Five takeaways on White House coronavirus guidelines

The White House has unveiled guidelines that recommend a three-phase approach for states and counties to begin reopening their economies, allowing residents to gradually return to something resembling normal life amid the novel coronavirus outbreak.  

The guidelines defer to states on reopening decisions and do not set a particular timeline for loosening coronavirus restrictions.

They call for states and counties to meet a series of criteria to being reopening, including seeing a downward trajectory of COVID-19 cases for 14 days and expanding testing for at-risk health care workers.

Here are five takeaways from the guidelines.

The reopening is likely to be slow

The guidelines recommend a gradual process for reopening, with areas that have recorded large numbers of COVID-19 cases resuming business over a period of several weeks to months. 

The guidelines suggest a three-phase process where states and counties see a downward trajectory in reported cases for two weeks before moving on to a new phase. 

In the first phase, officials recommend that employers continue to encourage telework and minimize travel. Businesses like gyms can open if they institute strict physical distancing, while bars are encouraged to remain closed. The guidelines say that large venues, including sit-down restaurants, movie theaters, sporting venues and places of worship, can operate with “strict physical distancing protocols” in place. 

The second phase allows nonessential travel to resume and says bars can begin to operate with “diminished standing-room occupancy,” while large venues can operate with “moderate physical distancing protocols.”

By the third phase, businesses can largely resume normal activities, though individuals are still encouraged to physically distance themselves.

States like New York, the epicenter of the U.S. outbreak, have issued stay-at-home orders extending until mid-May, a sign they are not likely to begin trying to reopen for at least a month. 

States that have not seen significant numbers of cases could begin to reopen more quickly. Trump has said optimistically that this could happen before May 1, though experts have cautioned this would be risky without extensive testing and contact tracing to quash outbreaks.  

“You could start to see some activity slowly come back to the states that weren’t affected,” former Food and Drug Administration Commissioner Scott Gottlieb said on CNBC. “I think by and large, the very affected states particularly in the tri-state area are going to be looking to start to resume business activity probably mid-May.” 

States are left to handle testing

Governors have said some of the most important information they need when making decisions is testing data, but the administration’s plan does not include a national testing strategy.

The guidelines explicitly leave it to states to scale up their own testing systems, including antibody tests. There was no plan on how the federal government would provide support to states trying to do that.

States are already competing against each other and the federal government for medical equipment and testing supplies. Without federal support, that is likely to continue. 

Governors say they can’t do it alone. 

“Yesterday I laid out what’s required for North Carolina’s path to gradual reopening, and it’s good the White House has shared similar guidance, but we still need the federal government to help with testing and personal protective equipment,” North Carolina Gov. Roy Cooper (D) said Thursday.

Testing “has to be figured out. I understand that this is a problematic area and the federal government’s not eager to get involved in testing. I get that, but the plain reality here is we have to do it in partnership with the federal government,” New York Gov. Andrew Cuomo (D) said Thursday.

Health officials have performed around 3 million tests to date, but experts have said the U.S. needs to test almost 1 million people a week, if not more, to safely open the economy. 

Former Centers for Disease Control and Prevention Director Tom Frieden on Friday called for a massive increase in testing as part of his four-pronged approach to getting everyone in the country working again.

“The number of testing done per day could need to increase by a factor of three to as much as a factor of 20 compared to the number of tests done today,” Frieden said Friday.  

Trump on Friday made it clear that states were on their own in a tweet that said they had to step up their testing.

Reopening are likely to vary between red and blue states

Republican governors may be more likely to follow Trump’s urging for businesses to get back to work.

All but seven states have instituted stay-at-home orders in order to lessen the spread of the virus. Those seven states — Arkansas, Iowa, Nebraska, North Dakota, South Dakota, Utah and Wyoming — have not seen significant numbers of cases and are all led by Republican governors.

However, some rural states like South Dakota have seen jumps in cases this month, potentially complicating efforts to reopen. 

Florida Gov. Ron DeSantis (R) initially resisted issuing a stay-at-home order for the Sunshine State and has not ruled out reopening schools during the month of May. The Republican mayor of Jacksonville, Fla., already moved to reopen beaches for some activities on Friday amid signs the curve of infection was flattening in the area. 

Those states may be in a position to open up more quickly, and GOP leaders may feel Trump’s outspoken desire to revive the economy has given them the political cover to do so. 

But the pressure to open up quickly may put more people at risk if it’s done too quickly and without a plan. Health experts have warned that more outbreaks will happen if mitigation measures are relaxed too early. 

“There needs to be criteria to tighten the faucet as well as loosen it” if an outbreak starts again in a newly reopened state, Frieden said.

Meanwhile, states that have seen large numbers of cases will take longer to begin reopening.

Some of the biggest outbreaks have taken place in urban settings and in blue states such as New York, New Jersey and Massachusetts.

Trump’s embrace of a plan to reopen the economy may also further energize his supporters, some of whom attended a protest in Michigan this week calling on Gov. Gretchen Whitmer (D) to rescind certain social distancing orders.

The president in a series of tweets on Friday appeared to endorse protests in Michigan and Minnesota calling for coronavirus restrictions to be lifted. 

Social distancing is here to stay

The plan leaves decisions on when to lift social distancing guidelines up to state leaders, many of whom have extended stay-at-home orders through May or beyond. But even the White House booklet lays out a number of restrictions that will persist for weeks or months to come. 

Phase two of the White House guidelines calls for all at-risk populations to continue sheltering in place and urges low-risk individuals to avoid gatherings of 50 or more people and maintain physical distance when in public spaces.

Phase two is only to be implemented once a state or locality has seen a decline in cases for 28 days, something that could still be weeks away for more densely populated areas.

The final phase of the White House plan, which can be implemented once there is no sign of a resurgence in cases, still includes some social distancing restrictions, calling for vulnerable individuals to maintain physical distancing when in public and allowing venues like restaurants and movie theaters to operate “under moderate physical distancing protocols.”

Some experts and state officials, including those in California, have cautioned that large gatherings are unlikely to return until there is a vaccine or some form of herd immunity.

Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said Thursday it’s “conceivable” that people could attend concerts and sporting events when states reach phase three, but acknowledged there could be setbacks that force the return of certain restrictions.

Guidelines offer no specifics on interstate travel

The guidelines are vague in many ways, including on the issue of travel restrictions.

The White House plan calls for employers to develop their own plans around how and when to resume business travel.

It recommends that individuals living in an area with strict measures still in place minimize nonessential travel but that those living in a locality that has moved on to phase two with fewer restrictions can resume traveling.

But the lack of specificity on how people can travel between states and between areas with differing levels of restrictions could be a cause for concern. 

Individuals traveling to and from spring break, Mardi Gras and trips abroad helped spread the virus around the U.S. in the first place, raising questions about what could happen if an individual living in a simmering hot spot travels to another state and becomes the source for a new outbreak.

The lack of White House guidance on travel will only heighten the importance of developing testing and contact tracing so officials can quickly identify the source of any spike in cases. It also puts the onus on states to not reopen too soon, allowing their residents to resume travel and potentially infect other areas.