Last week Friday, Americans were supposed to get some guidance from the CDC’s plan for reopening American businesses. The Centers for Disease Control and Prevention had drafted a 17-page report which was meant to help local authorities figure out when the time was right to reopen restaurants and other public-facing businesses.
Americans didn’t get the guidance. That’s because, for reasons that aren’t yet clear, the Trump administration told scientists from the CDC that the report would “never see the light of day.” This is a problem for many businesses and entities that are required to use the CDC’s guidelines in this case, per former FDA Commissioner Scott Gottlieb:
Irony around CDC not issuing it’s reopen guidance, whatever the reason, is a lot of business literally can’t reopen without it because CDC is a de-facto regulator in a public health crisis. CDC must publish its umbrella document to publish more detailed industry specific guidance
— Scott Gottlieb, MD (@ScottGottliebMD) May 7, 2020
But all is not yet lost. Thanks to the Associated Press, we at The Prepared were able to obtain a copy of the CDC’s reopening plan. We’ve read it, and so have many health officials. It’s a good plan, and the United States needs a plan if we want to reopen without inducing mass deaths and waves of lockdowns that might already be inevitable.
The choice we have before us is not about staying locked down forever or “killing grandma.” The United States, like all countries, will have to reopen eventually. The choice is between doing something like the CDC’s reopening plan or killing hundreds of thousands of people.
Here are the highlights of the CDC’s plan, which could still save lives if it’s used by the many businesses, schools, and churches that are reopening without much in the way of guidance.
The CDC reopening plan’s general structure
The CDC reopening plan was designed to work alongside and expand on the White House’s “Opening Up America Again” guidelines. For any business or organization to open, it would have to go through a series of phases.
Perhaps in a hint to how the CDC is thinking about transmission, each of the reopening phases involves restrictions for people who live in areas of high transmission. In every case, if someone lives where COVID-19 is spreading rapidly, they’re expected to stay home or distance themselves more strongly.
In phase one, all organizations were meant to ask themselves variations on the following questions:
- Are you in a community that no longer requires “significant mitigation?”
- Will your reopening comply with state and local orders?
- Will you be ready to protect people who are most vulnerable to severe illnesses?
If any response to those questions is “no,” the organization is not ready to reopen. If every answer is “yes,” organizations should move on to step two.
Phase two involves recommended safety actions like hand-washing and face-coverings, sanitation and ventilation, social distancing, and staff training.
Phase three requires ongoing monitoring of symptoms and creating plans for potential illness.
The CDC reopening plan directs businesses to reopen only after they met all those safeguards. Then businesses would be ready to serve the public safely and close down safely in case of another surge.
A plan for childcare, schools, and day camps
Under the drafted plan, there are supposed to be multiple safeguards for reopening businesses, schools, and organizations that serve children. The guidance to schools, daycares, and day camps included:
- Clean items that can be disinfected often, and eliminate any soft, plush toys that can’t be cleaned.
- Open windows and doors and use fans to ensure proper ventilation.
- Limit the people who work with children. Keep classes together in self-isolating pods. Close common areas, restrict visitors, and cancel field trips. Stagger drop-off and pick-up times.
- Keep children’s belongings separated and send them home each day for cleaning. Reduce sharing of art supplies, toys, books, etc.
- Distribute food in pre-packaged containers and don’t share food or utensils.
- Check every child’s temperature and do a quick health check upon arrival.
- Disinfect school busses.
As it becomes safer to be in public (i.e. when we have a vaccine or other therapies available or when community spread is reduced), the CDC plan says it’s possible to relax these guidelines.
Schools will slowly reopen as they’re able, with access given first to the children of essential workers and those who live closest to the schools.
A plan for faith communities
The CDC reopening plan recommends that faith organizations hold virtual services and provide drive-in options. Even at phase three of reopening, religious organizations should continue to make it possible for vulnerable populations to watch video streams or drive in for services.
The CDC also provided specific safety and monitoring actions for faith organizations:
- Everyone should wear a face covering, except for kids younger than 2 and people who have a hard time breathing.
- Add additional services so congregants, clergy, staff, and volunteers can maintain social distancing and reduce the risk of contracting the coronavirus.
- Space out seating so each household is at least six feet apart.
- Think about limiting capacity for events like weddings, funerals, religious education, support groups, and studies.
- Think about putting choirs and bands on hold for religious services.
- Visit congregants virtually instead of entering homes or hospitals.
- Minimize touching. Make the collection box stationary instead of passing it around, and photocopy or project songs and prayers.
A plan for businesses
The CDC reopening plan’s guidelines for places of work largely match up with the recommendations for schools and religious organizations. They’re also quite similar to the guidelines we’ve been hearing about since the pandemic began — social distancing, disinfection, cloth face coverings, and no-touch trash cans.
But in the CDC’s drafted plan, officials took time to emphasize that the main responsibility of workplaces is to protect their most vulnerable employees as the United States reopens:
As workplaces consider re-opening it is particularly important to keep in mind that some workers are at higher risk for severe illness from COVID-19. These vulnerable workers include individuals over age 65 and those with underlying medical conditions. Such underlying conditions include, but are not limited to, chronic lung disease, moderate to severe asthma, hypertension, severe heart conditions, weakened immunity, severe obesity, diabetes, liver disease, and chronic kidney disease that requires dialysis. Vulnerable workers should be encouraged to self-identify, and employers should avoid making unnecessary medical inquiries. Employers should take particular care to reduce vulnerable workers’ risk of exposure to COVID-19, while making sure to be compliant with relevant ADA and ADEA regulations.
The CDC’s reopening plan recommends continuing telework when possible, especially for the most vulnerable workers. It also recommends minimizing contact between vulnerable workers and customers and other employees. Perhaps instead of working at the cash register, a vulnerable employee could restock shelves.
In phase one (which is, by all accounts, where we are now), businesses can reopen as long as they can ensure ‘strict’ social distancing and disinfection. The CDC recommends that vulnerable workers shelter in place.
A plan for reopening bars and restaurants
The CDC offers a three-phase plan for bars and restaurants as long as facilities are able to implement proper social distancing and cleaning measures.
In phase one, bars stay closed and restaurants stick with takeout, drive-through, and delivery options. Restaurants are advised to limit the employees in shared spaces like kitchens and break rooms.
In phase two, bars can reopen. Restaurants can too, with limited capacity. The CDC recommends outdoor seating, ordering ahead, and using applications to check wait times.
Phase three is basically the same, but bars can provide more standing room and restaurants can open more fully.
A plan for public transit
It’s vital that we figure out a way to reopen public transit safely so Americans can get to and from the jobs listed above. At first, the CDC reopening plan recommends that only critical infrastructure workers be allowed to use public transportation. In phases two and three, the CDC expects riders to engage in social distancing.
On a high level, the CDC recommends reevaluating bus routes to keep areas of high transmission away from areas of low transmission. That should be the first step, and one that will likely require reevaluation as time goes on.
As much as possible, operators and riders should stay separate. The CDC recommends no-touch trash cans, doors, and payment methods. Transit lines should increase service to spread people out between vehicles. Bus passengers should enter and exit from the back so they don’t have to come in contact with operators.
Questions remain, but it’s still worth using
As of right now, it’s unclear why the plan was shelved. We know that the White House asked the CDC to make the reopening plan to work in concert with the phased “Opening Up America Again” guidelines the Trump administration released in April.
One source told CNN that the CDC guidelines we reference above were never cleared for release to the public. The CDC already lists some of these guidelines on its website, but not all in the same place.
It’s important to get this scientific information out to local governments and business leaders so the United States can reopen as safely and as quickly as possible. Our hope is that these local governments will follow the guidelines on their own, even if the federal government won’t give those instructions.