4 benchmarks that make it safe for a state to reopen during the coronavirus pandemic

Most people across the country have been shut in their house since the beginning or middle of March. It’s natural to be thinking, when will this be over? When can I go to the park again? Will I ever sit at a restaurant again?

Although everything across the country shut down virtually simultaneously, that is not likely to be the case for how things will reopen. In fact, 37 states have already begun to reopen, ten are experiencing regional reopening, one is reopening soon, and only four are still shut down.

As of May 20, more than half of U.S. states have reopened their economy in a meaningful way and all 50 states have reopened to some degree, according to the New York Times.

As some states open up beaches and other public areas, many people are still wondering if it is even safe to enter into these public spaces.  A report from the American Enterprise Institute laid out a plan for the country in order to slow the spread of the virus, reopen states, establish protection that will allow for safe lifting of restrictions, and finally, build our readiness for the next pandemic.

The report, written by Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis, and Crystal Watson, may have an answer to the “when is it safe” question. The authors lay out four benchmarks for cities and states to reach in order for it to be considered safe to reopen that area.

What does a “reopened state” mean?

A state is considered “reopened” when its stay-at-home order is lifted, or once reopening is allowed in at least one major sector like restaurants, retail stores, personal care businesses. A reopening state can also mean that a combination of smaller sectors is allowed to reopen.

A reopened state has opened outdoor and recreation spaces (parks and gyms), retail stores, food and drink spaces (restaurants, bars, breweries), and personal care spaces (salons).

Reopened states as of May 20: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, West Virginia, Wisconsin, Wyoming

A state can also be categorized as “regional reopening” if the governor allows certain counties or regions to open while others remain closed.

Regional reopened states as of May 20: California, Maine, Nebraska, New Mexico, New York, Oregon, Pennsylvania, Tennessee, Virginia, Washington

Michigan is labeled “reopening soon” because it is reopening in the next week. Outdoor recreation in the state is already remissible, as is retail for curbside pickup and industries like construction and real estate are open. In the next week, certain counties will open retail, restaurants, and bars in certain counties, and offices in certain counties.

Reopening soon as of May 20: Michigan

Even states that are “shut down” have reopened in some capacity. In New Jersey, outdoor recreation such as golf courses hav e reopened, industries like construction have resumed operations, and retail stores have reopened for curbside pickup. Outdoor recreational businesses and beaches will reopen soon.

Shut down as of May 20: Delaware, Illinois, New Jersey

4 benchmarks that mean it is safe to reopen a state

1. Hospitals in the state must be able to safely treat all COVID-19 patients who require hospitalization without resorting to crisis standards of care.

At the onset of the pandemic, hospitals and healthcare systems were afraid that they would become overwhelmed by those that needed to be treated for coronavirus in terms of the capacity of individuals they were able to provide care for.

As this is a global health crisis, this is the most immediate bar that must be met. Social distancing guidelines were put into place in order to slow the spread of the virus and not overwhelm healthcare systems at any point during the pandemic.

2. A state needs to be able to at least test all people who are exhibiting symptoms of COVID-19.

Coronavirus testing was also another immediate concern in this pandemic. Lack of available testing only makes it harder to get coronavirus under control. Dr. Gottlieb and the other authors estimate that the nation needs to have the capacity to run 750,000 tests per week.

“The 750,000 number should be viewed as a reasonable expectation for when we haven’t been having any major pockets or regional outbreaks to manage,” Mark McClellan, an author of the report and a professor of business, medicine, and policy at Duke told the Times. “If more testing to help contain outbreaks and potential outbreaks are needed, which seems very plausible, especially early on, the number would need to be significantly larger. We’ll also have to do some surveillance of people without symptoms, especially in higher-risk settings.”

As of May 20, there have been over 12.2 million tests administered in the US. To see how many total tests have been completed in each state, check out the COVID Tracking Project.

Local testing abilities matter more than national testing for this benchmark. For a state to be safe to reopen, it needs to make sure that it could test every single person who might be infected and be able to have the results back to individuals in a timely manner. This aspect is important for moving onto the next requirement.

3. The state is able to monitor confirmed cases and contacts of those individuals.

When lockdowns across the country are over, it does not mean that the coronavirus has gone away for good. According to the report, the country will need a robust system of contact tracing and isolation in order to prevent a second outbreak and lockdown.

What does that type of system look like? Well, each time a person tests positive for the virus, the public health infrastructure would need to be able to determine whom that person had been in close contact with. They would then need to find those people and have them enter into isolation or quarantine until it is established whether or not they have been infected with the virus, too.

Other countries have already began using cellphone tracking technology in order to determine whom infected people have been near. According to the report, building a system that is able to do that will take a significant amount of time and money, and the U.S. has not yet begun working on this project.

4. A state must see a sustained reduction in cases for at least two weeks.

Two weeks has been the golden time measurement for this virus, and that’s because it can take up to 14 days for symptoms of the virus to emerge. The two week rule also relates to the number of cases in a certain area; If the number of cases in a certain area is dropping for two weeks, public health officials can be comfortable in assuming that suppression has been achieved.

The nation saw cases rise in an exponential fashion, and that’s exactly how they move during suppression as well. Experts are unable to set a benchmark number of cases for every state because the number of infections that are able to be managed in any area depends on the population and the public health system’s ability to handle any sporadic cases.

“We wanted to suggest criteria that would allow locations to safely and thoughtfully begin to reopen, but what that looks like exactly will vary from state to state,” Caitlin Rivers, another author of the report and an epidemiologist at the Johns Hopkins Center for Health Security told the Times. “We therefore included some flexibility for jurisdictions to tailor these criteria to their local context.”

Jennifer Fabiano is an SEO reporter at Ladders.