Governor Gavin Newsom on Thursday announced that the state will begin moving into Stage 2 of his reopening plan and begin granting counties additional jurisdiction over the pace of reopening in their communities. 

Counties will be allowed to reopen more quickly if they meet common sense public health prerequisites and other criteria established by the state. This county-by-county flexibility is known as the Regional Variance Model.  Gov. Newsom said that some counties, including San Francisco, have already indicated they intend to keep more stringent restrictions in place because of local public health concerns.  

The Newsom Administration was clear that Stage 2 is not a return to normal, because COVID-19 is still spreading in California. But Gov. Newsom said that a period of caseload stability is allowing for the reopening of various industries including retailers, manufacturers and warehouses, so long as workplace modifications are made. Those include introducing distancing protocols, increased sanitation standards, curbside pickup and the use of personal protective equipment (PPE) to mitigate the spread of COVID-19 

Later in Stage 2, offices that could not transition to telework could potentially open, seated dining can start again, and shopping malls and outdoor museums might open. 

All openings are subject to change and industries will be required to take steps to mitigate the spread of COVID-19. Such steps will include performing detailed, industry-based risk assessments, employee training and site specific implementation plans and protocols.

Individuals continue to play a large part in ensuring the success in moving to Stage 2 by maintaining safety precautions like physical distancing, face coverings, avoiding all non-essential travel, and supporting and caring for people who are high risk.  

Counties can move further into Stage 2 when they attest and meet California public health criteria, under the Regional Variance Criteria. These criteria include: 

• Epidemiological Stability – no more than 1 case per 10,000 people in last 14 days 
• Testing Capacity – minimum daily testing of 1.5/1000 residents 
• Protection of Stage 1 Essential Workers with PPE 
• Containment Capacity – 15 contact tracers per 100,000 residents, and the ability to house at least 15% of county residents experiencing homelessness 
• Hospital Capacity – the ability to accommodate a 35% surge
• Skilled Nursing Facilities – must have more than 14 days of PPE on hand and an ability to restock PPE when it is low 
• Triggers for Adjusting Modifications – must understand their data and what serves as triggers for either slowing the pace through Stage 2 or tightening modifications 

These criteria can also be found on the California Department of Public Health ‘s COVID-19 website, and a technical assistance team is being assembled to work with counties and locals and certify their attestations. More information and guidance regarding regional variance will be released on Tuesday.  

As the state as a whole moves into Stage 2, physicians need to continue to prepare themselves for how this might impact their practices. To help prepare physicians for reopening, the California Medical Association (CMA) has created a Best Practices for Reopening a Medical Practice guide. This guide document includes steps to take prior to reopening, financial and staffing considerations, and universal safety precautions.  CMA has also created Guidelines and Recommendations for Reopening the Health Care System, which gives a more global look at restarting health care in California.  

CMA has a variety of reopening and other COVID-19 resources—including FAQs, toolkits and webinars—available free to physicians to aid them through this difficult time. These resources are updated regularly as new information is made available.