Linn County Public Health recommends a three-phase approach to reopening businesses

Tables at Rodina in Cedar Rapids, Dec. 9, 2019. — Jav Ducker/Little Village

Linn County Public Health is recommending a phased reopening approach and has released guidance for businesses as additional establishments prepare to reopen.

As part of Gov. Kim Reynolds’ most recent public health proclamation, restaurants, retail stores, tanning facilities, tattoo establishments and other selected businesses were permitted to reopen at 50 percent capacity starting on Friday, May 15. Barbershops and salons can also reopen, but can only see customers by appointment.

In light of this, LCPH has released a three-phase reopening approach that “enables businesses to reopen and events and gatherings to occur, while at the same time protecting the health and safety of employees, patrons, guests and the general public,” LCPH Clinical Services Supervisor Heather Meador said at the department’s Thursday press conference.

LCPH’s approach aligns with recommendations from the Centers for Disease Control and Prevention and other national organizations, Meador said. The CDC released their guidance documents on Thursday, after the White House rejected a draft that was “too prescriptive,” according to Politico.

LCPH’s guidance is determined by 10 disease and resource metrics, which are categorized under epidemiology, health care and public health. All metrics must be met before moving to the next phase of the reopening process, Meador said.

The phase one criteria that needs to be met before moving on to phase two includes:

• Decreased test positive rate for at least 14 days
• Sustained reduction in number of cases for at least 14 days
• Decrease in deaths for at least 14 days

Health care
• Sufficient personal protective equipment for all health care workers, even if cases double
• Sufficient face masks available to provide to patients seeking care, even if cases double
• More discharges than admissions for COVID-19 within a seven day period

Public health
• All cases interviewed for contact elicitation
• Contacts elicited for at least 90 percent of cases
• Capacity to monitor all confirmed cases and their contacts
• Capacity to test all people who are symptomatic

In order to move from phase two to phase three, the same criteria need to be met, as well as a reduction in cases for an additional 14 days and a vaccine is made available. LCPH has the metrics they are using to track each category of criteria published online.

“The first phase of the reopening process is necessary to slow community spread of COVID-19 and avoid overwhelming the local health care system,” Meador said. “During this phase, recommendations are for limited operations when reopening. The risk of transmission increases as the number of those in attendance grows.”

The second phase, according to the LCPH guidance documents, recommends businesses continue many of the limited operations in phase one with a slight expansion. Phase three includes a return to “normal operations” with some mitigation guidance still in place, such as staying home when sick, hand washing and having hand sanitizer available.

COVID-19 Press Conference, May 14th 2020, 3:30 PM

Now streamed live on Facebook, YouTube (, and local news sites.

Posted by Linn County Public Health on Thursday, May 14, 2020

Dr. Dustin Arnold of UnityPoint Health said that as restrictions begin to loosen, he expects there will be “spikes” in cases.

“We don’t want to see that spike in cases, which will be manageable, to happen at the same time we start to have our patients that have a chronic medical condition that have perhaps been neglecting them or not getting the care that they need on a regular basis during this pandemic,” Arnold said. “Then, in addition, you add the surgical volume that we are starting to ramp up slowly. So that’s one thing we want to avoid.”

In addition to releasing the metrics and steps in the reopening approach, LCPH has put together guidance for various businesses, including health clubs, libraries, malls and restaurants. There is also guidance on mass gatherings, campgrounds and amusement facilities.

Each document includes a list of actions and what LCPH recommends in each of the three phases.

“The health and safety of Linn County is our number one priority, especially during a pandemic,” Meador said. “We understand that many organizations and individuals rely on local guidance and expertise to provide recommendations that are relevant to our community.”

“If you do not feel comfortable visiting businesses that are opening, you don’t have to. Additionally, as a business owner, if you don’t feel comfortable opening right now, you don’t have to do this at this time. It is OK to take your time and make decisions that are best for you and for your customers.”

Meador reminded residents that Linn County continues to see community spread.

Linn County has 897 confirmed cases of COVID-19, and 69 residents have died from the virus, according to LCPH data published at noon on Friday, May 15. Ten residents are currently hospitalized.

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