The following closures are currently in effect for the week of March 30th – April 5th:

• I-75 northbound between County Road 25A (between Troy and Piqua) and US 36, Traffic pattern shift April 5th at 7 pm – August 31st at 6 am. One NB lane will be shifted on to the SB side of I-75. *The available lane width is 10’ with a 1’ shoulder.*
• I-75 southbound at US 36, one lane closures March 30th from 9 am – 1 pm for pavement repairs. One lane of traffic will be maintained.
• I-75 southbound between County Road 25A (between Troy and Piqua) and US 36, Traffic pattern shifts March 23rd at 1 pm – August 31st at 6 am. There will be two 10′ lanes with 1′ shoulder.

Contact: Tiffany Oliphant – (937) 497-6959

ODOT closures focus on Interstate, US and State routes. For information on local roads you will need to contact the county, city or township where the road is located. Arrow boards and signs will be in place prior to the work zone to alert motorists of the upcoming closure. All work is weather permitting. Safety is a top priority at ODOT. To help ensure the safety of the construction workers as well as the traveling public, motorists should remain alert, reduce their speed and watch for stopped traffic while passing through the work zone.

This is an official CDC HEALTH ADVISORY

Distributed via the CDC Health Alert Network
March 28, 2020
CDCHAN-00431

Severe Illness Associated with Using Non-Pharmaceutical Chloroquine Phosphate to Prevent and Treat Coronavirus Disease 2019 (COVID-19)

Summary
Chloroquine phosphate, when used without a prescription and supervision of a healthcare provider, can cause serious health consequences, including death. Clinicians and public health officials should discourage the public from misusing non-pharmaceutical chloroquine phosphate (a chemical used in home aquariums). Clinicians should advise patients and the public that chloroquine, and the related compound hydroxychloroquine, should be used only under the supervision of a healthcare provider as prescribed medications.

Background
The Centers for Disease Control and Prevention (CDC) has become aware of two individuals who ingested non-pharmaceutical chloroquine phosphate, a chemical for aquarium use that is commercially available for purchase at stores and through internet websites. One of the individuals died shortly after arrival to the hospital. The second individual was critically ill with severe gastrointestinal symptoms and cardiac conduction abnormalities. Upon recovery, the surviving individual reported to the media that they ingested the product to prevent infection with SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), after seeing information on the medical use of chloroquine on television. The product in their possession was in powder form inside a 2.2-lb. container and labeled “for Ornamental Fish Use Only”. CDC is also aware of unconfirmed media reports that these commercially available aquarium-use chemicals may be out of stock due to potential increased demand by the public.

At this time, there are no routinely available pharmaceutical products that are FDA-approved for the prevention or treatment of COVID-19. Pharmaceutical chloroquine phosphate and hydroxychloroquine sulfate are approved by the US Food and Drug Administration (FDA) to treat specific medical conditions, such as malaria, lupus, and rheumatoid arthritis. Currently, these medications are being studied and evaluated as treatment for COVID-19; however, their efficacy to either prevent or treat this infection are unknown. In overdose situations or when used inappropriately, these medications can lead to severe toxicity, including cardiac rhythm disturbances such as prolonged QT, severe hypokalemia, cardiovascular collapse, seizures, coma, and death. Inappropriate uses include taking commercially available non-pharmaceutical preparations, taking chloroquine phosphate or hydroxychloroquine sulfate without a prescription, and taking additional doses not recommended by a healthcare provider.

Chloroquine phosphate has a narrow therapeutic index—it can be toxic at levels not much higher than those used for treatment—which raises the risk of inadvertent overdose.

Recommendations for Clinicians and Public Health Officials:

1. Educate patients on the serious risks of misusing non-pharmaceutical chloroquine products and other aquarium use chemicals.
2. Counsel your patients on the importance of taking medications only as prescribed and as directed by healthcare providers.
3. Contact your local poison center (1-800-222-1222) to report cases and to obtain specific medical management of chloroquine and hydroxychloroquine poisoning.
4. Adverse events related to pharmaceuticals can be reported to the FDA MedWatch program (https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program).
   Adverse events related to non-pharmaceutical products can be reported by emailing FDA-COVID-19-Fraudulent-Products@fda.hhs.gov or calling 1-888-InfoFDA (1-888-463-6332).

Recommendations for the Public

1. Do not ingest aquarium use products or any other chemicals that contain chloroquine phosphate. These chemicals are not intended for human consumption and can lead to serious health consequences, including death.
2. Medications like chloroquine phosphate and hydroxychloroquine sulfate should be taken only when prescribed by and under the supervision of your healthcare provider and always according to the instructions provided.
3. Seek immediate medical attention if you are experiencing any unexpected symptoms after taking chloroquine or hydroxychloroquine by contacting your healthcare provider or your poison center (1-800-222-1222).

For More Information

• CDC coronavirus website (https://www.cdc.gov/coronavirus)
• U.S. Government coronavirus website (https://www.coronavirus.gov/)
• FDA Letter to Stakeholders (https://www.fda.gov/animal-veterinary/product-safety-information/fda-letter-stakeholders-do-not-use-chloroquine-phosphate-intended-fish-treatment-covid-19-humans)
• Banner Health (Phoenix, AZ) press release (https://bannerhealth.mediaroom.com/chloroquinephosphate)
• Dailymed (https://dailymed.nlm.nih.gov/dailymed/index.cfm) for medical prescribing information
• American College of Medical Toxicology (https://www.acmt.net) for poisoning information
• Association of American Poison Control Centers (https://www.aapcc.org)

The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

Categories of Health Alert Network messages:
Health Alert Requires immediate action or attention; highest level of importance
Health Advisory May not require immediate action; provides important information for a specific incident or situation
Health Update Unlikely to require immediate action; provides updated information regarding an incident or situation
HAN Info Service Does not require immediate action; provides general public health information
##This message was distributed to state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations##

Due to golf courses being deemed non-essential by the State of Ohio, the City of Piqua will be closing the Echo Hills Golf Course effective today, March 26, 2020 and will be closed until further notice.

Maintenance is still allowable on golf courses and will continue as scheduled.

PIQUA — The Piqua City Health Department is reporting the first confirmed COVID-19 case within the City of Piqua health jurisdiction. The case is related to the outbreak at Koester Pavilion in Troy.

The Piqua Health Department is working very closely with Miami County Public Health (MCPH) in response to the coronavirus pandemic. Contact tracing has been completed and the patient is isolated at home.

“The response efforts from Miami County Public Health to the outbreak at Koester Pavilion have been tremendous. We appreciate their partnership in dealing with this situation,” said Amy Welker, Piqua Health & Sanitation Director.

The public should take the following action to reduce the spread of COVID-19:

• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Cover coughs and sneezes with your arm or your inner elbow, NOT your hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick, except to get medical care.
• Avoid touching your eyes, nose and mouth.
• Clean and disinfect frequently touched surfaces.

If a person believes they may have symptoms or have come in contact with a positive COVID-19 case, they should CALL their doctor. People with mild illness are encouraged to stay home and care for themselves. It is strongly discouraged to show up to your healthcare provider office or hospitals without calling first, which can risk the health of others.

“We do expect to see more local cases as this outbreak evolves, and are working diligently to respond to the situation and protect the health and safety of our community,” Welker said.

For more information, visit coronavirus.ohio.gov or call ODH COVID-19 Hotline at 833-4-ASK-ODH (833-427-5634). The ODH call center is open 7 days a week from 9 a.m. to 8 p.m.

 Miami County – Miami County Public Health is issuing an update on the COVID-19 in Miami County.

It has been confirmed that an 89 year old female Springmeade resident, who had been hospitalized and tested positive for COVID-19, has died. This is the 4^th death associated with the COVID-19 outbreak at Koester Pavilion and Springmeade Health Center.

Our deepest condolences go out to the family and our thoughts and prayers are with them.

As of today, Tuesday, March 25, 2020 there are no new cases of COVID-19 being reported in Miami County.

Miami County Public Health continues to receive a lot of questions around Governor DeWine & Dr. Acton’s most recent Stay-at -Home order. To provide guidance on essential business classification, MCPH is working with companies to identify how their organization qualifies as essential or non-essential.

MCPH was also notified that Miami County Sheriff’s Department has received calls from employees of various companies, regarding employers not following social distancing guidelines or essential status. Concerns about the guidelines in the Governor’s orders or recommendations on social distancing, should be addressed with the employer and their employers Human Resources. If concerns continue, then employees should contact Miami County Public Health.

To read the full Stay-at-Home order or the Frequently Asked Questions visit: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home/public-health-orders/directors-order-to-stay-at-home

MCPH will continue working with companies on clarifying the essential and non-essential businesses. As new information becomes available on new guidelines and COVID-19 cases, MCPH will provide updates to the community.

Click here for the full Order: Director’s Order to Close Facilities Providing Child Care Services

DIRECTOR’S ORDER

I, Amy Acton, MD, MPH, Director of the Ohio Department of Health (ODH), pursuant to the authority granted to me in R.C. 3701.13 to “make special orders … for preventing the spread of contagious or infectious diseases” Order the following to prevent the spread of COVID-19 within the State of Ohio:

1. Effective at 11 :59 p.m. on March 25, 2020, all facilities providing child care services are closed unless they have a Temporary Pandemic Child Care License issued by the Ohio Depmiment of Job and Family Services.
2. This Order exempts any facility that stays open for the purpose of operating a United States Depmiment of Agriculture food service program, but does not continue to provide child care services.
3. This Order shall remain in full force and effect until the State of Emergency declared by the Governor no longer exists, or the Director of the Ohio Department of Health rescinds or modifies this Order.
4. To the extent any public official enforcing this Order has questions regarding what services are prohibited under this Order, the Director of Health hereby delegates to the local depmiments of job and family services the authority to answer questions regarding Temporary Pandemic Child Care Licenses and to the Ohio Depmiment of Education (ODE) the authority to answer questions regarding ODE licensed services in writing and consistent with this Order.

COVID-19 is a respiratory disease that can result in serious illness or death, is caused by the SARS-Co V 2 virus, which is a new strain of coronavirus that had not been previously identified in humans and can easily spread from person to person. The virus is spread between individuals who are in close contact with each other (within about six feet) through respiratory droplets produced when an infected person coughs or sneezes. It may be possible that individuals can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes.

The order will take effect at 11:59 p.m. EDT on Monday, March 23^rd until 11:59 p.m. on April 6, 2020.

All Essential Businesses and Operations are encouraged to remain open as long as they meet the requirements in the Order.

READ THE FULL ORDER BY CLICKING ON THE PHOTO BELOW OR CLICKING ON THIS LINK DIRECTOR’S STAY AT HOME ORDER IN FULL

Essential businesses and services include:

• Healthcare and Public Health Operations
• Human Services Operations
• Essential Infrastructure
• Essential Governmental Functions
• Critical infrastructure workers
• Stores that sell groceries and medicine
• Food and beverage production and agriculture
• Organizations that provide charitable and social services
• Religious entities and gatherings, including weddings and funerals
• News media
• First amendment protected speech
• Gas stations and businesses needed for transportation
• Financial and insurance institutions
• Hardware and supply stores
• Critical trades
• Mail, post, shipping, logistics, delivery, and pick-up services.
• Educational institutions.
• Laundry services.
• Restaurants providing carry-out, third party delivery, and curbside pickup.
• Businesses that sell, manufacture, or supply products needed for people to work from home or support material for essential businesses.
• Transportation services.
• Home-based care and services.
• Residential facilities and shelters.
• Professional services.
  • Includes legal, accounting, insurance, and real estate services.
• Manufacturing companies, distributors, and supply chain companies producing and supplying essential products and services.
• Critical labor union functions.
• Hotels and motels, to the extent used for lodging and delivery or carry-out food services.
• Funeral and related services.

Essential Businesses and Operations include:

• Stores that sell groceries and medicine.
• Food, beverage, and licensed marijuana production and agriculture
• Organizations that provide charitable and social services.
• Religious entities
• Media
• First amendment protected speech.
• Gas stations and businesses needed for transportation
• Financial and insurance institutions
• Hardware and supply stores
• Critical trades
• Mail, post, shipping, logistics, delivery, and pick-up services
• Educational institutions.
• Laundry services
• Restaurants for consumption off-premises
• Supplies to work from home
• Supplies for Essential Businesses and Operations
• Transportation
• Home-based care and services
• Residential facilities and shelters
• Professional services
• Manufacture, distribution, and supply chain for critical products and industries
• Critical labor union functions
• Hotels and motels
• Funeral services

The Health Department will make the determination if a business meets the criteria of an Essential Business. Those who do not meet the criteria are expected to close in accordance with the Order.

Businesses that remain open MUST meet the Social Distancing Requirements including maintaining at least six-foot social distancing from other individuals, washing hands with soap and water for at least twenty seconds as frequently as possible or using hand sanitizer, covering coughs or sneezes (into the sleeve or elbow, not hands), regularly cleaning high-touch surfaces, and not shaking hands.

Required measures. Essential Businesses and Operations and businesses engaged in Minimum Basic Operations must take proactive measures to ensure compliance with Social Distancing Requirements, including where possible:

1. Designate six-foot distances. Designating with signage, tape, or by other means six-foot spacing for employees and customers in line to maintain appropriate distance;
2. Hand sanitizer and sanitizing products. Having hand sanitizer and sanitizing products readily available for employees and customers;
3. Separate operating hours for vulnerable populations. Implementing separate operating hours for elderly and vulnerable customers; and
4. Online and remote access. Posting online whether a facility is open and how best to reach the facility and continue services by phone or remotely.

COVID-19 Information and Checklist for Businesses/Employers. Business and employers are to take the following actions:

1. Allow as many employees as possible to work from home by implementing policies in areas such as teleworking and video conferencing.
2. Actively encourage sick employees to stay home until they are free of fever (without the use of medication) for at least 72 hours (three full days) AND symptoms have improved for at least 72 hours AND at least seven days have passed since symptoms first began. Do not require a healthcare provider’s note to validate the illness or return to work of employees sick with acute respiratory illness; healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
3. Ensure that your sick leave policies are up to date, flexible, and non-punitive to allow sick employees to stay home to care for themselves, children, or other family members. Consider encouraging employees to do a self-assessment each day to check if they have any COVID-19 symptoms (fever, cough, or shortness of breath).
4. Separate employees who appear to have acute respiratory illness symptoms from other employees and send them home immediately. Restrict their access to the business until they have recovered.
5. Reinforce key messages stay home when sick, use cough and sneeze etiquette, and practice hand hygiene to all employees, and place posters in areas where they are most likely to be seen. Provide protection supplies such as soap and water, hand sanitizer, tissues, and no-touch disposal receptacles for use by employees.
6. Frequently perform enhanced environmental cleaning of commonly touched surfaces, such as workstations, countertops, railings, door handles, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label. Provide disposable wipes so that commonly used surfaces can be wiped down by employees before each use.
7. Be prepared to change business practices if needed to maintain critical operations (e.g., identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations).

Further questions can be directed to Piqua Health and Sanitation Department.

To address the “stay at home order” issued by Governor Mike DeWine that mandates all Ohioans stay in their homes for all but essential outings, the Piqua Police Department and Piqua Health Department offer the following information.

This is taking place in an effort to combat the spread of the corona virus. It is important to remind the community that their continued cooperation in following the direction of Governor DeWine’s mandates will benefit all of us as this crisis progresses.

It is emphasized that “common sense” exceptions have been included in the state order, so people will still be permitted to leave their homes for groceries, carryout meals, medical supplies and other essentials. People are permitted to go outside for physical exercise (though not at public playgrounds) and are allowed to tend to family members, friends, and pets that may be in other homes and in need of care. Essential businesses will still be open and persons will be permitted to travel to report for work and return home. Governor DeWine noted this is an order, not a suggestion, and he expects all people to comply and that all health departments and local law enforcement can enforce this order.

I can anticipate that the enforcement action with respect to the Governor’s order will typically only occur under extreme circumstances or during a blatant disregard of the order(s), which would impact public safety. Officers will not be stopping persons to address why they are out or where they are going. The philosophy of this office will be to ask everyone to voluntarily comply with the order(s) and only leave their residences on permitted outings. Officers will only intervene when it is necessary to preserve public safety and to maintain the health and public peace of the community.

The Piqua Health Department will be working with the business community to ensure compliance with the order. To remain open, a business must provide an essential service to the community as defined in the Order. The Health Department will make the interpretation as to which businesses are exempt and can remain open. All business that remain open are subject to the social distancing required measures which include: maintaining six foot distances, providing hand sanitizer, implementing operating hours for vulnerable populations, and posting online if the facility is open and how best to reach the facility. The Health Department will work in conjunction with Law Enforcement as needed to enforce the provisions of the state Order.

Public safety has to adjust to this crisis as it unfolds and we are attempting to navigate these times to provide essential services and protect our employees. We are mindful of the sacrifices that residents are making and we are trying to make common sense decisions that serve us all well. The sacrifices we make today and the coming weeks, will greatly benefit others and us in the days to come.

On March 22, 2020 the Ohio Governor, Mike DeWine, announced a Director’s Stay at Home Order signed by Dr. Amy Acton to become effective at 11:59 pm on Monday, March 23, 2020 until 11:59 pm on April 6, 2020 to help prevent the spread of COVID-19.

The Ohio Department of Health states this order prohibits gatherings of any size and prohibits all nonessential business. There are certain essential activities that are NOT prohibited as in going to the grocery store, medical care, or taking walks.

Click the photo below or this link to read the full Stay at Home Order Frequently Asked Questions released by the Ohio Department of Health.

Click this link to read the full Stay at Home Order.

It is important to note there are NO positive cases in Piqua at this time.

The Miami County Public Health has issued an update on the COVID-19 outbreak in Miami County.

At Koester Pavilion there are:
• 13 residents who are presumptive positive for COVID-19
• 2 residents with COVID-19 tests pending, both them are deceased.
• 3 residents that are hospitalized
• 3 staff that are presumptive positive for COVID-19
• Multiple additional staff members have pending tests for COVID-19

There is additional COVID-19 activity to report at Springmeade Health Center:
• 2 residents are presumptive positive for COVID-19
• 2 resident tests are pending for COVID 19
• 1 resident is hospitalized
• 1 staff member who worked at both facilities is presumptive positive for COVID-19 and is hospitalized.

There is also one additional presumptive positive case to report of COVID -19 in that is not associated with Koester or Springmeade.  This is 56-year-old male resident of Miami County with a history of travel outside the US.  This resident is not hospitalized and is isolated at home.

MCPH staff have formed a team comprised of additional staff from Ohio Department of Health, Public Health Dayton Montgomery County and Clark County Combined health District to address the tracing of contacts with these cases.

In the days and weeks ahead, the community can expect to see an increase in positive cases. This is due to test results becoming available and continued testing of those who are ill with COVID-19 symptoms. It is important to understand that this is expected and not cause for alarm. It is also important that everyone continue to follow safe social distancing practices, don’t go out if unnecessary, washing your hands frequently with soap & water, staying home if you are sick & avoiding those who are sick. This will help slow the spread of the virus and help flatten the curve.

As new information becomes available, MCPH will be providing daily updates to keep the community informed of the evolving situation.