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Public Health Principles for a Phased Reopening During COVID-19: Guidance for Governors

Public Health Principles for a Phased Reopening During COVID-19: Guidance for Governors report cover
Caitlin Rivers; Elena Martin; Scott Gottlieb; Crystal Watson; Monica Schoch-Spana; Lucia Mullen; Tara Kirk Sell; Kelsey Lane Warmbrod; Divya Hosangadi; Amanda Kobokovich; Christina Potter; Anita Cicero; Tom Inglesby
Date posted:
April 17, 2020
Publication type:
The Johns Hopkins Center for Health Security
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As the COVID-19 pandemic continues to progress, most jurisdictions have implemented physical distancing measures to reduce further transmission, which have contributed to reductions in numbers of new cases. As chains of transmission begin to decline, along with new COVID-19 cases, there will need to be decisions at the state level about how to transition out of strict physical distancing measures and into a phased reopening.

This document provides an assessment of the risk of SARS-CoV-2 transmission in a variety of organizations and settings that have been closed during the period in which physical distancing and mitigation measures have been put in place. We outline steps to reduce potential transmission during the reopening of these organizations and settings, building on the proposed phased approach from the National Coronavirus Response: A Road Map to Reopening. Reopening businesses and other sectors represents one of many steps that will need to be taken to revitalize communities recovering from the pandemic, restore economic activity, and mitigate the unintended public health impact of the distancing measures that were necessary to confront the epidemic of COVID-19. A discussion of larger community-wide considerations for holistically enhancing recovery can be found in the Appendix.

State-level decision makers will need to make choices based on the individual situations experienced in their states, risk levels, and resource assessments, and they should do so in consultation with community stakeholder groups. Different parts of the country face varying levels of risk and have different resources available to confront these uncertainties. These decisions will need to be accompanied by clear and transparent communication to gain community engagement around the greatly anticipated reopenings. Individuals, businesses, and communities have a role to play in taking actions to protect themselves and those around them during this time. In this report, we offer a framework for considering risks regarding the likelihood of transmission and potential consequences of those transmissions. This is accompanied by proposed measures for nonessential businesses, schools and childcare facilities, outdoor spaces, community gathering spaces, transportation, mass gatherings, and interpersonal gatherings. This is followed by proposed action steps for state-level decision makers on how to utilize risk assessment findings.



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