On March 16, 2020, the respective health officers for the Bay Area counties of San Francisco, Santa Clara, San Mateo, Marin, Contra Costa and Alameda issued an order to all residents in their counties to shelter in residence. The order became effective at 12:01 a.m. on March 17, 2020, and will continue until 11:59 p.m. on April 7, 2020. During this period, all essential businesses are strongly encouraged to remain open but are expected to comply with social distancing requirements to the extent feasible. These “essential businesses” include “healthcare operations,” which term covers “hospitals, clinics, dentists, pharmacies, pharmaceutical and biotechnology companies, other healthcare facilities, healthcare suppliers, home healthcare services providers, mental health providers, or any related and/or ancillary healthcare services.” As ambulatory surgery centers (ASCs) were not identified specifically, we informally confirmed with the Alameda County Public Health Department the inclusion of ASCs in essential businesses. Consistent with this, the health officers have declared that this “healthcare operations” exemption shall be construed broadly to “avoid any impacts to the delivery of healthcare.” Furthermore, the residents in these counties are permitted to travel to and from, including using public transportation, these healthcare operations sites to perform their work functions.

Separately, while the order does not call for the cancellation of routine appointments or elective procedures, all residents are advised to only travel to obtain medical care that is essential to their health. Also, the website of the City and County of San Francisco has announced to the public that “some services, especially elective procedures, may be postponed or canceled.” Our clients are encouraging the rescheduling of elective procedures where quality of care is not compromised. For primary care visits, our clients are putting resources into encouraging and expanding capabilities for video visits.