As reopening the economy is an inflection point that could have many consequences to both the economy and the health and well-beings of many, important measures cannot be taken lightly. According to the White House's plan for opening up America post Coronavirus COVID-19 pandemic, states and regions must satisfy three criteria before proceeding to the “Unpause” phase:
Consecutive decline of COVID-like illnesses: there must be a downward trajectory of flu-like AND COVID-like illnesses within a consecutive 14 days period, these are cases that have similar symptoms to COVID-19 but are not tested and confirmed by a lab test. This means that the “curve” has to go down consistently before we could decide that the risk for a second peak is unlikely.
Consecutive decline of confirmed COVID-19 cases: there must be a downward trajectory of documented Coronavirus COVID-19 cases OR a downward trend of people tested positive for COVID-19 in a period of 14 days.
Hospital capacity and readiness: hospitals must be able to treat all patients without having to utilize crisis mode AND must have a robust testing program in place to test health workers for COVID-19, including the use of antibody (blood) test.
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Because the Coronavirus spreads locally and in communities, reopening plans will also have to be hyper-localized. For example, in New York City, reopening could happen first in Lower Manhattan where the Coronavirus has less of an impact compared to Queens and Brooklyn.
To ensure there will not be another crisis, before reopening, each state and city must have three things in place:
Be able to test and trace contacts for COVID+ cases: there must be accessible test sites for symptomatic individuals and have the capability to conduct contact tracing for those with positive results.
Have enough PPE and hospital beds: state and local government must be able to supply enough PPE for care facilities and hospitals and have enough ICU beds to handle dramatic surges.
Have a plan in place to protect essential workers: cities must have a mitigation plan to protect health and public workers. Citizens are informed to practice physical distancing and face covering.
What are the phases of reopening?
There are three phases of reopening specific to each state and city depending on the level of readiness:
Phase 1 - minimal reopening: states and cities that meet three criteria for the first time could proceed to the initial reopening. All high-risk individuals should still be shelter-in-place, visits to senior care are not recommended, telework, and strict social distancing are still enforced. Crowd size is limited to 10 people.
Phase 2 - reopen with physical distancing: if there is no evidence of a rebound, cities could proceed to phase 2 and relax stay at home orders. In this phase, most businesses could start to operate again with strict physical distancing protocols. Crowd size is limited to 50 people.
Phase 3 - resume to normal: if there is no evidence of a rebound for the third time, vulnerable individuals could resume public interactions, and businesses could restore to a normal level of staffing.
How long will each reopening phase last?
Depends on the state and local government. According to the White House's guidelines, each observation period is 14 days. This means each phase could last up to a month or more.
From phase 1 to phase 3, we could expect there will be a gradual transition from strict social and physical distancing to complete normal in a period of 3-6 months contigent on whether there will be a second peak.
When will NYC reopen?
Current cases in NYC
In NYC, there have been a total of 132,467 cases and 10,022 deaths. The Bronx and Staten Island have the highest number of cases adjusted to their population size. The most hospitalizations and deaths have been in the age group of individuals 75 and older. It is likely that the actual statistics are higher than these numbers, as there are many unreported cases and individuals who are not getting tested.
Current state of hospital utilization
According to data collected by covid19.healthdata.org, the United States had its peak resource use about 7 days ago, on April 14th 2020. New York had its peak resource use on April 15th.
It appears as if the demand on hospitals will be slowly declining over the next few weeks; however, there is some uncertainty. According to the report, it may be possible for social distancing to be slowly relaxed in June. Reopening New York will be a slow process and will require some precautionary measures, such as more extensive testing and avoiding large gatherings.
Current state of testing readiness
The state of New York has 28 testing facilities that are testing thousands of people each day. However, New York does not currently have enough testing kits to test those who are asymptomatic or low risk.
Officials are working on increasing the volume of available tests. There is also a newly developed antibody test that checks for immunity to the virus (link to our article). This test is currently given to individuals who had symptoms of tested positive for COVID-19. It is important that these tests are given at least 3 weeks after symptoms begin, since it can take a few weeks for the body to produce IgG antibodies.
When happen to individuals, employers, restaurants, bars, gyms, and schools during each phase?
In phase 1, individuals will be permitted to go out in public while staying the maximum distance from others. It’s highly suggested to not socialize in groups greater than 10. Non-essential travel should be limited.
In phase 2, individuals should still remain the maximum distance from others while in public and should avoid social settings greater than 50. Additionally, non-essential travel may resume.
In phase 3, individuals should consider minimizing social gatherings.
In phase 1, telework should be encouraged and common areas should be closed. Non-essential travel should be limited. Special accommodations should be strongly considered for the vulnerable population.
In phase 2, telework is still encouraged as well as accommodations for the vulnerable population. Common areas should remain close.
In phase 3, unrestricted staffing may remain on worksites.
In phase 1, vulnerable individuals should continue following shelter-in-place order.
In phase 2, they should continue to shelter in place and their family members must remain cautious in regard to their safety and health.
In phase 3, vulnerable populations can resume public interactions, but should practice physical distancing, minimizing exposure to social settings.
Sitting down venues could start to operate with strict physical distancing guidelines in phase 2 and resume to normal operations in phase 3.
Equinox, NYSC, Blink, Crunch Fitness could open again in phase 1 with strict physical distancing and sanitation protocols (continuous swiping, etc)
Allowed to reopen in phase 2. We will likely see public schools reopen first in counties with lower Coronavirus cases.
Can operate with standing room occupancy in phase 2. We will unlikely to see crowded bars like pre-COVID for a long time after phase 3.
What should I do in the meantime?
Life could be disruptive during quarantine, not being able to see your family and friends is hard. It is neccessary to pracice social distance, observe shelter-in-place order, and try to maintain your emotional health.