How realistic is Trump’s re-opening plan and what does it really spell out for America?

President Donald Trump has presented his road-map to governors for reopening their states, gradually easing up on social distancing, but critics say it is lacking in crucial details. 

The guidelines, distributed to governors Thursday, are published under the headline ‘Opening Up America Again’ and present a three-phase approach to relaxing shutdowns state-by-state, based on case data on the ground.

Each phase of relaxed restrictions would be triggered after a state recorded a new two-week period of falling case numbers and reported symptoms – but the plan acknowledges that there could be snap-backs to harsher restrictions if cases rise again. 

Pointing to the relative success that countries such as Sweden have had with only limited social restrictions, some applauded the plan as a much-needed guide to getting the economy back on track. 

Critics argued, though, that Trump’s plan offers no specifics on how the widespread testing it calls for would be achieved by states.

President Donald Trump has presented his road-map to governors for reopening their states gradually easing up on social distancing

‘I’m concerned that this plan is laying out what needs to happen, without saying how it’s going to happen and what the federal role is,’ said Jeremy Konyndyk, former director of USAID’s Office of US Foreign Disaster Assistance under the Obama Administration, told CNN.

Konyndyk said that the 10-page plan offers no specifics on how testing capabilities, contact tracing, and access to personal protective equipment (PPE) would be ramped up to the massive levels needed to relax shutdowns.

‘We need a much more detailed implementation plan. It’s fine to say the states need much greater access to PPE. How are they going to get that?,’ he said.

‘There are these bottlenecks we are facing now that are not being resolved,’ he went on.

Experts from all sides agree that reopening parts of the country would require massive levels of testing in order to identify cases and isolate them and their contacts.

Registered medical assistant Lauiesha Plummer administers a nasal COVID-19 test to a patient at a drive-through testing site Thursday in St. Louis

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, reacts on Thursday as Trump describes his plan to re-open the country

Random testing, known as surveillance testing, would also be needed to help identify the rate of asymptomatic cases in the population.

Estimates for the national testing capability needed range from 775,000 tests a week, from the conservative-leaning think tank American Enterprise Institute, to a Harvard white paper saying a staggering 100 million weekly tests could be needed.

In total, the United States has administered 3.26 million tests to date, which comes to just 1 percent of the nation’s population. 

Irwin Redlener, a public health professor at Columbia University, argued in an op-ed for CNN that Trump’s guidelines are meaningless until testing is available on a massive scale. 

‘The governors — all 50 of them — would be wise to ignore the President’s advice until we can do at least one to two million rapid diagnostic tests per week,’ he wrote.

Redlener also said that widespread testing for antibodies and high-level contact tracing’ should be prerequisite to any relaxation of restrictions.

Trump’s plan doesn’t set out any deadlines for reaching any of its three phases, and if his critics are right, it may be difficult or impossible for any state to make it though the gauntlet without rising case numbers triggering a snap-back.

Here’s how the plan lays out its guidelines for states:

Gating criteria: 14-day period of falling cases needed to trigger each phase of the plan

Under Trump’s plan, each phase of relaxed restrictions would by triggered after a state or region recorded 14 days of falling numbers of confirmed coronavirus cases and reports of the disease’s symptoms.

The ‘gating criteria,’ as the plan calls them, also require that a state’s hospitals be able to provide care without resorting to crisis standards, and have protections in place for healthcare workers, including antibody testing.

It’s not clear that any state currently meets the gating criteria to enter Phase One, and the decision to do so would be left up to governors. 

After entering Phase One, states would have to meet the same 14-day gating criteria to enter Phase Two, and meet it again to enter Phase Three, which has the loosest restrictions. 

Phase One: Schools and bars remain closed, social gatherings limited to 10 people

The guidance in each phase affects certain employers differently. 

In Phase One, schools and organized youth activities that are currently closed, such as daycare, should remain closed. 

The guidance also says that bars should remain closed. 

However, larger venues such as movie theaters, churches, ballparks and arenas would be able to operate, but only under ‘strict’ distancing protocols. 

If possible, employees should continue to work from home, and employers should only have workers return to the job site or office in phases.

Also under Phase One, vulnerable individuals such as elderly people and those with underlying health conditions should continue to shelter in place. 

Individuals who do go out should avoid socializing in groups of more than 10 people in places that don’t provide appropriate physical distancing. Trade shows and receptions are cited as examples.

The guidelines also recommend minimizing nonessential travel during phase one.

Phase Two: Schools and bars reopen, gatherings limited to 50 people

The guidelines say nonessential travel can resume in Phase Two, however all vulnerable individuals should continue to shelter in place. 

When people go out in public, they should avoid social settings with more than 50 people when appropriate physical distancing is not practical.

Employers in Phase Two are asked to continue to encourage telework when possible and to close common areas where personnel are likely to congregate, or enforce ‘moderate social distancing protocols’.

Schools and daycare can reopen. Bars may reopen, but should restrict standing-room occupancy where appropriate.

Bars could reopen in Phase Two. Pictured: Casements Bar co-owner and bartender Gillian Fitzgerald teaches how to make a drink on a livestream video at the closed bar in San Francisco

Phase Three: Visits to nursing homes allowed and vulnerable people can resume going out in public

In this phase, vulnerable individuals can resume going out in public but should practice physical distancing. 

Visits to senior care centers and hospitals can also resume, though those who interact with residents and patients must remain diligent about following good hygiene practices, namely washing their hands frequently. 

Meanwhile, low-risk populations should consider minimizing time spent in crowded environments. Employers can resume unrestricted staffing of worksites.

There is no set timeline for moving through each of the three phases. That will be up to the governors. 

However, before a state or region moves on to the next phase, it would have to experience another 14-day decline in documented cases.

 

Read more at DailyMail.co.uk