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April 4, 2020
FORMAL ISSUANCE OF HEALTH DIRECTIVE NO. 2
TO: Citizens of Shelby County, Tennessee
FROM: Bruce Randolph, M.D., M.P.H, Shelby County Health Officer
RE: Public Health Announcement on COVID-19 Response
Pursuant to the authority vested in my office as Health Officer of Shelby County, Tennessee, and in collaboration with the Shelby County Health Director, I am formally issuing this Health Directive No. 2 in order to protect the public health for all citizens and businesses in Shelby County, Tennessee. I am issuing this Health Directive to assure your compliance in preventing the spread of the Coronavirus Disease (COVID-19). Those citizens and owners of businesses described herein and currently within Shelby County, Tennessee serve as the class of people subject to this Directive. This Health Directive No. 2 supersedes the written Health Directive issued on March 25, 2020 and any oral Health Directive issued on April 3, 2020.
My review of all relevant cases, including but not necessarily limited to medical records, and my consultation with medical expert s, reveals that the COVID-19 is a respiratory disease caused by the SARS- coV-2 virus that can result in mild or severe symptoms, including fever, cough, and shortness of breath, and can lead to serious illness or death. On January 21, 2020, following the guidance of the Centers for Disease Control and Prevention ("CDC"), the Tennessee Department of Health designated COVID-19 as a reportable disease in Tennessee.
As of April 3, 2020, the CDC, the Tennessee Department of Heal the, and the Shelby County Health Department reports indicate the number of confirmed cases of COVID-19 continue to rise in the State of Tennessee, and, specifically, in Shelby County, Tennessee. Cases of COVID-19 in Shelby County have resulted in serious complications, up to and including death. Consultation with experts and review of data provided to us by the State of Tennessee and the CDC show that transmission of the disease increases in locations where groups of people congregate.
Based on the clinical and epidemiological evidence, COVID-19 is a direct and deadly threat to the population of Shelby County, Tennessee.
By virtue of this Directive, I am directing that:
"Essential services" means services and/or businesses that the interruption of which would endanger the life, health, or personal safety of the whole or part of the population and shall include the following:
In addition, the following businesses may continue to operate only as recommended by CDC guidelines, but at the very least are required to limit the total number of patrons in the establishment to 10 at any one time. Because such services require close contact, patrons must not have a fever or any other symptoms of COVID-19, and these establishments must ensure additional steps are taken to enhance personal hygiene of employees and to provide extraordinary sanitization efforts within the facilities themselves:
All essential services, especially grocery stores and pharmacies, will make best efforts to establish hours when only available to senior citizens or otherwise vulnerable populations. These businesses will adhere to CDC guidance on social distancing and hand hygiene in the workplace, including encouraging work-from-home and allowing employees when possible to work on-site in shifts to optimize social distancing in the workplace.
All businesses not deemed to provide essential services are hereby required to close their physical locations to the public. This applies to all non-essential businesses and establishments. If your business does not provide essential services, you are required to immediately cease operations until this or a superseding health directive regarding the COVID-19 public health threat no longer exists. The primary purpose of the business on or before March 24, 2020 will be the basis for determining whether the business provides essential services.
In addition, all nursing homes, assisted living facilities, and any other such facilities housing, treating, or caring for senior citizens or other vulnerable populations shall be closed to all visitors. Only employees and residents of such facilities will be permitted. Facilities should strictly adhere to CDC guidance regarding social distancing. Employees must not be permitted to enter if they have a fever or any other symptoms of COVID-19, and these establishments must ensure additional steps are taken to enhance personal hygiene of employees and to provide extraordinary sanitization efforts within the facilities themselves.
"Essential Activities" permitted under this Directive shall include:
It is my belief that the aforementioned guidelines are the least restrictive means by which to slow the transmission of COVID-19.
Due to the state of emergencies declared nationally, statewide, and locally, the Shelby County Health Department is authorized to take emergent and immediate action to enforce this Health Directive. This Directive serves as official notice of your requirement to comply with it, and therefore immediate action may be taken for any violation of this Directive.
This Health Directive shall remain in force until such time as we have determined that the disease is no longer a threat to the public, but shall expire after thirty (30) days. Upon expiration of this Health Directive, as Health Officer and in consultation with medical experts, I have the authority to extend this Directive for an additional thirty (30) days if such an extension is deemed to be in the best interest of public health.
If you feel this Directive has been issued in error, you may request a review by the TDH’s Chief Medical Officer, Dr. Tim Jones (615) 741-3111, or a designee. Dr. Jones, or a designee, will review your request within five (5) business days of its receipt, and you will receive a decision in writing. You may also request that the TDH obtain a court order containing the provisions of this Directive. If you request this option, the TDH will take the matter to an available and appropriate court of record. Please be aware you are still required to abide by all of the provisions contained in this Health Directive during any review process.
A copy of the rules setting forth the Health Directive procedure and your related rights is attached to this Health Directive.
BRUCE RANDOLPH, M. ., M.P.H. SHELBY COUNTY HEALTH OFFICER
cc: Dr. Tim Jones