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Trump announces reopening guidelines as HHS Secretary Azar takes Michigan tour

Before the three-phase plan can be executed, hospitals should ensure adequate screening and testing capacity as well as access to PPE.

Jeff Lagasse, Associate Editor

The Trump Administration has unveiled Guidelines for Opening Up America Again, a three-phased approach based on the advice of public health experts. These steps are intended to help state and local officials make decisions about reopening their economies, getting people back to work and preventing further widespread COVID-19 infections.

Health and Human Services Secretary Alex Azar was expected to travel to Grand Rapids, Michigan today to tour Allegan General Hospital to learn about the hospital's efforts to safely provide both routine care and COVID-related care during the pandemic. While in Grand Rapids, Azar was also expected to tour and meet with leadership at Skytron, an infection-prevention technology manufacturer.


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Each phase of the reopening process outlined in the plan is broken down into the categories of individuals, employers and "specific types" of employers.

Phase One for individuals looks much like the social distancing protocols that have been enacted in various states for months. Vulnerable people should continue to shelter in place, according to the guidelines, especially if social distancing at their work environment is not practical. When in public, individuals should maximize distance from others and avoid gatherings of more than 10 people. Non-essential travel should also be minimized.

Employers, the guidelines say, should continue to encourage working remotely, and should return to work in phases if possible, as well as close common areas consider special accommodation for employees who may be vulnerable.

A "specific type" of employer – think schools, nursing homes, gyms and bars – should make additional or altered considerations, according to the guidelines. The administration is recommending that schools and organized youth activities remain closed, and that visits to senior living facilities and hospitals should be prohibited.

Large venues can operate under strict physical-distancing protocols, as can gyms, assuming they maintain proper sanitation. Bars should remain closed.


In the second phase, individuals should continue sheltering in place, though nonessential travel can resume and gatherings of up to 50 people will be allowed. Employers should maintain the status quo of work-from-home and special accommodations for vulnerable populations.

Schools, however, will be allowed to reopen in Phase Two, and large venues can somewhat relax their physical distancing protocols. Bars can operate with diminished standing-room capacity if feasible.


In Phase Three, vulnerable individuals can resume public interactions but should still be mindful of their physical distance from others, while those who are low-risk should consider minimizing their time in crowded environments.

Employers will be allowed to resume unrestricted staffing of their worksites in this last phase. Visits to hospitals and senior care facilities can resume, large venues can operate under limited physical-distancing protocols and bars can operate with increased standing-room occupancy.

A timetable for when these phases can roll out was not outlined in the guidelines, suggesting flexibility based on how the virus spreads. Before they can take place, several pieces need to be in place, including the ability to set up efficient screening and testing sites and contact-tracing capabilities.

In terms of health system capacity, healthcare organizations will need to ensure the ability to independently supply adequate personal protective equipment and surge ICU capacity.


Waystar estimates that the cancellation of elective procedures has cost hospitals about $161 billion as of mid-May. Meanwhile, the Advisory Board has advised hospitals that they should confirm their ability to safely manage elective procedures before resuming them.

Hospitals can safely do procedures when the region is past the COVID-19 curve; when there is state and local government approval; when there are sufficient beds, supplies, including PPE, and staff; and when there is the capability to screen patients and staff for COVID-19 symptoms, the Advisory Board said.

Twitter: @JELagasse

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