President Trump’s Coronavirus Task Force Releases Data-Driven, Governor-Led Plan to Reopen America in 3 Phases

President Donald Trump on Thursday released a plan titled “Opening Up America Again” that provides guidelines for states to gradually reopen depending on the local conditions of the coronavirus (COVID-19) pandemic. The 18-page plan developed by the White House Coronavirus Task Force, including Dr. Deborah Birx and Dr. Anthony Fauci, provides recommendations for states & regions to adopt as they pursue the reopening of their communities and satisfy certain conditions. 

GATING CRITERIA

The plan proposes “gating criteria” for states and/or regions to satisfy before proceeding to the first phase. States and/or regions that satisfy them for a second time advance the second phase, and for a third time before the third phase. The criteria include:

• Downward trajectory of influenza-like illnesses reported within a 14-day period.
• Downward trajectory of COVID-like syndromic cases reported within a 14-day period.
• Downward trajectory of documented cases within a 14-day period, or downward trajectory of positive tests as a percentage of total tests within a 14-day period (and a flat or increasing volume of tests).
• Hospital capacity to treat all patients without crisis care.
• Robust testing program in place for at-risk healthcare workers, including emerging antibody testing.

State and local officials may need to tailor these criteria to local circumstances, such as in metropolitan areas that have gone through severe COVID outbreaks, or rural & suburban areas where outbreaks have been mild or haven’t occurred. Where appropriate, governors are encouraged to work on a regional basis to satisfy these criteria.

Additionally, states are tasked with several preparedness responsibilities in the gating criteria phase:

TESTING & CONTACT TRACING: 

• The ability to quickly set up safe & efficient screening & testing sites for symptomatic individuals & trace contacts of COVID+ results. 
• Ensure sentinel surveillance sites are screening for asymptomatic cases & contacts for COVID+ results are traced (sites at locations serving older individuals, lower-income Americans, racial minorities, and Native Americans).

HEALTHCARE SYSTEM CAPACITY:

• Ability to quickly & independently supply sufficient Personal Protective Equipment & critical medical equipment to handle dramatic surge in need.
• Ability to surge ICU capacity.

PLANS:

• Protect the health & safety of workers in critical industries.
• Protect the health & safety of those living & working in high-risk facilities (e.g. senior care facilities).
• Protect employees & users of mass transit.
• Advise citizens regarding protocols for social distancing & face coverings.
• Monitor conditions & immediately take steps to limit & mitigate any rebounds or outbreaks by restarting a phase or returning to an earlier phase, depending on severity.

PHASE ONE

INDIVIDUALS:

• All vulnerable individuals (including elderly individuals & people with serious underlying health conditions) should continue to shelter in place. Members of households with vulnerable residents should be aware that they could carry the virus back home after returning to work or other places where distancing isn’t practical. Precautions should be taken to isolate from vulnerable residents.
• All individuals should maximize physical distance from others when in public places (e.g. parks, outdoor recreation areas, shopping areas). Social settings of more than 10 people where appropriate distancing isn’t practical should be avoided unless precautions are observed.
• Avoid socializing in groups of 10 people in circumstances that don’t readily allow for physical distancing (e.g. receptions or trade shows).
• Minimize non-essential travel and adhere to Centers for Disease Control & Prevention (CDC) guidelines regarding isolation following travel.

EMPLOYERS:

• Continue to encourage telework whenever possible and feasible with business operations.
• Return to work in phases if possible.
• Close common areas where personnel are likely to congregate and interact, or enforce strict social distancing protocols.
• Minimize non-essential travel & adhere to CDC guidelines regarding isolation following travel.
• Special accommodations should be strongly considered for personnel who are members of a vulnerable population.

SPECIFIC EMPLOYERS:

• Schools & organized youth activities (e.g. daycare, camp) that are currently closed should remain closed.
• Visits to senior living facilities & hospitals should be prohibited. Those who do interact with residents & patients must adhere to strict protocols regarding hygiene.
• Large venues (e.g. sit-down dining, movie theaters, sporting venues, places of worship) can operate under strict physical distancing protocols.
• Elective surgeries can resume, as clinically appropriate, on an outpatient basis at facilities that adhere to Centers for Medicare & Medicaid Services (CMS) guidelines.
• Gyms can open if they adhere to strict physical distancing & sanitation protocols.
• Bars should remain closed.

PHASE TWO

INDIVIDUALS:

• All vulnerable individuals (including elderly individuals & people with serious underlying health conditions) should continue to shelter in place. Members of households with vulnerable residents should be aware that they could carry the virus back home after returning to work or other places where distancing isn’t practical. Precautions should be taken to isolate from vulnerable residents.
• All individuals should maximize physical distance from others when in public. Social settings of more than 50 people, where appropriate distance may not be practical, should be avoided unless precautionary measures are observed.
• Non-essential travel can resume.

EMPLOYERS:

• Continue to encourage telework whenever possible and feasible with business operations.
• Close common areas where personnel are likely to congregate and interact, or enforce moderate social distancing protocols.
• Non-essential travel can resume.
• Special accommodations should be strongly considered for personnel who are members of a vulnerable population.

SPECIFIC EMPLOYERS:

• Schools & organized youth activities (e.g. daycare, camp) can reopen.
• Visits to senior living facilities & hospitals should be prohibited. Those who do interact with residents & patients must adhere to strict protocols regarding hygiene.
• Large venues (e.g. sit-down dining, movie theaters, sporting venues, places of worship) can operate under moderate physical distancing protocols.
• Elective surgeries can resume, as clinically appropriate, on an outpatient and in-patient basis at facilities that adhere to Centers for Medicare & Medicaid Services (CMS) guidelines.
• Gyms can remain open if they adhere to strict physical distancing & sanitation protocols.
• Bars can operate with diminished standing-room occupancy where applicable & appropriate.

PHASE THREE

INDIVIDUALS:

• Vulnerable individuals can resume public interactions, but should practice physical distancing, minimizing exposure to social settings where distancing may not be practical, unless precautionary measures are observed.
• Low-risk populations should consider minimizing time spent in crowded environments.

EMPLOYERS:

• Resume unrestricted staffing of worksites.

SPECIFIC EMPLOYERS:

• Visits to senior living facilities & hospitals can resume. Those who interact with residents and patients must be diligent regarding hygiene.
• Large venues (e.g. sit-down dining, movie theaters, sporting venues, places of worship) can operate under limited physical distancing protocols.
• Gyms can remain open if they adhere to standard sanitation protocols.
• Bars can operate with increased standing-room occupancy where applicable.

— Eric Revell

(Photo Credit: White House via Flickr / Public Domain)