President Trump Issues Guidelines for 'Opening Up America Again'

Trump's plan has three phases and suggests certain requirements must be met before states can move on to the next phase

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click to enlarge President Trump (right) and Vice President Pence - Photo: whitehouse.gov
Photo: whitehouse.gov
President Trump (right) and Vice President Pence

As states across the country start to put plans in place to slowly reopen their economies, President Trump has issued a series of federal guidelines for "Opening Up America Again." The White House says these can be implemented statewide or by county, based on the discretion of each governor.   

Trump's plan has three phases and suggests certain requirements must be met before states can move on to the next phase. These are based on the number of cases of COVID-19 in an area, the preparedness of hospitals and the trajectory of symptoms. 

  1. The White House says there should be a "downward trajectory of documented cases within a 14-day period" or "downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests)."
  2. Hospitals should be able to "treat all patients without crisis care" or have a "robust testing program in place for at-risk healthcare workers, including emerging antibody testing."
  3. There should be a "downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period" or "downward trajectory of covid-like syndromic cases reported within a 14-day period."

In addition, each state should be able to "quickly set up safe and efficient screening and testing" for those exhibiting both COVID and influenza-like illnesses and do contact tracing for those individuals if they test positive, as well as make sure that "sentinel surveillance sites" are screening for asymptomatic COVID cases. States should be able to provide PPE and medical equipment to health care workers and adjust for ICU surges. And they should have plans in place to protect employees in critical industries, those who work or live in high-risk facilities and those who work or use mass transit. States also need to continue to recommend social distancing and the use of cloth face masks to the public and have plans in place to mitigate any outbreaks. 

As for individuals, Trump says they should continue to follow the Centers for Disease Control and Prevention's hygiene practices for stopping the spread of COVID-19, including using cloth face masks and staying home if they feel sick.

And employers need to develop and implement best practices in regards to keeping both employees and patrons safe and healthy and follow local, state and federal regulations and guidelines surrounding COVID-19. Ohio Gov. Mike DeWine said that he and Lt. Gov. Jon Husted will be unveiling their plans in the days to come regarding these criteria; DeWine plans to start opening Ohio on May 1. 

So, with all that said, what is Phase One?

In Trump's plan, if a state or region meets all of the criteria, they can move to Phase One, which allows: 

  • Large venues (e.g., sit-down dining, movie theaters, sporting venues, places of worship) to "operate under strict physical distancing protocols."
  • Outpatient elective surgeries to resume.
  • Gyms to open as long as they adhere to strict physical distancing and sanitation.
  • Those not in vulnerable populations to resume socializing in groups of up to 10 people but "Social settings of more than 10 people, where appropriate distancing may not be practical, should be avoided unless precautionary measures are observed."
  • Under Phase One, schools and organized youth activities remain closed, telework is encouraged, visitors are not permitted in senior living facilities or hospitals and bars remain closed.

If Phase One goes well and there is not a second wave of infection and a state continues to meet the criteria, it can move on to Phase Two. In Phase Two:

  • Non-essential travel can resume.
  • Socializing can bump up to 50 people but "Social settings of more than 50 people, where appropriate distancing may not be practical, should be avoided unless precautionary measures are observed."
  • Schools and organized youth activities can reopen.
  • "Large venues (e.g., sit-down dining, movie theaters, sporting venues, places of worship) can operate under moderate physical distancing protocols."
  • Outpatient and inpatient elective surgeries can resume, as clinically appropriate.
  • Bars can reopen "with diminished standing-room occupancy, where applicable and appropriate."
  • Visitors to senior facilities and hospitals should still be prohibited, telework should still be encouraged and vulnerable populations should still stay at home.

If Phase Two goes well and there isn't an outbreak, Phase Three can take place. Phase Three says:

  • Vulnerable individuals may resume activities as long as they continue to practice precautionary measures and social distancing.
  • Low-risk populations should not spend large amounts of time in crowded environments.
  • Work may resume as normal at all worksites.
  • Visits to senior care facilities and hospitals can resume.
  • Large venues can operate with limited social distancing.
  • Bars can remain open with "increased standing room occupancy, where applicable."

So perhaps the shortest amount of time a state could take to get to Phase Three would be 28 days, if they are currently documenting a decrease in cases for Phase One — for example if Ohio is using this time to monitor a decrease in cases over a 14 day period to reopen May 1 under the Phase One conditions. 

The CDC also has its own landing page dedicated to resources to help get America open and keep it open. It says, "In order to get and keep America open states, tribes, localities, and territories must be able to quickly identify new cases, break chains of transmission, and protect first responders and health care workers from infection." And it provides guidance on topics including infection prevention and control, contract tracing and community mitigation. 


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