The plan divides coming months into four phases and sets “triggers” for states to move from one phase to the next. Given the uneven spread and stages of outbreak, not all states would move through the phases at the same time. While the overall peak of the epidemic may occur in late April or early May, the timing may be different in different states. New York, the current epicenter, may see a decline in infection rates as other states have an increase.
With most of the nation in phase one of the epidemic, the goal should be a sharp increase in hospital critical care beds and an increase of testing to 750,000 people a week to track the epidemic — a number Gottlieb said could be achieved in the next week or two. For a state to move to phase two, it should see a sustained reduction in new cases for at least 14 days, and its hospitals need to be able to provide care without being overwhelmed.
“The reason we set it at 14 days is that’s the incubation period of the virus,” said Rivers, of Johns Hopkins. “That way you know the downward trend is certain and not because of a holiday or blip or some other delay in reported cases.”
States moving into phase two would gradually lift social distancing measures and open schools and businesses, while increasing surveillance. The key goals thereafter would be accelerating the development of new treatments and deploying tests to determine who has recovered from infection with some immunity and could rejoin the workforce.
Phase three occurs when the nation has a vaccine or drugs to treat covid-19 in place and the government launches mass vaccinations.
Phase four involves rebuilding the nation’s capacity to deal with the next pandemic by building up its scientific and public health infrastructure.