SHELBY COUNTY HEALTH DEPARTMENT LEE HARRIS MAYOR ALISA R. HAUSHALTER, DNP, RN, PHNA-BC DIRECTOR BRUCE RANDOLPH, MD, MPH HEALTH OFFICER August 7, 2020 FORMAL ISSUANCE OF HEALTH ORDER AND DIRECTIVE NO. 10 (effective date: August 10, 2020) Pursuant to the Declarations of a State of Emergency by Shelby County Mayor Lee Harris and the Necessity of a Communicable Disease Control Threat Procedure by the Shelby County Health Department _______________________ TO: Residents, Visitors, and Owners/Operators of Services, Facilities, and/or Businesses in Shelby County, Tennessee FROM: Lee Harris, Shelby County Mayor Bruce Randolph, M.D., M.P.H, Shelby County Health Officer Alisa Haushalter, DNP, RN, PHNA-BC, Shelby County Health Director RE: Public Health Announcement on COVID-19 Response _______________________ Pursuant to the emergency management authority vested in Shelby County, Tennessee, for coordination of relief efforts in the event of a countywide emergency that may result in substantial injury or harm to the population, and the necessity to respond to public health emergencies vested in the Shelby County Public Health Department (“the Department”), this Health Order and Directive (“Directive”) is being issued to protect the public health for all citizens and businesses in Shelby County, Tennessee. This Directive incorporates by reference the Shelby County Face Mask Order and Directive (“Face Mask Directive”), issued July 7, 2020, and together, both documents supersede all other written or oral Health Directives. This Health Directive will be modified as needed to account for current and relevant Shelby County health data. This Directive shall take effect, August 10, 2020. Page 2 All Health Directives are informed by data, evidence, and input from appropriate public health, health care, medical, legal and political leaders. This includes consultation with a back-to-business committee comprised of representative stakeholders in the County, including municipalities in the County, public health officials, physicians, and governmental attorneys. Pursuant to Tennessee law and regulations and Shelby County’s charter, ordinances, and resolutions, whenever any health emergency occurs, or any rare or unusual disease appears, or when any disease becomes unduly prevalent, the Shelby County Health Director and Health Officer have the power to employ any measures necessary for the protection of the public health, including the exclusive power to quarantine, establish contract tracing measures, and to promulgate such countywide rules and regulations as may be necessary to combat such emergencies, including rules and regulations for persons residing in, entering, or leaving the county and rules regarding the regulation of property. SARS-CoV-2, the virus that causes COVID-19, is thought to be mostly spread by respiratory droplets released when people talk, cough, sneeze, or sing. It is thought that the virus may also spread to hands from a contaminated surface and then to the nose, mouth, or eyes, causing infection. Therefore, the important personal practices to prevent the virus’s spread are: • • • • • • Staying home when sick Limiting close contact with others Maintaining at least 6-feet of distance from other people Wearing a cloth face covering or mask over your nose and mouth (see the Face Mask Directive) Frequently washing hands with soap and water, or using hand sanitizer (60% alcohol) Cleaning and disinfecting frequently touched surfaces and objects The goal is safety while balancing the needs of citizens to receive the necessities of life, i.e., food and shelter, allowing people to work in a safe manner, and further ensuring the availability of resources to the community. Every effort should be made by businesses and services to take steps to stop the spread of this deadly disease. These actions are meant to protect everyone. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 3 This Directive removes certain restrictions on the ability to return to work and engage in essential activities. It is intended to be a guide toward developing long-term safety measures, as detailed below, to slow and end the transmission of COVID-19, which continues to be a direct and deadly threat to the population of Shelby County, Tennessee. When determining whether a specific Service or Business should reopen, the Department considers two main factors: the risk of COVID-19 spread when conducting said business activity in light of the latest science and research about the spread of COVID-19, and the prevalence of the disease in our community. As prevalence goes down, the level of acceptable risk increases. This is due to the fact that with low prevalence, the risk that any one person is spreading the disease decreases. In order to facilitate evolving efforts to expand the opening of services and businesses in Shelby County, this Directive provides the following guidance on: 1) Safety Measures for Individuals; 2) Safety Measures for all Services and Businesses; and 3) Safety Measures for Services and Businesses that require in-person interaction with the public or those who otherwise regularly welcome non-employees into their place of business. Certain restrictions or the removal of such restrictions may be implemented when the following conditions occur. Municipalities may impose greater, but not lesser, restrictions contained in this Directive: Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 4 IMPROVEMENTS RESPONSE • New cases over a 1-week period averaging less than • Open limited service restaurants and other food/drink 180 cases/day based upon date of testing establishments that are currently closed • Downward trend line for 2 consecutive weeks (14 days) • Rate of new cases decreasing by ≥ 30 % per week over 2 consecutive weeks (14 days) • Reproductive Rate ≤ 1.0 • Positivity Rate ≤ 10% • New cases over a 1-week period averaging less than 75 • Allow increased gathering sizes, increased capacity per day based upon date of testing within businesses, special events (under approved • Continued downward trend line for 2 consecutive plans) weeks (14 days) • Rate of new cases decreasing by ≥ 30 per week over 4 consecutive weeks (28 days) • Reproductive Rate ≤ 1.0 • Positivity Rate ≤ 5% SET-BACKS RESPONSE • New cases over a 1-week period averaging more than 450 cases/day based upon date of testing • Rate of new cases increasing by ≥ 40% over one week (7 days) • Reproductive Rate ≥ 1.4 • Positivity Rate ≥ 18% • Provide targeted education and communication • Increased enforcement • Closure of limited service restaurants • Restrictions on full service restaurants • Restrict sports related events and activities • Impose a curfew • New cases over a 1-week period averaging more than 650 cases/day based upon date of testing • Rate of new cases increasing by ≥ 40% over two consecutive weeks (14 days) • Reproductive Rate ≥ 1.4 • Positivity Rate ≥ 20% • New cases over a 1-week period averaging more than 750 cases/day based upon date of testing • Rate of new cases increasing by ≥ 40% over two consecutive weeks (14 days) • Reproductive Rate ≥ 1.6 • Positivity Rate ≥ 25% • Targeted education and communication • Increased, targeted enforcement • Decrease gathering sizes to ≤ 10 • Return to Safer at Home • Closure of Schools Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 5 Currently, all businesses and services in Shelby County may open for business with the following exceptions: 1) Bars/Limited Service Restaurants, Clubs, and Multi-Person Biking vehicles that serve beer or alcohol. • Please visit https://www.tn.gov/abc/licensing/liquor-by-the-drinklicenses.html for assistance on licensing information. • Beer/wine/liquor production facilities that are not otherwise licensed as restaurants may continue to operate their production enterprise, but onpremises consumption of alcohol, inside or outside, cannot occur at this time. • If properly permitted by local and state law, any curb-side, drive-thru, or delivery services may continue, but any such sales of alcoholic beverages must end at 10 p.m. 2) Full Service Restaurants that have a gross annual revenue from the sale of prepared food that is 50% or less than the gross annual revenue from the sale of alcoholic beverages regardless of their licensure by the Tennessee Alcohol Beverage Commission (Commission). • Please be prepared to provide 1) the most recent sales numbers that were provided to the Commission for license renewals or sales number for year-todate sales and 2) a “food affidavit” by an owner of the establishment attesting that the numbers submitted are correct. • If applicable to you or your establishment, please see further information regarding “Full-Service Restaurants” and their operations below. 3) Adult entertainment venues; and 4) Festivals, fairs, parades, large-scale sporting events, and large-scale community events unless the Department has approved a site-specific plan for conducting the event. Nothing in this order restricts the ability of the Department to take targeted action against specific businesses where COVID-19 outbreaks or clusters occur under the Department’s standing authorities to control disease outbreaks. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 6 Nothing in this Directive mandates closure of a place of worship or prohibits weddings or funerals as a matter of law. Weddings may be conducted in any manner that is permissible under Governor Lee’s Executive Order No. 38 (as extended). However, places of worship are strongly encouraged to continue to utilize virtual or online services and gatherings, and are strongly encouraged to follow guidelines as issued by the State of Tennessee’s Office of Faith-Based and Community Initiatives regarding any in-person services that can be conducted safely. Further, it is strongly encouraged that the public celebration component of weddings and funerals be postponed or attended only by close family members and that all safety precautions in this Directive are followed, including wearing cloth face coverings. Any modification by the State of Tennessee to this provision must also be followed. _______________________ 1) Safety Measures for Individuals: • Individuals must cooperate with health authorities’ efforts to prevent and control the spread of COVID-19. • Individuals who test positive for COVID-19 must report this information to the Department by faxing the information to 901-222-8249 or by calling 901-426-2624 (or the COVID Call Center at 833-943-1658) to discuss a case they wish to report. Individuals who test positive for COVID-19 must notify those who are known to have been in contact with them. • Individuals should stay at home when possible and limit unnecessary activity. Although this Directive allows some individuals to return to work (as provided for below), the threat of COVID-19 remains very serious. Because avoiding unnecessary public interactions is critical to protecting the health and safety of everyone in Shelby County, all persons are still strongly encouraged to continue to stay at home and to minimize in-person contact with people not in the same household, except when engaging in essential activities such as employment or exercise or other activities as outlined in this Directive. Individuals should also be aware of the need to take extra precautions to protect those who are most vulnerable. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 7 • Individuals must practice social distancing, which means keeping at least 6-feet of space between yourself and other people outside of your home. Please see additional, more specific guidance below for situations that involve increased vocalization (such as singing and shouting). • Individuals must comply with the Face Mask Directive on wearing cloth face coverings in public: http://www.shelbytnhealth.com/DocumentCenter/View/1766/Face-Mask-Orderand-Health-Directive-7-7-20. • Individuals must avoid using communal items and products that are shared with people who are not of the same household; such items include writing utensils, condiment containers, and work-related devices. • Individuals may engage in outdoor activities provided that persons adhere to the CDC, Tennessee Department of Health, and Shelby County Health Department health guidelines, including, but not limited to physical activities that utilize public areas while maintaining the aforementioned safety precautions. • Individuals may assist all businesses that are closed under this Directive with minimum basic operations consisting in performing activities at their own residences (i.e., working from home) or at their workplaces in order to maintain the value of the business’s inventory, ensure security, process payroll and employee benefits, or for other related, necessary business functions. _______________________ 2) Safety Measures for all Services and Businesses The following safety measures must be in place for services and businesses to remain open or to reopen. Services and Businesses that may not reopen should consider adopting these safety measures to prepare for reopening in the future. • Cooperate with health authorities’ efforts to prevent and control the spread of COVID-19. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 8 • Request technical assistance from the Department when needed. • Comply with all federal and state business COVID-19 safety requirements, whether industry-specific or not, such as the Occupational Safety and Health Administration (OSHA) requirements. • Place prominent informational signs at entrances and high-traffic areas (such as entrances and restroom areas) to educate and encourage a partnership of safety for businesses and the public. Signs must meet or exceed the requirements and safety guidelines outlined by the CDC at https://www.cdc.gov/coronavirus/2019ncov/downloads/stop-the-spread-of-germs.pdf • Place prominent informational signs at entrances and high-traffic areas (such as entrances and restroom areas) that masks are required within the business. • Place prominent informational signs at entrances that employees, patrons, and all others must not enter if they are sick or currently have signs or symptoms of COVID-19, such as the CDC’s recommended sign located here: https://www.cdc.gov/coronavirus/2019ncov/downloads/StayHomeFromWork.pdf • Ensure proper ventilation in all indoor areas of any business location. • Require all employees, customers and visitors to wear a mask or cloth face covering while within their establishments. Employees are not required to wear masks when at their desk or workstation alone and so long as the workstation is not shared with any other employee. • Continue promoting frequent and thorough handwashing by providing workers, customers, and visitors a place to wash their hands or use alcohol-based hand sanitizer at or near entrances to a facility and other high-traffic areas. It is strongly encouraged that CDC handwashing guides be placed in all bathrooms and near any handwashing sink as described at https://www.cdc.gov/handwashing/pdf/wash-your-hands-poster-english-508.pdf • Close all water fountains that require individuals to drink from the same spout. • Require workers to stay home if they are sick pursuant to the following CDC guidance: Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 9 “How to Protect Yourself and Others”: https://www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/prevention.html (as of July 24, 2020). “What to Do if You are Sick”: https://www.cdc.gov/coronavirus/2019-ncov/if-youare-sick/steps-when-sick.html (as of July 24, 2020). • Health checks and screenings for fever (100.4 degrees Fahrenheit) or other signs and symptoms of COVID-19 must be performed at the start of each employee’s shift so that any employee that exhibits such symptoms may not enter any workplace. This includes taking the temperature of employees who are reporting to work and asking the following: 1. 2. 3. 4. 5. Have you been in close contact with a confirmed case of COVID-19? Are you experiencing a cough, shortness of breath or sore throat? Have you had a fever in the last 48 hours? Have you had new loss of taste or smell? Have you had vomiting or diarrhea in the last 24 hours? Employees who exhibit COVID-19 symptoms (i.e., by answering yes to any of the screening questions or who are running a fever) should be directed to leave the premises immediately and seek medical care and/or COVID-19 testing. Alternatively, employees may self-validate their status at the beginning of each shift to their supervisor. • Report to the Department any employee who has had contact with a person who tests or has tested positive for COVID-19 to notify the Department by faxing the information to 901-222-8249 or by calling 901-426-2624 (or the COVID Call Center at 833-943-1658) to discuss a case they wish to report. • If an employer is informed that an employee has tested positive for COVID-19, the area(s) where the employee worked should be closed for cleaning and disinfecting pursuant to CDC and OSHA guidance: https://www.cdc.gov/coronavirus/2019 “Worker Safety and Support”: ncov/community/worker-safety-support/index.html “Guidance on Preparing Workplaces https://www.osha.gov/Publications/OSHA3990.pdf for COVID-19”: Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 10 • Develop a plan on how to communicate with customers/patrons if they are exposed to someone (such as an employee or another patron) who tests positive for COVID19. For example, restaurants must maintain seating charts for 21 days to assist with contact tracing as further explained below. • As determined by the employer and where feasible, allow employees to work from home or permit flexible worksites and hours (including staggered shifts) to increase physical distancing among and between employees. • Discourage workers from using other employee’s phones, desks, offices or other work tools and equipment, when possible. When this is not possible, sanitizers should be used both prior to use of communal items and immediately after, and care should be taken not to touch the face. • Increase regular housekeeping practices for all areas to more than twice a day cleanings, including routine cleaning and disinfecting of surfaces, equipment, high-touch surfaces, work areas, break rooms, bathrooms, common areas, and any other areas of the work environment. • Limit the number of people who can enter a facility at any time to no more than 50% of listed occupancy and ensure that people inside can easily maintain a minimum 6-foot distance from each other at all times, except when necessary to complete a business transaction such as payment or delivery of goods. _______________________ 3. Safety Measures for Services and Businesses that require in-person interaction with the public or those who otherwise regularly welcome non-employees into their place of business (The following measures are required in addition to the requirements listed above for all businesses.) • Where feasible, implement contactless transactions. • Close all self-service customer bulk-item food and/or supply bins. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 11 • Place an employee at entrances to ensure any applicable building occupancy thresholds (as further delineated below) are not exceeded and customers are wearing masks prior to entering the store. • Indicate where lines may form at a facility, marking 6-foot increments as guides for where individuals should stand to maintain social distancing. • Concession registers should be configured to allow for 6-foot spacing between customers. • Consider installing plexiglass barriers at registers and other employee/customer points of contact. • If gloves are used by employees, they should be replaced every 30 minutes and discarded whenever an employee washes his/her hands. If at any time the gloves become contaminated with a foreign substance, the gloves are to be discarded and replaced with a new pair. • Make best efforts to establish hours when they are only available to senior citizens age 55 and older, pregnant women, and otherwise vulnerable populations and consider implementing other measures to help serve vulnerable populations, such as offering delivery services. • As described above, occupancy limits must not exceed 50% of the allowed occupancy of the facility. • Patrons must not be allowed to congregate in groups larger than six and each group must maintain social distance of greater than 6 feet from any other group and follow all appropriate safety procedures. Where the service or business routinely provides seating or other congregate settings (e.g. tables, benches, fitness equipment, etc.), each setting or group of seats must be placed more than 6 feet from every other table or group of seats. In the event the business has fixed seating or equipment, seats and equipment must be closed with signs to allow for social distancing. • Subject to more specific restrictions outlined below for sporting events and activities, restaurants, theaters, and other businesses that allow for group Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 12 activities or dining (e.g. recreational facilities, pools, etc.) may allow groups (no larger than six) to enter together and act as a “family unit” so long as each group maintains a distance of 6 feet from all other groups. Regardless of “family unit” status, all patrons must continue to wear a mask unless eating or drinking. Where these family unit groups are allowed, the facility must maintain a record of all patrons to include, at a minimum, first name, last name, time of service/attendance, and cell phone or other contact number to allow for contact tracing in the event a COVID+ case is identified. Restaurants must maintain seating charts for 21 days to assist with contact tracing. Records must be maintained for a minimum of 30 days after the date on which the service occurred. The Department will provide technical assistance to any business upon request. • All business that require close contact between patrons and/or employees for the provision of services (i.e. Nail Salons, Barbershops, Salons, and other personal appearance businesses) must maintain a record of all patrons including, at a minimum, first name, last name, time of service, and cell phone number or other contact number to allow for contact tracing in the event a COVID+ case is identified. Records must be maintained for a minimum of 30 days after the date on which the service occurred. • Where practical, businesses are encouraged to use outdoor space for the provision of services. Restaurants in particular are encouraged to provide outdoor dining. • All communal use of items and products should be prevented, including, for example, writing utensils, store bags, condiment containers, self-service stations, and buffets. All menus or service literature should be disposable, single-patron usage, and/or accessible by personal electronic devices (e.g., internet website, QR Code, etc.). • Patrons or facility personnel must clean equipment with disinfecting wipes before and after each use. Shared equipment that cannot be cleaned in between use is not allowed. • High-touch areas, such as elevator buttons, door handles, and counters must be cleaned regularly throughout the day with disinfectant. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 13 • Communal showers and locker rooms must be closed to the public; bathrooms should remain open with regular cleaning and disinfection as required for highcontact areas. Facilities that would normally require changing clothes prior to using their services should encourage all patrons to change prior to coming to the facility; where this is not practical, facilities may allow for a changing area. • Hot tubs must remain closed. • If the layout of the facility is such that ingress/egress would often prompt encounters of less than 6 feet, facilities must use best efforts to make for one-way traffic flow and/or specific entrances and exits. • Live music should not be permitted unless appropriate precautions are taken. Research and the CDC suggest that activities like singing may project respiratory droplets in greater quantity and over greater distance, increasing the risk of COVID-19 transmission, particularly with prolonged exposure. Live music performers should maintain at least 18 feet of separation—and more if possible— between audience members and the performer(s) (e.g., vocalists and singers). Thus, seating and spacing modifications should be adopted to increase physical distances between any observer and any performer. Where necessary, install barriers to minimize travel of aerosolized particles from performers or implement alternative placements of performers. In addition, maximize physical spacing between performers on-stage by at least 6 feet unless barriers are used. Dancing should not be allowed unless it occurs outdoors and dancers maintain six feet separation from those who are not of their same household. • Schools, School Systems, Daycare and Childcare businesses may operate, provided that they implement screening procedures, develop safe drop-off and pickup procedures, ensure additional steps are taken to enhance personal hygiene of employees, (including wearing face coverings that cover the nose and mouth), and provide regular sanitization efforts within the facilities themselves. Activities that occur at any of these businesses must follow any applicable safety measures outlined in the current Health Directive and should follow any guidance or protocols recommended by the Tennessee Department of Health, the Tennessee Department of Education, and the CDC. To submit a reopening plan to the Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 14 Department for review and technical assistance, www.shelbytnhealth.com/healthdirectives and follow the instructions. • visit Colleges and Universities, through their governing boards and presidents, retain sole responsibility in making decisions on providing instruction to their students while protecting the health and safety of their students, faculty, and staff. Nothing in this Directive should be construed to stipulate or require campuses to reopen in the Fall. In all cases, colleges and universities should consult the guidance issued by OSHA, the CDC, and the State of Tennessee as well considerations outlined by the American College of Health Association: “Colleges, Universities, and Higher https://www.cdc.gov/coronavirus/2019-ncov/community/collegesuniversities/index.html Learning”: “Higher Education Guidelines”: https://www.tn.gov/governor/covid-19/economicrecovery/higher-education-guidelines.html “Considerations for Reopening Institutions of Higher Education in the COVID-19 Era”:https://www.acha.org/documents/resources/guidelines/ACHA_Consideration s_for_Reopening_IHEs_in_the_COVID-19_Era_May2020.pdf • The Shelby County Government Division of Corrections shall follow all safety precautions as stated in any executive order by Mayor Lee Harris. • Detention facilities: If not already established, facility administrators should adopt protocols that house new detainees separately from the inmate population in order to properly screen and care for the new inmate until such time as the new inmate can safely be placed in the same environment with the existing inmate population. If any detained person is released on their own recognizance (ROR) or makes bond, they should be provided with a copy of the current “Shelby County Health Order and Directive” and instructed to follow that directive upon release. Additionally, they shall be provided information (6th grade reading level) about COVID-19 and “How to Protect Yourself and Others” issued by the CDC: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 15 Nothing in this Directive is intended to delay or impede the release of detained individuals if they are eligible to be released. • The State of Tennessee has developed statewide guidelines for the following types of establishments/activities. Each type of establishments/activity is required to follow all applicable state guidelines located online as indicated below (as of August 7, 2020). 1. Full-Service Restaurants: https://www.tn.gov/governor/covid-19/economicrecovery/restaurant-guidelines.html. The following additional restrictions must be followed: • • • • • • • • There shall be no standing room or seating at a physical bar. Alcohol may only be served with food and to customers who are seated at a table. Food service at a table for each customer/group should not exceed two hours. If properly permitted by local and state law, any curb-side, drive-thru, or delivery services may continue, but any such sales of alcoholic beverages must end at 10:00 p.m. All restaurants shall close at 10:00 p.m. This means that guests who are already in the restaurant at 10:00 p.m. may remain there until 10:30 p.m. but may not be served food or beverages after 10:00 p.m. Only staff needed to close, open, clean, or operate curb-side/delivery services shall be in any restaurant between the hours of 10:30 p.m. and 5:00 a.m. Legally permitted curb-side, drive-thru, and delivery service may continue (except for the sale of alcoholic beverages as provided above) without the restriction of closing at 10:00 pm as long as such services also comply with state law. Music (live or recorded) must be kept at a decibel level that permits regular conversation. In other words, the noise level should not be so great as to cause patrons to raise their voices to be heard. Dancing is not permitted at a restaurant. Club houses at golf courses, tennis courts, and other facilities if they qualify as a full-service restaurant under state law, must comply with these requirements as well. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 16 2. Recreational Facilities: https://www.tn.gov/governor/covid-19/economicrecovery/recreation-guidelines.html 3. Exercise Facilities: https://www.tn.gov/governor/covid-19/economicrecovery/exercise-facilities-guidelines.html 4. Salons, Barbershops, and Nail Salons, and other personal appearance businesses that require close contact between patrons and employees: https://www.tn.gov/governor/covid-19/economic-recovery/close-contactbusiness-guidelines.html 5. County Courts and Court Buildings: All county courts and county buildings where courts are located must follow the guidelines established by the Tennessee Supreme Court, which can be found at: https://www.tncourts.gov/Coronavirus. Also, as set forth above, these additional restrictions must be followed: • All employers or officials who oversee employees must comply with all applicable businesses and services safety measures contained in this Directive, including 1) 50% courtroom occupancy restrictions (please contact the Department for occupancy information), 2) required 6-feet social distancing between all individuals inside and outside courtrooms, and 3) completing health check/screening protocols for their respective employees. If desired, please contact the Shelby County Health Department for information on contactless screening, staggered/timed court settings, and other technical assistance. • It is Shelby County Government’s prerogative to implement health checks and screening protocols for visitors to any County building. • Court dockets should be restricted or scheduled so that the requirements of this Directive are met. • Face coverings should be worn by employees and visitors in compliance with the Shelby County Health Department’s Face Mask Order, located here: http://www.shelbytnhealth.com/DocumentCenter/View/1766/Face-MaskOrder-and-Health-Directive-7-7-20. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 17 • The Shelby County Sheriff’s Office has the responsibility of ensuring that all areas of the courthouse, including courtrooms and common areas, are in compliance with this Directive. • The Shelby County Health Department may close all or part of the courthouse if 1) safety measures are not observed or 2) if current conditions present an increased public health risk within the courts or buildings where courts are housed. 7. Visitation in Long Term Care Facilities and Assisted Living Centers: https://www.tn.gov/content/dam/tn/health/documents/cedep/novelcoronavirus/LTCF_Visitation.pdf. Any positive test result shall be reported to the Department of Health by 5:00 p.m. of the day following receipt of such test result. The Department shall have unrestricted access to the facility where such access is determined necessary by the Department for purposes of testing all personnel for COVID-19, and in such circumstances, the operator and administrator shall cooperate fully to facilitate such testing. Consistent with CDC guidance, facilities must inform residents and their representatives within 12 hours of the occurrence of a confirmed infection of COVID-19, or three or more residents or staff with new-onset of respiratory symptoms that occur within 72 hours. Updates to residents and their representatives must be provided weekly, or each subsequent time a confirmed infection of COVID-19 is identified and/or whenever three or more residents or staff with new onset of respiratory symptoms occurs within 72 hours. Facilities shall include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the facility will be altered. 6. Sporting/Team Events and Activities. Please review more specific guidance below these additional general requirements: • Coaches, school officials, and sponsors of any of sports/team event or activity must: 1) cooperate with the Department and provide names and contact information of participants or staff who may have been a contact with a COVID-19 case and 2) report to the Department any participant or Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 18 • • • staff who has had contact with a person who tests or has tested positive for COVID-19 by calling 901-426-2624 (or the COVID Call Center at 833-9431658). Outdoor sporting events that involve the likelihood that visitors will engage in increased vocalization, such as yelling, cheering, singing, or speaking loudly, must be separated at least 12 feet apart and must wear face coverings consistent with the Face Mask Directive. Family units/groups of up to six people may sit together, but no member of one group can be within 12 feet of any member of another group. Indoor sporting events that involve the likelihood that visitors will engage in increased vocalization, such as yelling, cheering, singing, or speaking loudly, must be separated at least 18 feet apart and must wear face coverings consistent with the Face Mask Directive. Family units/groups of up to six people may sit together, but no member of one group can be within 18 feet of any member of another group. All locations where events/activities occur must continue to abide by the requirements set forth in this Directive. Grade 6-12 School-Sponsored Sporting Events and Activities: https://tssaa.org/returntoplay. Local education agencies and schools shall, notwithstanding any orders or provisions to the contrary, have the authority to permit, but are not required to permit, school-sponsored sporting events and activities, provided that all such activities, including practices and games or competition, must be conducted in a manner consistent with COVID-19-related regulations adopted by the Tennessee Secondary Schools Athletic Association. Non-School-Sponsored Athletics: https://www.tn.gov/governor/covid19/economic-recovery/tennessee-pledge.html. These athletic activities (including practices and games/competition) may take place as permitted by the Tennessee Economic Recovery Group (i.e., Tennessee Pledge) and provided that all such activities are conducted in a manner consistent with COVID-19 related regulations adopted by Tennessee Pledge, including any forthcoming state guidance. Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 19 Collegiate and Professional Sporting Events and Activities: must be conducted pursuant to the rules or guidelines of their respective governing bodies. Scholastic and Other Organized Teams: If none of the aforementioned guidance applies, teams must follow guidance established by the National Federation of State High School Associations set forth at https://www.nfhs.org/media/3812287/2020-nfhs-guidance-for-opening-uphigh-school-athletics-and-activities-nfhs-smac-may-15_2020-final.pdf (as of August 3, 2020) and any requirements set forth in this Directive. Please contact the Shelby County Health Department if you require technical assistance regarding any safety parameters. ______________________ In conclusion, the aforementioned guidelines set forth in this Directive present, at this time, the least restrictive means by which transmission of COVID-19 may be slowed while also permitting businesses to reopen and remain open. The Shelby County Health Department, with the assistance of the Shelby County Sheriff’s Office, is authorized to take emergent and immediate action to enforce this Directive. _______________________ Requirement to Collect Demographic Data. Any health care provider located in Shelby County, Tennessee that provides COVID19 testing or clinical care shall provide to the Shelby County Health Department (SCHD), as requested by the SCHD, demographic data regarding individuals tested or cared for by the provider. Such data shall be in such forms, formats and/or schedules that the SCHD will reasonably specify to the provider by written guidelines, including by way of example and without limitation the following data: gender, race, ethnicity, date of birth or other indicia of age, and such other demographic-based clinical information that the SCHD deems Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com Page 20 relevant and necessary to respond to and serve the needs of Shelby County related to the COVID-19 pandemic. Approved and adopted by: LEE HARRIS, SHELBY COUNTY MAYOR BRUCE RANDOLPH, M.D., M.P.H., SHELBY COUNTY HEALTH OFFICER ALISA HAUSHALTER, DNP, RN, PHNA-BC, SHELBY COUNTY HEALTH DIRECTOR Mission To promote, protect and improve the health and environment of all Shelby County residents. 814 Jefferson Avenue Memphis, TN 38105 901 222-9000 www.shelbytnhealth.com