The plan for reopening America outlines a three-phased approach for reducing community mitigation measures while protecting vulnerable populations. The phased approach can be implemented statewide or community-by-community at governors’ discretion. The guidelines propose the use of six “gating” indicators to assess when to move through from one mitigation phase to another.
Decisions to move between phases should also consider the public health capacity of the jurisdiction based on the criteria listed below. Other epidemiologic data sources available locally can be used to corroborate trends seen in core epidemiologic gating criteria. Special consideration should be given to infections identified in populations and settings such as healthcare personnel, patients in healthcare facilities (e.g., nursing homes, dialysis centers, long-term care facilities), and residents of congregate living settings (e.g., prisons, youth homes, shelters), underserved populations, and people of racial and ethnic minority groups (e.g., African Americans, American Indians, Alaska Natives) at higher risk of disease. Incidence and trajectory (increasing versus decreasing) of COVID-19 illnesses in the surrounding region should also be considered.
While some communities will progress sequentially through the reopening phases, there is the possibility of recrudescence in some areas. Given the potential for a rebound in the number of cases or level of community transmission, a low threshold for reinstating more stringent mitigation standards will be essential. The decision to reinstate community mitigation strategies will undoubtedly be very difficult and will require careful thought to define an evidence-based monitoring strategy and specific guidance for these decisions.
Technical Support for States
As part of the “Whole-of-Government” public health effort, CDC is providing states and other jurisdictions with technical assistance regarding testing, surveillance data collection and reporting, contact tracing, infection control, and outbreak investigation. Implementation of these activities is supported by the Paycheck Protection Program and Health Care Enhancement Act, which includes $11 billion to be awarded, within 30 days, directly to states, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes to develop, purchase, administer, process, and analyze COVID-19 tests, conduct surveillance, trace contacts, and related activities. Listed below are additional strategies CDC is using to strengthen the capacity of state, tribal, local, and territorial (STLT) health departments to fight against COVID-19. This technical assistance is essential to ready the nation to re-open and minimize future COVID-19 outbreaks in jurisdictions across the country.
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