Reopening does not mean that COVID-19 has magically disappeared. We are opening too early, with unclear guidance that is unlikely to be properly enforced.

On June 15, 2021, Governor of California Gavin Newsom announced that the state was fully reopening. The COVID-19 related restrictions that had been in place will be eliminated, including physical distancing, capacity limits, county tier systems, and masks in almost all settings for vaccinated Californians.

The press release on the Governor’s website makes it abundantly clear that vaccinated Californians will be allowed to go into some settings without having to wear a mask. People who aren’t fully vaccinated – or who refuse to get vaccinated – will still be required to wear masks.

Based on the behavior of anti-vaxxers and anti-maskers, it is reasonable to assume that those groups of people will stop wearing masks anyway. Some of them never bothered to wear a mask at all. As a result, COVID-19 (and its variants) will continue to spread.

I live in California. I am immune-compromised, and I am fully vaccinated.

Beyond the Blueprint

The official website of the Governor of California (also called California for ALL) posted information titled Beyond the Blueprint. It is a fact sheet that describes what people can expect when the state reopened. Here are some important details:

Resuming Everyday Life

  • Everyday life will feel a lot like before COVID-19. Restaurants, shopping malls, movie theaters, and most everyday places will be open as normal with no capacity limits or social distancing required. The county tier system will also be eliminated entirely.
  • Lifting mask requirements for vaccinated Californians. California’s Department of Public Health has updated statewide masking guidance to match the CDC’s guidance, lifting California’s mask requirements for vaccinated individuals starting on June 15.

Please note that the mask requirements are lifted for vaccinated individuals.

Limited Exceptions for Unique Settings

  • Mask requirements for uniquely vulnerable settings. In accordance with CDC guidance, masks will still be required for uniquely vulnerable settings such as: hospitals, long-term care facilities, homeless shelters, and public transit.

I have hardly ever left the house since the pandemic started. If I did go outside, it was to access medical care. My husband and I took a Lyft or Uber to our destination, or got on the bus. Previous to June 15, 2021, the requirement was that everyone needed to wear a mask on the bus, or in an Uber or Lyft (including drivers).

  • Public health recommendations for mega events. For indoor events of 5,000 people or more, attendees must confirm proof of vaccination or negative COVID-19 status in order to attend. For outdoor events of 10,000 people or more (like concerts, sporting events, festivals, and conventions), it is recommended that attendees confirm proof of vaccination or negative COVID-19 status to attend, due to increased risk caused by travel and crowds.

On June 14, 2021, Cal Matters posted an article titled: “As California reopens, 6 things you need to know about COVID-19”. It was written by Ana B. Ibarra. From the article:

Infections and hospitalizations are down, but not gone.

…At the peak of the pandemic, 17% of people in California tested for COVID-19 were infected. For about a month now, it’s been under 1%

Last week, California recorded between 792 to 1,136 new infections every day. That’s comparable to the early days of the pandemic last spring.

Hospitalizations have been on a downward trend for several months. As of Friday, 1,263 people statewide were hospitalized with COVID-19 and another 261 were in intensive care. During the mid-January peak, more than 22,000 infected people were hospitalized and more than 4,800 were in ICU’s.

It’s a new record low: Hospitalizations are now less than half what they were in mid-October, when around 3,000 infected people were hospitalized, according to the 14-day average…

…The tragedies, however, remain. Fifty-five more people were added Friday to California’s pandemic death toll, which now includes 62,593 people…

California is not close to herd immunity yet

According to the Mayo Clinic, herd immunity. occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected – not just those who are immune.

The Mayo Clinic states that vaccines can help a population gain herd immunity. Herd immunity can be reached when enough people have been vaccinated against a disease and have developed protective antibodies against future infection. Herd immunity makes it possible to protect the population from a disease, including those who can’t be vaccinated, such as newborns or those who have compromised immune systems.

Cal Matters reported that about two-thirds of eligible residents have received at least one dose of the vaccine. State health officials don’t set a vaccination goal for herd or community immunity, since children under 12 – 15% of the population – cannot yet be vaccinated and previously infected people may already be protected.

According to Cal Matters, experts say that 70% to 85% of the total population must be fully vaccinated to reach large-scale protection against the virus. California isn’t there yet.

Outbreaks are still possible

Cal Matters quoted Andrew Noymer, who is an epidemiologist at University of California, Irvine. “Let’s not forget that this is an ongoing pandemic,” he said. “… in Orange County, Latino males are lagging in vaccination, so that group is still at risk.” Andrew Noymer expects to see another wave of COVID infections in fall or winter.

Cal Matters also quoted Dr. Mark Ghaly, California state’s health and human services secretary. Cal Matters stated that Dr. Mark Ghaly said he expects to see outbreaks, especially in counties with lower vaccination rates. “It’s at those moments of an outbreak that we need to be ready to vaccinate additional people,” he said.

Blacks and Latinos are still at high risk

…About 56.5% of Black residents and 55% of Latinos have not been immunized, compared to 38% of white residents and 15.5% of Asian Americans, according to the state’s vaccination breakdown.

This means that the groups that were harmed the most by the virus are still facing the most risk. Mistrust in the health system and vaccine hesitancy are barriers, but experts say access issues, like the inability to take time off work and lack of transportation are likely the bigger issue…

Many seniors aren’t vaccinated, and most kids aren’t even eligible

A significant portion of California’s seniors – about 1.5 million of them – have not been vaccinated, despite being among the most vulnerable to the virus. Seniors make up almost 16% of the state’s population, but 73% of COVID-related deaths. Still, 22% of them have not been vaccinated…

…Many seniors may be facing access issues. If they don’t drive, they likely rely on family members’ schedules. If they are ill or homebound, they might be waiting for public health departments and providers to come to them

Experts say it also will be important to see how infections play out among kids, many of whom will be heading back to the classroom soon for the first time in a long time. About 34% of children ages 12 through 17 have received at least one dose.

Vaccines for the approximate 6 million children in California younger than 12 years may not be available until well into the fall…. Pfizer said it expects to seek emergency use authorization from the Food and Drug Administration for its vaccine for kids 2 to 11 years old in September…

You may need a booster shot.

According to Cal Matters, there are two reasons why people may need booster shots – waning immunity, and the need for additional protection because of a more dangerous variant.

On June 15, 2021, CBS News posted an article titled: “Gottlieb says Delta virus variant likely to become dominant U.S. strain”. It was written by Kimani Hayes. From the article:

Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said Sunday that a coronavirus strain known as the Delta variant is likely to become the dominant source of new infections in the U.S. and could lead to new outbreaks in the fall, with unvaccinated Americans being most at risk.

“Right now, in the United States, it’s about 10% of infections. It’s doubling every two weeks,” Gottlieb said on “Face the Nation”. “That doesn’t mean that we’re going to see a sharp uptick in infections, but it does mean that this is going to take over. And I think the risk is really to the fall that this could spike a new epidemic heading into the fall.”

The Delta variant, also known as B.1.617.2, was first discovered in India and is one of three related strains. It has become famous for its ability to outpace and replicate quicker than other variants in its lineage…

…However, Gottlieb said the COVID-19 vaccines approved for use in the U.S. and overseas appear to be effective at containing the Delta variant, highlighting the importance of the public vaccination campaign…

California is opening up too soon

According to Cal Matters, in order to obtain herd immunity, 70% to 80% of the total population must be vaccinated. Cal Matters reported that about two-thirds of eligible residents have received at least one dose of the vaccine. California is opening too soon.

There appears to be some confusion about what the new reopening rules actually mean. Information from Cal Matters is conflicting. I’m not sure how businesses – or customers – are going to be able to navigate through requirements that are not standard nor required.

Do you want to go to a concert?

California defines anything that draws more than 5,000 people (indoors) or 10,000 people (outside) as a “mega event”.

People who want to go to concerts, conventions, or other indoor “mega events” will have to prove that they have been vaccinated. They can do this by showing a vaccination card, a photo of the card, or documentation from a doctor that they tested negative for coronavirus in the previous 72 hours.

CBS News posted an article on April 20, 2021, titled: “Scammers are selling fake COVID-19 vaccination cards online”. It was written by Megan Cerullo. From the article:

Criminals are looking to cash in on the U.S. immunization push against COVID-19 by selling forgeries of government-issued “vaccination record cards” that show people have been inoculated.

Hundreds of fraudsters are selling blank or forged versions of the cards over ecommerce sites including eBay, Etsy and Shopify, while also running advertisements for the fakes on Facebook, according to Saoud Khalifah, CEO of Fakespot, which uses artificial intelligence to detect online retail scams. And with names like blankcovidcard.com, such sellers are hardly discreet…

…Khalifah of Fakespot suspects some purchasers of fake cards are “anti-vaxxers” who don’t plan on becoming vaccinated but want whatever access a card can afford them…

Scammers are making it impossible to determine which concert-goers have actually been vaccinated, and which have purchased a fake card. This sort of situation could easily lead to superspreader events.

Cal Matters reported that proof of vaccination or documentation from a doctor that a person tested negative for coronavirus in the previous 72 hours won’t necessarily be required at outdoor events like baseball games. However, California is recommending that stadiums either impose a rule or require masking.

What about bars, gyms, or movie theaters?

People who are vaccinated are allowed to take off their mask once they go inside these venues. It appears that bars, gyms and movie theaters will be allowed to drop social distancing rules. The result is the honest people, who got vaccinated, will be mixing with people who lied about being vaccinated and who aren’t wearing masks.

Those who are unvaccinated are required to wear a mask indoors in most public places. However, there’s no clear guidance about how the rule will be enforced. California’s Health and Human Services (HHS) Secretary Mark Ghaly said that business can require masks of all customers, implement a vaccination verification system, or simply go with the honor system. The Secretary says the state is not requiring businesses to have someone at the door checking for vaccine status.

What about workplaces?

On June 17, 2021, Cal Matters updated an existing blog post and reported that this is where things get complicated.

Since November of 2021, California’s workplace safety regulator has been requiring most employees across the state to mask up and maintain six feet of distance from one another when possible. In addition, stores, restaurants and other employers were required to provide personal protective equipment to their staff, to offer testing when necessary, and in some cases, to set up pathogen-blocking furnishings such as plexiglass shields.

Those rules have changed.

What are the new rules regarding workplaces and COVID-19?

On June 17, 2021, a press release titled: “Governor Newsom Signs Executive Order Expediting Cal/OSHA’s Revised COVID-19 Regulations to Ensure Consistency with Public Health Guidance”. It was posted on the Governor of California’s website. Here are some key parts of the press release:

Following the vote by the Occupational Safety and Health Standards Board to adopt revised COVID-19 Prevention Emergency Temporary Standards that reflect the state’s latest COVID-19 public health order, Governor Gavin Newsom today signed an executive order enabling the revisions to take effect without the normal 10-day review period by the Office of Administrative Law – providing clarity and consistency for employers and employees as California fully reopens its economy.

Among other updates, Cal/OSHA’s revisions align with the latest guidance from the California Department of Public Health – based on guidelines issued by the Centers for Disease Control and Prevention – on face coverings and eliminate physical distancing requirements, except for certain employees during outbreaks. Unless they show symptoms, fully vaccinated employees do not need to be offered testing or be excluded from work after close contact with a COVID-19 positive person…

On June 17, 2021, the San Francisco Chronicle reported that workplaces in California can let vaccinated employees “do away with masks and many other coronavirus restrictions”. Unvaccinated employees have to keep their masks on indoors, in line with the California state health department and federal recommendations.

Changes were made after after a vote by the California Occupational Safety and Health Standards Board (OSHA). In a 5-1 vote, the Board approved a clearer set of rules for vaccinated people in the workplace.

The San Francisco Chronicle reported the following:

  • Unvaccinated employees have to keep their masks on indoors.
  • Those who have not received the COVID-19 shots can also request N95 masks from their employers to reduce the chance of being infected with the virus.

In my opinion, this will help protect people who are immune-compromised who cannot safely get vaccinated. The N95 mask can protect immune-compromised people from catching the virus. It would be unethical for an employer to insist immune-compromised workers return to work and risk catching coronavirus (or the flu, or a cold) from their unmasked coworkers.

  • California plans to make a one-month supply of N95 masks available to employers for unvaccinated workers.

It is unclear how many N95 masks employers will receive or when they will arrive. What happens if the employer runs out of masks for unvaccinated workers? Will the employer be expected to purchase more N95 masks? Will California supply those employers with more of them?

  • Workers still have to wear masks on public transit and in other settings where they are required to by California’s health department, including during workplace outbreaks. Physical distancing requirements are no longer in effect under the new rules.
  • Employers are required to document the vaccination status of their workers. The employers do not have to obtain copies of vaccine cards. Employers can also “self attest” that they have been vaccinated. The San Francisco Chronicle, this is a topic that many of the Board members expressed concern about.

On June 17, 2021, KSBY posted an article titled: “Employers must document the vaccination status of employees under revised CAL/OSHA rules”. It was written by Megan Healy. From the article:

Some of the revised rules by CAL/OSHA say:

  • Employers must verify and document the vaccination status of fully vaccinated workers if they do not wear masks indoors;
  • Employers must make COVID-19 testing available to unvaccinated employees who have symptoms, as well as vaccinated employees who have symptoms after close contact with a COVID-19 case;
  • Workers must be allowed to wear a face-covering if they choose to without fear of retaliation from employers;
  • Employers must provide workers who are not fully vaccinated with respirators for voluntary use, upon request, and at no cost.

According to KSBY, employment attorney Kathy Eppright said: “Not only will employers be allowed to ask for the vaccination status of their employees, but they will also be required to.” She continued, “It’s permissible for an employer if they wanted to ask that information of employees or customers in order to determine what rules to apply.”

How does having to disclose your vaccination status relate to HIPPA?

Not long after these types of news articles appeared, I noticed that several people had become incredibly concerned about HIPPA. The prevailing thought was that an employer who asks for a worker’s (or customer’s) vaccination status is breaking HIPPA.

The Centers for Disease Control and Prevention (CDC) provides information about HIPPA. It stands for The Health Insurance Portability and Accountability Act of 1996. HIPPA is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.

The Privacy Rule standards address the use and disclosure of individuals’ health information by entities subject to the Privacy rule. Those individuals and organizations are called “covered entities”. The Privacy Rule contains standards for individuals’ rights to understand and control how their health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well being.

Covered Entities include:

  • Healthcare providers: All healthcare providers who electronically transmit health information in connection with certain transactions are Covered Entities. These transactions include claims, benefit eligibility inquiries, referral authorization requests, and other transactions for which HHS has established standards under the HIPAA Transactions Rule.
  • Health plans: Health plans are Covered Entities that provide or pay the cost of medical care. Health plans include health, dental, vision, and prescription drug insurers; health maintenance organizations (HMO’s); Medicare, Medicaid, Medicare+Choice, and Medicare supplement insurers and long-term care insurers (excluding nursing home fixed-indemnity policies). Health plans also include employer-sponsored group health plans, government-and church sponsored health plans, and multi-employer health plans.

A groups health plan with fewer than 50 participants that is administered solely by the employer that established and maintains the plan is not a Covered Entity.

  • Healthcare clearinghouses: These Covered Entities that process nonstandard information they receive from another entity into a standard format. Healthcare clearinghouses usually receive individually identifiable health information only when they are providing these processing services to a health plan or healthcare provider as a business associate.
  • Business associates: A person or organization using or disclosing individually identifiable health information to preform or provide functions, activities, or services for a Covered Entity is also a Covered Entity. These functions, activities, or services may include claims processing, data analysis, utilization review, and billing.

As you may have noticed, most employers are not considered to be Covered Entities. That means your employer can ask you about your vaccination status. The U.S. Department of Heath and Human Services (HHS) posted information titled: “Your Rights Under HIPAA”.

A list of those who are not required to follow HIPPA include: life insurers, employers, workers compensation carriers, most schools and school districts, many state agencies like child protective service agencies, most law enforcement agencies, and many municipal offices.

The San Francisco Chronicle reported that labor and employment attorney Martha Doty, with the law firm Alston & Bird, said many of her company clients had been using the honor system when determining who was vaccinated and who wasn’t.

The San Francisco Chronicle also reported that employment groups don’t like these rules because they feel it puts too much of a burden on employers to “police worker vaccination status and masking.” Labor advocates pointed to ongoing workplace outbreaks and questioned if it was too early to ease restrictions.

What about government entities?

According to Cal Matters, the California Department of Human Resources sent an advisory to department heads of State offices that directly serve the public. Those agencies will not be required “to inquire about a member of the public’s vaccine status.”

Instead, agencies “should provide notice to all customers, guests and members of the public that face covering are required for unvaccinated individuals. If an individual without a face covering enters a state building, the department should assume the individual is complying with the requirement.”

People will not have to wear a mask to enter the Department of Motor Vehicles (DMV). There won’t be any temperature checks, and capacity restrictions will ease. However, if you want to take a behind-the-wheel driving test, you will be required to wear a mask.

Putting all of this together

It is too early for California to fully reopen. We have not yet hit herd immunity. There are Californians who want to get vaccinated but cannot because they can’t get an appointment for a shot. Some worry they will experience a side effect from the shot that will cause them to miss work – especially if their employer does not offer paid sick leave.

It is possible to be entirely vaccinated and to still catch COVID-19. It has been said that those who do will get a much milder case than if they were unvaccinated. There is a Delta variant going around that is said to be more dangerous than the COVID-19 version that started spreading in late 2019 or early 2020. It is too early for California to fully reopen.

The new rules are a mess! Some business may ask customers if they are fully vaccinated, and will require those who aren’t to wear a mask. Employers might ask workers about their vaccination status, and might or might not require proof. Businesses can choose to let in every unmasked person without asking if they have been vaccinated, or could require everyone who enters to wear a mask. Government offices are also inconsistent about these rules – which vary from one office to another.

This causes confusion, and mistakes will be made. California is not ready to reopen yet.

California Reopened – And I have Concerns is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.

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