Draft Sublette County Public Health Mask Mandate
by Dr. Brendan Fitzsimmons, Sublette County Health Officer
November 12, 2020
Below is the text of the public health order request submitted by the Sublette County Health Officer. It does not go into effect until approved by the State Health Officer.
SUBLETTE COUNTY HEALTH OFFICER PUBLIC HEALTH VARIANCE NO.
COUNTYWIDE VARIANCE TO THE RESTRICTIONS MANDATED IN STATEWIDE PUBLIC HEALTH ORDER # 1 & # 3
(14th Continuations): Limitation on Gatherings of 100 persons or more, and mask requirement for persons in indoor public places.
ORDER REQUIRING ALL ADULTS WITHIN SUBLETTE COUNTY, WYOMING, TO WEAR FACE COVERINGS IN CERTAIN PUBLIC PLACES, WITH EXCEPTIONS
WHEREAS, Dr. Brendan Fitzsimmons, MD serves as the Sublette County Health Officer pursuant to Wyoming Statute § 35-1-306(a); and
WHEREAS, Wyoming Statute § 35-1-240(a)(i), (ii) and (iv) gives the power to the Wyoming Department of Health, through the State Health Officer, or under her direction and supervision, or through the other employees of the Wyoming Department of Health to control the causes of communicable disease; to close theaters, schools, and other public places; and to forbid gatherings of people when necessary to protect public health; and to take other measures deemed necessary to prevent the spread of communicable diseases; and
WHEREAS, as evidenced by her signature below, Alexia Harrist, MD, Ph.D., the Wyoming State Health Officer, has reviewed and does hereby authorize the issuance of this Variance Order by Dr. Fitzsimmons, the Sublette County Health Officer, and the State Health Officer, Dr. Alexia Harrist, also specifically makes the finding that this Order is necessary for the protection of the public health; and
WHEREAS, the State Health Officer has issued Statewide Orders 1 & 3 (14th Continuation) do not specifically address mask requirements or limitations on gatherings in public spaces; and
WHEREAS, Statewide Orders 1 & 3 (14th Continuation) allows Countywide variances to restrictions in those Orders, and allows for a County Health Officer to request a less restrictive or more restrictive variance to the Order; and
WHEREAS, COVID-19 was first detected in Wuhan, China in 2019, and since then has spread to over 60 countries including the United States.; and
WHEREAS, COVID-19 is a respiratory illness, transmitted through person-to-person contact or by contact with surfaces contaminated with the virus. Persons infected with COVID-19 may become symptomatic two to fourteen days after exposure. The symptoms of COVID-19 include fever, cough, and shortness of breath. In some cases, COVID-19 can result in severe disease including hospitalization, admission to an intensive care unit, and death; and
WHEREAS, the World Health Organization declared COVID-19 a worldwide pandemic as of March 11, 2020; and
WHEREAS, on March 13, 2020, the President of the United States declared a national emergency concerning the coronavirus, specifically stating that, in "December 2019 a novel (new) coronavirus known as SARS-Co V-2 ("the virus") was first detected in Wuhan, Hubei Province, People’s Republic of China, causing outbreaks of the coronavirus disease (COVID-19) that has now spread globally […] The spread of COVID-19 within our Nation’s communities threatens to strain our Nation’s healthcare systems […] Additional measures […] are needed to successfully contain and combat the virus in the United States;" and
WHEREAS, on March 13, 2020, Wyoming Governor Mark Gordon declared a State of Emergency and Public Health Emergency in the State of Wyoming, and the State of Wyoming is experiencing a public health emergency in response to the evolving COVID-19 outbreak; and
WHEREAS, Governor Gordon’s Declaration of a State of Emergency and Public Health Emergency directs the Wyoming Department of Health to take all appropriate and necessary actions, and that in the judgment of the Director of the Wyoming Department of Health, any actions necessary should be taken to provide aid to those locations where there is a threat or danger to public health, safety and welfare; and
WHEREAS, a significant number of Wyoming citizens are at risk of serious health complications, including death, from COVID-19. Although most individuals who contract COVID-19 do not become seriously ill, people with mild symptoms, and even asymptomatic people, place other vulnerable members of the public at significant risk; and
WHEREAS, a large number of persons with serious infections can compromise the ability of the healthcare system in Sublette County to deliver the necessary healthcare to the public; and
WHEREAS, Sublette County, Wyoming is a tourist destination and a stop-over location for travelers from around the nation and the world; and WHEREAS, as of October 25th 2020, there have been 10,035 laboratory confirmed and 1,771 probable cases of COVID-19 in the state of Wyoming; and
WHEREAS, as of October 25th 2020, there have been 122 laboratory-confirmed and 16 probable cases of COVID-19 in Sublette County with 15 currently active cases; and 1 death from Covid-19; and
WHEREAS, Wyoming presently has a high per capita transmission rate of Covid19 spread in the United States as of October 28th 2020, evidencing a serious health crisis; and
WHEREAS, Sublette County lacks medical equipment and resources to treat serious cases of Covid-19, and options to transport seriously ill patients are greatly diminishing as regional hospitals are nearing or exceeding their capacity to accept patients suffering from Covid-19; and
WHEREAS, Sublette County has for more than 1 month, had high rates of community spread of Covid 19 with increasing virulence; and
WHEREAS, repeated and constant entreaties on the part of various public organizations to encourage mask wearing has produced little or no improvement in the amount of mask wearing in public spaces by the general public; and
WHEREAS, the University of Utah medical center, which has in the past served as a resource for gravely ill patients from Sublette County, has declared that they will likely be required to ration medical services under "crisis standards of care" protocol, resulting in medical care being provided to only those patients most likely to survive, leaving many elderly patients to die from Covid-19; and other hospitals may soon be unable to accept patients from Sublette County who require hospitalizations; and
WHEREAS, many Wyoming hospitals are already stretched beyond their capacities and capabilities and no longer have the ability to transfer critically ill patients; and
WHEREAS, Sublette County is the only County in Wyoming which does not have a Hospital and has no innate ability to provide inpatient care for its citizens; and
WHEREAS, additional mandates are necessary to protect the health and safety of Sublette County residents, which can be best accomplished by implementation of an Order that gathering sizes be limited and that all persons who are indoors in public spaces wear face masks; and
WHEREAS, Face Coverings reduce droplet dispersal and cloth-based coverings reduce emission of particles by variable amounts; and
WHEREAS, in the most comprehensive, systematic review and meta-analysis of Face Coverings published to date, Chu et al. found that face masks could reduce risk of transmission of COVID-19 by an expected 85 percent; and
WHEREAS, guidelines published by the U.S. Centers for Disease Control (CDC) on April 3, 2020, recommend that all people wear cloth Face Coverings in public settings where other physical distancing measures may be difficult to maintain. CDC also advises the use of simple cloth Face Coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others, and
NOW THEREFORE, IT IS HEREBY ORDERED THAT residents of Sublette County shall comply with Statewide Order # 1 (Fourteenth Continuation and Modification, of Statewide Public Health Order Regarding Bars, Restaurants, Theaters, Gymnasiums, Child Care Facilities, K-12 Schools, Colleges, Universities, And Trade Schools), and Statewide Order # 3 (Fourteenth Continuation and Modification, of Statewide Public Health Order Regarding Nail Salons, Hair Salons, Barber Shops, Massage Therapy Services, Tattoo, Body Art and Piercing Shops, & Cosmetology, Electrology, and Esthetic Services) or any subsequent Statewide Order, with the following exceptions, additions, or modifications which shall continue until such time as these exceptions, additions, or modifications are lawfully terminated.
• All persons except minors in any indoor public space shall at all times wear a mask (defined as N-95 masks, surgical masks or cloth face coverings), unless in the actual process of eating or drinking or engaging in physical exercise.
• "Minor" for purposes of this Order is any person five (5) years of age or younger.
• "Face Covering," as used in this Order, means a covering made of cloth, fabric, or other soft or permeable material, without holes, that covers the nose and mouth and surrounding areas of the lower face.
• Indoor Gatherings of more than 100 persons shall be prohibited. IT IS FURTHER ORDERED, except as specifically exempted herein, all members of the public, except minors must wear a face covering outside of their home or any other place they reside in the following situations:
a. When any person is inside any retail or commercial business;
b. When any person is obtaining services at or visiting healthcare operations, including, but not limited to, hospitals, clinics and walk-in health facilities, dentists, pharmacies, blood banks, other healthcare facilities, any spaces operated by the Sublette County Public Health Department, behavioral health providers, facilities offering physical or occupational therapy services and facilities providing veterinary and similar healthcare services for animals.
c. When any person is in a public space utilized by county, state and federal governments, including but not limited to the County Clerk’s Office, county and municipal courts and other County and Municipal Offices.
IT IS FURTHER ORDERED, all retail and commercial businesses must post notices stating that Face Coverings are required in a clearly visible location at or near the entrance of the business. All employees, owners, and volunteers of retail and commercial businesses shall wear Face Coverings at the business when interacting with the public, or working in a space visited by members of the public, such as by way of example, but not limited to: reception areas, grocery store aisles, service counters, public restrooms, cashier and checkout areas, waiting rooms, service areas, and other spaces used to interact with the public.
IT IS FURTHER ORDERED, a face covering is not required under the following circumstances:
a. When a person is in a personal office (a single room) where others outside of that person’s household are not present as long as the public does not regularly visit the room, but that individual must put on a Face Covering when being visited by a client/customer, and anywhere members of the public are regularly present; or
b. The person is a minor. Minors are not required to wear a face covering, however minors three years old and older are encouraged to wear Face Coverings. Minors age two years or younger should not wear a Face Covering; or
c. When a person is seated at a table of a restaurant or other food service venue, the person is separated by at least six (6) feet from other patrons at other tables, and no more than six (6) people in total are seated at the table. If more than six (6) individuals are seated at the table, but all individuals are members of the same household, this exception applies. The person shall wear a mask while entering, exiting, or otherwise moving about the establishment; or d. When a person is inside or obtaining services at a location, engaged primarily in providing congregate care, residential health care, or congregate shelter, or a detention facility, and the individual is engaged in activities not conducive to wearing a Face Covering, such as eating or drinking, or the individual is in an area of the facility that is not designed for community gathering, such as a sleeping area; or
e. If a person has a medical condition, mental health condition, or disability that prevents wearing a face covering. This includes, but is not limited to, persons with a medical condition for whom wearing a face covering could obstruct breathing or who are unconscious, incapacitated, or otherwise unable to remove a face covering without assistance. Such persons should be prepared to produce documentation of the formal recommendation of any licensed healthcare practitioner, licensed to practice medicine anywhere in the United States, that he or she not wear a mask. Such documentation can be obtained with a formal consultation with a healthcare practitioner at the Sublette County Rural Health Care District and that consultation shall occur at no cost to the person seeking a medical exemption from this order.
f. Individuals who are hearing impaired, or communicating with an individual who is hearing impaired, where the ability to see the mouth is essential for communication.
g. Individuals for whom wearing a face covering would create a risk to the individual related to their work, as determined by local, state, or federal workplace safety guidelines.
h. Individuals who are obtaining a service involving the nose or face for which temporary removal of the face covering is necessary to perform the service.
i. Individuals who are purchasing a product or receiving a service that requires identification may briefly remove a face covering, as necessary, so that the retailer or service provider can verify identity.
j. When actively exercising in a gym in accordance with State Health Orders, as amended.
IT IS FURTHER ORDERED, that the Sublette County Health Officer may grant exceptions to the Order on a case by case basis after evaluating the request and obtaining written approval from the State Health Officer; and
IT IS FURTHER ORDERED, that this Countywide Variance to the Statewide Public Health Order #1 and #3 (Fourteenth Continuations) shall remain in effect until such time as the Sublette County Health Officer enters a decision to revoke or modify this variance, under the direction and supervision of the State Health Officer; and
IT IS FURTHER ORDERED, that any person or legal entity that violates this variance shall be subject to criminal prosecution under Wyo. Stat. Ann. §§ 35-1-105 and 106.
DATED THIS ____ DAY OF _______________, 2020.
__________________________________, MD Dr. Brendan Fitzsimmons Sublette County Health Officer