GRAND TRAVERSE COUNTY HEALTH DEPARTMENT

COMMUNITY HEALTH ENVIRONMENTAL HEALTH ADMINISTRATION & EMERGENCY MANAGEMENT &

2600 LaFranier Road, Suite A 2650 LaFranier Road MEDICAL EXAMINER PUBLIC HEALTH PREPAREDNESS
Traverse City, MI 49686 Traverse City, MI 49686 2600 LaFranier Road, Suite A 2600 LaFranier Road, Suite A
231-995-6111 231-995-6051 Traverse City, MI 49686 Traverse City, MI 49686
231-995-6100 231-995-6100

www.gtchd.org

April 8, 2020

From the desk of:

Wendy Hirschenberger, MPH
Health Officer, Grand Traverse County Health Department

Dear Grand Traverse County Community,

Earlier today, I issued Grand Traverse County Public Health Officer - Emergency Order
(GT-2020-01). This emergency order was set in place for essential businesses that are still
operating during this uncertain and scary time, and was done so in the interest of the health and
safety of our entire Grand Traverse County community in an effort to slow and reduce the
transmission of COVID-19.

Many businesses in the county have already implemented these measures in conjunction with
the Governor’s order to Stay Home and Stay Safe. Thank you for prioritizing the health of
everyone during this difficult time. I also understand that there may be some that are still
operating businesses that may be struggling with the swiftness of this order, finding it difficult to
immediately comply. While the Emergency Order goes into effect on April 9, 2020 at 12:00am, I
know it might take some businesses time to meet all conditions within the order. Our goal is to
not be punitive and engage in immediate enforcement, but rather to work with employers to
become compliant with the order so we may lessen the spread of COVID-19 in our community
and ensure the safety of you, your staff, and all that come into contact with you.

We have provided the attached tool kit for your reference. We encourage you to contact us at
231-995-6800 if you have any questions about this Emergency Order or how we may help you.

Your willingness to participate will potentially save lives!

Thank you,

Wendy Hirschenberger, MPH

Health Officer, Grand Traverse County Health Officer
 COVID-19 HEALTH ORDER

EMERGENCY ORDER (2020-1) FOR CONTROL OF PANDEMIC

Required screening and social distancing measures at open businesses and
operations subject to the Governors Executive Order 2020-21
Health Order attached for reference.

In accordance with Grand Traverse County Health Order 2020-01

ESSENTIAL OPERATIONS
AND SERVICES ARE REQUIRED TO:

• Screen employees for COVID-19 symptoms

A Sample Employee Screening Checklist is included for your convenience.

• Provide visible guidance of 6-ft physical distancing

Guidance included in this packet about Social Distancing and how to establish
visual distance markings in your facility for customers and employees. Sample
signs are included to remind customers about social distancing.

• Limit capacity to comply with 6-ft social distancing

Capacity should be limited based on the size of your facility to maintain
appropriate social distancing requirements.

• Publish notice at entrance to inform public of order

A sample public notice sign that summarizes the Order is included. Please post a
sign at your entrance along with the full text of the Order.

For questions please contact the Grand Traverse County Health Department
Call: 231-995-6800 or Email: [email protected]
 SAMPLE SCREENING
COVID-19 CHECKLISTS FOR
BUSINESSES

This checklist is a sample only. It is not intended to take the place of medical advice, diagnosis or treatment.

What TO DO
Create and implement an active screening plan including:
• Location and staffing of the screening table • Alcohol-based hand sanitizer available at the
• Signage to support the active screening process screening table
• Rules to allow or prohibit entry • Handout explaining the changes
• Script for screening • Develop sick policies, like work from home options

Screening questions to consider

In the past 24 hours, have you experienced:
• Subjective fever (felt feverish): Yes No
• New or worsening cough: Yes No
• Shortness of breath: Yes No
• Sore throat: Yes No
• Vomiting/Diarrhea: Yes No
• Current temperature:

If you answer “yes” to any of the symptoms listed above, or your temperature is 100.4°F or higher, please do not go
into work. Self- isolate at home and contact your primary care physician’s office for direction.
• You should isolate at home for minimum of 7 days since symptoms first appear.
• You must also have 3 days without fevers and improvement in respiratory symptoms

Have you had close contact in the last 14 days with an individual diagnosed with COVID-19?
Have you engaged in any activity or travel within the last 14 days which fails to comply with the Stay Home, Stay Safe
Executive Order?
Have you been directed or told by the local health department or your healthcare provider to self-isolate or self-
quarantine?

If you answer “yes” to either of these questions, please do not go into work. Self-quarantine at home for 14 days.

how to respond
If the individual answers NO to all questions, they have passed the screening and can begin working.
If the individual answers YES to any screening questions, or refuses to answer, they failed the screening. Instruct the employee to
return home and quarantine for 14 days. They should also be advised to call their healthcare provider or 911 as needed.

Please refer to the attached flow chart as needed for guidance on employees returning to work.

For more information, visit CDC’s Resources for Businesses and Employers. For questions call 231-995-6800
 Social distancing
What You Need to Know

Social distancing means keeping a physical separation from other people. This includes avoiding groups of people and
keeping space between yourself and others. It can include larger measures like closing public spaces and canceling group
events. It helps protect people from illness, especially those who are more vulnerable. Social distancing limits the spread of
disease by lowering the chance of contact with someone with COVID-19. Please create specific business plans based on
these guidelines.

PRACTICE SOCIAL DISTANCING

Individuals Can
• Keep six (6) feet between yourself and others. • Use online, curbside or drive-through services such as banking,
• Avoid getting together in social groups and gatherings. groceries, pharmacy and carryout.
• Use Skype and FaceTime to visit family and friends. • Avoid public places at their busiest times.

Businesses can
• Have employees tele-work when possible.
• Modify operations to provide online options.
• Restrict areas where people may gather.
6 ft.
• Limit in-person meetings and use electronic communication methods.
• Assess store layout and modify high traffic areas (i.e. checkout lines, pharmacy
counter etc.) to create six (6) feet of space between people:
- Special store hours for seniors, healthcare workers and first responders to shop.
- Signage asking people to remain at least 6 feet apart from others.
- Mark floors of checkout lines with tape for 6 foot spacing between customers.
- Promote curbside pick-up, delivery and online services.

Everyone should
• Stay home when sick.
• Avoid hugging, high-fives, shaking hands, and sharing cups or eating utensils.
• Use good personal hygiene practices whenever you are out in public:
- Washing your hands often with soap and warm water for 20 seconds, and help young children do the same. If soap and
water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
- Covering your nose and mouth with a tissue when you cough or sneeze, or cough/sneeze in your upper sleeve. Immediately
throw away used tissues in the trash, then wash hands.
- Avoiding touching your eyes, nose, and mouth with unwashed hands.
- Cleaning and disinfecting frequently touched surfaces, such as toys and doorknobs.

Learn more about slowing the spread of COVID-19 from the State of Michigan at
https://bit.ly/3dj7jO4

The Oakland County Health Division will not deny participation in its programs based
on race, sex, religion, national origin,age or disability. State and federal eligibility
requirements apply for certain programs.
20-XXX • 3/19/20
 COVID-19 HEALTH ORDER

In accordance with the Grand Traverse County Health Order 2020-01

CUSTOMERS
& EMPLOYEES MUST PRACTICE
6-FEET
SOCIAL
DISTANCE
WHILE INSIDE THIS FACILITY The Oakland County Health Division will not deny participation in its programs based
on race, sex, religion, national origin,age or disability. State and federal eligibility
requirements apply for certain programs.
2/28/20
 COVID-19 HEALTH ORDER
SUMMARY

EMERGENCY ORDER (2020-1) FOR CONTROL OF PANDEMIC

Required screening and social distancing measures at open businesses and
operations subject to the Governors Executive Order 2020-21

In accordance with the Grand Traverse County Health Order 2020-01

ESSENTIAL OPERATIONS
AND SERVICES ARE REQUIRED TO:

Screen employees for

COVID-19 symptoms

Provide visible guidance

of 6-ft physical distancing

Limit capacity to comply

with 6-ft social distancing
For questions please contact the Grand Traverse County Health Department
Call: 231-995-6800 or Email: [email protected]
When is it safe to leave home
if you have symptoms of COVID-19 or
live with someone who does?

Employers can't retaliate against workers for taking time

away from work under these circumstances.
File a complaint with MIOSHA . Learn more at Michigan.gov/MIOSHAcomplaint.

For Me Close Contacts

I have developed I live with I live with someone

I have been
one or more someone who has developed one
diagnosed with
symptoms of diagnosed with or more symptoms of
COVID-19.
COVID-19. COVID-19. COVID-19.

Stay home for 14 days after your last

Stay home for 7 days after you were contact with the sick person.
tested or developed symptoms.
Monitor yourself for symptoms.

You may leave if

After staying home for 7 days, have How do I
you are
you been symptom-free for 3 days? monitor
symptom-free.
myself?
YES NO
Pay attention for
COVID-19 symptoms:
You may leave if you are Stay home until 3 days have passed Fever
symptom-free. after all symptoms have stopped. Cough
Shortness of breath
If you are concerned
about your health or
Should I wear a mask?
develop symptoms,
If you or your close contact is symptomatic and you must
contact your health care
leave home, you should cover your nose and mouth with
provider or urgent care.
a homemade mask, scarf, bandana or handkerchief.

*Process for general public, does not specifically apply to workers at a health-care facility,
first responders (e.g., police officers, fire fighters, paramedics), and prison employees.

I have developed symptoms and my doctor decided to test for COVID-19.

 CLEANING & DISINFECTION
For Facilities After Suspected or
Confirmed COVID-19 Exposure

Michigan.gov/Coronavirus

Timing and location of cleaning • Unexpired household bleach will be

effective against coronaviruses when
and disinfection of surfaces.
properly diluted.
At a school, daycare center, office, or other
Prepare a bleach solution by mixing:
facility that does not house people overnight:
o Five tablespoons (1/3 cup) bleach
per gallon of water, or
It is recommended to close off areas used
o Four teaspoons bleach per quart
by the ill persons and wait as long as
of water.
practical before beginning cleaning and
disinfection to minimize potential for
Products with EPA-approved emerging viral
exposure to respiratory droplets. Open
pathogens claims are expected to be
outside doors and windows to increase
effective against COVID-19 based on data for
air circulation in the area. If possible, wait
harder to kill viruses. Follow the
up to 24 hours before beginning cleaning
manufacturer’s instructions for all cleaning
and disinfection.
and disinfection products (e.g.,
concentration, application method and
How to clean and disinfect. contact time, etc.).
Surfaces
If surfaces are dirty, they should be cleaned Soft Surfaces
using a detergent or soap and water prior to For soft (porous) surfaces such as carpeted
disinfection. floor, rugs, and drapes, remove visible
contamination if present and clean with
For disinfection, diluted household bleach appropriate cleaners indicated for use on
solutions, alcohol solutions with at least 70% these surfaces. After cleaning:
alcohol, and most common EPA-registered
household disinfectants should be effective. • If the items can be laundered, launder
• Diluted household bleach solutions can items in accordance with the
be used if appropriate for the surface. manufacturer’s instructions using the
Follow manufacturer’s instructions for warmest appropriate water setting for the
application and proper ventilation. items and then dry items completely.
• Check to ensure the product is not past Otherwise, use products with the EPA-
its expiration date. Never mix household approved emerging viral pathogens
bleach with ammonia or any other claims that are suitable for porous
cleanser. surfaces.

For more information, visit Michigan.gov/Coronavirus.

SEOC TA 8648486 03/20/2020
Linens, Clothing, and Other Items That Go in Cleaning staff and others should clean hands
the Laundry often.
• Do not shake dirty laundry; this minimizes Clean hands often including immediately
the possibility of dispersing virus through after removing gloves and after contact with
the air. an ill person, by washing hands with soap
• Wash items as appropriate in accordance and warm water for 20 seconds. If soap and
with the manufacturer’s instructions. If warm water are not available and hands are
possible, launder items using the not visibly dirty, an alcohol-based hand
warmest appropriate water setting for the sanitizer that contains at least 60% alcohol
items and dry items completely. Dirty may be used. However, if hands are visibly
laundry that has been in contact with an dirty, always wash hands with soap and
ill person can be washed with other warm water.
people’s items.
• Clean and disinfect hampers or other Follow normal preventive actions while at
carts for transporting laundry according work and home, including cleaning hands
to guidance above for hard or soft and avoiding touching eyes, nose, or mouth.
surfaces. Additional key times to clean hands include:
• After blowing one’s nose, coughing, or
Personal protective equipment sneezing
• After using the restroom
(PPE) and hand hygiene
• Before eating or preparing food
considerations. • After contact with animals or pets
Cleaning staff should wear disposable gloves • Before and after providing routine care
and gowns for all tasks in the cleaning for another person who needs assistance
process, including handling trash. (e.g., a child)
• Gloves and gowns should be compatible
with the disinfectant products being used.
• Additional PPE might be required based
on the cleaning/disinfectant products
being used and whether there is a risk of
splash.
• Gloves and gowns should be removed
carefully to avoid contamination of the
wearer and the surrounding area. Be sure
to clean hands after removing gloves.
• Gloves should be removed after cleaning
a room or area occupied by ill persons.
Clean hands immediately after gloves are
removed.
• Cleaning staff should immediately report
breaches in PPE (e.g., tear in gloves) or
any potential exposures to their
supervisor.

For more information, visit Michigan.gov/Coronavirus.

SEOC TA 8648486 03/20/2020
 EXECUTIVE ORDER

No. 2020-21

Temporary requirement to suspend activities that

are not necessary to sustain or protect life

The novel coronavirus (COVID-19) is a respiratory disease that can result in serious illness
or death. It is caused by a new strain of coronavirus not previously identified in humans
and easily spread from person to person. Older adults and those with chronic health
conditions are at particular risk, and there is an increased risk of rapid spread of COVID-19
among persons in close proximity to one another. There is currently no approved vaccine or
antiviral treatment for this disease.

On March 10, 2020, the Michigan Department of Health and Human Services identified the
first two presumptive-positive cases of COVID-19 in Michigan. On that same day, I issued
Executive Order 2020-4. This order declared a state of emergency across the state of
Michigan under section 1 of article 5 of the Michigan Constitution of 1963, the Emergency
Management Act, 1976 PA 390, as amended, MCL 30.401-.421, and the Emergency Powers
of the Governor Act of 1945, 1945 PA 302, as amended, MCL 10.31-.33.

The Emergency Management Act vests the governor with broad powers and duties to
“cop[e] with dangers to this state or the people of this state presented by a disaster or
emergency,” which the governor may implement through “executive orders, proclamations,
and directives having the force and effect of law.” MCL 30.403(1)-(2). Similarly, the
Emergency Powers of the Governor Act of 1945, provides that, after declaring a state of
emergency, “the governor may promulgate reasonable orders, rules, and regulations as he
or she considers necessary to protect life and property or to bring the emergency situation
within the affected area under control.” MCL 10.31(1).

To suppress the spread of COVID-19, to prevent the state’s health care system from being
overwhelmed, to allow time for the production of critical test kits, ventilators, and personal
protective equipment, and to avoid needless deaths, it is reasonable and necessary to direct
residents to remain at home or in their place of residence to the maximum extent feasible.

This order takes effect on March 24, 2020 at 12:01 am, and continues through April 13,
2020 at 11:59 pm.

GEORGE W. ROMNEY BUILDING • 111 SOUTH CAPITOL AVENUE • LANSING, MICHIGAN 48909
www.michigan.gov
PRINTED IN-HOUSE
Acting under the Michigan Constitution of 1963 and Michigan law, I order the following:

1. This order must be construed broadly to prohibit in-person work that is not
necessary to sustain or protect life.

2. Subject to the exceptions in section 7, all individuals currently living within the
State of Michigan are ordered to stay at home or at their place of residence. Subject
to the same exceptions, all public and private gatherings of any number of people
occurring among persons not part of a single household are prohibited.

3. All individuals who leave their home or place of residence must adhere to social
distancing measures recommended by the Centers for Disease Control and
Prevention, including remaining at least six feet from people from outside the
individual’s household to the extent feasible under the circumstances.

4. No person or entity shall operate a business or conduct operations that require

workers to leave their homes or places of residence except to the extent that those
workers are necessary to sustain or protect life or to conduct minimum basic
operations.

(a) For purposes of this order, workers who are necessary to sustain or protect
life are defined as “critical infrastructure workers,” as described in sections 8
and 9.

(b) For purposes of this order, workers who are necessary to conduct minimum
basic operations are those whose in-person presence is strictly necessary to
allow the business or operation to maintain the value of inventory and
equipment, care for animals, ensure security, process transactions (including
payroll and employee benefits), or facilitate the ability of other workers to
work remotely.

Businesses and operations must determine which of their workers are

necessary to conduct minimum basic operations and inform such workers of
that designation. Businesses and operations must make such designations in
writing, whether by electronic message, public website, or other appropriate
means. Such designations, however, may be made orally until March 31, 2020
at 11:59 pm.

5. Businesses and operations that employ critical infrastructure workers may continue
in-person operations, subject to the following conditions:

(a) Consistent with sections 8 and 9, businesses and operations must determine
which of their workers are critical infrastructure workers and inform such
workers of that designation. Businesses and operations must make such
designations in writing, whether by electronic message, public website, or
other appropriate means. Such designations, however, may be made orally
until March 31, 2020 at 11:59 pm. Businesses and operations need not
designate:

2
 (1) Workers in health care and public health.

(2) Workers who perform necessary government activities, as described in

section 6.

(3) Workers and volunteers described in section 9(d).

(b) In-person activities that are not necessary to sustain or protect life must be
suspended until normal operations resume.

(c) Businesses and operations maintaining in-person activities must adopt social
distancing practices and other mitigation measures to protect workers and
patrons. Those practices and measures include, but are not limited to:

(1) Restricting the number of workers present on premises to no more

than is strictly necessary to perform the business’s or operation’s
critical infrastructure functions.

(2) Promoting remote work to the fullest extent possible.

(3) Keeping workers and patrons who are on premises at least six feet
from one another to the maximum extent possible, including for
customers who are standing in line.

(4) Increasing standards of facility cleaning and disinfection to limit

worker and patron exposure to COVID-19, as well as adopting
protocols to clean and disinfect in the event of a positive COVID-19
case in the workplace.

(5) Adopting policies to prevent workers from entering the premises if

they display respiratory symptoms or have had contact with a person
who is known or suspected to have COVID-19.

(6) Any other social distancing practices and mitigation measures

recommended by the Centers for Disease Control.

6. All in-person government activities at whatever level (state, county, or local) that
are not necessary to sustain or protect life, or to supporting those businesses and
operations that are necessary to sustain or protect life, are suspended.

(a) For purposes of this order, necessary government activities include activities
performed by critical infrastructure workers, including workers in law
enforcement, public safety, and first responders.

(b) Such activities also include, but are not limited to, public transit, trash pick-
up and disposal, activities necessary to manage and oversee elections,
operations necessary to enable transactions that support the work of a
business’s or operation’s critical infrastructure workers, and the maintenance
of safe and sanitary public parks so as to allow for outdoor recreation.

3
 (c) For purposes of this order, necessary government activities include minimum
basic operations, as described in section 4(b). Workers performing such
activities need not be designated.

(d) Any in-person government activities must be performed consistently with the
social distancing practices and other mitigation measures to protect workers
and patrons described in section 5(c).

7. Exceptions.

(a) Individuals may leave their home or place of residence, and travel as
necessary:

(1) To engage in outdoor activity, including walking, hiking, running,

cycling, or any other recreational activity consistent with remaining at
least six feet from people from outside the individual’s household.

(2) To perform their jobs as critical infrastructure workers after being so

designated by their employers. (Critical infrastructure workers who
need not be designated under section 5(a) may leave their home for
work without a designation.)

(3) To conduct minimum basic operations, as described in section 4(b),

after being designated to perform such work by their employers.

(4) To perform necessary government activities, as described in section 6.

(5) To perform tasks that are necessary to their health and safety, or to
the health and safety of their family or household members (including
pets). Individuals may, for example, leave the home or place of
residence to secure medication or to seek medical or dental care that is
necessary to address a medical emergency or to preserve the health
and safety of a household or family member (including procedures
that, in accordance with a duly implemented nonessential procedures
postponement plan, have not been postponed).

(6) To obtain necessary services or supplies for themselves, their family or

household members, and their vehicles. Individuals must secure such
services or supplies via delivery to the maximum extent possible. As
needed, however, individuals may leave the home or place of residence
to purchase groceries, take-out food, gasoline, needed medical
supplies, and any other products necessary to maintain the safety,
sanitation, and basic operation of their residences.

(7) To care for a family member or a family member’s pet in another

household.

4
 (8) To care for minors, dependents, the elderly, persons with disabilities, or
other vulnerable persons.

(9) To visit an individual under the care of a health care facility, residential
care facility, or congregate care facility, to the extent otherwise
permitted.

(10) To attend legal proceedings or hearings for essential or emergency

purposes as ordered by a court.

(11) To work or volunteer for businesses or operations (including both and

religious and secular nonprofit organizations) that provide food,
shelter, and other necessities of life for economically disadvantaged or
otherwise needy individuals, individuals who need assistance as a
result of this emergency, and people with disabilities.

(b) Individuals may also travel:

(1) To return to a home or place of residence from outside this state.

(2) To leave this state for a home or residence elsewhere.

(3) To travel between two residences in this state.

(4) As required by law enforcement or a court order, including the

transportation of children pursuant to a custody agreement.

8. For purposes of this order, critical infrastructure workers are those workers
described by the Director of the U.S. Cybersecurity and Infrastructure Security
Agency in his guidance of March 19, 2020 on the COVID-19 response (available
here). Such workers include some workers in each of the following sectors:

(a) Health care and public health.

(b) Law enforcement, public safety, and first responders.

(c) Food and agriculture.

(d) Energy.

(e) Water and wastewater.

(f) Transportation and logistics.

(g) Public works.

(h) Communications and information technology, including news media.

(i) Other community-based government operations and essential functions.

5
 (j) Critical manufacturing.

(k) Hazardous materials.

(l) Financial services.

(m) Chemical supply chains and safety.

(n) Defense industrial base.

9. For purposes of this order, critical infrastructure workers also include:

(a) Child care workers (including workers at disaster relief child care centers),
but only to the extent necessary to serve the children or dependents of critical
infrastructure workers as defined in this order. This category includes
individuals (whether licensed or not) who have arranged to care for the
children or dependents of critical infrastructure workers.

(b) Workers at designated suppliers and distribution centers, as described below.

(1) A business or operation that employs critical infrastructure workers

may designate suppliers, distribution centers, or service providers
whose continued operation is necessary to enable, support, or facilitate
the work of its critical infrastructure workers.

(2) Such suppliers, distribution centers, or service providers may

designate workers as critical infrastructure workers only to the extent
those workers are necessary to enable, support, or facilitate the work
of the original operation’s or business’s critical infrastructure workers.

(3) Designated suppliers, distribution centers, and service providers may

in turn designate additional suppliers, distribution centers, and
service providers whose continued operation is necessary to enable,
support, or facilitate the work of their critical infrastructure workers.

(4) Such additional suppliers, distribution centers, and service providers

may designate workers as critical infrastructure workers only to the
extent that those workers are necessary to enable, support, or
facilitate the work of the critical infrastructure workers at the
supplier, distribution center, or service provider that has designated
them.

(5) Businesses, operations, suppliers, distribution centers, and service

providers must make all designations in writing to the entities they
are designating, whether by electronic message, public website, or
other appropriate means. Such designations may be made orally until
March 31, 2020 at 11:59 pm.

6
 (6) Businesses, operations, suppliers, distribution centers, and service
providers that abuse their designation authority shall be subject to
sanctions to the fullest extent of the law.

(c) Workers in the insurance industry, but only to the extent that their work
cannot be done by telephone or remotely.

(d) Workers and volunteers for businesses or operations (including both and
religious and secular nonprofit organizations) that provide food, shelter, and
other necessities of life for economically disadvantaged or otherwise needy
individuals, individuals who need assistance as a result of this emergency,
and people with disabilities.

(e) Workers who perform critical labor union functions, including those who
administer health and welfare funds and those who monitor the well-being
and safety of union members who are critical infrastructure workers,
provided that any administration or monitoring should be done by telephone
or remotely where possible.

10. Nothing in this order should be taken to supersede another executive order or
directive that is in effect, except to the extent this order imposes more stringent
limitations on in-person work, activities, and interactions. Consistent with prior
guidance, a place of religious worship, when used for religious worship, is not subject
to penalty under section 14.

11. Nothing in this order should be taken to interfere with or infringe on the powers of
the legislative and judicial branches to perform their constitutional duties or
exercise their authority.

12. This order takes effect on March 24, 2020 at 12:01 am, and continues through April
13, 2020 at 11:59 pm.

13. The governor will evaluate the continuing need for this order prior to its expiration.
In determining whether to maintain, intensify, or relax its restrictions, she will
consider, among other things, (1) data on COVID-19 infections and the disease’s rate
of spread; (2) whether sufficient medical personnel, hospital beds, and ventilators
exist to meet anticipated medical need; (3) the availability of personal protective
equipment for the health-care workforce; (4) the state’s capacity to test for COVID-
19 cases and isolate infected people; and (5) economic conditions in the state.

14. Consistent with MCL 10.33 and MCL 30.405(3), a willful violation of this order is a
misdemeanor.

7
Given under my hand and the Great Seal of the State of Michigan.

Date: March 23, 2020 ___________________________________

GRETCHEN WHITMER
Time: 10:39 am GOVERNOR

By the Governor:

___________________________________
SECRETARY OF STATE

8
 STATE OF MICHIGAN
GRETCHEN WHITMER DEPARTMENT OF HEALTH AND HUMAN SERVICES ROBERT GORDON
GOVERNOR LANSING DIRECTOR

MEMORANDUM

Date: March 20, 2020

To: Health Care Providers

From: Joneigh Khaldun, MD, MPH, FACEP

Chief Medical Executive and Chief Deputy for Health
Michigan Department of Health and Human Services

Thank you for your continued service in responding to the COVID-19 pandemic. This letter
introduces guidance for all providers and staff involved in patient care and public health staffing
with critical roles in the COVID-19 response (local or state).

The Michigan Department of Health and Human Services is currently reporting sustained
widespread community transmission of COVID-19 in multiple areas of the State. This guidance is
intended to help with the development of occupational health programs, policies, and priorities for
groups that are critical to the healthcare system in the State of Michigan and is applicable to the
following groups: hospitals, healthcare facilities, EMS, other organizations that employ healthcare
workers in the inpatient or outpatient setting, all providers and support staff involved in patient care,
and public health staffing actively involved in the COVID-19 response (local or state).

This interim guidance should be considered alongside applicable state and federal regulations and
provided to all healthcare workers as appropriate. The primary recommendations in this guidance
include:

1) If you are sick, please stay home.

2) Healthcare workers currently prohibited from working because of previous guidance

may return to work if asymptomatic if they are able to be closely monitored by their
facility’s occupational health program and adhere to all requirements for self-
monitoring.

3) In the context of sustained community transmission of COVID-19, all healthcare

workers are at risk for unrecognized exposures. Therefore, ALL healthcare workers
should self- monitor for fever with twice-daily temperature measurements and for
symptoms consistent with COVID-19.

4) If you are a healthcare worker who has had a known high-risk exposure to a
patient(s) with confirmed COVID-19, you should take extra care to monitor your
health but can keep working. There is no requirement for 14-day quarantine of
healthcare workers with high-risk exposures in the setting of sustained community
transmission as we have in multiple areas of the State of Michigan.

5) MDHHS advises against testing of any asymptomatic individuals with or without an

exposure to COVID-19, including healthcare workers.

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www.michigan.gov/mdhhs  517-241-3740