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New report recommends four-tiered steps to reduce the risks of reopening during the COVID-19 pandemic

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Summary of alert-level systems for COVID-19 based on experience from U.S. and around the world
 WED, MAY 20 2020-theG&BJournal- COVID-19 is a long-term threat to public health, with most experts predicting waves of infection until there is a vaccine or highly effective treatment.
Staying Alert: Navigating COVID-19 Risk Toward a New Normal” recommends that governments implement a four-tiered, color-coded level system that grades the current state of risk from red, “4-Very High Risk,” to green, “1-New Normal.”
The report was released today by Resolve to Save Lives, an initiative of the global health organization Vital Strategies, based on an intensive review of the best practices in countries around the world and states in the U.S.
Levels are based on publicly available, critically important data, have objective triggers, and provide practical, actionable information to guide policies and behaviors at each level. The color and numerical coding also communicates risk-level information clearly, similar to the types of warning systems used for weather and air quality. Although no single system is appropriate for every setting, if designed and implemented well, alert-level systems protect health while enabling social and economic activity to resume.
“We’re at an inflection point in the COVID-19 pandemic response. Cases are coming down and people are going out,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives. “If governments use a graded, objective, transparent alert system they can protect both health and the economy in the different phases of the pandemic. Our ‘Staying Alert: Navigating COVID-19 Risk Toward a New Normal’ report outlines a system governments use to empower people to protect themselves and their families.”
“People should expect routine, clear and data-driven guidance on the changing levels of risk and how to respond. A color-coded alert system for COVID-19 empowers the public and inspires confidence,” said Amanda McClelland, Senior Vice President for the Prevent Epidemics team at Resolve to Save Lives. “In the not-too-distant future, knowing that this is a week to wear your mask should be as easy and straightforward as bringing an umbrella to work on a rainy day.”
Based on a first-of-its-kind comparison of alert-level systems, “Staying Alert: Navigating COVID-19 Risk Toward a New Normal” provides a four-tiered framework for governments to adopt to support clear decision-making, improve accountability and transparency, and communicate with the public to ensure needed behavior change. In addition to highlighting key principles and features of effective alert-level systems, the report provides a reference for the strong datasets that must support such a system, notes that the best systems are developed with the involvement of a wide set of stakeholders, and provides a list of pitfalls and how to avoid them.
“The recommendations in ‘Staying Alert: Navigating COVID-19 Risk Toward a New Normal’ lean on decades of practice in the field of risk and crisis communication,” said Sandra Mullin, Senior Vice President for Policy, Advocacy and Communication at Vital Strategies. “Our ‘new normal’ will require governments to convey changing and complex COVID-19 information to the public. A systematic alert system is a lifesaving intervention that can break this down into easy-to-understand and easy-to-follow guidelines for the public.”
To bolster this alert system, a collaboration of expert partners supported by Bloomberg Philanthropies will soon roll out tools to help city leaders better manage their responses to these alert levels. What Works Cities, working closely with Johns Hopkins University’s Bloomberg School of Public Health, Vital Strategies and other collaborators, will develop and share metrics that city leaders can use to nimbly govern their cities as the crisis evolves.
The report highlights the features of alert-level systems that several governments have adopted. South Africa’s Risk Adjusted Strategy provides details on how restrictions will be loosened and tightened in each economic sector, using epidemiologic and fiscal data to guide these changes. Other systems use economic and social indicators when determining the level, such as the system in effect in the state of Utah in the U.S.. Singapore’s Disease Outbreak Response System Condition (DORSCON) applies to any disease outbreak and provides messaging to the public, and New Zealand’s COVID-19 Alert System focuses specifically on COVID-19.
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