Oh Department 10 of Health Mike DeWine, Governor Amy Acton, M.D., MPH, Director Jon Husted. Lt. Governor ORDER Re: Director?s Order for Performing COVID-19 Testing 1, Amy Acton, MD, MPH, Director of the Ohio Department of Health (ODH), pursuant to the authority granted to me in in RC. 3701.04 t0 ?[r]equire reports and make inspections and investigations that the director considers necessary?; RC. 3701.13 to ?make special orders. . .for preventing the spread of contagious or infectious diseases?; and RC. 3701.14 to ?investigate or make inquiry as to the cause of disease or illness, including contagious, infectious, epidemic, pandemic, or endemic conditions, and take prompt action to control and suppress it? Order the following to prevent the spread of within the state of Ohio: 1. Effective immediately, all hospitals and physicians in the state of Ohio that are not currently conducting testing for shall contract with a hospital system with a laboratory that is performing COVID-19 testing to maximize the testing volume in Ohio. A list of hospital system laboratories with the testing capabilities can be found at . All hospitals, freestanding emergency departments, urgent care facilities, and ambulatory surgical facilities (that are not performing surgeries at this time) shall take all steps to acquire the COVID-19 rapid testing methods. Once testing capacity is reached using the Ohio Department of Health laboratory or a hospital system laboratory then hospitals are encouraged to use commercial laboratories for COVID-19 testing. Hospitals should refer the testing that meets the following priorities to the ODH laboratory or the larger laboratories that have agreed to perform prompt testing. Cases meeting the below priorities do not need approval by the local health department prior to sending specimens to the ODH lab: . 0 Priority 1: To ensure optimal care option for all hospitalize patients and to lessen the risk of nosocomial infections and maintain the integrity of the healthcare system. 0 Hospitalized patients 0 healthcare workers 0 Priority 2: To ensure those who are at highest risk of complication of infection are rapidly identi?ed and appropriately triaged. 0 Residents in a long-term care facility with 0 First responders with 246 North High Street 614 466-3543 Columbus, Ohio 43215 U.S.A. The State of Ohio is an Equal Opportunity Employer and Provider of ADA Services. 0 Patients 65 years of age or older with and testing referred from a hospital, including emergency department. 0 Patients with underlying conditions with and testing referred from a hospital, including emergency department. 5. 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 modi?es this Order. is a respiratory disease that can result in serious illness or death, is caused by the 2 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 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes. On January 23, 2020, the Ohio Department of Health issued a Director?s Journal Entry making 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 On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak of 9 a public health emergency of international concern. On January 31, 2020, Health and Human Services Secretary, Alex Azar ll, declared a public health emergency for the United States to aid the nation 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 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 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 PUls 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 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 9. 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 Prevention and Preparedness Plan" was sent to a broad range of associations representing healthcare, dental, long?term care, 1 2 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 9 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 On March 9, 2020, testing by the Department of Health con?rmed that three (3) patients were positive for in the State of Ohio. This con?rms 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 On March 11, 2020, the head of the World Health Organization declared a pandemic. On March 11, 2020, testing by the Ohio Department of Health confirmed that one (1) more patient was positive for in the State of Ohio. On March 1 l, 2020, the Ohio Departments of Health and Veterans Services issued a Joint Directors? Order to limit access to Ohio nursing homes and similar facilities. On March 15, 2020, the Ohio Department of Health issued a Director?s Order to limit access to Ohio?s jails and detention facilities. On March 15, 2020, the Ohio Department of Health issued a Director?s Order to limit the sale of food and beverages, liquor, beer and wine to carry?out and delivery only. On March 15, 2020, the CDC issued Interim Guidance for mass gatherings or large community events, stating that such events that consist of 50 or more people should be cancelled or postponed. On March 16, 2020 the Ohio Department of Health issued a Director?s Order closing polling locations for the March 17, 2020 primary election. On March 17, 2020 the Ohio Department of Health issued a Director?s Order for the management of non? essential surgeries and procedures throughout Ohio. On March 17, 2020 the Ohio Department of Health issued an Amended Director?s Order to limit and/or prohibit mass gatherings and the closure of venues in the State of Ohio. On March 19, 2020, the Ohio Department of Health issued a Director?s Order closing hair salons, nail salons, barber shops, tattoo parlors, body piercing locations, and massage therapy locations. On March 21, 2020, the Ohio Department of Health issued a Director?s Order closing older adult day care services and senior centers. On March 21, 2020, the Ohio Department of Health issued a Director?s Order closing family entertainment centers and internet cafes. On March 22, 2020, the Ohio Department of Health issued a Director?s Order that all persons are to stay at home unless engaged in essential work or activity. Multiple areas of the United States are experiencing ?community spread? of the virus that causes COVID- 19. Community spread, de?ned 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 (the sickest) however some spread might be possible before people show although that is not the main way the virus spreads. Mass gatherings (10 or more persons) increase the risk of community transmission of the virus 19. Accordingly, to avoid an imminent threat with a high probability of widespread exposure to with a signi?cant 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 Effective immediately, all hospitals and physicians in the state of Ohio that not currently conducting testing for shall contract with a hospital system with a laboratory that is performing COVID-19 testing to maximize the testing volume in Ohio. A list of hospital system laboratories with the testing capabilities can be found at . All hospitals, freestanding emergency departments, urgent care facilities, and ambulatory surgical facilities (that are not performing surgeries at this time) shall take all steps to acquire the rapid testing methods. Once testing capacity is reached using the Ohio Department of Health laboratory or a hospital system laboratory then hospitals are encouraged to use commercial laboratories for testing. Hospitals should refer the testing that meets the following criteria to the ODH laboratory or the larger laboratories that have agreed to perform testing. Cases meeting this clinical criteria do not need approval by local health department prior to sending specimens to the ODH lab. 0 Priority 1: To ensure optimal care option for all hospitalize patients and to lessen the risk of nosocomial infections and maintain the integrity of the healthcare system. 0 Hospitalized patients 0 healthcare workers 0 Priority 2: To ensure those who are at highest risk of complication of infection are rapidly identi?ed and appropriately triaged. 0 Residents in a long-term care facility with 0 First responders with 0 Patients 65 years of age or older with and testing referred from a hospital, including emergency department. 0 Patients with underlying conditions with and testing referred from a hospital, including emergency department. 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 thi Order Mi Mi 1, Am/ As; MD, MPH Director Health