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Symptoms of COVID-19

Current Case and Death Counts

Update as of 3/24/2021 - Indiana reports 680,998 cases of Covid19. 12,576 of those cases have resulted in death.  Noble County reports 5218 cases and 79 deaths at this time.

PUBLIC HEALTH ORDER

NOBLE COUNTY HEALTH OFFICER

JANUARY 14, 2020

Due to the ongoing COVID-19 pandemic and the recent surge of new cases and related hospitalizations in Allen County, and pursuant to the authority granted in Governor Eric Holcomb’s Executive Order 20-50 issued December 10, 2020, and extended through January 24, 2021 by Executive Order 20-53, and the authority granted by I.C. 16-41-9-1.6, I, the Noble County, Indiana, Health Officer ORDER the following local restrictions for Noble County, Indiana, which are in addition to those set forth in Executive Order 20-50. The definitions and provisions of Executive Order 20-50 are incorporated here in their entirety by reference. This Order shall become effective at 12:00 AM on January 16, 2021, and shall expire at 11:59 PM on January 31, 2021, unless superseded by a later Executive Order issued by Governor Holcomb or rescinded by the Health Officer.

1. Social Gatherings and Events

Social Gatherings and Events are specific categories of human interactions defined in Executive Orders 20-48 and 20-50. While there are establishments and facilities that tend to host a majority of non-residential Social Gatherings and Events, i.e. banquet and event halls, conference centers, etc., the Health Officer and Noble County Health Department do not interpret the provisions of the Governor’s Executive Order pertaining to Social Gatherings and Events to be exclusive to those establishments or facilities. All facilities or individuals that host Social Gatherings and Events, including, but not limited to, entertainment venues, sports venues, restaurants, bars, taverns, nightclubs, and other establishments providing in-person food and drink service, shall, pursuant to Executive Order 20-50, follow the provisions and restrictions for Social Gatherings and Events.

Pursuant to Executive Order 20-50, the Noble County Health Department will not accept or approve plans for Social Gatherings or Events at which attendance is expected to surpass the limits set forth in Executive Order 20-50, Paragraphs 7.c. and 7.e..

1. Restaurants, Bars, Taverns, Nightclubs and Other Establishments Providing In-Person Food and Drink Service

During any period of time in which Noble County is designated as Red under Executive Order 20-50, the following additional restrictions applicable to restaurants, bars, taverns, nightclubs, and other establishments providing in-person food and drink service are hereby ORDERED.

1. Capacity is limited to 50% of indoor capacity and 100% of outdoor capacity. Outdoor tent seating is permitted only if the tent has at least two (2) open-air sides for maximum ventilation.
2. These establishments must be closed and cleared of customers between the hours of 12:00 AM and 5:00 AM.
3. Bar seating shall be closed; table seating only. Table seating within a bar areas is permitted in accordance with this Order and with Executive Order 20-50.
4. Table seating is limited to 10 people per table and tables must be spaced such that individuals will be at least six (6) feet away from individuals seated at other tables.
5. Self-service style food stations (buffets, salad bars, etc.) are not permitted unless a staff member serves patrons.
6. If a restaurant, bar, tavern, nightclub or other establishment is hosting a group of persons for a Social Gathering or Event, as defined by Executive Order 20-50, the restrictions and procedures in place for such Social Gathering or Event under the Executive Order shall be followed.

1. Sports Events

Sports Events in Noble County shall be conducted in accordance with Paragraph 7.f. of Executive Order 20-50. Additional spectator attendance at collegiate or professional sports games and tournaments may be approved by the Noble County Health Department upon submission of a safety plan submitted seven (7) days in advance of the event and submitted with the Noble County Health Department COVID-19 Gathering and Events Plan Review Submission cover sheet indicating that the host will comply with the following safety provisions:

1. Guest information. Guests must be provided with information indicating that they should stay home if sick or part of a vulnerable population, engage in social distancing, increase handwashing, etc.
2. Measures must be taken to appropriately screen staff and volunteers for COVID-19 symptoms.
3. Measures must be taken to ensure attendees engage in social distancing such as use of multiple entrances, designated seating, one-way flow of attendees, ground makings, distance between seating/tables, etc.
4. Measures must be taken to ensure the event space is appropriately cleaned and sanitized, that high touch areas have increased cleaning, and that additional handwashing or hand sanitizing is available.
5. Measures must be taken to ensure that face coverings are required of attendees and that they are actually being worn by attendees, unless subject to an exemption.
6. Measures must be taken to ensure that a sufficient number of event staff or volunteers are present to monitor the sports event and to ensure compliance with approved plan.

1. Gyms, Exercise & Fitness Centers

During any period of time in which Noble County is designated as Red under Executive Order 20-50, the following additional restrictions applicable to gyms and exercise and fitness centers are hereby ORDERED.

1. This Order is applicable to all exercise and fitness/workout facilities or gyms, including yoga studios, dance studios, karate studios, martial arts studios, and other similar fitness centers whether located in a standalone facility, a community center, or other place of business.
2. In addition to any requirements of Executive Order 20-50, it is hereby ORDERED that gyms and exercise and fitness centers shall also be restricted to 50% capacity.

1. Color Code Status

Pursuant to Section 9.e. of Executive Order 20-50, a county will be moved to a more restrictive category whenever the county’s metric/score rises to the higher category; however, a county must meet the metrics/score of a less restrictive category for two (2) consecutive weeks before being permitted to move to that category.

Unless otherwise specified in this Public Health Order, dated January 14, 2021, the restrictions imposed by Governor Holcomb’s Executive Order 20-50 (extended by Executive Order 20-53) apply unless superseded by a later Executive Order issued by Governor Holcomb.

___________________________________

Terry Gaff, M.D.

Noble County Health Officer

PUBLIC HEALTH ORDER

NOBLE COUNTY HEALTH OFFICER

NOVEMBER 18, 2020

(This Order is more restrictive than Executive Order 20-48 in that it sets upper limits on the Social Gathering/Event Safety Plans that will be reviewed by the Noble County Health Department as well as in other regards. It is in no way less restrictive.)

Due to the ongoing COVID-19 pandemic and the recent surge of new cases and related hospitalizations in Noble County, and pursuant to the authority granted in Governor Eric Holcomb’s Executive Order 20-48 issued November 13, 2020 (hereinafter referred to as Executive Order 20-48 or the Executive Order), and the authority granted by I.C. 16-41-9-1.6, I, the Noble County, Indiana, Health Officer ORDER the following local restrictions for Noble County, Indiana, which are in addition to those set forth Executive Order 20-48. The definitions and provisions of Executive Order 20-48 are incorporated here in their entirety by reference. This Order shall become effective at 12:01 a.m. on November 22, 2020 and shall expire at 11:59 PM on December 12, 2020.

1. Social Gatherings

Pursuant to Section 7.c. of Executive Order 20-48, Social Gatherings (as defined by the Executive Order) are limited in number pursuant to the applicable color designation for the County as indicated in the Executive Order. The Executive Order provides that if the host of the Social Gathering cannot cancel, postpone, or reduce the number of individuals expected to be present at the Social Gathering to comply with the applicable limit, then the host shall seek and obtain approval of a safety plan for the Social Gathering from the local Health Department. It is hereby ORDERED that no such plan shall be approved by the Noble County Health Department unless the number of people to be present at the Social Gathering shall be less than the following according to the applicable color-coded metric designation and unless the safety plan is submitted with the Noble County Health Department COVID-19 Gathering & Events Plan Review Submission cover sheet indicating that the host will comply with the safety provisions contained in Section 7.f. of the Executive Order.

Orange: 250

Red: 100

1. Events

Pursuant to Section 7.e. of Executive Order 20-48, Events (as defined by the Executive Order) are limited in number pursuant to the applicable color designation for the County as indicated in the Executive Order. The Executive Order provides that if the host of the Event cannot cancel or reduce the number of individuals expected to be present at the Event to comply with the applicable limit, then the Host shall seek and obtain approval of a safety plan for the Event from the local Health Department. It is hereby ORDERED that no such plan shall be approved by the Noble County Health Department unless the number of people to be present at the Event shall be less than the following according to the applicable color-coded metric designation and unless the safety plan is submitted with the Noble County Health Department COVID-19 Gathering & Events Plan Review Submission cover sheet indicating that the host will comply with the safety provisions contained in Section 7.f. of the Executive Order.

Orange: 250

Red: 100

1. Social Gatherings and Events Held at Multiple Site Venues

Notwithstanding Sections 1 and 2 of this Public Health Order, for venues with multiple, clearly separate areas, such as separate banquet rooms, conference rooms, or multiple sports fields, it is ORDERED that a submitted safety plan submitted to the Noble County Health Department in accordance with Sections 7.c. and 7.e. of the Executive Order may be approved for each separate area up to a maximum of 250 individuals per gathering or event during any time that Noble County is designated as Orange under Executive Order 20-48 or up to a maximum of 100 individuals per gathering or event during any time that Noble County is designated as Red under Executive Order 20-48. The safety plan for each separate and discrete area of a multiple site venue must be submitted with the Noble County Health Department COVID-19 Gathering & Events Plan Review Submission cover sheet indicating that the host will comply with the safety provisions contained in Section 7.f. of the Executive Order. In addition, the venue shall:

1. Ensure separate social gathering and event attendees do not comingle;
2. Within each area/site, ensure 6 feet of social distancing within tables with seating spaced to achieve and maintain social distancing between individuals or households, and for classroom, auditorium, bleacher, or other style seating, ensure 6 feet of separation between individuals or household units;
3. Ensure separate and designated restroom facilities for each area/site and designated facilities must be sufficient for the number of attendees in each site or area;
4. Provide hand sanitizer or other prevention supplies in each area/site; and
5. Message that attendance is prohibited if sick or recently exposed to COVID-19.

1. Community Recreational Sports Leagues and Tournaments

In addition to the requirements set forth in Sections 9.c. and 9.d. of Executive Order 20-48, it is hereby ORDERED that community recreational sports leagues and tournaments shall also be restricted in the number of individuals present (including participants, personnel, and spectators) based on the color-coded metric designation for the County as follows.

Orange: 250

Red: 100

1. Restaurants, Bars, Taverns, Nightclubs and Other Establishments Providing In-Person Food and Drink Service

During any period of time in which Noble County is designated as Red under Executive Order 20-48, the following additional restrictions applicable to restaurants, bars, taverns, nightclubs, and other establishments providing in-person food and drink service are hereby ORDERED.

1. Capacity is limited to 50% of indoor capacity and 100% of outdoor capacity. Outdoor tent seating is permitted only if the tent has at least two (2) open-air sides for maximum ventilation.
2. These establishments must be closed and cleared of customers between the hours of 12:00 AM and 5:00 AM.
3. Bar seating shall be closed; table seating only. Table seating within a bar areas is permitted in accordance with this Order and with Executive Order 20-48.
4. Table seating is limited to 10 people per table and tables must be spaced such that individuals will be at least six (6) feet away from individuals seated at other tables.
5. Self-service style food stations (buffets, salad bars, etc.) are not permitted unless a staff member serves patrons.

1. Gyms, Exercise & Fitness Centers

During any period of time in which Noble County is designated as Red under Executive Order 20-48, the following additional restrictions applicable to gyms and exercise and fitness centers are hereby ORDERED.

1. This Order is applicable to all exercise and fitness/workout facilities or gyms, including yoga studios, dance studios, karate studios, martial arts studios, and other similar fitness centers whether located in a standalone facility, a community center, or other place of business.
2. In addition to any requirements of Executive Order 20-48, it is hereby ORDERED that gyms and exercise and fitness centers shall also be restricted to 50% capacity.

1. Color Code Status

Pursuant to Section 9.e. of Executive Order 20-48, a county will be moved to a more restrictive category whenever the county’s metric/score rises to the higher category; however, a county must meet the metrics/score of a less restrictive category for two (2) consecutive weeks before being permitted to move to that category.

Unless otherwise specified in this Public Health Order, dated November 18, 2020, the restrictions imposed by Governor Holcomb’s Executive Order 20-48 apply unless superseded by a later Executive Order issued by Governor Holcomb.

___________________________________

Terry Gaff, M.D.

Noble County Health Officer

Covid Etiquette!  By Dr. Terry Gaff - Noble County Health Officer

COVID-19 Etiquette 2020.14

Hopefully, everyone has gotten the message by now that we are supposed to try to keep 6 feet between us and everyone else. Because of the COVID-19 pandemic virus, being closer might endanger us and those around us, which is potentially dangerous and downright rude.

But rudeness can be countered by applying social etiquette. So, here are some rules of COVID-19 etiquette suggested by friends on Facebook.

• First and foremost, stay home if it is not essential.
• Wash, wash, wash those hands. 
• Cover your nose and mouth with a cloth mask, scarf or bandana whenever you leave home. This is not as much to protect you as it is to help keep you from spreading the virus if you have if you already have it with mild or no symptoms.
• Avoid public playgrounds. The virus can stay on the equipment for a long time. So, you or your child might bring it home.
• People with strollers have the right of way on sidewalks and trails.
• Only one person needs to shop, not the whole household.
• If you do shop, follow the social distancing and mask. Encourage the stores to make aisle traffic one way to make social distancing easier.
• Call your friends and family regularly, especially those residing in long term care.
• Get out and walk, run or bike, but mind your distance.
• Enjoy your children, cook with them, do crafts, plant some seeds, hug them. Be glad they are with you and not miles away.
• No basketball at the park!!
• Help someone!
• DON'T VISIT.
• Remove your shoes at the door when you return home.
• If you're an essential worker also remove your clothes (I bag mine) and take a shower. I leave my keys and badge on tray in my enclosed porch where I leave my clothes and shoes. I don't take my purse in the building and I have taken off all my jewelry.
• Banish the negative! Do what it takes to get your mind in a good place. Sing, dance, PRAY without ceasing, take every thought captive and don’t touch your face and wash those hands!
• Shower as soon as you get home from work and bag your clothes until you launder them.
• Wear protective eye wear
• Discuss contingency plans for your care should you become ill, end of life wishes that are also called “advance directives” and be sure loved ones know where to find your records and documents.
• One friend put up an eight-foot table in their attached garage. When the husband (an essential worker) comes home, the groceries he brought go on the table. Shoes stay in the garage. Clothes get bagged and he goes straight to a shower. The table gets sanitized, groceries get wiped off. Once they dry, they are brought in to be put away.
• Greet people with a wave, nod, do not shake hands since respiratory viruses can be passed by shaking hands, then touching your eyes, nose and mouth.
• Use proper cough etiquette by coughing into your elbow or tissue and disposing the tissue immediately.
• When putting on or removing a mask, only touch the elastic or the strings.
• If you cannot tell which is the inside of a cloth mask, mark it so you can tell.
• Launder your mask between uses.
• Do not mess with your mask or touch your face.
• Act like a celebrity when you see someone; hide your face and get away.
• Love your people from afar!
• Carry hand wipes or sanitizer with you when you need to go out.
• Please dispose of gloves properly. Take a Ziploc bag and put the gloves inside until you can put them in the trash at home.

Feel free to add your own suggestions.

If you need information about how to be safe in this time of uncertainty, consult the websites of reliable sources, like the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH). But do not become surprised if you cannot find all the answers to your questions, because much is still unknown.

If all else fails, just try to use common sense and courtesy to others.

Isolation vs Quarantine Press Release 09.2020

There seems to be some confusion about what is meant by isolation and quarantine in our response to COVID-19.

Isolation is used to separate people infected with SARS-CoV-2, the virus that causes COVID-19, from people who are not infected, even in their home.

Quarantine keeps someone who might have been exposed to the virus away from others.

Who needs to isolate?

• People who have COVID-19

• People who have symptoms of COVID-19 and are able to recover at home
• People who have no symptoms (are asymptomatic) but have tested positive for the infection

Steps to take to isolate:

• Stay home except to get medical care

• Monitor symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately
• Stay in a separate room from other household members, if possible
• Use a separate bathroom, if possible
• Avoid contact with other members of the household and pets
• Do not share personal household items, like cups, towels, and utensils

• Wear a mask when around other people

After isolation, you can be with others after the following:

• At least 10 days since symptoms first appeared and
• At least 24 hours with no fever without fever-reducing medication and

• Other symptoms of COVID-19 are improving

(If you had severe illness from COVID-19, your healthcare provider may recommend that you stay in isolation for longer than 10 days after your symptoms first appeared.)

If you tested positive for COVID-19 but have no symptoms, you can be with others after:

• 10 days have passed since the date you had your positive test
• If you develop symptoms after testing positive, follow the guidance above.

On the other hand, quarantine is separating and restricting the movement of people who were exposed to the disease to see if they become sick.

Individuals exposed to a person who has tested positive for COVID-19 should quarantine for 14 days after their last exposure, even if they test negative before the end of quarantine.

People need to quarantine who have been in close contact with someone who has COVID-19 (except people who have tested positive for COVID-19 do not need to quarantine or get tested again for up to three months as long as they do not develop symptoms again.)

What counts as close contact?

• You were within six feet of someone who has COVID-19 for a total of 15 minutes or more
• You provided care at home to someone who is sick with COVID-19
• You had direct physical contact with the person (hugged or kissed them)
• You shared eating or drinking utensils
• They sneezed, coughed, or somehow got respiratory droplets on you

How to be quarantined:

• Stay home for 14 days after your last contact with a person who has COVID-19
• Watch for fever (100.4◦F), cough, shortness of breath, or other symptoms of COVID-19
• If possible, stay away from others, especially people who are at higher risk for getting very sick from COVID-19

As you can see, isolation is stricter but briefer than quarantine because the virus is contagious for a shorter time (10 days) than the possible incubation period (14 days) after just being exposed to a positive case. However, both are important in the effort to control the spread of the virus to those around you.