Reopening America could be done in 2 to 3-week phases, with certain aspects of society resuming sooner than others

• The US is considering what reopening would look like amid the coronavirus pandemic.
• For each state that might be different. To help governors navigate strategies to reopen, researchers with Johns Hopkins Center for Health Security outlined the best approach to gradually return to normalcy.
• To be sure, decisions about whether to reopen parts of society hinge on key criteria that suggest states are past the point of an epidemic, criteria states haven't hit yet.
• Certain aspects of society will return in phases considering carefully weighed risks of transmitting the virus.
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Reopening the country isn't an overnight process.

Likely as states reopen, certain aspects of society will return sooner than others, but all carry the risk of spreading the novel coronavirus in the absence of an effective vaccine.

When state governors are considering relaxing some of the strict social distancing measures put in place in the wake of the coronavirus pandemic, they should be sure to weigh the risks against the benefits of opening certain sectors, with some activities and businesses providing a lower risk than others, according to a report compiled by researchers with the Johns Hopkins Center for Health Security and the American Enterprise Institute (AEI), including former Food and Drug Administration Commissioner Scott Gottlieb.

The research builds on an approach outlined by the AEI at the end of March, one that has parallels to the phased approach the Trump administration released last week.

To be sure, decisions about whether to reopen parts of society hinge on key criteria, similar to those proposed by the Trump administration.

That is, the state has to see a declining number of new cases for at least two weeks, there has to be enough rapid diagnostic testing for people who have symptoms of COVID-19, the healthcare system in a particular state is able to safely handle COVID-19 patients — that includes having enough protective gear on hand — and contact tracing can be conducted. It's a threshold states haven't officially hit yet.

Re-opening step by step

Once those measures are in place, the researchers said, modifications can be made so businesses and elements of society can be performed relatively safely.

Phases should be spaced out by two to three weeks, at which point case counts, hospitalizations and deaths should be evaluated. If those counts go up over that time, the next steps of reopening should be put on pause, the researchers recommended.

The researchers laid out the risks of particular businesses and activities based on how close people come in contact with one another, how many contacts people have over time, and how long that contact lasts. The researchers then evaluated the activity or business potential for modification that could mitigate exposure, like setting up physical distancing measures, requiring people to wear a mask, and finding ways to limit physical contact.

For example, restaurants carry a medium level of contact with others and a medium level for modification. Bars, on the other hand, come with a high level of contact, but also have potential for modifications.

Libraries, which the researchers considered to have a low-level risk of contact, also carry a potential for modifications that could allow them to reopen.

While outdoor large events like concerts and sports carry the potential for modifications, the researchers noted that indoor events of that size have a low chance for modifications.

For the most part, school, daycare, and dorms have a lower potential for modification, which could be a key consideration. While the coronavirus appears to have less of a severe impact on children, it's still unclear what role children might have in transmitting the disease.

Certain activities, especially those outdoors, carry a lower risk of transmission, especially if people remain distant from one another. Large gatherings, like parties and weddings, which have been implicated in some coronavirus outbreak incidents, have a high potential for modifications that include limiting physical contact and opportunities to reduce the number of people present.