President Trump and the White House COVID-19 Task Force members today spoke of the newly-released White House guidelines for reopening America.

The guidelines include a three-step process, but Dr. Debra Birx made it clear that before any state could even get to Step One, they had to meet certain criteria:

SYMPTOMS

Downward trajectory of influenza-like illnesses reported within a 14-day period AND downward trajectory of covid-like syndromic cases reported within a 14-day period  (note, Hawaii is not there yet, Gov. Ige said in his Thursday afternoon press conference)

CASES

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)

HOSPITALS

Treat all patients without crisis care AND robust testing program in place for at-risk healthcare workers, including emerging antibody testing

Dr. Birx said local and state officials might need to tailor the application of the criteria to local circumstances (e.g., metropolitan areas that have suffered severe COVID outbreaks, rural and suburban areas where outbreaks have not occurred or have been mild).

The White House also suggested Governors should work on a regional basis regarding these criteria, and the phases.  Right now, at least three coalitions of governors have their states working together on regional guidelines:

California, Oregon, and Washington

Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin

New York, New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and    Massachusetts.

The guidelines assign responsibilities for readiness to advance to the first phase to the state, to employers, and to individuals.  For states, examples are to have the ability to quickly set up safe and efficient screening and testing sites, the ability to trace contacts of those with COVID-19, and do “sentinel surveillance” (which Hawaii is doing for people with flu-like symptoms to see if they really do have COVID-19, to provide a better idea of the spread).   States have to also ensure hospitals have adequate amounts of Personal Protective Equipment and medical equipment to handle any surge in demand.

For businesses, they need to have social distancing and hygiene policies, among other things.  And for individuals, all need to practice good hygiene and frequent hand washing, disinfect surfaces frequently, and practice social distancing.

The Guidelines detail what could happen in each phase, including in Phase One, continued social distancing, vulnerable individuals staying at home, and social gatherings limited to 10 or fewer people.  People should work from home when possible, schools closed now should stay closed, and nobody should visit people in senior care homes or hospitals.  Gyms and large venues could reopen with social distancing.

In Phase Two, social gatherings could expand to 50 people but with continued social distancing, non-essential travel could resume, schools could begin to reopen, and employers should continue to encourage working from home but for those in the business setting, make the physical environment conducive to social distancing.

In Phase Three, businesses and schools could begin operating more normally, but social distancing would have to be considered.

The entire set of guidelines is here.