Sneeze guards in offices to digital menus at restaurants, all you need to know about CDC's reopening guidelines
The US Centers for Disease Control and Prevention (CDC) has quietly released detailed guidelines on how to reopen the US amid the Covid-19 pandemic. It was reportedly shelved earlier by the Trump administration for being overly ‘prescriptive.’
The 60-page document has guidelines for childcare programs, schools and day camps, employers with workers at high risk, restaurants and bars, and mass transit administrators. The latest guidance is meant to supplement the decision tools released by CDC on May 14. The document also includes guidelines on health system surveillance, on testing, on infection control and contact tracing, and for public health and government officials to aid their decisions when to reopen communities.
The current advisory does not include any guidelines for communities of faith, but they were part of the draft advisory. A CDC spokesman had told the New York Times that the draft guidance infringed on religious rights, that it was still under discussion with the White House and a revised version could be published soon. “White House and other administration officials rejected the recommendations over concerns that they were overly prescriptive, infringed on religious rights, and risked further damaging an economy that Trump was banking on to recover quickly,” the spokesperson had said.
The draft guidance for communities of faith had suggested restricting gatherings to those that can be held virtually (by remote viewing) for vulnerable populations and video streaming or drive-in options for services during the first and second phases. During phase 3, it had recommended restricting gatherings to those that can maintain social distancing and considering video streaming or drive-in options for vulnerable populations.
A CDC official told CNN recently, “We've been muzzled. What's tough is that if we would have acted earlier on what we knew and recommended, we would have saved lives and money.”
What does the current guidance say?
The May 2020 document is titled “CDC activities and initiatives supporting the Covid-19 response and the President’s plan for opening America up again.” It retains many recommendations that were part of the draft guidelines.
“CDC is releasing this interim guidance, laid out in a series of three steps, to inform a gradual scale-up of operations. The scope and nature of community mitigation suggested decreases from step 1 to step 3. Some amount of community mitigation is necessary across all steps until a vaccine or therapeutic drug becomes widely available,” say experts.
Schools, day camps, child care programs
Schools that are currently closed can remain closed in step 1 while providing e-learning or distance learning opportunities. In the second step, schools can open with enhanced social distancing measures and for children who live in the local geographic area only, while they can remain open with distancing measures and restricted attendance to those from limited transmission areas (other step 3 areas) only in the last step.
Stating that face coverings may be challenging for students (especially younger students) to wear in all-day settings such as school, the CDC recommends that face coverings should be worn by staff and encouraged in students (particularly older students) if feasible, and are most essential in times when physical distancing is difficult.
“Information should be provided to staff and students on proper use, removal, and washing of cloth face coverings. Face coverings are not recommended for babies or children under the age of 2, or for anyone who has trouble breathing, or is unconscious, incapacitated, or otherwise unable to remove the covering without assistance,” it says.
Similar to the draft, the final guidelines say that in steps 1 and 2, seating/desks should be placed at least six feet apart, arrival and drop-off times or locations must be staggered, or other protocols must be put in place to limit close contact with parents or caregivers as much as possible. It says cancel all field trips, inter-group events, and extracurricular activities in step 1. In step 2, it calls for limiting gatherings, events, and extracurricular activities to those that can maintain social distancing, supporting proper hand hygiene, and restricting attendance of those from higher transmission areas.
In step 3 too, the experts suggest allowing minimal mixing between groups, limiting gatherings, events, and extracurricular activities to those that can maintain social distancing and support proper hand hygiene, and continuing to space out seating and bedding (head-to-toe positioning) to six feet apart, if possible. The experts say sharing of food should be avoided and if food is offered at any event, there should be pre-packaged boxes or bags for each attendee instead of a buffet or family-style meal.
The advisory says schools can consider keeping communal use spaces closed, such as game rooms or dining halls, and if this is not possible, there should be staggered use and disinfection in between uses. It also says that each child’s belongings must be kept separated from others’ and in individually labeled containers, cubbies, or areas and taken home each day and cleaned, if possible.
“If feasible, conduct daily health checks (e.g. temperature screening and/or symptoms checking) of staff and students safely, respectfully, as well as in accordance with any applicable privacy laws or regulations. Confidentiality should be maintained,” says the document.
Similar recommendations have been made for child care programs. It says that step 1 should restrict opening child care programs to children of essential workers, it can be expanded to all children with enhanced social distancing measures in step 2, and it can remain open for all children with social distancing measures in the final step.
Employers with workers at high risk
Establishments have been asked to consider offering workers, who are at higher risk, duties that minimize their contact with customers and other employees (for example, restocking shelves rather than working as a cashier) if agreed to by the worker. “Encourage any other entities sharing the same workspace also follow this guidance. Provide employees from higher transmission areas telework and other options as feasible to eliminate travel to workplaces in lower transmission areas and vice versa,” it says.
The experts recommend scaling up to step 3 only if businesses can ensure limited social distancing, proper cleaning and disinfecting requirements, and protection of their workers and customers. They suggest installing physical barriers, such as sneeze guards and partitions, and changing workspace layouts to ensure all individuals are at least six feet apart.
Restaurants and bars
In step 1, the CDC suggests that bars should remain closed and restaurant service should remain limited to the drive-through, curbside take out, or delivery with strict social distancing. In the next step, bars may open with limited capacity; restaurants may open dining rooms with limited seating capacity that allows for social distancing. In the final step, the CDC says that bars may open with increased standing room occupancy that allows for social distancing; and restaurants may operate while maintaining social distancing. Restaurants and bars have also been asked to consider assigning such duties to workers at risk that can minimize their contact with customers and other employees.
Here too, it retains recommendations from the draft and asks restaurants and bars to avoid using or sharing items such as menus, condiments, and any other food. It suggests using disposable food service items (utensils, dishes) as much as possible. “Use disposable or digital menus, single-serving condiments, and no-touch trash cans and doors. Use touchless payment options as much as possible, when available. Ask customers and employees to exchange cash or card payments by placing on a receipt tray or the counter rather than by hand. Clean and disinfect any pens, counters, or hard surfaces between use or customer,” say guidelines.
While step 1 calls for limiting service to the drive-through, delivery, or curbside pick-up options only, in the second and third steps, the CDC recommends providing drive-through, delivery, or curbside pick-up options and prioritizing outdoor seating as much as possible. It asks employers to consider reducing occupancy and limiting the size of parties dining in together to sizes that ensure that all customer parties remain at least six feet apart. Installing sneeze guards and partitions at cash registers, bars, or other food pickup areas where maintaining physical distance of six feet is difficult, is a recommendation. “Provide physical guides, such as tape on floors or sidewalks and signage on walls, to ensure that customers remain at least six feet apart in lines or waiting for seating,” it adds.
The experts say restaurants and bars can consider conducting daily health checks of employees, as well as implementing flexible sick leave and other flexible policies and practices, such as telework, if feasible.
Mass transit administrators
The document says that in all steps, routes must be adjusted between areas experiencing different levels of transmission (between areas in different steps), to the extent possible. It says employees from higher transmission areas can be provided telework and other options as feasible to eliminate travel to workplaces in lower transmission areas.
In steps 1 and 2, it calls for providing physical guides to ensure that customers remain at least six feet apart while on vehicles and at transit stations and stops. For example, floor decals, colored tape, or signs to indicate where passengers should not sit or stand can be used to guide passengers, say experts. It says one must consider or continue instituting measures to physically separate or create distance between occupants in the final step too. The CDC also suggests installing physical barriers across all steps (sneeze guards and partitions) at staffed kiosks and on transit vehicles to the extent practicable.
“Establish and maintain communication with state and local health officials to determine current mitigation levels in the communities served. Decisions about how and when to resume full service should be based on these levels. Conduct worksite hazard assessments to identify Covid-19 prevention strategies, such as appropriate use of cloth face coverings or personal protective equipment (PPE), and follow the prevention strategies,” says the CDC.
In the first step, the CDC suggests restricting ridership to essential critical infrastructure workers in areas needing significant mitigation and maintaining strict social distancing as much as possible. The experts recommend maintaining social distancing between transit riders and employees as much as possible in step 2, and encouraging social distancing as much as possible in the final step.