White House Guidelines For States Reopening Seem Short On Specifics

Apr 17, 2020
Originally published on April 17, 2020 8:31 am
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RACHEL MARTIN, HOST:

At the beginning of this week, the president said he had the total authority to decide when state economies can reopen. After a lot of toing and froing, that message has changed in the past few days. The White House has now released new guidance emphasizing that it is up to governors to make that call. NPR's global health correspondent Nurith Aizenman joins us now to discuss the guidelines. Hi, Nurith.

NURITH AIZENMAN, BYLINE: Good morning, Rachel.

MARTIN: What do they actually say?

AIZENMAN: They're pretty short on specifics, so states are going to have to figure out a lot of this for themselves. That said, the proposal is that states open in three stages. To give you a flavor, phase one looks a lot like the current stay-at-home situation, except if you're not in a vulnerable category like the elderly, you can socialize in groups of less than 10 people; telework still encouraged, but employers can bring some people back in the workplace. Phase two - now it's socializing with up to 50 people, schools reopen, nonessential travel can resume. Phase three - even vulnerable people can go back in public if they keep six feet apart, and everyone's back in the workplace. But still, large venues like churches, sports arenas have to make sure people can sit at a distance. And all along, states will be keeping an eye on this system the U.S. has for flagging sudden rises in flu-like cases as a kind of early warning to alert them if, oops, the virus is spreading again.

MARTIN: Yeah. So when can states go into phase one?

AIZENMAN: Well, there are criteria that states have to meet before they can start phase one and then again before they can advance to stage two and to stage three. For instance, over the last 14 days, new confirmed COVID cases need to be trending down; so does the percentage of tests that are coming back positive and also cases of people with COVID-like or flu-like symptoms. And the state's hospitals have to be able to treat everybody and test their health care workers.

MARTIN: Are there any states that are already at that point?

AIZENMAN: Technically, maybe. We've already heard from North Dakota, Idaho, Ohio. Their governors say they'll start phased opening by May 1, and President Trump says he thinks a lot of states can do the same. But here's the issue - while public health specialists say, sure, states need to have a downward trend in their cases before they can open up, that's just one of several targets they say states need to meet, and the rest of those targets aren't in these guidelines.

MARTIN: So what are those targets? What is not in the guidelines?

AIZENMAN: Right. For one thing, the guidelines don't say how low your case count needs to get. Also in countries that managed to control their outbreaks without resorting to drastic social distancing, the consensus is what's made the difference has been to have these rapid reaction teams that can quickly identify anyone who's been infected, trace their contacts, test those contacts and isolate and quarantine as needed - you know, basically detecting and quashing any new rises in cases before it can start a whole new flare up. Because, remember, the virus is still out there, and the vast majority of us remain vulnerable to it. So public health specialists say before states can open up, they have to make sure they have enough capacity to test everyone who is sick and trace their contacts.

MARTIN: But do the guidelines say anything about how states should ramp up testing?

AIZENMAN: I mean, the guidelines do note that states need to have this testing and contact tracing ability, but they don't tell states how to determine if they have enough. And at the press conference last night, officials basically just said that, oh, that's not going to be a problem. But NPR's reporting indicates that it is still a problem. State labs and hospitals are continually telling us they can't get enough chemical reagents, can't get enough swabs, machines are breaking down. It's not the case that everyone who needs to be tested can be. So, you know, by that measure, very few, if any, states are ready to open up.

MARTIN: NPR's global health correspondent Nurith Aizenman, thank you.

AIZENMAN: You're welcome. Transcript provided by NPR, Copyright NPR.