Noem Issues Executive Order Regarding COVID-19 Guidelines

The Executive Order reads:

Whereas, An outbreak of the severe respiratory disease, COVID-19, which is caused by and is transmitted by the person-to-person spread of the novel coronavirus, started in late 2019 and has currently been detected in more than 100 countries, including the United States; and,

Whereas, The World Health Organization has designated COVID-19 a pandemic, and the U.S. Centers for Disease Control and Prevention (CDC) has declared a public health emergency; and,

Whereas, The CDC has issued guidance to state and local governments and all citizens recommending steps to prevent community spread and guard against the COVID-19 outbreak; and,

Whereas, Executive Order 2020-04 declared South Dakota to be in a State of Emergency due to the COVID-19 pandemic; and,

Whereas, As members of a community, South Dakotans join together in times of crisis to confront difficult times and help their neighbors:

NOW, THEREFORE, I, KRISTI NOEM, Governor of the State of South Dakota, by the authority vested in me by the Constitution and the Laws of this State, including but not limited to SDCL 34-48A, do hereby Order and Direct the following:

Every South Dakotan should:

1.  Review and practice the recommended CDC hygiene practices designed to stop the spread of the disease COVID-19 and encourage others to do so as well.

2.  Know the signs and symptoms of COVID-19, call a health care provider if suffering symptoms in advance of a visit to a provider, and stay at home if sick.

3.  Understand that those who are particularly vulnerable to COVID-19, including those over age 60 and those suffering from respiratory or cardiac conditions, should take extra precautions and remain home if possible.

4.  Implement social distancing measures and support businesses who are adjusting their business model to reduce the spread of COVID-19.

5.  Assist those who work in essential jobs such as emergency personnel, medical professionals, and law enforcement.

All employers, both for profit and not-for-profit, within the State of South Dakota should:

6.  Implement the recommended CDC hygiene practices and other business strategies designed to reduce the likelihood of spreading the disease.

7.  Understand that the COVID-19 is not a short-term challenge, and operations will need to endure a difficult and limited social environment for potentially eight weeks or more.

8.  Innovate and continue to demonstrate entrepreneurial excellence in their operations during this difficult and uncertain environment.

9.  Encourage staff to telework if possible, implement social distancing measures, limit unnecessary work gatherings, limit non-essential travel, and consider regular health checks including CDC guidance for COVID-19 screening if possible.

10.  Offer, to the extent possible, special shopping times or access periods for populations particularly vulnerable to COVID-19.

Any “enclosed retail business that promotes public gatherings” within the State of South Dakota should:

11.  Suspend or modify business practices as recommended by CDC guidance that involve ten or more people to be in an enclosed space where physical separation of at least six feet is not possible.

12.  Continue offering or consider offering business models that do not involve public gatherings, including takeout, delivery, drive-through, curb-side service, off-site services, social distancing models, or other innovative business practices that do not involve public gatherings in an enclosed space.

13.  Consider business arrangements and innovative ideas intended to support the critical infrastructure sectors, as defined by the Department of Homeland Security.

For the purpose of sections 11 through 13, an “enclosed retail business that promotes public gatherings” means any enclosed facility operating as a bar, restaurant, brewery, cafe, casino, coffee shop, recreational or athletic facility, health club, or entertainment venue.

All healthcare organizations within the State of South Dakota should:

14.  Implement or Continue to follow CDC guidance and maintain their exceptional efforts to prepare for the expected surge of patients needing health care services as a result of the COVID-19 disease.

15.  Postpone all non-essential elective surgeries to conserve (and thereby maximize) supplies of personal protective equipment (PPE).

All local and municipal governments within the State of South Dakota should:

16.  Implement the recommended CDC hygiene practices and public employee arrangements designed to reduce the likelihood of spreading the disease, and take action based on facts, data, and science.

17.  Restrict public gatherings of ten people or more, unless it is necessary.

18.  Review the business practices of each “enclosed retail business that promotes public gatherings” in their community for compliance with this Executive Order and protect the ability of those businesses to innovate.

19.  Encourage entrepreneurial innovation in the private sector to provide employment opportunities to protect the continued operation of the free market consistent with recommended CDC hygiene practices and understand that COVID-19 will impact their communities for potentially eight weeks or more.

20.  Protect the critical infrastructure sectors, as defined by the Department of Homeland Security, such as healthcare services, pharmaceutical industry, and food supply entities, as these sectors have a special responsibility to maintain their normal work schedule.

Limitations:

1. This Order should be read in conjunction with the list that is attached to the Cybersecurity and Infrastructure Security Agency (CISA) memorandum dated March 19, 2020.
2. This Order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the State of South Dakota, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
3. Sovereign nations within the borders of South Dakota should review the matters set forth herein and make their own decisions in accordance with tribal law.
4. This Order is based on developing data, facts, and science and may be rescinded or amended, and shall expire on the earlier of when revoked, superseded, or automatically on May 2, 2020.

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March 10, 2020

SD-HAN 20-007: South Dakota Guidance on Evaluating Persons for Novel Coronavirus (COVID-19) Infection (Updates SD-HAN 20-003) 

Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html

Please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html to review the full Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States.

Updated March 10, 2020

Summary of Key Changes for the EMS Guidance:

• Updated PPE recommendations for the care of patients with known or suspected COVID-19:
• • Facemasks are an acceptable alternative until the supply chain is restored. Respirators should be prioritized for procedures that are likely to generate respiratory aerosols, which would pose the highest exposure risk to HCP.

• • Eye protection, gown, and gloves continue to be recommended.
  • • If there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of HCP.
  • When the supply chain is restored, fit-tested EMS clinicians should return to use of respirators for patients with known or suspected COVID-19.
• Updated guidance about recommended EPA-registered disinfectants to include reference to a list now posted on the EPA website.

Register for Webinar Medic Ambulance Service and Solano County Public Health in Solano County, CA are on the front-line of managing COVID-19 confirmed and persons under investigation (PUI) patients at Travis AFB in Northern California. Over 40 patients have transported to area hospitals for further treatment.  Hear first-hand from Jimmy Pierson, President/COO Medic Ambulance; Dr. Bela Matyas, Solano County Public Health Director; and Ted Selby, Solano County EMS Administrator, how they planned for and executed the management of these patients and the impacts from a public health and EMS perspective.   This valuable webinar will give attendees the ‘ground level truth’ about things like: Myth vs. Reality of PPE Crew preparation and communication Ambulance decon Crew member quarantine Public Health Information  The presenters will plan 30 minutes of content so that there will be significant time to answer participant questions.  ‌  ‌  ‌  ‌

Source: https://doh.sd.gov/news/Coronavirus.aspx 3/10/20 

INFORMATION FOR MEDICAL PROVIDERS (Updated 3/10/20)

• Medical providers who are concerned a patient may be infected with COVID-19 should:
• • Mask the patient
  • Isolate the Patient in a private room or separate area, and
  • Contact with SD-DOH (800-592-1861) immediately for consultation and guidance
• Clinicians are strongly encouraged to test for other infectious causes of respiratory illness, such as influenza and RSV. Note: Asymptomatic patients are not eligible for testing at the SD Public Health Laboratory.

Priority Level	Clinical Features	Risk Exposure*
Low	Fever OR Cough OR Shortness of Breath	None identified
Medium	Fever OR Cough OR Shortness of breath AND Elevated risk for severe infection**	None identified
Medium	Fever OR Cough OR Shortness of Breath	Identified risk
High	Fever OR Cough OR Sore Throat OR Shortness of Breath	Identified healthcare risk***
High	Fever AND Cough OR Shortness of Breath	Identified risk
*Individual meets the risk exposure criterion if they have one of the following: Close contact to a laboratory-confirmed case within 14 days of symptom onset. History of travel to a geographic area with community transmission in a state within 14 days of symptom onset. Visit CDC website for the current list of states. History of travel from a country under a Level 2 or Level 3 Travel Advisory. Visit CDC website for the current list of countries.	**Elevated Risk for Severe COVID-19 Infection Hospitalized patients Older adults (65 years of age and older Individuals with certain pre-existing conditions (e.g., heart disease, lung disease, diabetes, and immunosuppressed)	***Any healthcare worker who was caring for or who had unprotected direct contact with infectious secretions or excretions of a suspected COVID-19 patient or laboratory-confirmed case within 14 days of symptoms onset.

• Guidance on specimen collection and testing, infection control practices, and other considerations are available at:
• • SD-HAN 20-006: Healthcare Facility Checklist
  • SD-HAN 20-005: CDC COCA Call
  • SD-HAN 20-004: Webinar for Healthcare
  • SD-HAN 20-003: Evaluating Persons for COVID-19
  • CDC Clinician Call: What Clinicians Need to Know to Prepare for COVID-19
  • CDC HAN 427: Updated and Interim Guidance on Outbreak of 2019 Novel Coronavirus
  • SD Public Health Lab Specimen Guidance
  • SD-HAN 20-002: Monitoring and Movement Guidance on Novel Coronavirus
• CDC COCA Call COVID-19 Update - March 5, 2020 call in information

• SD-DOH would like to remind medical providers, hospitals, and laboratories that cases of COVID-19, caused by the SARS-CoV-2 virus, are considered immediately reportable in South Dakota (under Coronavirus Respiratory syndromes).

• CDC issued guidance to healthcare facilities in the event that a traveler with illness is identified.
• • Evaluating and reporting persons under investigation
    Evaluating PUIs and Asymptomatic Close Contracts
  • Healthcare infection control guidance
  • Clinical care guidance
  • Home care guidance
  • Guidance for EMS
  • Healthcare personnel with potential exposure guidance
  • Inpatient Obstetrics Care
  • Disposition of patients with novel coronavirus
  • Collection and testing of postmortem samples

Source: https://doh.sd.gov/news/Coronavirus.aspx 3/10/20 

The Centers for Disease Control & Prevention (CDC) 

• Main Coronavirus 2019 (COVID-19) Resource: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
• COVID-19 Information for Healthcare Professional: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html
• COVID-19 Interim Guidance for EMS and 911 PSAPs: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html
• COVID-19 Infection Control: https://www.cdc.gov/coronavirus/2019-ncov/infection-control/index.html
• What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection: https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html
• Strategies for Optimizing the Supply of N95 Respirators: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html
• Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19): https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

South Dakota Department Of Health (SD DOH)

• COVID-19 Updates & Information - https://doh.sd.gov/news/Coronavirus.aspx
• • March 5, 2020 - Update Webinar for Healthcare Providers | Slides
  • March 4, 2020 - Informational Briefing for Senate Health and Human Services Committee
  • February 27, 2020 - South Dakota Prepares for COVID-19
• South Dakota Health Alert Network - https://sdhan.sd.gov/
• • The South Dakota Health Alert Network(SDHAN) is a secure, web-based communication system. The SDHAN uses email, phone, text, pagers, fax, and other messaging formats to provide timely alert messages to authorized individuals. The system is available on a 24/7/365 basis for distribution of health alerts, notifications, preparedness information and other initiatives that strengthen state and local preparedness, response and safety.
    
  • If your agency is not listed please have your agency director email a request to be added. Email to: DOHHealthAlert@state.sd.us