and/or excludes religious
gatherings, gatherings for the purpose of the expression of First Amendment protected speech, weddings
and funerals. This Order shall take effect immediately and remain in full force and effect until the State
of Emergency declared by the Governor no longer exists, or the Director of the Ohio Department of Health
rescinds or modifies this Order. To the extent any public official enforcing this order has questions
regarding the definition of mass gathering under this Order, the Director of Health hereby delegates to
local health departments the authority to answer questions in writing and consistent with this Order.
Regardless of whether an event or gathering falls within the definition of mass gathering, all persons are
urged to maintain social distancing (approximately six feet away from other people) whenever possible
and to continue to wash hands, utilize hand sanitizer and practice proper respiratory etiquette (coughing
into elbow, etc.)

Amy Acton, MD, MPH
Director of Health, Ohio Department of Health
March 12, 2020

Posted by: Christy Cauley

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