A report from an expert at Johns Hopkins aims to help the governor navigate the way to resumption

Nothing is clear about the coronavirus pandemic. However, it does not restart within a day. It has taken weeks to months, or longer, and it looks different in all states, and perhaps cities and towns.

Image caption: “Public Health Principles for Phased Resumption During COVID-19: Guidance for Governors” was released by Johns Hopkins Health and Safety Center on Friday 17 April.Download the report (PDF)

A new report released on Friday, Johns Hopkins Health and safety center It outlines potential pathways for transitioning from strict physical distance measures to a phased restart of the entire organization and a central setting for the functioning and vitality of communities nationwide.

Report, Public Health Principles for COVID-19 Phased Resumption: Guidance for GovernorPresents a framework for assessing the risk of viral infections associated with reinstatement of unwanted businesses, schools and daycare facilities, outdoor spaces, public transport, gatherings, and interpersonal gatherings.

“It’s an effort to provide some of the basis for decision making,” said Caitlin Rivers, a senior researcher at the Health and Safety Center and one of the report’s co-authors. “We don’t say’this is in, it’s out ‘, because many of them change, but we want to provide support when decision makers start thinking through these decisions. . “

This report builds on the phased approach described in the American Enterprise Institute’s previous report, “National Coronavirus Response: A Road Map to Reopening,” published last month. The report outlines the four phases and identifies the capacity required in each phase and the triggers needed to go from one phase to the next.

Rivers, who also co-authored an earlier report, talked with Bloomberg School of Public Health writer Jackie Powder about how the US governor would begin to tackle the complex decision-making process for resumption.

What are the key community health and safety considerations in the resumption process?

We try to assess the risk of infection at a high level based on contact strength. This is how closely people make contact in a particular setting and number of contacts. Where there are many people, the risk is high. Then consider the possibility of changes. In some places there is not much that can be done to actually achieve physical distances, and in others it is more feasible, which is another aspect to consider.

Give examples of restarting in different types of spaces.

In a shared space such as a restaurant or workplace, it is possible to limit the number of people who can enter the room. You can also set up physical barriers. I saw a photo of an Asian restaurant and there is a plexiglass between the diner so I can share the table. These types of interventions are modifications that reduce risk. However, it becomes more difficult to implement, for example, physical distance measures, as young children, for example, cannot actually adhere to those principles.

What advice would you give to the governor who has to restart?

Today, resuming economic activity and financially supporting people is a very urgent priority, but the last thing we want to do is create the situation we need to be at home. We don’t want it to happen again. This is a very important phase, so be careful about how you restart it.

It’s a good idea for the governor to do some movements when the time comes and wait and see what happens. I know that the changes don’t show up in the data for a couple of weeks, so I have to wait at least for a while to see if I’ve done anything to resume sending. And if you find out, you’ll have to stop or return to a physical distance. You shouldn’t continue new community activities, so be really careful and proceed.

Although the report is aimed at governors, it emphasizes the need to utilize a diverse group of stakeholders in making resumption decisions. Why is it important?

Each community has different capacities and occurrences. Some communities have very good resources in their healthcare system and public health sector, so they may be in a position to handle a slightly higher level of infection. Resources may be low elsewhere, so you should lower the send level before you consider restarting. The governor must have that context and background to make the right decisions.

The report covers not only corporate, school and retail settings, but also personal events such as birthdays, weddings and funerals. How do they fit in the photo?

For the average person, one of the most difficult parts of this situation is uncertainty, not sure when to start planning these events, or that big trip you put off. This is not to minimize the actual suffering of people affected by the virus and their families, but we understand that its uncertainty is truly disturbing. The truth is that no one knows what these timelines are. There are many potential futures and it is hard to say in which direction to go. Therefore, for the time being, we must continue to live with some of that uncertainty.

Does restarting necessarily mean more transmission of the virus?

Our hope, shown in the Roadmap for Resumption, is to be able to shift from physical distances at the community level to case-based interventions, and that shift becomes the mechanism used to control infections. However, as you start to have more contacts in the community and spend more time in the community, you should expect to have an opportunity for infection. It is right to be prepared for that possibility.

So what about a way to resume, rather than a full return to normal?

We still need to take steps to reduce our personal risk and the risk to others in the community. Vulnerable adults, people with underlying illnesses, and the elderly need to limit their activities in the community. We are already being asked to wear non-medical cloth masks as we spend more time in the community, even when shopping for groceries and going to pharmacies, and that will continue. . There are some activities that are not available to us, at least in the near future. It’s a large gathering. In the near future, you’ll never see a stadium full of people or a big concert.