Apr 2, 2020 — Press Conference on Imperial College of London Modeling Data
Remember, with any model, the output depends on the quality of the input data; we should NOT depend on data coming out of China, because it is not dependable data.
Sonoma County Dept of Public Health Press Conference (Q&A Session)
Screen Grabs from the Sonoma County Dept of Public Health Press Conference
Mar 31, 2020 Sonoma County Shelter In Place Order Extension
No. C19-05 Extending The Shelter In Place Order No. C19-03 Beyond April 7, 2020 To May 3, 2020.
DATE OF ORDER: Mar 31, 2020
Detailed Summary of Changes – New Shelter Order issued on March 31, 2020 (pdf)
Please read this Order carefully. Violation of or failure to comply with this Order is a misdemeanor punishable by fine, imprisonment, or both. (California Health and Safety Code § 120275, et seq.; Cal. Penal Code §§ 69, 148(a)(1).)
UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 101040, 101085, AND 120175, THE HEALTH OFFICER OF THE COUNTY OF SONOMA (“HEALTH OFFICER”) ORDERS:
This Order shall become effective at 12:01 a.m. on April 1, 2020 and will continue to be** in effect until 11:59 p.m. on May 3, 2020**, or until it is extended, rescinded, superseded, or amended in writing by the Health Officer or the State Health Officer.
This Order supersedes the March 17, 2020 Shelter in Place Order of the Health Officer (C19-03) directing all individuals to shelter in place (“Prior Shelter Order”). This Order clarifies, strengthens, and extends certain terms of the Prior Shelter Order to increase social distancing and further reduce person-to-person contact in order to further slow transmission of Novel Coronavirus Disease 2019 (“COVID-19”). As of the effective date and time of this Order set forth in Section 1 above, all individuals, businesses and government agencies in the County of Sonoma (“County”) are required to follow the provisions of this Order.
The intent of this Order is to ensure that the maximum number of people self-isolate in their places of residence to the maximum extent feasible, while enabling essential services to continue, to slow the spread of COVID-19 to the maximum extent possible. When people need to leave their places of residence, whether to obtain or perform vital services, or to otherwise facilitate authorized activities necessary for continuity of social and commercial life, they should at all times reasonably possible comply with Social Distancing and Hygiene Requirements as defined in Section 13 below. All provisions of this Order should be interpreted to effectuate this intent. Failure to comply with any of the provisions of this Order constitutes an imminent threat to public health.
All individuals currently living within the County are ordered to shelter at their place of residence. All persons may leave their residences only for Essential Activities, Essential Governmental Functions, to work for Essential Businesses, or to perform Minimum Basic Operations for non-essential businesses, all as defined in Section 13. Individuals experiencing homelessness are exempt from this Section, but are strongly urged to obtain shelter, and governmental and other entities are strongly urged to make such shelter available as soon as possible and to the maximum extent practicable (and to utilize Social Distancing and Hygiene Requirements in their operation).
When people need to leave their place of residence for the limited purposes allowed in this Order, they must strictly comply with Social Distancing and Hygiene Requirements as defined in Section 13, except as expressly provided in this Order.
All businesses with a facility in the County, except those where the primary function or activities of the facility are Essential Businesses, as defined in Section 13.f, are required to cease all activities at facilities located within the County except Minimum Basic Operations, as defined in Section 13. Businesses may also continue operations consisting exclusively of employees or contractors performing activities at their own residences (i.e., working from home). Essential Businesses are directed to maximize the number of employees who work from home. Essential Businesses may only assign those employees who cannot perform their job duties from home to work outside the home. All Essential Businesses shall prepare, post, and implement a Social Distancing Protocol at each of their facilities at which they are maintaining operations, as specified in Section 13.h. Businesses that include an Essential Business component at their facilities alongside non-essential components must, to the extent feasible, scale down their operations to the Essential Business component only; provided, however, that mixed retail businesses that are otherwise allowed to operate under this Order may continue to stock and sell non-essential products. Essential businesses must follow industry-specific guidance issued by the California Department of Public Health (“CDPH”) related to COVID-19.
All public and private gatherings of any number of people occurring outside a household or living unit are prohibited, except for the limited purposes as expressly permitted in Section 13.
All travel, except Essential Travel and Essential Activities as defined below in Section 13, is prohibited. People must use public transit only for purposes of performing Essential Activities or to travel to and from work to operate Essential Businesses or maintain Essential Governmental Functions. People riding on public transit must comply with Social Distancing and Hygiene Requirements as defined in Section 13 below. This Order allows travel into or out of the County to perform Essential Activities, operate Essential Businesses, or maintain Essential Governmental Functions.
This Order is issued based on evidence of increasing occurrence of COVID-19 within the County, throughout the Bay Area, and throughout the United States and scientific evidence and best practices regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically, and evidence that the age, condition, and health of a significant portion of the population of the County places it at risk for serious health complications, including death, from COVID-19. Due to the outbreak of the COVID-19 virus in the general public, which is now a pandemic according to the United States and the World Health Organization, there is a public health emergency throughout the County. Making the problem worse, some individuals who contract the COVID-19 virus have no symptoms or have mild symptoms, which means they may not be aware they carry the virus. Because even people without symptoms can transmit the disease, and because evidence shows the disease is easily spread, gatherings can result in preventable transmission of the virus. The scientific evidence shows that at this stage of the emergency, it is essential to slow virus transmission as much as possible to protect the most vulnerable and to prevent the health care system from being overwhelmed. One proven way to slow the transmission is to limit interactions among people to the greatest extent practicable. By reducing the spread of the COVID-19 virus, this Order helps preserve critical and limited healthcare capacity in the County.
This Order also is issued in light of the existence of 73 cases of COVID-19 in the County as well as 1 fatality, as of March 31, 2020. The County has confirmed through testing that every section of the County suffers from infection. This Order is necessary to slow the rate of spread and the Health Officer will re-evaluate it as further data becomes available.
This Order is issued in accordance with, and incorporates by reference, the
- March 19, 2020 Executive Order of the Governor (N-33-20);
- March 13, 2020 Order of the [Sonoma County] Health Officer No. C19-02;
- March 4, 2020 Proclamation of a State of Emergency issued by Governor Gavin Newsom;
- March 2, 2020 Proclamation of Local Emergency for the County of Sonoma issued by the Director of Emergency Services Declaring the Existence of a Local Emergency in the County Regarding Novel Coronavirus 2019 (COVID-19);
- Declaration of Local Health Emergency Regarding Novel Coronavirus 2019 (COVID-19) issued by the Health Officer;
- March 4, 2020 Resolution of the Board of Supervisors of the County of Sonoma Ratifying and Extending the Declaration of a Local Health Emergency, and the
- March 4, 2020 Resolution of the Board of Supervisors of the County of Sonoma Ratifying and Extending the Proclamation of a Local Emergency.
This Order comes after the release of substantial guidance from the County Health Officer, the Centers for Disease Control and Prevention, the California Department of Public Health, and other public health officials throughout the United States and around the world, including a variety of prior orders to combat the spread and harms of COVID-19. The Health Officer will continue to assess the quickly evolving situation and may modify or extend this Order, or issue additional Orders, related to COVID-19.
Definitions and Exemptions. For purposes of this Order, individuals may leave their residence only to perform any of the following “Essential Activities.” But people at high risk of severe illness from COVID-19 and people who are sick are urged to stay in their residence to the extent possible except as necessary to seek medical care. For purposes of this Order, people at “high risk of severe illness from COVID-19” are people who meet the CDC definition of higher risk. (https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html)
- To engage in activities or perform tasks important to their health and safety, or to the health and safety of their family or household members (including pets), such as, by way of example only and without limitation, obtaining medical supplies or medication, or visiting a health care professional.
- To obtain necessary services or supplies for themselves and their family, household members, and pets, or to deliver those services or supplies to others, such as, by way of example only and without limitation, canned food, dry goods, fresh fruits and vegetables, pet food and supply, fresh meats, fish, and poultry, and any other household consumer products, and products necessary to maintain the habitability, sanitation, and essential operation of residences.
- To engage in outdoor activity, provided the individuals comply with Social Distancing and Hygiene Requirements as defined in this Section, such as, by way of example and without limitation, walking, hiking, biking, or running.
- To perform work providing essential products and services at an Essential Business or to otherwise carry out activities specifically permitted in this Order, including Minimum Basic Operations.
- To provide necessary care for a family member or pet in another household who has no other source of care.
- To attend a funeral with no more than 10 individuals present.
- To move residences, but only if it is not possible to defer an already planned move, if the move is necessitated by safety, sanitation, or habitability reasons, or if the move is necessary to preserve access to shelter. When moving into or out of the Bay Area region, individuals are strongly urged to quarantine for 14 days. To quarantine, individuals should follow the guidance of the United States Centers for Disease Control and Prevention
- For the purposes of this Order, individuals may leave their residence to work for, volunteer at, or obtain services at “Healthcare Operations,” including, without limitation, hospitals, clinics, COVID-19 testing locations, dentists, pharmacies, blood banks and blood drives, pharmaceutical and biotechnology companies, other healthcare facilities, healthcare suppliers, home healthcare services providers, mental health providers, or any related and/or ancillary healthcare services. “Healthcare Operations” also includes veterinary care and all healthcare services provided to animals. This exemption for Healthcare Operations shall be construed broadly to avoid any interference with the delivery of healthcare, broadly defined. “Healthcare Operations” excludes fitness and exercise gyms and similar facilities.
- For the purposes of this Order, individuals may leave their residence to provide any services or perform any work necessary to the operation and maintenance of “Essential Infrastructure,” including airports, utilities (including water, sewer, gas, and electrical), oil refining, roads and highways, public transportation, solid waste facilities (including collection, removal, disposal, and processing facilities), cemeteries, mortuaries, crematoriums, and telecommunications systems (including the provision of essential global, national, and local infrastructure for internet, computing services, business infrastructure, communications, and web-based services).
- For the purposes of this Order, all first responders, emergency management personnel, emergency dispatchers, court personnel, and law enforcement personnel, and others who need to perform essential services are categorically exempt from this Order to the extent they are performing those essential services. Further, nothing in this Order shall prohibit any individual from performing or accessing “Essential Governmental Functions,” as determined by the governmental entity performing those functions in the County. Each governmental entity shall identify and designate appropriate employees, volunteers, or contractors to continue providing and carrying out any Essential Governmental Functions, including the hiring or retention of new employees or contractors to perform such functions. Each governmental entity and its contractors must employ all necessary emergency protective measures to prevent, mitigate, respond to and recover from the COVID-19 pandemic, and all Essential Governmental Functions shall be performed in compliance with Social Distancing and Hygiene Requirements to the greatest extent feasible.
- For the purposes of this Order, a “business” includes any for-profit, non-profit, or educational entity, whether a corporate entity, organization, partnership or sole proprietorship, and regardless of the nature of the service, the function it performs, or its corporate or entity structure.
For the purposes of this Order, “Essential Businesses” means:
- Healthcare Operations and businesses that operate, maintain, or repair Essential Infrastructure;
- Grocery stores, certified farmers’ markets, farm and produce stands, supermarkets, food banks, convenience stores, and other establishments engaged in the retail sale of unprepared food, canned food, dry goods, non-alcoholic beverages, fresh fruits and vegetables, pet supply, fresh meats, fish, and poultry, as well as hygienic products and household consumer products necessary for personal hygiene or the habitability, sanitation, or operation of residences. The businesses included in this subparagraph (ii) include establishments that sell multiple categories of products provided that they sell a significant amount of essential products identified in this subparagraph, such as liquor stores that also sell a significant amount of food. Farmer’s markets shall comply with CDPH Guidance regarding Retail Food, Beverage, and Other Related Service Venues issued March 16, 2020;
- Businesses engaged in the production, cultivation, processing, testing, or distribution of food, beverage, or other agricultural products. These businesses shall be closed to the public, except that retail sales to the public may occur via curbside pick-up, delivery, shipping, farm and produce stands, or farmer’s markets (see Subsection 13.f.ii. of this Order), where otherwise allowed by law. Such businesses include agriculture, farming, ranching, fishing, dairies, creameries, wineries, breweries, and licensed cannabis businesses;
- Businesses that are necessary to support businesses described in Subsection 13.f.iii. above, including but not limited to farm management companies, food and beverage processing, equipment dealerships, fuel companies and deliveries, mobile and fixed mechanics, agricultural transportation services, and companies providing seeds, nursery stock, fertilizer, livestock feed, and crop production products;
- Businesses providing food, shelter, and social services, and other necessities of life for economically disadvantaged or otherwise needy individuals;
Construction, but only of the types listed in this subparagraph below:
- Projects immediately necessary to the maintenance, operation or repair of Essential Infrastructure;
- Projects associated with Healthcare Operations, including creating or expanding Healthcare Operations, provided that such construction is directly related to the COVID-19 response.
- Affordable housing that is or will be income-restricted, including multi-unit or mixed-use developments containing at least 10% income-restricted units;
- Public works projects if specifically designated as an Essential Governmental Function by the lead governmental agency;
- Shelters and temporary housing, but not including hotels or motels;
- Projects immediately necessary to provide critical non-commercial services to individuals experiencing homelessness, elderly persons, persons who are economically disadvantaged, and persons with special needs;
- Construction necessary to ensure that existing construction sites that must be shut down under this Order are left in a safe and secure manner, but only to the extent necessary to do so; and
- Construction or repair necessary to ensure that residences and buildings containing Essential Businesses are safe, sanitary, or habitable to the extent such construction or repair cannot reasonably be delayed;
- Construction or debris removal activities undertaken pursuant to Chapters 40 and 40A of the County Code, or any other construction and debris removal activities on fire damaged or destroyed properties;
- Newspapers, television, radio, and other media services;
- Gas stations and auto-supply, auto-repair (including, but not limited to, for cars, trucks, motorcycles and motorized scooters), and automotive dealerships, but only for the purpose of providing auto-supply and auto-repair services (and not, by way of example, car sales or car washes). This subparagraph does not restrict the on-line purchase of automobiles if they are delivered to a residence or Essential Business;
- Bicycle repair and supply shops;
- Banks and related financial institutions;
- Service providers that enable residential transactions (including rentals, leases, and home sales), including, but not limited to, real estate agents, escrow agents, notaries, and title companies, provided that appointments and other residential viewings must only occur virtually or, if a virtual viewing is not feasible, by appointment with no more than two visitors at a time residing within the same household or living unit and one individual showing the unit (except that in person visits are not allowed when the occupant is still residing in the residence);
- Hardware stores;
- Plumbers, electricians, exterminators, and other service providers who provide services that are necessary to maintaining the habitability, sanitation, and operation of residences and Essential Businesses, but not for cosmetic or other purposes;
- Arborists, landscapers, gardeners, and similar service professionals, but only to the limited extent necessary to maintain the habitability, sanitation, operation of businesses or residences, or the safety of residents, employees, or the public (such as fire safety or tree trimming to prevent a dangerous condition), and not for cosmetic or other purposes (such as upkeep);
- Businesses providing mailing and shipping services, including post office boxes;
- Educational institutions—including public and private K-12 schools, colleges, and universities—for purposes of facilitating distance learning or performing essential functions, provided that social distancing of six-feet per person is maintained;
- Laundromats, drycleaners, and laundry service providers;
- Restaurants and other facilities that prepare and serve food, but only for drive-thru, delivery, or carry out. Schools and other entities that typically provide free food services to students or members of the public may continue to do so under this Order on the condition that the food is provided to students or members of the public on a pick-up and take-away basis only. Schools and other entities that provide food services under this exemption shall not permit the food to be eaten at the site where it is provided, or at any other gathering site. Food trucks shall comply with CDPH Guidance regarding Retail Food, Beverage, and Other Related Service Venues issued March 16, 2020;
- Funeral home providers, mortuaries, cemeteries, and crematoriums, to the extent necessary for the transport, preparation, or processing of bodies or remains;
- Businesses that supply other Essential Businesses with the support or supplies necessary to operate, but only to the extent that they support or supply these Essential Businesses. This exemption shall not be used as a basis for engaging in sales to the general public from retail storefronts;
- Businesses that have the primary function of shipping or delivering groceries, food, or other goods directly to residences or businesses. This exemption shall not be used to allow for manufacturing or assembly of non-essential products or for other functions besides those necessary to the delivery operation;
- Airlines, taxis, rental car companies, rideshare services (including shared bicycles and scooters), and other private transportation providers providing transportation services necessary for Essential Activities and other purposes expressly authorized in this Order;
- Home-based care for seniors, adults, or children;
- Residential facilities and shelters for seniors, adults, and children;
- Professional services, such as legal, notary, or accounting services, when necessary to assist in compliance with non-elective, legally required activities;
- Services to assist individuals in finding employment with Essential Businesses;
- Moving services that facilitate residential or commercial moves that are allowed under this Order;
Childcare facilities providing services that enable owners, employees, volunteers, and contractors for Essential Businesses, Healthcare Operations, or Essential Governmental Functions to work as permitted. Children of owners, employees, volunteers, and contractors who are not exempt under this Order may not attend childcare facilities. To the extent possible, childcare facilities must operate under the following conditions:
- Childcare must be carried out in stable groups of 12 or fewer (“stable” means that the same 12 or fewer children are in the same group each day).
- Children shall not change from one group to another.
- If more than one group of children is cared for at one facility, each group shall be in a separate room. Groups shall not mix with each other.
- Childcare providers shall remain solely with one group of children.
- Short-term lodging facilities (including short-term rentals, vacation rentals, timeshares, hotels, motels, and other short-term lodgings) only to the extent they provide: (1) lodging to protect the County homeless population, (2) lodging for County residents who have been displaced and cannot return to their residence because there is a person residing at their residence that must isolate or quarantine or is at a high risk of severe illness from COVID-19, as defined in this Section 13.a. above, (3) lodging for County residents who need to isolate or quarantine, (4) housing support for Healthcare Operations, Essential Infrastructure, Essential Businesses, and Essential Governmental Functions (i.e. housing traveling nurses or government contractors). Short-term lodging facilities shall not operate for tourism. No homeowner, agent of the homeowner, property manager, marketing agent, listing agent, or real estate agent shall engage in efforts to rent or lease any short-term lodging facilities within the County for any other purpose.
For the purposes of this Order, “Minimum Basic Operations” include the following activities when they cannot be performed remotely, provided that there are only the minimum number of persons on-site and persons comply with Social Distancing and Hygiene Requirements as defined this Section:
- The minimum necessary activities to maintain and protect the value of the business’s inventory and facilities; ensure security, safety, and sanitation; process payroll and employee benefits; provide for the delivery of existing inventory directly to residences or businesses; and related functions.
- The minimum necessary activities to facilitate owners, employees, and contractors of the business being able to continue to work remotely from their residences, and to ensure that the business can deliver its service remotely.
- For the purposes of this Order, all Essential Businesses must prepare and post by no later than 11:59 p.m. on April 2, 2020 a “Social Distancing Protocol” for each of their facilities in the County frequented by the public or employees. The Social Distancing Protocol must be substantially in the form attached to this Order as Appendix A. The Social Distancing Protocol must be posted at or near the entrance of the relevant facility, and shall be easily viewable by the public and employees. A copy of the Social Distancing Protocol must also be provided to each employee performing work at the facility. All Essential Businesses shall implement the Social Distancing Protocol and provide evidence of its implementation to any authority enforcing this Order upon demand. The Social Distancing Protocol must explain how the business is achieving the following, as applicable:
- Limiting the number of people who can enter into the facility at any one time to ensure that people in the facility can easily maintain a minimum six-foot distance from one another at all times, except as required to complete the Essential Business activity;
- Where lines may form at a facility, marking six-foot increments at a minimum, establishing where individuals should stand to maintain adequate social distancing;
- Providing hand sanitizer, soap and water, or effective disinfectant at or near the entrance of the facility and in other appropriate areas for use by the public and employees, and in locations where there is high-frequency employee interaction with members of the public (e.g. cashiers);
- Providing for contactless payment systems or, if not feasible to do so, the providing for disinfecting all payment portals, pens, and styluses after each use;
- Regularly disinfecting other high-touch surfaces; and
- Posting a sign at the entrance of the facility informing all employees and customers that they should: avoid entering the facility if they have a cough or fever; maintain a minimum six-foot distance from one another; sneeze and cough into one’s elbow; not shake hands or engage in any unnecessary physical contact.
- Any additional social distancing measures being implemented (see the Centers for Disease Control and Prevention’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html).
For the purposes of this Order, “Essential Travel” means travel for any of the following purposes:
- Travel related to the provision of or access to Essential Activities, Essential Governmental Functions, Essential Businesses, or Minimum Basic Operations.
- Travel to care for any elderly, minors, dependents, or persons with disabilities.
- Travel to or from educational institutions for purposes of receiving materials for distance learning, for receiving meals, and any other related services.
- Travel to return to a place of residence from outside the County.
- Travel required by law enforcement or court order.
- Travel required for non-residents to return to their place of residence outside the County. Individuals are strongly encouraged to verify that their transportation out of the County remains available and functional prior to commencing such travel.
- Travel to manage after-death arrangements and burial.
- Travel to arrange for shelter or avoid homelessness.
- Travel to avoid domestic violence or child abuse.
- Travel for parental custody arrangements.
- Travel to a place to temporarily reside in a residence or other facility to avoid potentially exposing others to COVID-19, such as a hotel or other facility provided by a governmental authority for such purposes.
- For purposes of this Order, “residences” include hotels, motels, shared rental units and similar facilities. Residences also include living structures and outdoor spaces associated with those living structures, such as patios, porches, backyards, and front yards that are only accessible to a single family or household unit. Hotels, motels and short term rentals are subject to the restrictions in Section 13.f.xxix above.
For purposes of this Order, “Social Distancing and Hygiene Requirements” means:
- Maintaining at least six-foot social distancing from individuals who are not part of the same household or living unit;
- Frequently washing hands with soap and water for at least 20 seconds, or using hand sanitizer that is recognized by the Centers for Disease Control and Prevention as effective in combatting COVID-19;
Covering coughs and sneezes with a tissue or fabric or, if not possible, into the sleeve or elbow (but not into hands); and
Avoiding all social interaction outside the household when sick with a fever or cough.
All individuals must strictly comply with Social Distancing and Hygiene Requirements, except to the limited extent necessary to provide care (including childcare, adult or senior care, care to individuals with special needs, and patient care); as necessary to carry out the work of Essential Businesses, Essential Governmental Functions, or provide for Minimum Basic Operations; or as otherwise expressly provided in this Order.
To the extent the Sheriff or any chief of police has any questions regarding the definitions under this Order, the Health Officer hereby delegates authority to the County Counsel to answer such questions in writing.
14. Government agencies and other entities operating shelters and other facilities that house or provide meals or other necessities of life for individuals experiencing homelessness must take appropriate steps to help ensure compliance with Social Distancing and Hygiene Requirements, including adequate provision of hand sanitizer. Also, individuals experiencing homelessness who are unsheltered should abide by 12 foot by 12 foot distancing for the placement of tents/sleeping quarters, and government agencies should provide restroom and hand washing facilities for such individuals as set forth in Centers for Disease Control and Prevention Interim Guidance Responding to Coronavirus 2019 (COVID-19) Among People Experiencing Unsheltered Homelessness (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/unsheltered-homelessness.html).
15. Pursuant to Government Code sections 26602 and 41601 and Health and Safety Code section 101029, the Health Officer requests that the Sheriff and all chiefs of police in the County ensure compliance with and enforce this Order. The violation of any provision of this Order constitutes an imminent threat and menace to public health, constitutes a public nuisance, and is punishable by fine, imprisonment, or both.
**16. **The County is ordered to establish an Emergency Operations Center, implement all emergency protective orders, implement all health officer orders, and implement the County’s pandemic response.
17. This order is given because of the propensity of the virus to spread person-to-person, and also because the virus physically is causing property loss or damage due to its proclivity to stay airborne and to attach to surfaces for prolonged periods of time.
18. Copies of this Order shall promptly be: (1) made available at the County Administration Center at 575 Administration Drive, Santa Rosa CA 95403; (2) posted on the County Public Health Department website (https://sonomacounty.ca.gov/Health/Public-Health/) and (https://socoemergency.org/); and (3) provided to any member of the public requesting a copy of this Order.
19. If any provision of this Order to the application thereof to any person or circumstance is held to be invalid, the reminder of the Order, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect. To this end, the provisions of this Order are severable.
It is so ordered:
Signed by Dr. Sundari R. Mase MD MPH, Health Officer of Sonoma County