Department 01110 of Health Mike DeWine. Governor Lance D. Himes, interim Director Jon Husted. Lt.Governor Re: ORDER Director?s Corrected Third Order to Extend the Expiration date of Second Amended Order that Provides Guidance for Contact Sport Practices and Non-Contact Sport Competitions, and Contact Competition, with Exceptions 1. Lance D. Himes, Interim Director of the Ohio Department of Health (ODH). pursuant to the authority granted to me in R.C. 3701.13 to "make special preventing the spread of contagious or infectious diseases? Order the following to prevent the spread 9 throughout the State of Ohio: 1. Preamble: The sacri?ces and incredible efforts that Ohioans have undertaken. make it possible to begin to lift the mandatory requirements and restrictions that were needed during the initial phase of the Pandemic. The adjustment of these orders is able to proceed based upon the facts and the science existing at this time in Ohio. however if the situation continues to improve. then more restrictions will be lifted, and if the situation deteriorates additional targeted restrictions will need to be made. While government can set the baseline. it should be understood that these orders set forth the minimum acts that must be taken and if people do more than the minimum to act safely. it will bene?t everyone. Contact Sport Practices and Non-Contact Sport Competitions to reopen. Contact practice and training may resume for all sports. Competitive games and tournaments are permitted for non- contact sports. provided. however. only intra-club/team scrimmages are permitted for contact sports. Practices. and/or open with another team or club. or competitive inter-club/team play are not permitted for contact sports unless all involved teams comply with the requirements set forth in Section 10 of this Order so as to minimize the spread 9. This Order applies to both public and private activities and facilities. These activities. businesses and operations shall continue to comply with Social Distancing Requirements as de?ned in this Order. including by maintaining six-foot social distancing for players when not engaged in play and coaching. Spectators are not pemiitted at the contact sports competitive inter-club/team play. Contact Sports De?ned. For this Order. contact sports are de?ned as football. basketball. rugby, ?eld hockey. soccer. lacrosse. wrestling. hockey. boxing. futsal and martial arts with Opponents. Elderly people and those who are vulnerable as a result of illness should take additional precautions. People at high risk of severe illness from COVID-19. including elderly people and those who are sick. are urged to stay in their residence to the extent possible except as necessary to seek medical care. According to CDC. the risk of severe illness from increases as people grow older and those at high-risk for severe illness from also include people and people of all ages with underlying medical conditions. particularly if not well controlled. including: a. Women who are pregnant; b. People with chronic lung disease or moderate to severe asthma; People who have serious heart conditions; People who are immune compromised; People with severe obesity (body mass index of 30 or higher); People with diabetes; People with Sickle Cell disease; People with chronic kidney disease undergoing dialysis; and People with liver disease. narrower-um 5. Facial Coverings (Masks). Businesses must allow all customers. patrons, visitors, contractors, vendors and similar individuals to use facial coverings, except for speci?cally documented legal, life, health or safety considerations and limited documented security considerations. Businesses must apply exceptions to wearing a mask equally to all persons and post the exceptions at all entrances. Businesses must require all employees to wear facial coverings, except for one of the following reasons: Facial coverings in the work setting are prohibited by law or regulation; Facial coverings are in violation of documented industry standards; Facial coverings are not advisable for health reasons; Facial coverings are in violation of the business?s documented safety policies; Facial coverings are not required when the employee works alone in an assigned work area; or There is a functional (practical) reason for an employee not to wear a facial covering in the workplace. 9999?s?: Businesses must provide written justi?cation, upon request, explaining why an employee is not required to wear a facial covering in the workplace. At a minimum, facial coverings (masks) should be cloth/fabric and cover an individual?s nose, mouth, and chin. 6. Social Distancing Requirements. For purposes of this Order, Social Distancing Requirements includes maintaining at least six-foot social distancing from other individuals, washing hands with soap and water for at least twenty seconds as frequently as possible or using hand sanitizer, covering coughs or sneezes (into the sleeve or elbow. not hands), regularly cleaning high?touch surfaces, and not shaking hands. 3. Required measures. Businesses and Operations and businesses must take proactive measures to ensure compliance with Social Distancing Requirements, including where possible: i. Designate six-foot distances. Designating with signage, tape, or by other means six- foot spacing for employees and customers in line to maintain appropriate distance; ii. Hand sanitizer and sanitizing products. Having hand sanitizer and sanitizing products readily available for employees and customers; and Online and remote access. Posting online whether a facility is open and how best to reach the facility and continue services by phone or remotely. 7. Questions. The Director of Health hereby delegates to local health departments the authority to answer questions in writing and consistent with this Order, but does not require local health departments to provide advisory opinions to nongovernmental entities. Page 2 of 11 8. General COVID-19 Information and Checklist for Businesses/Employers. Business and employers are to take the following actions: i. ii. iv. vi. vii. Strongly encourage as many employees as possible to work from home by implementing policies in areas such as teleworking and video conferencing, subject to the discretion of the employer; Actively encourage sick employees to stay home until they are free of fever (without the use of medication) for at least 72 hours (three full days) AND have improved for at least 72 hours AND at least ten days have passed since ?rst began. Do not require a healthcare provider?s note to validate the illness or return to work of employees sick with acute respiratory illness; healthcare provider of?ces and medical facilities may be extremely busy and not able to provide such documentation in a timely way; Ensure that your sick leave policies are up to date, ?exible. and non-punitive to allow sick employees to stay home to care for themselves, children, or other family members. Consider encouraging employees to do a self-assessment each day to check if they have any COVID-19 (fever, cough, or shortness of breath); Separate employees who appear to have acute respiratory illness from other employees and send them home immediately. Restrict their access to the business until they have recovered; Reinforce key messages stay home when sick, use cough and sneeze etiquette, and practice hand hygiene to all employees, and place posters in areas where they are most likely to be seen. Provide protection supplies such as soap and water, hand sanitizer, tissues, and no-touch disposal receptacles for use by employees; Frequently perform enhanced environmental cleaning of commonly touched surfaces, such as workstations, countertops, railings, door handles, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label. Provide disposable wipes so that commonly used surfaces can be wiped down by employees before each use; Be prepared to change business practices if needed to maintain critical operations identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations); and Comply with all applicable guidance from the US. Centers for Disease Control and Prevention and the Ohio Department of Health regarding social distancing. 9. Sector Speci?c COVID-19 Information and Checklist for Contact Sport Practices and Non- Contact Sport Competitions. Activities, leagues, organizations, businesses or employers, whether currently open or reopening, are to take the following actions: a. Players, Coaches, Athletic Trainers, and Of?cials i. Players, coaches. athletic trainers, and of?cials must conduct daily assessments. Anyone experiencing including fever or chills, cough, shortness of breath or dif?culty breathing, fatigue, muscle or body aches, headache, Page 3 of 11 ii. iv. vi. b. Spectators ii. vii. new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea, must stay home. Athletic trainers must wear a face covering when attending to an injured player, preferably a medical-grade mask, except for one of the following reasons: 1. Facial coverings in the work setting are prohibited by law or regulation; 2 Facial coverings are in violation of documented industry standards; 3. Facial coverings are not advisable for health reasons; 4 Facial coverings are in violation of the business?s documented safety policies; or 5. Facial coverings are not required when the employee works alone in an assigned work area. 6. There is a functional (practical) reason for an employee not to wear a facial covering in the workplace. Written justi?cation must be provided to local health of?cials, upon request, explaining why an athletic trainer is not required to wear a facial covering when attending to an injured player. At minimum, facial coverings (masks) should be cloth/fabric and cover an individual?s nose, mouth, and chin. It is recommended that, if possible, Coaches, athletic trainers and of?cials should wear face coverings at all times and players should wear face coverings when not on the ?eld or court of play except for one of the following reasons: 1 Facial coverings in the setting are prohibited by law or regulation; 2 Facial coverings are in violation of documented industry standards; 3. Facial coverings are not advisable for health reasons; 4 Facial coverings are in violation of documented safety policies; or 5. There is a functional (practical) reason not to wear a facial covering. It is recommended that, if possible, promote good hand hygiene and respiratory etiquette. Flyers and signs are available at coronavirus.ohio. gov. It is recommended that, if possible, ask a parent/volunteer to help monitor/ensure social distancing on teams of young children. It is recommended that, if possible, identify players at higher risk of developing serious complications from such as those with asthma diabetes or other health problems and take extra precautions to protect them. Spectators must conduct daily assessments. Anyone experiencing including fever or chills, cough, shortness of breath or dif?culty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea, must stay home. Six-feet social distancing must be maintained between individuals. No congregating before or after practices or games is permitted. It is recommended that, if possible, spectators should wear face coverings at all times except for one of the following reasons: 1. Facial coverings in the setting are prohibited by law or regulation; 2. Facial coverings are in violation of documented industry standards; 3. Facial coverings are not advisable for health reasons; Page 4 ofll 4. Facial coverings are in violation of documented safety policies; or 5. There is a functional (practical) reason not to wear a facial covering. 0. Practices, Games, and Tournaments ii. iv. vi. vii. d. Equipment ii. Six-feet social distance must be maintained between individuals except when on the ?eld or court of play. Physical contact is only permitted within the rules of the game during competitive practice. Players, coaches. and of?cials are not to physically contact each other before or after competitive practice greetings, team huddles, high-?ves, congregating, etc.) Limit time spent on activities where players are in close proximity for extended periods of time repeatedly practicing corner or penalty kicks in soccer or rebounding drills in basketball). Facilities/clubs/teams must ensure that facilities have adequate space for social distancing for players, coaches, of?cials, athletic trainers. parents/guardians, and spectators off the ?eld or court of play. No congregating before or after practices or games is permitted. Prior to competitive tournaments for non-contact sports, tournament organizers must alert the local health department. It is recommended that, if possible, during practices, consider putting players into small groups that remain together through practice stations rather than mixing groups for station to station. Whenever possible, equipment and personal items (such as water bottles) should have proper separation and should not be shared. If equipment must be shared, proper sanitation should be performed between users. Water bottles, food, and drinks should not be shared. It is recommended that, if possible, competing players/teams should not use the same equipment. It is recommended that, if possible, make sure there are adequate supplies of items and equipment to the extent possible to minimize the need for sharing bats, protective gear, etc.) e. Facilities and Venues ii. Time should be allotted between practice sessions to allow teams to exit ?elds/facilities prior to new teams arriving and for proper sanitizing for shared spaces (benches, equipment, etc.) Organizers of non?contact sports tournaments must follow applicable guidance for venues (including grandstands) in which the tournament is held. It is recommended that, if possible. promote good hand hygiene and respiratory etiquette. Flyers and signs are available at coronavirus.ohio.gov. Page 5 of 11 iv. It is recommended that, if possible, make hand sanitizer available at convenient locations. It is recommended that, if possible, if playing inside, ensure ventilation systems or fans operate properly. Increase circulation of outdoor air as much as possible, such as opening windows and doors unless doing so poses a safety or health risk. f. Non-Contact Travel Teams ii. It is recommended that, if possible, consider competing only against teams in your local area. Traveling outside the local community may increase the changes of exposing players, coaches, and fans to or unknowingly spreading it to others. It is recommended that, if possible, limit use of carpools. Encourage players to only ride with others in their household if possible. ix. Con?rmed Case ii. iv. Immediately isolate and seek medical care for any individual who develops Contact the local health district about suspected cases or exposure. It is recommended that, if possible, work with local health department to identify potentially infected or exposed individuals to help facilitate effective exposure noti?cation. It is recommended that, if possible, test all suspected infections or exposures. It is recommended that, if possible, following testing, contact local health department to initiate appropriate care and exposure notification. 10. Sector Speci?c COVID-19 Information and Checklist for Inter-Team Contact Sport Competition Teams, leagues, conferences, organizations, businesses or employers, whether currently open or reopening, shall take the following actions in order to safely engage in competitive play under the guidance of medical professionals: a. Players, Coaches, Athletic Trainers, Support Staff, and Of?cials must: i. ii. iv. Not exhibit signs or of within the past 72 hours prior to competition or if coming from outside the state, before arrival in Ohio. Should a player, coach, athletic trainer, support staff or of?cial exhibit signs or of they will not be permitted to participate in the competition and should not travel to Ohio; Acknowledge receipt of materials on that explains social distancing, mask wearing and appropriate handwashing and other hygiene to limit the spread of the disease; Receive a negative COVID-19 test result before traveling to competition; and, A PC COVID-19 test must be administered to each athlete and team staff member participating in the competition no more than 72 hours prior to the start of the competition and the results must be in hand prior to the start of the competition; Page 6 ofll vi. vii. xi. xii. any athlete or staff member testing positive and their entire team and staff are prohibited from participation in the competition; and all participants must remain in isolation with other their teammates and team staff from the time the 9 test is administered until completion of the competition. At all times, adhere to general quarantine by limiting contact with others to only teammates and team staff; Athletes and staff are required to have daily temperature checks administered by staff and complete a daily COVID-19 questionnaire as long as the competition continues; Require athletes and staff to wear face coverings (masks) at all times while outside rooms but within their quarantine areas (i.e travel to event with team); If competition lasts more than four days, administer a second test four days after the first test was administered. A negative test clears the athlete for competition; a positive test prohibits the athlete, teammates and all team staff from continued participation in the competition Be tested every two days after that for the duration of the tournament; If pre-competition practice is required, teams shall be assigned speci?c areas for practice and all areas shall be cleaned and sanitized before the next team can use the space. Event organizer shall certify daily in writing to the local health department that all required protocols are being followed. Event organizer shall maintain a contact log with each participant name, address, phone number and team name along with event schedule that includes the identity of all athletes against whom each team played and make contact log available to local health department or ODH upon request. Spectators are not permitted in the venue/facility for any competitive contact sports inter-club/team play. b. Confirmed Case ii. iv. Immediately isolate and seek medical care for any individual who develops Contact the local health district about suspected cases or exposure. Event organizer shall cooperate with local health department to identify potentially infected or exposed individuals to help facilitate effective exposure noti?cation. It is recommended that, if possible, test all suspected infections or exposures. It is recommended that, if possible, following testing, contact local health department to initiate appropriate care and exposure notification. 11. Duration. This Order shall be effective at 12:00 am. August 1, 2020 and remain in full force and effect until the State of Emergency declared by the Governor no longer exists or until the Director of the Ohio Department of Health rescinds or modi?es the Order, whichever occurs sooner. Page 7 of 11 COVID-19 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 identi?ed 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. 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 ?rst statewide call with local health departments and healthcare providers regarding 9. 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 M. Azar II, declared a public health emergency for the United States to aid the nation?s healthcare community in responding to 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 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 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. Page 8 ofll 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-pro?t 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 Govemor?s Summit on 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 9 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 2020-01D. 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 con?rmed that one (1) more patient was positive for COVID-19 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. Page 9 of 11 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 3 Order that all persons are to stay at home unless engaged in essential work or activity. On March 24, 2020, the Ohio Department of Health issued a Director?s Order that closed facilities providing child care services. On March 30, 2020, the Ohio Department of Health issued an Amended Director?s Order that closed all schools in the State of Ohio. On April 2, 2020, the Ohio Department of Health issued an Amended Director?s Order that all persons are to stay at home unless engaged in essential work or activity. On April 30, 2020, the Ohio Department of Health issued the Stay Safe Ohio Order that reopened businesses, with exceptions, and continued a stay healthy and safe at home order. 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. CDC reports that people infected with and demonstrating are most contagious. However, infected people can transmit COVID-19 when both and Mass gatherings (10 or more persons) increase the risk of community transmission of the virus COVID- 19. Accordingly, I hereby ORDER that contact practice and training may resume for all sports. Only intra? club/team scrimmages are permitted for contact sports and practices/open should be limited in the same way wherever possible. Competitive games and tournaments are permitted for non-contact sports only. as set forth in this Order. This Order shall remain in full force and effect until the State of Emergency declared by the Governor no longer exists or until the Director of the Ohio Department of Health rescinds or modi?es this Order at a sooner time and date. To the extent any public of?cial enforcing this Order has Page 10 ofll questions regarding what services are prohibited 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. August 1, 2020 Lance D. Interim Director of Health Page 11 of 11