SPECIAL REPORT: Examining the Plan on ‘Opening Up America Again’
On April 16, 2020, the Trump Administration released its initial guidance proposals for reopening the U.S. in three phases. Below is a brief summary of the guidance proposals and recommended measures for individuals and employers.
Proposed State and Regional Gating Criteria
The proposed guidelines contain state and regional gating criteria that should be satisfied prior to proceeding to phased openings, which are broken down in three main parts as follows:
1. A reduction in symptoms. There is to be (1) a downward trajectory of influenza-like illnesses reported within a 14-day period; and (2) a downward trajectory of COVID-19-like syndromic cases reported within a 14-day period.
2. A reduction of cases. There is to be (1) a downward trajectory of documented cases within a 14-day period; or 2) a downward trajectory of positive tests as a percent of total tests within a 14-day period with flat or increasing volume of tests.
3. Hospital preparedness. Hospitals should be in a position to (1) treat all patients without crisis case; and 2) have a robust testing program in place for at-risk healthcare workings, including antibody testing.
The guidance also recognizes that state and local officials may need to tailor the application of these aforementioned criteria to local circumstances. The guidance also suggests that governors should work together on a regional plan to satisfy the criteria, as appropriate.
Core State Preparedness Responsibilities
The U.S. guidelines also detail preparedness responsibilities for each state. For testing and contact tracing, states should have safe and efficient screening for testing for symptomatic individuals, the ability to test syndromic influenza-like illness persons for COVID-19 and trace contacts for individuals testing positive for COVID-19, and establish surveillance and tracing for asymptomatic cases and contacts for COVID-19 positive results. For healthcare system capacity, states should have the ability to quickly and independently supply PPE and critical medical equipment to handle potential surges and the ability to surge ICU capacity.
The U.S. guidelines also recommend that states develop the followings plans. States should have plans to protect the health and safety of workers in critical industries; protect the health and safety of those living and working in high-risk facilities; protect employees and users of mass transit; advise citizens regarding protocols for social distancing and face coverings; and monitor conditions and immediately take steps to limit and mitigate any rebounds or outbreaks by restarting a phase or returning to an earlier phase, depending on severity.
Guidelines for All Phases: Individuals
Good Hygiene
· Wash your hands with soap and water or use hand sanitizer, especially after touching frequently used items or surfaces
· Avoid touching your face
· Sneeze or cough into a tissue, or the inside of your elbow
· Disinfect frequently used items and surfaces as much as possible
· Strongly consider using face coverings while in public, and particularly when using mass transit.
People Who Feel Sick Should Stay Home
· Do not go to work or school
· Contact and follow the advice of your medical provider
The guidelines also recommend continued adherence to state, local guidance, and CDC guidance, particularly with respect to face coverings.
Guidelines for All Phases: Employers
The U.S. guidelines recommends employers to develop and implement appropriate policies, in accordance with Federal, State, and local regulations and guidance, and informed by industry best practices, regarding:
· Social distancing and protective equipment
· Temperature checks
· Testing, isolating, and contact tracing
· Sanitation
· Use and disinfection of common and high-traffic areas
· Business travel
Employers should monitor its workforce for indicative symptoms, and not allow symptomatic people to physically return to work until cleared by a medical provider. Employers should also develop and implement policies and procedures for workforce contact tracing following an employee COVID-19 positive test.
Phase One – For States and Regions that Satisfy the Gating Criteria
Individuals
All vulnerable individuals should continue to shelter in place. Members of households with vulnerable residents should know that their return to work or other environments that do not practice social distancing could carry the virus home. Vulnerable residents should take precautions to be isolated from members leaving the household. Individuals in public should continue practicing social distancing. Individuals should avoid social settings with more than 10 people if social distancing is not observable. Non-essential travel should be kept to a minimum, and CDC guidelines should be followed.
Employers
Employers are encouraged continuing telework, whenever possible and feasible with business operations. Employers are encouraged return to work in phases where possible. In the work place, employers should close common areas where personnel are likely to congregate and interact, or enforce strict social distancing protocols. Employers should also minimize non-essential travel and adhere to CDC guidelines regarding isolation following travel. Employers are also encouraged to consider special accommodations for personnel that are considered to be part of the vulnerable population.
Specific guidance relating to certain employers:
· Schools and organized youth activities (e.g., daycare, camp) that are currently closed should remain closed.
· Visits to senior living facilities and hospitals should be prohibited. Those who do interact with residents and 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 CMS guidelines.
· Gyms can open if they adhere to strict physical distancing and sanitation protocols.
· Bars should remain closed.
Phase Two – For States and Regions with No Evidence of a Rebound and that Satisfy the Gating Criteria a Second Time
Individuals
All vulnerable individuals should continue to shelter in place. Members of households with vulnerable residents should know that their return to work or other environments that do not practice social distancing could carry the virus home. Vulnerable residents should take precautions to be isolated from members leaving the household. Individuals in public should continue practicing social distancing. Individuals should avoid social settings with more than 50 people if social distancing is not observable. Non-essential travel can resume.
Employers
Employers are encouraged continuing telework, whenever possible and feasible with business operations. In the work place, employers should close common areas where personnel are likely to congregate and interact, or enforce strict social distancing protocols. Non-essential travel can resume. Employers are also encouraged to consider special accommodations for personnel that are considered to be part of the vulnerable population.
Specific guidance relating to certain employers:
· Schools and organized youth activities (e.g., daycare, camp) can reopen.
· Visits to senior living facilities and hospitals should be prohibited. Those who do interact with residents and 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 basis at facilities that adhere to CMS guidelines.
· Gyms can open if they adhere to strict physical distancing and sanitation protocols.
· Bars may operate with diminished standing-room occupancy, where applicable and appropriate.
Phase Three – For States and Regions with No Evidence of a Rebound and that Satisfy the Gating Criteria a Third Time
Individuals
Vulnerable individuals can resume public interactions, but should continue practicing social distancing or minimizing social settings where social distancing is not feasible. Even low risk populations should minimize crowded environments.
Employers
Employers may resume unrestricted staffing of worksites.
Specific guidance relating to certain employers:
· Visits to senior living facilities and hospitals can resume. Those who do interact with residents and 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 limited physical distancing protocols.
· Elective surgeries can resume, as clinically appropriate, on an outpatient basis at facilities that adhere to CMS guidelines.
· Gyms can remain open if they adhere to standard sanitation protocols.
· Bars may operate with increased standing-room occupancy, where applicable.
More information on the Guidelines for ‘Opening Up America Again’ on the White House’s website at: https://whitehouse.gov/openingamerica/.
Please be aware that this information contained herein is current as of the date of the release of this Special Report and is subject to further changes and modifications by federal and local officials. If you have any questions or need additional information, please contact us.
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