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California Reveals 6 Parameters For Lifting Stay-At-Home Orders, Reopening Economy

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Gov. Gavin Newsom announced a roadmap this afternoon for the state's plan to lift stay-at-home orders, as part of his daily update on California's response to coronavirus.

"This can't be a permanent state. And I want you to know, it's not," Newsom said. "We recognize the consequences of these stay-at-home orders have a profound impact on the economy."

WHEN WILL THE STATE REOPEN?

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If hospital and ICU numbers flatten and start to decline over a period of a few weeks, and if the required infrastructure to help with contact tracing is built, it could be possible to lift stay-at-home orders, Newsom said.

Newsom wouldn't give a specific date just yet, but said that if the hospitalization and ICU numbers decline over the next two weeks, contact tracing infrastructure is ready, and personal protective equipment is available, he will be able to provide a timeline in the first week of May.

Being able to do that relies on everyone holding the line on current stay-at-home orders and practicing physical distancing to bend the curve, Newsom said. He emphasized that it was important to avoid "pulling the plug" on stay-at-home orders and reopening too early.

6 METRICS FOR LOOSENING STAY-AT-HOME ORDERS

The state's framework for the next phase requires the ability to do six things, Newsom and California Department of Public Health Director Dr. Sonia Angell said. Angell laid out "key questions" for each of the indicators the state is looking at.

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Newsom noted that decisions around lifting stay-at-home orders will be guided by local leaders, but the state will provide baseline guidance.

1. Capacity to expand testing, to address the tracing and tracking of individuals, including isolating and quarantining people, as well as supporting those who are positive or exposed. The effort will use technology and require more infrastructure, Newsom said.

Key questions:

  • How prepared is our state to test everyone who is symptomatic?
  • Do we have the ability to identify contacts of those who are positive to reduce further transmission?

There is no specific target number of tests they're looking at, California Health and Human Services Secretary Dr. Mark Ghaly said, but they hope to be able to do tens of thousands of tests per day, and not just for those who are the sickest. Ghaly said the plan is: test, track, trace, isolate, and quarantine.
2. Protecting the most vulnerable from infection and spread, primarily senior citizens, as well as the homeless.

  • Are older Californians and the medically vulnerable living in their own homes supported so they can continue appropriate physical distancing?
  • Have we developed a plan to quickly identify and contain outbreaks in facilities housing older Californians, those living with disabilities, those currently incarcerated, and those with co-morbidities?

3. The ability of the hospital and health systems to handle surges. Excess capacity has been achieved at hospitals by postponing elective surgeries and other health care needs, Angell said, but we need to look at how to get back to providing that health care.

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  • Do we have adequate bed capacity, staff and supplies such as ventilators and masks?
  • Can our health care system adequately address COVID-19 and other critical health care needs?

4. The ability to develop therapeutic drugs to meet the demand. This includes both Californian and national labs advancing research on the way to a vaccine. Newsom said that the hope is that a vaccine will be developed within the next year.

  • Have we built a coalition of private, public, and academic partners to accelerate the development of therapeutics?
  • Have we identified potential therapeutics that have shown promise?

5. The ability for businesses, schools, and child care facilities to allow for physical distancing. Newsom called this aspect "redrawing floor plans," allowing people to stay six feet apart while inside these places. Even once orders are lifted, Newsom said to expect more teleworking and distance learning.

  • Have we worked with businesses to support physical distancing practices and introduced guidelines to provide health checks when employees or the general public enter the premises?
  • Do we have supplies and equipment to keep the workforce and customers safe?

6. The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary. Newsom said that we may need to go back and forth between stricter and looser interventions in the effort to fight coronavirus, with "more vigorous controls" coming back. This would be implemented as a response to data and health concerns.

  • Are we tracking the right data to provide us with an early warning system?
  • Do we have the ability to quickly communicate the need to reinstate these measures?

There have been teams assembled in each of the six categories within the framework that's been laid out, Newsom said, and discussions about these categories will be held with the public on a weekly basis.
THE FUTURE OF GATHERING IN PUBLIC, INCLUDING LARGE-SCALE EVENTS

"The prospect of mass gatherings is negligible at best until we get to herd immunity, and we get to a vaccine," Newsom said.

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Large-scale events that bring in hundreds or thousands of people are "not in the cards based upon our current guidelines and current expectations," Newsom said. However, he added, things like therapeutics, testing at scale and vaccine options could change radically during this time. "But when you suggest June, July August — it is unlikely."

Things will likely look different when stay-at-home orders are lifted, Angell said, as it will be a transitional phase:

  • Restaurants will likely reopen with fewer tables to allow for greater physical distancing. Newsom said that your waiter may be wearing a face mask and gloves, your menu may be disposable, half the tables may be gone, and your temperature will likely be checked on your way in.
  • Face coverings will likely be common in public — Angell noted that some areas have stricter face covering orders already.
  • New opportunities will likely arise to support mitigation — this includes efforts to improve contact tracing, as well as isolating people as needed, Angell said.

The workforce for contact tracing in California includes the state's Check In initiative, which will be powered by AmeriCorps and Cal Volunteers, as well as reprioritizing existing state staff to work on those efforts, Newsom said. The state is currently vetting various apps, such as the effort announced by Apple and Google, to determine which will be the best for its needs.
This all comes alongside a record number of deaths over the last day —71 deaths, bringing the state's total to 758, according to Newsom. There has been a modest increase in hospitalizations — 3.6% — though there has also been an increase in testing, Newsom said. There was a small decline in those in ICU beds — 0.1%, with 1,177 people in ICUs. The number of people being investigated for coronavirus is also decreasing, Newsom said.

STARTING SCHOOL THIS FALL

Looking ahead to school this fall, Newsom said that the state is looking at the possibility of staggering the arrival of students. Students could be staggered into morning and afternoon cohorts, according to the governor, but this plan will require working things out with teachers unions and others.

Newsom is also looking at reducing physical contact, reducing gatherings at meals, and figuring out how kids can safely get dressed for P.E. Administrators are also considering how to hold gatherings like assemblies and recess safely when school resumes.

There will also be a need for massive sanitization and deep cleaning in schools, Newsom said. The team working on this will continue to be built out more robustly.

ENTERING PHASE 4: SUPPRESSION

Adjusting the state's response to coronavirus isn't like an on-off switch – it's more like a dimmer on a light, Newsom said.

Newsom warned that while there is light at the end of the tunnel, suppression could also be the most difficult and challenging phase of re-opening. He emphasized the need to rely on science to make decisions, as well as the fact that conditions are changing every day.

We are currently in the third phase of strategies for dealing with coronavirus, Newsom said. Here's how he laid them out:

  • Phase 1: Containment. This includes bringing people back on flights from mainland China, including Wuhan, where the virus hit the hardest.
  • Phase 2: Mitigation. As a response to the first cases of community spread of coronavirus, the state began to close down schools and institute a stay-at-home effort, alongside other efforts to practice physical distancing.
  • Phase 3: Surging. This is the phase that Newsom said we are currently in. This includes surging resources for the hospital system and alternative care to meet potential demand, including more hospital rooms, health care workers, and protective gear.
  • The next phase is moving from surge into suppression, Newsom said, which comes before herd immunity, and ends with the creation of a vaccine.

This next phase also includes disinfecting not just schools, but parks, playgrounds, benches, swings, sidewalks, streets, business common areas, offices, and more. One example Newsom provided of something that will need to change – pushing buttons in the elevator. He suggested providing antibacterial wipes.
Until people have built immunity, the state's actions have four goals, according to Angell:

  • "Ensure our ability to care for the sick within our hospitals"
  • "Prevent infection in people who are at high risk for severe disease"
  • "Build the capacity to protect the health and well-being of the public"
  • "Reduce social, emotional and economic disruptions"

Current stay-at-home efforts can't be sustained, Angell said, due to the impact on the economy, the impact on poverty, and the impact on health care. The state is working to improve the overall health and well-being of Californians, Angell said.
The governor said that Californians have bent the curve, which has led to coronavirus models changing.

Newsom said that officials recognize that there are major economic impacts of these orders, including household budgets, lost jobs, lost wages, and keeping businesses afloat.

The governor declined to comment on President Donald Trump's comments Monday about his authority over states on when to reopen the nation's economy.

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