Overview of “Opening Up America Again”

Regulation | May 07, 2020 | by Linda Couch

The White House’s “Opening Up America Again” guidelines provide three phases for the country’s reopening. State and regional areas cannot proceed to the first, second, or third reopening phase before “gating criteria” are met for a first, second, or third time, respectively.

The White House’s “Opening Up America Again” guidelines provide three phases for the country’s reopening. State and regional areas cannot proceed to the first, second, or third reopening phase before “gating criteria” are met for a first, second, or third time, respectively.

The gating criteria are related to symptoms, cases, and hospitals. For symptoms, states and regions must have a downward trajectory of influenza-like illnesses reported within a 14-day period and a downward trajectory of covid-like syndromic cases reported within a 14-day period. For cases, states and regions must have a downward trajectory of documented cases within a 14-day period or a downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests). For hospitals, states and regions must be able to treat all patients without crisis care and have robust testing program in place for at-risk healthcare workers, including emerging antibody testing.

These three “gating criteria” must be achieved each time a state or region seeks to move into the first, second, or third phase of reopening. According to the White House, state and local officials may need to tailor the application of these 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). Additionally, where appropriate, the White House says that governors should work on a regional basis to satisfy these criteria and to progress through the three phases.

According to the White House, its proposed three-phase approach is based on up-to-date data and readiness, it mitigates risk and resurgence of the coronavirus, it protects the most vulnerable, and it can be implemented on a statewide- or county-by-county basis at a governor’s discretion.

For each phase, individual and employers have guidelines to adhere to. For example, individuals must continue to practice good hygiene and employers must develop and implement appropriate policies regarding social distancing and protective equipment, temperature checks, sanitation, use and disinfection of common and high-traffic areas, and business travel. Employers should also develop and implement policies and procedures for workforce contact tracing following an employee testing positive.

Each of the three phases has its own characteristics. In phases one and two, visits to “senior living facilities” and hospitals should be prohibited, according to the White House. And, those who do interact with residents and patients must adhere to strict protocols regarding hygiene. In phases one and two, vulnerable residents” should continue to shelter in place. In phase three, “vulnerable residents” 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. Also in phase three, visits to “senior care facilities and hospitals can resume.

The White House's plan defines “vulnerable” individuals as older adults or individuals with serious underlying health conditions, including high blood pressure, chronic lung disease, diabetes, obesity, asthma, and those whose immune system is compromised such as by chemotherapy for cancer and other conditions requiring such therapy.