Appendix FzGuidance for Implementing the Opening LIQALngrica Again Framework This implementation guidance provides tools and resources to assist decision makers to implement the Guidelines for Openim Up America Again framework. Guidance is provided to monitor local conditions (transmission, public health, and healthcare system capacity) and adjust mitigation strategies over time to effectively contain outbreaks and minimize negative side effects of more significant restrictions on commerce and education. It begins with steps that all Americans need to take in every community. From there, it outlines core capacities needed In communities to respond to and manage cases as well as delineates key metrics to monitor community mitigation efforts. All of the guidance is anchored to the phases of the Opening Up America Again framework. The appendices contain more detailed tools for communities such as indicators to better track and adjust mitigation efforts as well as comprehensive mitigation guidance organized by phase gag by setting. Finally, there are user-friendly decision trees to help leaders make informed decisions about reopening. A companion community leader? 5 guide to further enable implementation activities accompanies this resource. Steps for All Americans in Every Community ALL JURISDICTIONS SHOULD CONTINUE TO PROMOTE INDIVIDUAL AND WORKPLACE practices that reduce the risk of transmission AS PEOPLE MOVE THROUGH THE COMMUNITY. INDIVIDUALS SHOULD: I CONTINUE To ..-.. OFTEN COVER THEIR COUGHS AND SNEEZES AVOID CLOSE CONTACT WITH OTHERS DISINFECT FREQUENTLY-USED ITEMS AND SURFACES STAY HOME WHEN THEY FEEL SICK USE cloth face coverings WHEN OUT IN PUBLIC EMPLOYERS SHOULD: NOTIFY AND WORK WITH STATE LOCAL PUBLIC HEALTH OFFICIALS IF AN EMPLOYEE TESTS POSITIVE FOR COVID-19 DEVELOP AND IMPLEMENT APPROPRIATE POLICIES, IN ACCORDANCE WITH FEDERAL, STATE, AND LOCAL REGULATIONS AND GUIDANCE AND INFORMED BY INDUSTRY BEST PRACTICES, REGARDING: SOCIAL DISTANCING 0 PERSONAL PROTECTIVE EQUIPMENT 0 HEALTH CHECKS LIKE TEMPERATURE SCREENING ISOLATING AND SENDING HOME THOSE WHO ARE SICK 0 NOT ALLOWING EMPLOYEES POSITIVE FOR COVID-19 To PHYSICALLY RETURN TO WORK UNTIL CLEARED BY A MEDICAL PROVIDER, OR ACCORDING To the guidance for discontinuiru; home isolation for cases managed at home 0 NOTIFYING LOCAL HEALTH OFFICIALS AND INDIVIDUALS MAY HAVE BEEN EXPOSED WHEN SOMEONE IS CONFIRMED, OR PRESUMED To BE POSITIVE FOR SANITIZATION, CLEANING AND DISINFECTION 0 BUSINESS TRAVEL llPage Preparing? Establishing Core Capacity All jurisdictions need to build and maintain a core capacity to respond to and manage cases. Leaders should convene a broad set of stakeholders across sectors to: I I Communicate data about local transmission, public health and healthcare system capacity, risk to vulnerable populations, and economic considerations; Share local status of gating criteria (as described by Ope't?r?g America Up Again. framework, and below); and Develop coordinated re-opening plans and guidance lhe framework for Opening America up Again outlines core preparedness plans jurisdiction needs before beginning the process of ?gating" or reducing mitigation strategies. This is especially important in a jurisdiction that has experienced significant transmission and healthcare system strain. Assistance is available; includm stem, to support states, tribes, localities, and territories to establish and maintain this capacity. Plans should be updated throughout the response to ensure lessons learned are rapidly assimilated into practice and at a minimum address the following components: Testing and Contact Tracing Ability to quickly set up safe and ef?cient screening and testing sites for individuals, and to trace contacts of cases Ability to test Illness (ILl)-indicated persons for COVID-19 and trace contacts of cases Ability to test at sentinel surveillance sites for cases, and trace contacts of C8585 Healthcare System Capacity Ability to quickly and independently ensure adequate staff and provide critical medical equipment and supplies personal protective equipment to meet unexpected surge demands Ability to surge ICU capacity Develop Plans Specific to Community Needs Protect the health and safety of workers in all settings Protect the health and safety of vulnerable populations and those living and working in high-risk settings senior care facilities, correctional facilities) Protect employees and users of Mass transit Implement strategies to promote social distancing and use of cloth face coverings Monitor local transmission and public health and healthcare system capacity Immediately take steps to limit any rebounds in transmission, or outbreaks, by increasing mitigation strategies to address a specific outbreak returning to an earlier phase as outlined in the 9mm}; America Up Again framework, depending on severity). ZlPage Monitoring Community Conditions and Gating Criteria Once the core capacity is in place, monitoring community transmission, public health, and healthcare system capacity will help jurisdictions assess readiness for moving between phases for lifting mitigation strategies. The Opening Up America Again framework outlines gating criteria for states and localities to use in determining when and how to decrease or increase community mitigation strategies over time as the risk of transmission for changes. These gating criteria are anchored to time-bound, population-level metrics of burden (newly identi?ed cases, emergency department or outpatient visits associated with the disease, and percentage of positive tests) as well as measures of the public health and health-system capacity to address current circumstances (robust testing and contact tracing capabilities, hospital inpatient and ICU beds, and access to PPE). Communities with signi?cant or uncontrolled community transmission are considered in pre-gating or Phase 0. Jurisdictions need to meet all the gating criteria prior to removing any shelter in place order or entering Phase 1. These metrics and how to utilize them to inform decision-making are described in Appendix 1. Once the gating criteria are met, jurisdictions enter Phase 1 and proceed to move between three phases, altering the level of community mitigation recommended as they pass through each gate. Phase 1 corresponds to areas with the highest disease burden and ongoing community transmission, with the most signi?cant mitigation strategies in place. At the other end, Phase 3 corresponds to areas with lower disease burden and less frequent community transmission with the least signi?cant community mitigation strategies deployed. Each phase outlines necessary mitigation strategies to protect public health. Until a vaccine is widely available and/or medications are broadly accessible to manage individuals need to follow good personal hygiene practices, stay at home when sick, and practice some amount of physical distancing to lower the risk of disease spread. These precautions are needed regardless of the phase a community is in. It is also critical to identify when transmission begins to place the public health and healthcare system at risk, so appropriate actions can be taken. A gating indicators dashboard has been created as a tool to help pull relevant data streams into one platform to support decision making and regional planning and coordination. It can be accessed by jurisdiction of?cials through Geol lealth Again, indicators and thresholds can he found in Appendix 1. (:th ?page Community Mitigation Across the Phases Protecting public health is at the center of the Opening Up America Again framework. However, jurisdictions are also addressing the economic and social consequences of Mitigation strategies should be implemented in a manner that is sufficient to contain transmission and allow sectors to plan for and minimize the negative impacts of the mitigation. The earliest signs of a cluster of new cases or a reemergence of broader community transmission should result in a re-evaluation of community mitigation strategies and a decision on whether they should be strengthened. Increasing mitigation should be tailored and measured, specific to any increase observed. For example, an outbreak in a high risk setting such as a nursing home or correctional facility would result in strict mitigation, contact tracing and isolation of cases for all individuals entering that setting, but may not necessitate implementing strict community-wide measures such as a shelter-in-place order if the outbreak can be effectively contained. Assessing the appropriate mitigation approach and only implementing the strategies appropriate to the observed transmission will help minimize the societal and economic impacts of mitigation. The following framework categorizes jurisdictions based on the level of transmission and community capacity to contain the transmission. The categories align with the phases in the Opening Up America Again plan to assist with transitions between the gates and phases. lpi UL) f" .I lm'lurnum Lharmemtiu k1?17i'riti'1'n? Magnim Needs lhicsholds luv (mung AdiiMmr-ms 4 Page Travel patterns within and between Jurisdictions will impact efforts to reduce community transmission too. Coordination across state and. local' jurisdictions is critical? especially between jurisdictions with different mitigation needs. Considerations for employers and employees are outlined in Appendix 2. Refer to the latest LUL travel guiuame for additional information. Decision-Making for Community Mitigation State, local. tribal, and territorial officials are best positioned to determine whiCh phase theirjurisdiction falls within. Decisions about moving to a different phase will be made at the state, local, tribal and territorial ievel. APPENDICES 3-5 CONTAIN MORE DETAILED TOOLS AND RESOURCES TO HELP OFFICIALS MAKE DECISIONS ABOUT THE APPROPRIATE LEVEL OF COMMUNITY MITIGATION BY PHASE AND SETTING. APPENDIX 6 CONTAINS THE DEVELOPMENT AND PRE-PRODUCTION CONCEPTS FOR A COMMUNITY GUIDE TOOLKIT. SIPagc Appendix 1: Indicators and Thresholds for Monitoring and Adjusting Mitigation Strategies Wl-i Gating Criteria Decreases in newly lenti?ed cues Threshold for entering Phase 1 Downward trajectory Ior near-zero incrdence) of documented cases over a 14- day period Threshold for entering Phase 2 Downward trajectory (or near-zero incidence) of documented cases for at least 14 days after entering Phase 1 Threshold for entering Phase 3 Downward trajectory (or near-zero incidence) of documented cases for at least 14 days after entering Phase 2 Decreases in ED and/w outpatient visits for COVlD-like illness Downward trajectory ior near-zero incidence) of CLI cases reported over a 14-day period Downward trajectory (or near-zero incidence) of (Li cases reported for at least 14 days after entering Phase 1 Downward (or near-zero incidence) of CLI cases reported for at least an additional 14 days after entering Phase 2 Decreases in ED and/a mtpatient visits for in?uenza-like illness (Ill) Downward trajectory ior near-zero incidence) of ILI reported over a 14-day period Downward trajectory (or near-zero incidence) of ILI reported for at least 14 days after entering Phase 1 Downward trajectory (or near-zero Incidence) of reported for at least an additional 14 days after entering Phase 2 Decreases in percentqe of tests positive Downward trajectory ior near-zero percent posrtive) of positive tests as a percent of total tests over a 14-day period (flat or increasing volume of tests) Downward trajectory (cr near-zero percent positive) of positive tests as a percent of total tests for 14 days after entering Phase 1 (flat or increasing volume of tests) Downward trajectory (or near-zero percent positive) of positive tests as a percent of total tests for at least 14 days after entering Phase 2 (flat or increasing volume of tests) Treat all patients wltluut aisis care Jurisdiction inpt ICU beds <80% lull Staff shortage in last week no PPE supplies adequate for >4 days Jurisdiction inpt ICU beds full Statf shortage in last week no PPE supplies adequate for >4 days Jurisdiction inpt beds 00% full Staff shortage in last week no PPE supplies adequate for >15 days Robust testing program Test availability such that 96 positive tests 5 20% for 14 days Median time from test order to result <5 days Test availability such that 96 positive tests 15% for 14 days Median time from test order to result <4 days Test availability such that 96 positive tests 5 10% for 14 days Median time from test order to result <3 days 6 Page Community Demographics* *provided as conditions to consider as having an impact on other indicators Indicator Populatior density, as a metric lor feasibility of Level of Consideration Po ulation Den f< 50 eo Ie uare mile dty physical distancing in select settings gPopulatIon pr: . . . Less than 10% of population over 65 years Proportior Of population over years Less than 15% of population over 65 years. . Less than 3.7% of population estimated to have Prevalence of cardiovascular disease and/or COPD cardiovascular disease and 6% or less with COPD . . . . . Less than 30% of population I High risk populaion density H?useh?'ds w'th Eng '5 e'acy Map view Populatior below the poverty level Less than 10-12% of population Map view Percent with no health insurance coverage Less than 10% of population Map view Compliance indkators Number of violations [complaints related to mandatory or recommended community mitigation Significant increase in non-compliance 7 Page Category Economic Activity Economic Health Indicators? "Provided as conditions to observe as indications of civic strain under strict mitigation measures Indicator Overall Small Business Health lndices Thresholds quarterly change per indu5'.ry, lifeline, CIKR Foot traffic (leading), Business impact Index (lagging) Daily Economic Loss Federal, state and local orders are lifted with ability for 65-80% of in-person business activity to safely resume with guidance. Onsite worker wages lost Permanent business. closures Loss of jobs, businesses, real estate (lagging) Number of eviction; foreclosures and in community (commercial and residential) High output economic producers List, ranking By state, community Loss of sales and bu ;iness revenue Quarterly and Annual sales and earnings 'eports Earnings before interest/tax/depreciation by industry and geography (state, community) Permanent Easiness Closure it or in a community or state it or of a sector J. . Less than 30% loss from pre-COVlD-19 baseline 2 GDP Loss . business activity index at 80% pl levels A . i ed it Employees, customers and i 1'95??3 Requ to household members exposed with - - - - . Testing availability for 100% tnmati: individuals osed contacts Safely Operate Busimss planned business and industry re- openings . I Screening Company screening processes guidelines exist Testing Units i i 10 business my sta 1dby inventory of 1 test per 10 Production targets established and supply chains coordinated to ensure targets are met for 30 days for employees and households inc uding critical infrastructure, small businesses and retail business market segments. i Number or percentage of businesses with high conmct rates Percentage or number of businesses that cannot socially distance meat packing) i PPE/day/ employee for normal workplace requirer ents Sufficient routine PPE day employee far a minimum of 5 business days in the health medical lifeline, safety security lifeline, retail rrarketplace, manufacturing and constructions sites PPE Requlred to Safely PPE productidn targets established and supply chains cmrdinated to 0 rate Business . t: PPE/day/employee for comp?19 ensure production and delivery targets a'e met for a period of 15 business workplace requirements days for emptoyees of critical infrastructure, small busimss and retail - market segments. [Ab'l'tY 9f busmesses to obtain PPE PPE and cleaning requirements for esser?jal and reopened businesses . and dismfectants to support (contact rate (high, medium, low)) operations (-DC 9 Page Category Business Industry Capacity Indicators" Indicator continuity plan "Provided as conditions to observe as indications of civic strain under strict mitigation measures Thresholds Workplace has standard risk management guidance, safe work plans, and a monitoring and surveillance system; ability to enforce strict mitigation. it workforce lost and wages lost per day Employee and sales losses exceed stimulus provisiows and will result in irtractable service disruptions and business deaths Financial bene?ts of industry if Businesses per state, county. industry, lifeline, critical infrastructure hslness reopening if Employees per state, county. industry, lifeline, critical infrastructure Continuity if Projected new cases (growth rate) Public health cost/risk of industry Impacted employees and households reopening ti Impacted patrons per establishment, and patron ouseholds DUNS-level certification that bJsiness is ready to reopen. Scored by industry Score Compliance Score above 70 ready to reopen) Business-es have essential health and safety supplie; in place to ensure s: fe and 3 Essential responSIbIe operations for wc: 'kers and customers. Supply chain and critical infrastructure disruptions increase Critical ir frastructure and supply chain performance targets established to enable and viability and risk rates trend market segments of theeconc my to reopen. Supply Chain negative month over month. Stability in supply chains and Stability in supply chains and consumer confidence lndicators consumer con?dence indicators Import Export Supplier mlationships ii of OCONUS suppliers, supplies that require overseas production Food acquisition capability ls food available? Is food accessible through government assistance? CDC 10 Page Workforce Business/industry reopens Ability to provide onsite social distancing, alternative staf?ng, cohorts, or splitting shift workers for high, medium and low exposure workers. Telework rate Percentage of workforce telem orking Percentage of business/positic ns that cannot pivot ?o TW options tr staff and household members Decline In number of staff and household members for a minimum of 5 consecutive days. Workforce Loss Per Industry 96 loss in productivity New Medicaid enrollments Les than 5% increase in new applications for Medicaid Unemployment Claims if Repetit ve of total) ff First time of total) Return to work or job loss ?/96 Returning to job W96 Returning to work in different job Number of layoffs above a threshold 11 Page Appendix 2: Travel Recommendations Opening Up America Again Phase Characteristics Impact of vrrus Introduction into this setting by a domestic traveler Likelihood of vnus exportation from this setting to a new community by a domestic traveler Domestic Travel Guidance International Travel Pre-Gatlng or Phase Zero Significant or Uncontrolled Transmission Low High 0 Avoid non-essential travel to, from, and .vithin to prevent wfection during travel and spreai to :uther jurisdictions . \Vork?related travel needed for critical ifrastructure is xempt from 'estrictions . livoid non?essential iternational travel . F.eturning iternational travelers should be "ianaged according Travel Recommendations by Phase Phase 0 1e Significant Cc itrolled Transmission Low High Avoid nan?essential travel to, from, and within to prevent infecti 3n during travel and spread to other jurisdictions Work-reiated travel needed for critical infrastructure IS exempt from restrictic 15 Avoid non-essential international ti avel Phase Tm Moderate, Controlle: Transmission Low Medium A mid non-essential travel to Phase 0 and Phase 1 jcrisdictions to prevent ir?fection during travel A roid non-essential travel to Phase 3 jurisdictions to pi event spreading Vi ork-related trayel ne eded fc critical infrastructure is e:.empt from restrictio 15 Avoid non-essential international travel Phase Three Low, Contr: lled Transmission High Low Non-essential travel may be cons dered within 31d between low, controlld transmi-;sion jurisdictiqns Avoid non-essential travel to mod?: rate, controlled or uricontr alled transmission jurisdic: ons to protect those in low, controlled transmiusion jurisdicticms International travel may be consndered following CDC international travel guidance 12 Page CDC to Travel Health Notice Avoid international travel to Travel Health Notice Level 3 countries Returning international traveler; should be mnaged according to Travel Health Notice guidance 13 Page Appendix 3: Mitigation Guidance by Phase Gating Criteria for all Phases . Transmission: Community transmission is under control (Decrease in the percent of patie in?uenza-like illness or a decrease in activity levels over 14 days, plus downw . trajectory documented cases within a 14 day period or downward trajectory of positive te wcent of to tests within a 14-day period- flat or increasing volume of tests). - Health System Capacity: Health system is able to treat all witi?ekt orb increased transmission. I..u-nu. ?Cam. Hopes-\y. I Jbils hguk II sun LCJs, traCk, quickly contain an outbreak. 4? Pre-Gating/PhaseO: Signi?cant, 56% Jurisdictions in Phase 0 are in need of signi? on . ?mu ave often implemented this in the form of stay at home or shelter in place orders Ion, or spread of is still considered signi?cant and uncontrolled In these bei describes an overview of strategies to be implemented across different 5 Ingra nsdi&?5 that a In Phase 0. nkhQaskeono ensuri Ict aqbprevent hat signi?cant mitigation strategies are followed to the best rther COVID-19 spread, and ensure that jurisdictions can safely advance to Pha 16? \luk 19 nsmission decreases. it Is critI ?a?nmbs Phase nd in others, that jurisdictions continue to monitor their Gating Criteria data I Capacity, and 3) Health System Capacity to determine any mitigation on sion Ic djustr?its that may be Jurisdiction emain in Phase 0 until Gating Criteria is met. Jurisdi n5 may consider transitioning to Phase 1 after meeting G__at_i_ng Criteria The f0 Ing table describes guidelines for individuals, employers, and essential workplaces for jurisdictions that are in Phase 0. Pre-Gatlng/Phase 0. Community Strategies in Areas with 513mm. Uncontrolled Transmission MAE . Continue to practice good hygiene and implement personal protective measures handwashing, cough etiquette, and face coverings) Guidelines for All Phases Social distancing maintaining physical distance between persons) . Environmental surface cleaning at home and in community settings, such as schools or workplaces a People who feel sick should stay home 14 Page Essential Workplaces Develop and implement appropriate policies, in accordance with regulations and guidance, Informed by Industry best practices Monitor workforce for indicative 00 not allow people to physically return to work until cleared by a medical provider Develop and implement policies and procedures for workforce contact tracing following employee test Remain open and ensure social distancing, proper cleaning requirements and protection of workers and customers Institute or continue telework ?exibility ?taff from low and moderate and transmission settings should be offered telework to eliminate travel to workplaces in high transmission settings Encourage employees and customers to use face coverings when around others Consider Identifying childcare, schools and camps serving families of essential workers as essential workplaces 15 Page Phase 1: Signi?cant, Controlled Transmission Jurisdictions in Phase 1 are in need of signi?cant mitigation. That means the risk of transmission, or the spread of is suii consmereo Significant and controneo in these jurismcuoris. Leaders of these jurisdictions are tasked with ensuring that significant mitigation strategies are followed to the best extent possible to protect jurisdictions, prevent further spread, and ensure that jurisdictions can safely advance to Phase 2 as the risk of transmission decreases. it is critically important in this Phase, and in others, that jurisdictions continue to monitor their Gating Criteria data on 1) Transmission. 2) Public Health Capacity. and 3) Health System Capacity to determine any mitigation adjustments that may be needed. 0 Jurisdictions may consider transitioning to Phase 2 after meeting Gating Criteria a second time with no rebound. Jurisdictions should return to Pre-Gating/Phase 0 if the community experiences rebound in transmission or has insuf?cient Public Health and Healthcare System capacity to manage an increase in casesTh: Laulc UCJLI IUC.) all urcr vicw vi Du attain.) LU uc Hilylculcritcu )cLuusJ Jul iJUquou that are in Phase 1. The next section provides more detailed guidance for each of these settings.. Phase 1. Community Mitigation Strategies in Areas with Significant, Controlled Transmission Guidelines for All Phases Individuals Continue to practice good hygiene and implement personal protective measures handwashing, cough etiquette, and face coverings) . Social distancing maintaining physical distance between persons) . Environmental surface cleaning at home and in community settings, such as schools or workplaces . People who feel sick should stay home 0 Develop and implement appropriate policies, in accordance with regulations and I a . It, . Monitor workforce for indicative Do not allow people to physically return to work until cleared by a medical provider Develop and implement policies and procedures for workforce contact tracing following employee test Phase 1 Guidelines for individuals . ALL VULNERABLE should continue to shelter in place. Members of households with vulnerable residents should be aware that by returning to work or other envnronments where distancing is not practical, they could carry the Virus back home. Precautions should be taken to isolate from vulnerable residents All individuals, WHEN IN PUBLIC parks, outdoor recreation areas, shopping areas), should maximize physical distance from others. Social settings of more than 10 people, where appropriate distancing may not be practical, should be avoided unless precautionary measures are observed Avoid in groups of more than 10 people in circumstances that do not readily allow for appropriate physical distancing receptions. trade shows) 16lPage MINIMIZE NON-ESSENTIAL TRAVEL and adhere to CDC guidelines regarding isolation following travel Phase 1 Guidelines for Employers .. .. .. .. :Ll ?.144. .. operations If possible, RETURN TO WORK IN PHASES Close COMMON AREAS where personnel are likely to congregate and interact, or enforce strict social distancing protocols Minimize NON-ESSENTIAL TRAVEL and adhere to CDC guidelines regarding Isolation following travel Suungiy Lunsldei 3F ECEAL fut pccsumici Win.) an: member: ufa VULNERABLE POPULATION Phase 1 Guidelines for Specific ypes or Employers expanded below SCHOOLS AND ORGANIZED YOUTH ACTIVITIES daycare, camp) that are currently closed should remain closed VISITS TO SENIOR LIVING FACILITIES AND HOSPITALS should be prohibited Those who do interact with residents and patients must adhere to strict protocols regarding hygiene LARGE VENUES sit down dining, movie theaters, sporting venues, places of worship) can operate under strict physical distancing protocols ELECT SURGERIES can resume, as clinically appropriate, on an outpatient basis at facilities that adhere to CMS guidelines GYMS can open if they adhere to strict physical distancing and sanitation protocols BARS should remain closed Essential Workplaces Remain open and ensure social distancing, proper cleaning requirements and protection of workers and customers institute or continue telework flexibility Staff from low and moderate and transmission settings should be offered telework, where possible, to eliminate travel to workplaces in high transmission settings Encourage employees and customers to use face coverings when around others wroac r-mk (?\fnforlnr I Install physical barriers, such as sneeze guards and partitions, and change layout of workspaces to ensure all individuals remain at least 6 feet apart Strongly consider special accommodations for personnel who are members of a vulnerable population ?exible leave policies, telework, reassignment of duties to minimize contact with others) Cancel work-related gatherings staff meetings, after-work functions) where 6-foot distancing cannot be maintained Post signs on how to stop the spread of wash hands, and properly wear a cloth face covering implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Consider identifying childcare, schools and camps serving families of essential workers as essential workplaces General Workplaces Reopen only If busmess can ensure strict socrai distancmg, proper cleaning and and protection of their workers and customers CDC 17lPage Limit service to drive-throughs, curbside take out, or delivery Minimize non-essential travel and adhere to CDC guidelines regarding Isolation following travel Continue to encourage telework and virtual vs. in-person meetings wherever possible and feasible Encourage employees and customers to use face coverings when around others Close common areas such as breakrooms, cafeterias Install physical barriers, such as sneeze guards and partitions, and change layout of workspaces to ensure all individuals remain at least 6 feet apart fj' "53.3. (.5: . ., I . .cn'mablc population g. flexible leave and telework policies where possible, reassignment of duties to minimize contact with others) Staff from low and moderate transmission (Phase 2 3) areas should be offered telework or other options as feasible to eliminate travel to workplaces in high transmission settings Cancel work-related gatherings staff meetings, after-work functions) where 6ft distancing cannot be maintained Post signs nn tn step the spread nf wash hands and nrnnerlv wear rln?l? face covering Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns S:h::als Schools that are currently closed should remain closed E-learning or distance learning opportunities should be provided for all students Ensure provision of student services such as school meal programs Encourage employees to use face coverings when around others Post signs on how to stop the spread of COVID-19, wash hands, and properly wear a face covering Childcare Facilities Childcare facilities should only remain open for children of essential workers Childcare facilities that remain open should maintain enhanced social distancing measures g. spaced seating to at least 6 feet apart when possible, restrict mixing between classes/grows, ca Ice. e'dz: ?1722-51373Encourage employees to use face coverings when around others, particularly when physical distancing is not possible Restrict non-essential visitors and volunteers Close communal use spaces such as cafeterias and playgrounds if possible, or stagger use and clean/disinfect in between use. Serve individually plated meals to limit sharing of food or utensils and hold activities in separate classrooms ?niche?; Stagger arrival and drop-off times or locations, or put in place other protocols to limit direct contact with parents as much as possible Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (art supplies, equipment etc. assigned to a single child) or limit use of supplies and equipment for by one group of children at a time and disinfect between use Routinely clean, sanitize, and disinfect surfaces and objects that are frequently touched it's, . 18 Page Staff from low and moderate transmission (Phase 2 3) settings should be offered telework or other options as feasible to eliminate travel to childcare centers in high transmission settings ca-a?ugc OSL signs ui'i on to SLUP MIL CV ad, . Inuitua, mm . covering. Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Summer Camps Summer camps should only remain open for children of essential workers and only for children who live in the local geographic area Ensure enhanced meantime (n mated coating to at least 6 feet apart when possmle, restrict mixing between classes/groups, cancel all field trips and inter-group events) Encourage employees to use face coverings when around others, particularly when physical distancing is not possible Close communal use spaces such as cafeterias and playgrounds if possible, or stagger use and clean/disinfect in between use. Serve individually plated meals to limit sharing of food or utensils and hold activities in separate areas .. I . - I Keep: .o bcpuiuscu Stagger arrival and drop-off times or locations, or put in place other protocols to limit direct contact with parents as much as possible Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (art supplies, equipment etc. assigned to a single camper) Staff from low and moderate transmission (Phase 2 3) settings should be offered telework or other options as feasible to eliminate travel to workplaces in high transmission urilfligs Post signs on how to stop the spread of wash hands, and properly wear a face covering implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Parks and recreational facilities Remain open, or re-open if closed, with modifications to ensure visitors can maintain social distancing, and practice proper hand hygiene Close facilities and areas where social distancing cannot be maintained water parks, courts, playgrounds) Cancel or postpone events and gatherings Use flexible telework policies, especially for staff at higher risk for severe illness Staff from low and moderate transmission (Phase 2 3) settings should be offered telework or other options as feasible to eliminate travel to workplaces in high transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face covering implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to COVID-19 concerns Healthcare Settings Continue telehealth expansion Cancel elective surgeries 19 Page Only schedule essential outpatient care (routine immunizations, well child care visits, etc.: tlUlIlC.? QIIU ICJLIILL all VIJILUI .l Restrict entry of non-essential staff and contractors Limit group activities, including meals Colleges and Universities Guidance will be forthcoming . - can-u um.) Provide physical guides tape on floors/sidewalks) to ensure customers remain at least ti! apart in liner. rick 'n writ in rare when up. fnod, Post signs to inform customers of food pick-up protocols Consider installing physical barriers, such as sneeze guards and partitions at cash registers or other food pick-up areas where maintaining distancing of at least 6 feet is difficult Restrict the number of employees in shared spaces kitchens, break rooms, of?ces) to maintain at least 6 feet distance between people Rotate/stagger shifts to limit number of employees in the workplace at a time \lell?ilkn'Ll argyle. uhnvliu-quus-uila nun 01$. [Algal-uh- a u: a nulivgtuul? population ?exible leave and telework policies where possible, reassignment of duties to minimize contact with others) Staff from low and moderate transmission (Phase 2 3) settings should be offered telework or other options as feasible to eliminate travel to workplaces in high transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face ceve?ng implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Social Gatherings Cancel all gatherings of 10 or more Cancel gatherings of any size where distancing cannot be maintained (this does not include household contacts) .a Inna?f.) Restrict ridership to employees of essential businesses and critical infrastructure to the exicui puaalblc Restrict routes between areas experiencing different levels of transmission (between areas in different Phases) Ensure strict social distancing, proper cleaning and disinfecting and protection of workers and customers install no-touch trash cans Clean and disinfect fremmn?v touched surfaces kiosks, digital interfaces such as toucusueens and lmgeipi ml scanners, ticket machines, turnstiles, handrails, restroom surfaces, elevator buttons) at least daily Clean and disinfect the operator area between operator shifts Use touchless payment, trash cans, and doors as much as possible, when available. institute measures to physically separate or create distance of at least 6 feet between all occupants. This may include: 0 . I disabilities) ?r?rie? naecn-a-r" rr?n? e-?4 run-.- ?9 . . 20 Page . Close every other row of seats . Reduce maximum occupancy and increase service on crowded routes I a tape, or signs to indicate where passengers should not sit or stand can be used to guide passengers ,l -r .u . rr Install physical barriers, such as sneeze guards and partitions at staffed kiosks and on transit vehicles to the extent practicable Close communal spaces, such as break rooms or stagger use and clean in between uses Consider assigning vulnerable workers_duties that minimize their contact with_passengers and employees. Offer staff from low and moderate transmission (Phase 2 3) settings telework or other options as feasible to eliminate travel Mass Gatherings Guidance will be forthcoming Communities of Faith Limit gatherings to those that can be held virtually (online video streaming) for vulnerable populations and consider video streaming or drive-in options for services. Limit the size of in person gatherings in accordance with the guidance and directives of state and local Consider modifying clergy visits to over the phone or online Encourage the use of face coverings when around others Encourage proper hand hygiene and avoid direct person-to-person contact and sharing of objects Consider posting signs on how to stop the spread of wash hands, and properly wear a face covering. 4 I--..- -- - 2-..- .. .II. I - ,lq?r .. work from home, if feasible). 21 Page Phase 2: Moderate, Controlled Transmission Jurisdictions in Phase 2 are in need of moderate mitigation. That means that risk of transmission, or the Spread of 1? 1 . .. Leaders of these jurisdictions are tasked with ensuring that significant mitigation strategies are followed to the best extent possible to protect jurisdictions, prevent further spread, and ensure that jurisdictions can safely advance to the Phase 3 as COVID-19 transmission decreases. It is critically important in this Phase, and in others, thatjurisdictions continue to monitor their Gating Criteria data on 2) pighlir Health our! 1) Health Cutter? Pansy-Ha! 9.0 Mitigafion adjustments that may be needed. 0 Jurisdictions may consider transitioning to Phase 3 after meeting a third time with no rebound. Jurisdictions should return to Phase 1 if community experiences rebound in transmission or has insufficient public health and healthcare system capacity to manage increase in cases (or return to Pre-Gating/Phase 0, depending on severity of rebound and/or capacity needs). The following table describes an overview of strategies to be implemented across different settings in jurisdictions that are in Phase 2. Unks in the table are also included for more detailed guidance for each of these settings. Phase 2. Community Mitigation Strategies in Areas with Signi?cant, Controlled Transmission Individuals - Continue to practice coed hygiene and implement personal erotective measures. iiaudwasiimg, cough etiquette, and iace coverings) . Social distancing maintaining physical distance between persons) . Environmental surface cleaning at home and in community settings, such as schools or workplaces . People who feel sick should stay home Employers . Dacia; -, . guidance, informed by industry best practices Guidelines for All Phases . - - Monitor workforce for indicative Do not allow people to physically return to work until cleared by a medical provider. Develop and implement policies and procedures for workforce contact tracing following employee test. A. I NCPAQI than?! (Antigua 05 r?n?ny ip nI-sf-n K?ambpm of i 0U$ch0105 Willi resuuems DC aware U?ldl by returning to WOIIK Of ()1th environments where distancing is not practical, they could carry the virus back home. Phase 2 Guidelines for Precautions should be taken to isolate from vulnerable residents Individuals All individuals, WHEN IN PUBLIC parks, outdoor recreation areas, shopping areas), should maximize physical distance from others. Social settings of more than 50 people, where appropriate distancing may not be practical, should be avoided unless precautionary measures are observed i . NON-ESSENTIAL summss AND iRAVthan resume. Employers CDC 22 Page Businesses continue to ENCOURAGE TELEWORK, whenever possible and feasible with business operations Businesses close COMMON AREAS where personnel are likely to congregate and interact ?Havens-3:; S-L. a .1- . Businesses strongly consider SPECIAL ACCOMMODATIONS for personnel who are members of a VULNERABLE POPULATION Phase 2 Guidelines for Speci?c Types of Employers expanded below Essential Workplaces SCHOOLS AND ORGANIZED YOUTH ACTIVITIES daycare, camp) can VISITS TO SENIOR CARE FACIUTIES AND HOSPITALS should be prohibited. Those who do interact with residents and patients must adhere to strict protocols regarding hygiene LRRGE (c _n fit ??nin: ?15:13? Che-329v: rrn?ino: arr?upr nl-H-nr 5? ?Jars-?Hip, can operate under moderate phySical distancing protocols ELECTIVE SURGERIES can resume, as clinically appropriate, on an outpatient and inpatient basis at facilities that adhere to CMS guidelines GYMS can remain open if they adhere to strict physical distancing and sanitation protocols BARS may operate with diminished standing room occupancy, where applicable and appropriate Remain open and ensure social distancing, proper cleaning and disinfecting requirements and protection of workers and customers Institute or continue telework to the extent feasible Staff from significant transmission (Phase 1) areas should be offered telework or other options as feasible to eliminate travel to workplaces in moderate transmission settings Encourage employees and customers to use cloth face coverings when around others Close common dieds such as Ldieielias or slugger use and clean/disinfect between use Install physical barriers, such as sneeze guards and partitions, and change layout of workspaces to ensure all individuals remain at least 6 feet apart Strongly consider special accommodations for personnel who are members of a vulnerable population ?exible leave and telework policies where possible reassignment of duties to minimize contact with othersCurloluti .. . ail- W.-- chic. guidance Cancel work-related gatherings staff meetings, after-work functions) where 6-foot distancing cannot be maintained Post signs on how to stop the spread of COVID-19, wash hands, and properly wear a cloth face covering. - . . . 'F?ms I implement ?exible sick- leave policies where possible, create a roster of trained back up General Workplaces Reopen only if business can ensure moderate social distancing staggered work shifts to limit number of employees in workplace at a time), proper cleaning and disinfecting requirements (Infection Prevention Certification), and protection of their workers and customers Continue to encourage telework and virtual vs. in-person meetings wherever possible and feasible I I . Ericuuiabc .3..- - -4. --.c.i.ibs woo..- 23lPage Schools between use install physical barriers, such as sneeze guards and partitions, and change layout of I s. - . Close common areas such as breakrooms, cafeterias or stagger use and clean/disinfect Strongly consider special accommodations for personnel who are members of a vulnerable population ?exible leave and telework policies where possible, reassignment of duties to minimize contact with others) I I i Consider resuming non-essential travel in accordance with state and local regulations and guidance Staff from significant transmission (Phase 1) areas should be offered telework or other . . . ., . . . - - a . - Cancel work-related gatherings staff meetings, after-work functions) where 6 feet I distancing cannot be maintained Post signs on how to stop the spread of wash hands, and properly wear a cloth face covering Implement flexible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Remain open with enhanced distancing measures spaced seating to at least 6 feet apart when possible, restrict mixing between classes/groups, cancel field trips, limit gatherings 81 extracurricular events to those that can maintain social distancing, support proper hand hygiene, and restrict attendance of those from signi?cant mitigation (Phase I 1) areas) Restrict non-essential visitors and volunteers Encourage employees to use face coverings when around others, particularly when . . 5 . . 0?8 9 Close communal use spaces such as cafeterias and playgrounds if possible, or stagger use and clean/disinfect in between use. Serve individually plated meals to limit sharing of food or utensils and hold activities in separate classrooms. Keep children?s belongings separated Stagger arrival and drop-off times or locations, or put in place other protocols to limit direct contact with parents as much as possible . possible (art supplies, equipment etc. assigned to a single camper) student) or limit use of supplies and equipment for by one group of children at a time and clean and disinfect between use E-Iearning or distance learning opportunities should be provided for higher-risk students, and those with vulnerable family members Teachers, staff, and students from significant transmission (Phase 1) areas should be nfferqu a-learning? nr nfl'inr nptinnc :c fancihln fr} eliminatp travel to schools in nmueiate cautioned liaiusmissiou sellings Post signs on how to stop the spread of wash hands, and properly wear a face covering Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Childcare Facilities Childcare facilities should remain open with enhanced social distancing measures spaced seating to at least 6 feet apart when possible, restrict mixing between I cla??" . 17? .. 1_ . 5 24lPage where can maintain social distancing can be maintained, support proper hand hygiene, and restrict attendance of those from signi?cant mitigation (Phase 1) areas). Encourage employees to use face coverings when around others, particularly when phySiCd: JIDLOIILIIDE I.) I a; Restrict non-essential visitors and volunteers Close communal use spaces such as cafeterias and playgrounds if possible, or stagger use and clean/disinfect in between use. Serve individually plated meals to limit sharing of food or utensils and hold activities in separate classrooms Keep children?s belongings separated Qtaawaer arrival and drnp-nff rimnc nr lnrationcl or put in plan} other tn limit uucci canton. wil'n paicii?ts as a) Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (art supplies, equipment etc. assigned to a single child) or limit use of supplies and equipment for by one group of children at a time and disinfect between use Routinely clean, sanitize, and disinfect surfaces and objects that are frequently touched toys) and avoid use of items that are not easily cleaned Staff from significant transmission (Phase 1) areas should be offered telework or other transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face covering Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Summer Camps apart when pun-Um, icsuiu inwub ocuwccn cancel hips, limit gatherings extracurricular events to those that can maintain social distancing, support proper hand hygiene, and restrict attendance of those from significant mitigation (Phase 1) areas) Restrict attendance to those from the local geographic area Restrict non-essential visitors and volunteers Encourage employees to use face coverings when around others, particularly when phjainufu' .- 0 - Close communal use spaces such as cafeterias and playgrounds if possible, or stagger use and clean/disinfect in between use. Serve individually plated meals to limit sharing of food or utensils and hold activities in separate areas. Keep children?s belongings separated Stagger arrival and drop-off times or locations, or put in place other protocols to limit direct contact with parents as much as possible Luau?. JUr?Jlth .u ?Milan-us; .niui ?lb Hi sue-ii xv possible (art supplies, equipment etc. assigned to a single camper) or limit use of supplies and equipment for by one group of children at a time and disinfect between use Staff from signi?cant transmission (Phase 1) areas should be offered telework or other options as feasible to eliminate travel to camps in moderate controlled transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face cor sting Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Parks and recreational facilities - proper hand hygiene Close facilities and areas where social distancing cannot be maintained water parks, courts, playgrounds) Cancel or postpone events and gatherings that do not ensure social distancing Use ?exible telework policies where possible, especially for staff at higher risk for severe illness options as feasible to eliminate travel to workplaces in moderate transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face cove?ng Implement flexible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Healthcare Settings Continue Tele-health expansion Schedule elective surgeries on a case-by-case basis based on the clinical urgency procedures that cannot be postponed for greater than 1 week) Schedule routine outpatient care on a case-by-case basis considering factors such as clinical urgency, need for follow-up for pre-existing conditions, as well as potential vulnerability of patients based on underlying comorbidities Nursing homes and hospitals should restrict all visitors, including consider restriction of entry of non~essential staff and contractors Luniinue leie-hedlill expansion Nursing homes and hospitals should restrict all visitors, including consider restriction of entry of non-essential staff and contractors Consider limiting group activities, including meals Colleges and Universities Guidance will be forthcoming I ualS a . I (minimum of 6 feet between groups of people) to?protect employees and guests Bars open with limited standing room only capacity that can allow for 6- foot social distancing among patrons Provide drive-through, delivery, or curb-side pick-up options and prioritize outdoor seating as much as possible Ensure proper cleaning, sanitizing, and disinfecting requirements, and protection of ?n4 au?o?'hars Reduce occupancy and limit the size of parties dining together to ensure all customer parties Install physical barriers, such as sneeze guards and partitions, at cash registers, bars, host stands, and other areas where maintaining physical distance of six feet is dif?cult Provide physical guides tape on ?oors/sidewalks) to ensure customers remain at least 6 feet apart in lines/waiting for seating .. I 1 rl- I ?buzzers? and ask patrons to wait for their table in cars or away from establishment Avoid offering any self-serve food or drink options buffets, salad bars, drink stations) Offer disposable or digital menus, single sewing condiments, and no-touch payment, trash cans, doors Consider special accommodations for personnel who are members of a vulnerable population flexible leave and telework policies where possible, reassignment of duties to minimize contact with others) Staff from signi?cant transmission (Phase 1) areas should be offered telework or other options as feasible to eliminate travel to workplaces in moderate transmission settings Post signs on how to stop the spread of COVID-19, wash hands, and properly wear a face covering. ileum: punucs wiieic waslbie, Lie-Kc a luslei ul trained back-up staff, and designate someone to be responsible for responding to concerns Social Gatherings Cancel all gatherings of 50 or more Cancel gatherings of any size where distancing cannot be maintained. Do not allow attendance of individuals from signi?cant transmission jurisdictions Mass Transit Restrict 'outcs areas in different Phases) to the extent possible I Ensure strict social distancing, proper cleaning and disinfecting requirements and protection of workers and customers Install no?touch trash cans Clean and disinfect frequently touched surfaces (for example kiosks, digital interfaces such as and ?ngerprint scanners, ticket machines, turnstiles, handrails, turf-spar a'ou-sfnr kir?nnel 5? loge. dqs'fv I 0 . Clean and disinfect the operator area between operator shifts Use touchless payment options as much as possible, when available. Institute measures to physically separate or create distance of at least 6 feet between all occupants. This may include: Adjust how passengers enter and exit (while allowing exceptions for persons with disabilities) Clue 5 al Reduce maximum occupancy and increase service on crowded routes Provide physical guides on vehicles and at transit stations and stops. Floor decals, colored tape, or signs to indicate where passengers should not sit or stand can be used to guide passengers Install physical barriers, such as sneeze guards and partitions at staffed kiosks and on transit vehicles to the extent practicable CIAUJC Lbnu-iUnlu?. 6.: ?lil C?'k iUun-a v: has: ail-s: ill INC-LWCCII ?58$ Consider assigning vulnerable workers duties that minimize their contact with passengers and other employees. Staff from signi?cant transmission (Phase 1) areas should be offered telework or other options as feasible to eliminate travel to workplaces in moderate transmission settings Post signs on how to stop the spread of COVID-19, wash hands, and properly wear a face covering. Implement flexible sick-leave where pussibie, ueale a iuslei oi trained back-up staff, and designate someone to be responsible for responding to concerns 27 Page Mass Gatherings Guidance will be forthcoming Communities of Faith 0 Consider holding gatherings virtually (online video streaming) for vulnerable populations 0' . . 0 Limit the size of in person gatherings in accordance with the guidance and directives of state and local authorities, and maintain social distancingz 0 Consider limiting in home or in hospital clergy visits and offering visits over the phone or online Encourage the use of face coverings when around others Encourage proper hand hygiene and avoid direct person-to-person contact and sharing of nhjerfs 0 Lunsiuci posting signs on now to stop me sprcau oi cuvru 19, wash hands, and properly wear a face covering. 0 Implement flexible sick leave and related flexible policies and practices for staff allow work from home, if feasible). 28 Page Phase 3: Low, Controlled Transmission States and Jurisdictions in Phase 3 are in need of low mitigation. That means that risk of transmission, or the spread 0? L, Leaders of these jurisdictions are tasked with ensuring that significant mitigation strategies are followed to the best extent possible to protect jurisdictions, prevent further spread, and ensure that jurisdictions can safely remain in Phase 3 as risk for transmission remains low. It is critically important in this Phase, and in others, that jurisdictions continue to monitor their Gating Criteria data an 1\Tr1nemiccinn Duklir- anlfk renal-Eh: and 1? lJn-AlOk Cur-00M renal-3h: On dokornf?ina any miH?ql?ion - adjustments that may be needed. 0 Jurisdictions may remain in Phase 3 if Gating Criteria remain stable. 0 Jurisdictions should return to Phase 2 if community experiences rebound in transmission or has insuf?cient Public Health and Healthcare System capacity to manage increase in cases (or return to an earlier stage/Pre- Gating, depending on severity of rebound and/or capacity needs). lht? - that are in Phase 3. Links in the table are also included for more detailed guidance for each of these settings. Phase 3. Community Mitigation Strategies In Areas with Low, Controlled Transmission individuals I . .e -. .. handwashing, cough etiquette, and face coverings . Social distancing maintaining physical distance between persons) . Environmental surface cleaning at home and in community settings, such as schools or workplaces 0 People who feel sick should stay home Guidelines for All Phases . . Develop and Implement appropriate policies, in accordance with regulations and guidance, informed by industry best practices Monitor workforce for indicative Do not allow people to physically return to work until cleared by a medical provider. 0 Develop and implement policies and procedures for workforce contact tracing following employee test. 0 VULNERABLE INDIVIDUALS can resume public interactions, but should practice physical distancing, minimizing exposure to social settings where distancing may not be practical, unless precautionary measures are observed. LOW RISK POPULATIONS should consider minimizing time spent in crowded environments. Phase 3 Guidelines for Individuals Phase 3 Guidelines for Enr; Rcr-umn a? .u?ulq-ibno- 1? . I CDC 29 Page Phase ?4 Guidnlinps for Specific types of Employers expanded below VISITS T0 SENIOR CARE FACILITIES AND HOSPITALS can resume. Those who interact with residents and patients must be diligent regarding hygiene can operate under limited physical distancing protocols. GYMS can remain open if they adhere to standard sanitation protocols BARS may operate with increased standing room occupancy, where applicable. Essential Workplaces Remain open and ensure social distancing, proper cleaning and disinfecting, and protection of workers and customers . Staff from moderate and significant transmission (Phase 1 2) areas should be offered telework or other options as feasible to eliminate travel to workplaces in low transmission settings Encourage employees and customers to use cloth face coverings when around others Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns 9 9 covering General Workplaces Remain open if business can ensure limited social distancing, proper cleaning and disinfecting, and protection of their workers and customers Continue to encourage telework and virtual vs. in-person meetings wherever possible and feasible Encourage employees and customers to use face coverings when around others Stagger use of common areas such as breakrooms, cafeterias and clean/disinfect between use Install physical barriers, such as sneeze guards and partitions, and change layout of workspaces to ensure all individuals remain at least 6 feet apart Staff from significant and moderate transmission (Phase 1 2) areas should be offered telework or other options as feasible to eliminate travel to workplaces in low controlled transmission settings Consider canceling work-relaicu gainemigs (cg, stair meetings, alter-worn runciruns; where 6-foot distancing cannot be maintained Post signs on how to stop the spread of COVID-19, wash hands, and properly wear a cloth face covering. Implement flexible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Schools . A possible, limit mixing between classes/groups, and limit gatherings extracurricular events to those that can maintain social distancing, support proper hand hygiene, and restrict attendance of those from higher transmission (Phase 1 8: 2) areas. Consider limiting non-essential visitors and volunteers. Restrict attendance of those from higher transmission (Phase 1 2) areas. Encourage employees to use cloth face coverings when around others, particularly when physical distancmg is not possible. Consrder keeping communal use spaces such as Laleleuas anu playgrounas croseo in betwesmse- 30lPage Childcare Facilities plated meals to limit sharing of food or utensils and holding actlvitles in separate classrooms. Keep children's belongings separated Consider staggering arrival and drop-off times or locations, or putting in place other protocols to limit direct contact with parents as much as possible Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (art supplies, equipment etc. assigned to a single student or limit use of supplies and equipment for one group of children at a time and clean and disinfect between use E-learning or distance learning and telework opportunities should be provided, where feasible, for higher-risk students and staff icuuicla, atuucun Jim): 1 o: died) )?I?iould be offered telework, e-learning, and other options as feasible to eliminate travel to schools in low controlled transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face covering. Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to COVID-19 concerns Childcare faCIlities should remain open With limited soaal distancmg measures spaced seating to at least 6 feet apart when possible, limit mixing between classes/groups, and limit gatherings extracurricular events to those where social distancing can be maintained, support proper hand hygiene, and restrict attendance of those from higher mitigation (Phase 1 2) areas. Consider non-essential visitors and volunteers. Restrict attendance of those from higher transmission (Phase 1 2) areas.cn physical distancing is not possible. Consider keeping communal use spaces such as cafeterias and playgrounds closed if possible, or stagger use and clean/disinfect in between use. Consider servmg individually plated meals to limit sharing of food or utensils and holding activities in separate classrooms. Keep children's belongings separated . I i_ fr.' I I .i protocols to limit direct contact with parents as much as pOSSible Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (art supplies, equipment etc. assigned to a single child) or limit use of supplies and equipment for by one group of children at a time and disinfect between use Routinely clean, sanitize, and disinfect surfaces and objects that are frequently touched toys) and avoid use of items that are not easily cleaned Chi? rinmfir-int and mrvinrata (DH-ten 1 R, 7) nrna': chniild hp nffarnd I I UI u) LU uuvu cu controlled transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face covering. Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns Camps CDC i .- possible, limit mixing between classes/groups, and limit gatherings extracurricular events to those that can maintain social distancing, supponpmper hand_ hygiene1 and? 31 Page restrict attendance of those from significant and moderate mitigation (Phase 1 8i 2) areas). 0 Restrict attendance to those from limited transmission areas . Encourage employees to use face coverings when around others, particularly when physical distancing is not possible . Consider keeping communal use spaces such as cafeterias and playgrounds closed if possible, or stagger use and clean/disinfect in between use. Consider serving individually plated meals to limit sharing of food or utensils and holding activities in separate areas. i 0 Keep children's belongings separated I rnncir?ar crnaanrinq arrival and drop-n? fimac nr Irv-?imsy nr putting in plan- nfher plUtULUi?.? iu unu?t ml): parents as as possible I . Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (art supplies, equipment etc. assigned to a single camper) or limit use of supplies and equipment for by one group of children at a time and disinfect between use - Staff from significant and moderate transmission (Phase 1 8: 2) areas should be offered telework or other options as feasible to eliminate travel to camps in low controlled transmission settings . .. av. . - I covering. Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to concerns i . Open with modi?cations to ensure visitors can maintain social distancing, and practice . proper hand hygiene. I . n? Vargas and gafh?rings 0 Use ?exible telework policies, especnally for staff at higher risk for severe illness. I Parks and recreational . Staff from moderate and signi?cant transmission (Phase 1 2) areas should be offered facilities telework or other options as feasible to eliminate travel to workplaces in low transmission settings . . Post signs on how to stop the spread of wash hands, and properly wear a face coveringstaff, and deSIgnate someone to be responsible (or responding to concerns . Continue telehealth expansion . Schedule elective surgeries . Consider gradually returning to normal scheduling of all routine outpatient medical and dental care Cranium: . Nli'rin? F??v?r anr') bnfhifalr ran rnr?rir?nr "slay-qt: \nrifnr rac?rirfinne an 2 I .- yea-a (nahduics .u hvi-3luc- ?luau: qucapicuu chaiidLJAIk) u: .Cs..iI5 1U CIDUIC Idpld identification of potential nursing home clusters; adequacy of personal protective equipment and training of staff on appropriate practices to help mitigate risk of nosocomial transmission) 0 Resume care {insert link to new CMS guidance} . . . Colleges and Universmes Guidance will be forthcoming. I . - Raul? 3 I protect employees and guests CDC 32 Page Bars operate with increased standing room occupancy that allows for social distancing. 1 Provide drive-through, delivery, or curb-side pick-up options and prioritize outdoor seating as much as possible I Consider options for dine-in customers to order ahead of time to limit the amount of time spent in the establishment Ensure proper cleaning, sanitizing, and disinfecting, and protection of workers and customers. Install physical barriers, such as sneeze guards and partitions, at cash registers, bars, host stands, and other areas where maintaining physical distance of six feet is difficult. provide nlwcir-il unit-inc In r: farm nn finnrsIriHmu-illrr) tn nnsrirn remain at I a' I Icon 0 wet upon in waiting seating. Consider using phone apps to alert patrons when their table is ready to avoid use of communal ?buzzers' and ask patrons to wait for their table in cars or away from establishment Avoid offering any self-serve food or drink options buffets, salad bars, drink stations) Consider special accommodations for personnel who are members of a vulnerable population ?exible leave and telework policies where possible, reassignment of dirty. I Staff from moderate and significant transmission (Phase 1 2) areas should be offered telework or other options as feasible to eliminate travel to workplaces in low transmission settings Post signs on how to stop the spread of wash hands, and properly wear a face covering. Implement flexible sick-leave policies where possible, create a roster of trained back-up '15 - I Social Gatherings Cancel gatherings where social distancing cannot be maintained. Discourage attendance of individuals from significant transmission jurisdictions Mass Transit Restrict routes between areas experiencing different levels of transmission (between areas in different Phases) to the extent possible Continue to encourage social distancing Ensure proper cleaning and disunlecting and protection of workers and customers Clean and disinfect frequently touched surfaces kiosks, digital interfaces such as and fingerprint scanners, ticket machines, turnstiles, handrails, restroom surfaces, elevator buttons) at least daily. Clean and disinfect the operator area between operator shifts Use touchless payment, trash cans, and doors as much as possible, when available. . . . . . between occupants Provide physical guides on vehicles and at transit stations and stops. Floor decals, colored tape, or signs to indicate where passengers should not sit or stand can be used to guide passengers Maintain physical barriers, such as sneeze guards and partitions at staffed kiosks and on transit vehicles to the extent practicable Pawn-id?- .. .lan?l?'it. and other employees. 33 Page 0 Staff from moderate and signi?cant transmission (Phase 1 8: 2) areas should be offered telework or other options as feasible to ellminate travel to workplaces in low transmission settings covering. - Implement ?exible sick-leave policies where possible, create a roster of trained back-up staff, and designate someone to be responsible for responding to COVID-19 concerns Mass Gatherings Guidance will be forthcoming Communities of Faith 0 Consider video streaming or drive-in options for vulnerable populations . - . hygiene. 0 Consider limiting in home or in hospital clergy visits and offer visits over the phone or online for those who are at vulnerable Encourage the use of face coverings when around others Encourage proper hand hygiene and avoid direct person-to-person contact and sharing of objects 0 Consider posting signs on how to stop the spread of wash hands, and properly Mu! bU'kl 0 Implement ?exible sick leave and related ?exible policies and practices for staff allow work from home, if feasible). MlPago Appendix 4: Example - Setting Specific Decision Tools THIS PAGE IS INTENTIONALLY BLANK fublic Health Considerations for REOPENING MASS TRANSIT DURING THE Down-19 PANDEMIC The purr :-se of tool IS to a? 515! mass transn Mn~ mstrator?: In making ?ecxsons dunng me 19 oandemuc I: IS Importer! to check ?Mlh state mo local health offuc :als and Cher perm?: rs to determme the 'nost asmoorlate ans Note Mess transn :scntucal f0! man; Amenoansto omrvute 10er MG and to access esse?: al goods and 5 Ir areas re' 1.1:an sugmfucant rm! gatlm mass transm \ay weed to remain 0 )en and certam route '3 zed Fo?ow :9 83? gundeImts for ogjr and 119'. n1 mtket as these 0_ 1 ~23an -:oth face oovenngs St )uld you consider A tetomTended sa 'ely In Icasmg