The 7SEF: Stage 7 - Reopen

This is Stage 7 of ICAN's 7 Stage Elimination Framework. You can read the Introduction here.

Goal: To safely and reliably return society to normal.

Timeframe: Most business and other social venues can expect to resume normal operations within 4 weeks of reopening, with the reopening of the largest venues deferred.

The reopening process is managed in phases that gradually lower the degree of social distancing in society. The phases and the measures in effect are communicated by the government in advance of implementation. As more time passes without a confirmed case, the risk of hidden transmission falls, so larger numbers of people can be allowed to gather and in higher densities. As we work through the phases, the social distancing requirements are eased, and society gradually returns to normal.

Schools and creches are open. Gyms and salons are open. The vast majority of businesses, venues, and public spaces are open and free to serve their customers from the start of the reopening process. The number of customers that they can serve is determined by the venue’s risk profile, including the size of the premises, the degree of ventilation, and the duration of the customer’s stay. Restrictions remain on venues and events that are exposed to super-spreader risk, but these restrictions begin to roll off after a month without a confirmed case.

The fear and uncertainty that has characterised life in Ireland over the last year can only end when the people are confident that their health can be protected without resorting to civilian-level restrictions. This can be achieved post-elimination by combining population-level screening and surveillance programs with a robust contact tracing system. If these measures are designed and implemented effectively, the people can be confident that the days of extreme restrictions are behind them. The clouds will part, and they can begin to plan their lives again.

Implementation | Screening and Surveillance

Screening and surveillance are population-level measures that can find pre-symptomatic and asymptomatic individuals in the population, enabling earlier detection of the virus and reducing potential transmission. They include PCR testing of sewage and wastewater, temperature checks at entrances to public spaces, and repeated rapid testing in schools, universities and workplaces. The rapid testing approach naturally integrates itself into our social lives and community structures, so that individuals are automatically tested during the course of their day, without having to book a test or wait for a result. High volume rapid testing is also cheaper, simpler, and less resource-intensive than PCR testing, so it provides marginal cost savings over time.

Implementation | Contact Tracing

If and when the screening process leads to a confirmed infection, the individual goes straight to isolation and the contact tracing system will be activated. The individual’s close contacts from the previous 14 days are traced and moved to quarantine, where they receive regular testing. Contacts of contacts are also be traced, tested, and quarantined. If the full contact-tracing process happens within 4 days of the test result, policymakers can be confident that they have successfully traced the infection back to its source and there will be no opportunity for community transmission to occur. In a ‘ZeroCOVID’ environment, there would be few cases to trace and the contact tracing system may not even need permanent staff. It can perform at a significantly higher level and with a lower demand on our health care resources.