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Hillsborough County leaders look to expert-recommended 4 conditions before reopening county

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TAMPA, Fla. — The Emergency Policy Group is exploring the best strategy to adopt in reopening Hillsborough County. New numbers show a "flattening of the curve" with fewer new daily cases of the coronavirus.

Some members expressed interest in reopening parks and beaches. Others questioned the need for a local safer-at-home order considering the governor's statewide order.

In the past four weeks, about 4,000 people were tested for COVID-19 at Raymond James Stadium. The site averages 990 tests per week. The county is average nine new cases a day.

Currently, 35 people are hospitalized with the virus, which is down from 42 people on Monday.

But, data shows only 1% of Hillsborough County residents have been tested. It's a concern for Commissioner Kimberly Overman.

"We've had a pretty consistent 6-7% positive rate. If we were to test everyone in Hillsborough County that means if we have 1.4 million people and 6% are positive, that's 84,000 people within Hillsborough County," she said.

As of Thursday morning, the county launched mobile testing sites. The county wants a gradual reopening with full engagement from the community.

The EPG sees the reopening as a "bi-directional dial." That means more and less social distancing will be ordered in response to spikes of cases, rather than an off and on switch.

Dr. Douglas Holt, the director of the county's department of health, warns even when seemingly reduced the virus will make a comeback.

"We will have a second wave. What we don't know is when and how big it will be," he said.

Meanwhile, Governor Ron DeSantis's task force, assigned to come up with recommendations for reopening the state, is set to deliver its preliminary report this Friday.

In a memo, County Administrator Mike Merrill acknowledges the approach ultimately ordered by the governor may limit what course local jurisdictions may take.

"The speed that you turn the dial is directly related to personal responsibility robust collection testing and the analytics. We're taking care of the analytics. Testing collection will hopefully get to where it needs to be," Merrill said after the meeting.

He said they are still waiting on the delivery of about 45,000 rapid test kits.

The group decided to wait until Monday to discuss potentially reopening parks and beaches and the status of the local safer-at-home order.

Some members were concerned about what reopening facilities may look like.

"When we tried for a couple of days early on to open the parks back up, there was nothing but bad behavior in direct opposition to social distancing. There were threats made to my employees. My employees felt unsafe trying to enforce, and I said 'we are closing the parks,'" said County Administrator Mike Merrill.

The EPG meeting invited medical voices such as director of the county's department of health Dr. Doug Holt, the Dean of USF School of Public Health Dr. Donna Petersen, USF professor Dr. Marissa Levine, USF distinguished professor Dr. Thomas Unnasch and Dr. John Curran. Dr. Eric Eisenberg, Dean of the USF School of Arts & Sciences, moderated the discussion.

According to Merrill's memo, together, they will begin to lay the groundwork for a community discussion on the best way to approach reopening the county. The EPG stresses science, data, and an understanding of the disease will take precedence in every step of the way.

The USF experts said mitigation efforts have been effective but cautioned against moving too quickly. They recommended efforts be taken gradually, and added that people would still need to cooperate.

"If we decide to just go ahead and do a complete reopening and do away with all the social distancing we're basically putting ourselves right back in the same position we were in in late February, early March and we're gonna ignite a monster epidemic where probably somewhere north of half a million people in the Tampa Bay Area will be infected as of mid- late June if we opened up on May 1," Unnasch said.

A PHASED REOPENING

The EPG is taking into account a report from the Johns Hopkins Bloomberg School of Public Health titled "Public Health Principles for a Phased Reopening During COVID-19: Guidance for Governors" in crafting a strategy.

The report says, "there is no one-size-fits-all approach to reopening."

It states a majority of models have shown that in the absence of social distancing, coronavirus reproduces between two and threefold. Meaning, every infected person will spread it to two to three more people.

"To end an epidemic," states the report, "control measures need to drive that number as far below one as possible."

A vaccine could take care of the goal, but, in the meantime, social distancing measures and community interventions are the "key tools to maintaining the reproduction rate below one."

The report states, "If the reproduction rate rises above one, this means that epidemic growth has resumed. If that occurs, it may be necessary to re-initiate large-scale physical distancing."

The report taps into the "National Coronavirus Response: A Road Map to Reopening" and details four phases.

Phase I has the community using social distancing to slow the spread and asks community leaders to increase access to diagnostic testing as well as public health and medical system capacities.

THE FOUR CONDITIONS TO REOPENING

To trigger Phase II, which is the gradual reopening of businesses, four criteria must be met under the report.

1. The number of new cases has declined for at least 14 days.
2. Rapid diagnostic testing capacity is sufficient to, at a minimum, test people with COVID-19 symptoms, those in essential roles and people with close contact with those who have tested positive.
3. The healthcare system must be able to safely care for all patients and have enough personal protective equipment, or PPE.
4. There must be sufficient public health capacity to do contact tracing for all new cases.

Additionally, workers who can telework should continue to do so, says the report. All individuals who return to work should wear nonmedical cloth masks to reduce the chance of transmitting the virus to their co-workers.

Phase III happens when there is a vaccine or therapeutic available to treat COVID-19.

Phase IV looks ahead to the next public health threat and identifies ways to better prepare from lessons learned.

The report says governors should make plans to reintroduce social distancing measures should there be an uptick in cases and should consider reopening in phases separated by two to three weeks.

RISKS WITH CERTAIN ORGANIZATIONS

The report states organizations and activities that are outdoors are "less likely to result in transmission than are indoor activities and seem to carry the lowest risk" on the assumption social distancing is maintained.

Businesses that don't have as many customers or workers and that are able to modify the way they do business, to reduce the potential spread, will be "safer to reopen sooner and more fully than those with high contact intensity, high contacts, and the inability to modify or mitigate operations."

Public transportation has, by nature, a high volume of people that are close together. The report recommends changes to make them safer by creating more space between people and limiting ridership. The report acknowledges without public transportation, some people will not be able to get to work.

"If schools are reopened, most kids will be at low risk of severe infection themselves," says the report, "However, some kids will have underlying conditions that increase their risks, and some teachers and staff will be at high risk."

Schools and childcare facilities "pose special challenges," according to the report.

It states that many scientific uncertainties make it difficult to determine when to reopen schools. For example, children with the coronavirus generally experience milder symptoms, but it's unknown how quickly they spread the virus to others.