ISSN: 2455-5479
Archives of Community Medicine and Public Health
Perspective Article       Open Access      Peer-Reviewed

Phased Reopening during COVID-19 in a nut shell

Joshua Chadwick Jayaraj*

Nalatham Charitable Trust Clinic, Chennai, India
*Corresponding author: Joshua Chadwick Jayaraj, Nalatham Charitable Trust Clinic, Chennai, India, E-mail: joshuachadwick89@gmail.com
Received: 20 April, 2020 | Accepted: 24 April, 2020 | Published: 25 April, 2020

Cite this as

Citation: Jayaraj JC (2020) Phased Reopening during COVID-19 in a nut shell. Arch Community Med Public Health 6(1): 055-057. DOI: 10.17352/2455-5479.000076

As the COVID-19 pandemic is rapidly progressing, most countries have implemented physical distancing measures community-wide. As transmission dynamics begin to decline, along with incidence of COVID-19 cases, there will be a need for decisions at the country level about how to transition out of strict physical distancing and into a phased reopening.

Models have shown that, in the absence of social distancing, COVID-19 has a Reproduction rate (Ro) of between 2 and 3, this means, on average every person with the disease will spread it to 2 to 3 others [1]. To end an epidemic, control measures have to be in place to drive that number as far below 1 as possible. Meanwhile, social distancing measures, combined with case-based interventions, are the key tools to maintaining the Ro below 1 [2]. If the Ro rises above 1, this means the curve has been heightened. If that occurs, it may be necessary to re-initiate large-scale physical distancing. It is important to recognize that countries will need to actively manage COVID-19 cases with surveillance for the entire duration of the pandemic until a safe and effective vaccine is widely available.

As we transition out to phase II, economies can begin a process of reopening, with modifications. Rather than asking everyone to stay home, countries can limit SARS-CoV-2 transmission through a combination of physical distancing and case-based interventions (testing, contact tracing, and self-isolation for those with active disease or individuals who may have contracted SARS-CoV-2 and are awaiting test results), which in most places may require an expanded workforce and resources.

This document is limited to phases of reopening and does not address other important matters related to the risk of SARS-CoV-2 transmission in businesses, schools, etc. which are considered nonessential by countries.

This table summarizes 4 phases and identified capacities required in each phase, as well as the triggers needed to progress from one phase to the next [3].

Based on the public health principles [7], coming days will have the following in place until we have a therapeutic option or an effective vaccine:

1. Physical Distancing- wherever possible people will work or access the business from home; needs restructuring responsibilities to minimize the number of workers that need to be physically present.

2. Engineering controls- creating physical barriers between people (ideally, at least 6 feet).

3. Administrative controls0- redistributing responsibilities to reduce contact between individuals, using technology to facilitate communication.

4. PPE- Wearing non medical cloth masks.

This document briefly summarizes the phases of reopening. Decisions should be made carefully and thoughtfully to limit the risk of second wave of the disease [8].

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  2. Ridenhour B, Kowalik JM, Shay DK (2018) Unraveling R0: Considerations for public health applications. Am J Public Health 108: S445-S454. Link: https://bit.ly/3bOyEqx
  3. Mcclellan MB, Silvis L, Gottlieb S, Rivers C, Watson C (2020) National Coronavirus Response. 1-16. Link: https://bit.ly/2zv4slT
  4. 15 Days to Slow the Spread. The White House. Link: https://bit.ly/3ePfUJd
  5. CDC (2020) Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposures: Geographic Risk and Contacts of Laboratory-Confirmed Cases. Link: https://bit.ly/2zvrtVN
  6. Feng S, Shen C, Xia N, Song W, Fan M, et al. (2020) Rational use of face masks in the COVID-19 pandemic. Lancet Respir Med Link: https://bit.ly/2VzqPiG
  7. Martin E, Rivers C, Gottlieb S, Watson C, Schoch-Spana M, et al. (2020) Public Health Principles for a Phased Reopening During COVID-19 : Guidance for Governors. Johns Hopkins Center for Health Security. Link: https://bit.ly/35bPFZa
  8. Xu S, Li Y (2020) Comment Beware of the second wave of COVID-19. Lancet 395: 1321-1322. Link: https://bit.ly/3bEChin
© 2020 Jayaraj JC. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.