After much anticipation, pressure from elected officials and protests to reopen Nevada in Carson City and Las Vegas, Nevada Governor Steve Sisolak on Tuesday released a partial plan for what it will take to reopen businesses in the state.
Sisolak said Nevada must meet four criteria provided by President Trump and the federal government before phase one of the plan can even begin.
The COVID-19 outbreak must first substantially decline. That means, over a 14-day period, there is a consistent decrease in people testing positive for the virus and fewer hospitalizations.
Second, healthcare systems must be able to maintain hospital capacity without operating under crisis standards of care and have a sufficient healthcare workforce, Sisolak said.
Additionally, COVID-19 testing for symptomatic patients and laboratory capacity to run these tests needs to be expanded. When asked how much testing is needed to enter phase one of reopening, Sisoak said he doesn’t know, but there needs to be more. Officials have increased testing capacities but say testing capacity is not yet at a level to accurately determine how much the virus has spread.
Lastly, Sisolak said vulnerable populations also need to be protected before Nevada can reopen, including no outbreaks at health facilities and nursing homes.
Gradual reopening
Once the criteria is met, Nevada will enter phase one of reopening. This phase will closely follow the criteria laid out by the federal government’s ‘Opening Up America Again‘ plan.
Under the plan vulnerable populations like seniors and individuals with underlying immunocompromising conditions are to remain sheltering in place. Restrictions on gatherings of more than 10 people, travel advisories and guidance on wearing face masks will remain in place during phase one.
For businesses, in-person visits to senior living facilities and hospitals will be prohibited. Sisolak said bars will also not open under phase one. He announced that schools in Nevada will remain closed for the rest of this school year.
Sisolak is still reviewing how to reopen gyms, restaurants, movie theaters, sporting events and places of worship. He said experts are trying to determine how they can operate with strict social distancing guidelines.
Sisolak will be working with stakeholders, community leaders and elected officials to determine the best way to gradually reopen businesses. He doesn’t have a timeline of when that will happen or what businesses will be the first to reopen their doors.
“A good friend of mine sent me a text that said, ‘If we open up on May 1, or June 1, or July 1, a year from now, you’re not going to remember what date we opened up on, but you’re sure the heck going to remember if a loved one died as a result of COVID-19’,” Sisolak said.
Reno businesses should have a plan for reopening
Moving forward, social distancing guidelines practices need to be followed in order to avoid further spikes in positive cases, according to Sisolak.
Reno Mayor Hillary Schieve said the city will be following Sisolak’s direction. She said in the meantime, businesses need to start thinking about how to implement social distancing and safe practices for staff for when they do reopen.
“Businesses should be prepared to have masks because they want to do everything they can to protect their staff and their customers, and they should be prepared to have hand sanitizer,” she said. “They should be prepared to start looking at their floor plans, especially if you’re a retail or a restaurant owner: what those floor plans look like if you can only have so many patrons in your business. Also, having very strict guidelines on cleaning protocols, and checking in with your staff, and making sure that people are not coming to work with fevers or coming to work sick.”
Not everyone is eager to go back to work. Some are afraid of getting infected upon their return. Schieve said employers need to start thinking about how to protect their employees and if they do get infected, consider providing paid sick time.
Every business is different, so reopening will be a unique process. Businesses might need to get creative in order to uphold social distancing guidelines.
“I think one thing that we could roll out is curbside commerce, certainly retail locations. I think that’s really important to be innovative,” Schieve said.
Why models vary and change
Different models are being looked at to predict when Nevada’s peak number of COVID-19 cases will be. Models can calculate how many people are susceptible to contracting the virus, how many people have been exposed but aren’t infectious, the amount of people who are currently infected, the amount of recoveries and how long it has been since the pandemic started.
During Sisolak’s press conference, Kyra Morgan, state biostatistician from the Nevada Division of Public and Behavioral Health, addressed the COVID ACT NOW model, which was originally predicting death tolls of Nevadans in the tens of thousands.
Morgan said due to control measures like declarations of emergency, Stay at Home guidances, the encouraged use of face masks and closures of schools, golf courses, church activities and non-essential businesses, the model is predicting a more positive outcome.
“All of the measures that we’re monitoring do indicate that Nevada has started to reach a plateau. However, there’s not sufficient data to indicate that we’ve actually started to see a significant decline in new cases,” Morgan said.
According to a model from the Los Alamos National Laboratory, there is an 82 percent chance that Nevada has reached its peak number of COVID-19 cases. Washoe County Health District Officer Kevin Dick also confirmed this during a media press conference on April 17, but he said it’s not guaranteed.
“We’re only really going to know when our peak was by looking back at our data and seeing the decline in our case counts occurring after the peak,” Dick said. “But it’s an encouraging sign that this model, that we think is tracking fairly closely what we’re actually seeing, is now telling us that we’re either just passed or are going to be experiencing our peak very soon.” 
“It’s important that we maintain our social distancing. In fact, double down on our actions to stay at home for Nevada, only leave home when we have essential needs to be out, keep non-essential businesses closed, cover our faces with a cloth covering when we’re out to prevent spread of disease, clean high contact surfaces frequently, wash our hands [and] use hand sanitizer. All of those messages are especially important right now,” Dick added.
On March 29, This Is Reno reported that Nevada should expect a death rate of 35 people per day by April 17 and a projected 800 people will be dead by May 20, 2020, based on a model created by the Institute for Health Metrics and Evaluation.
Those numbers have been regularly revised and now show 240 deaths from COVID-19 in Nevada by August 4.
As of Wednesday, April 22, there are 3,937 positive cases and 163 deaths in Nevada. Since the pandemic started, there has been less than a dozen additional deaths reported per day in Nevada.
The discrepancy in reporting points to the fact that COVID-19 models are in constant flux. The predictions fluctuate based off actions the community take. This is why health experts are urging individuals to continue practicing social distancing, even if COVID-19 cases begin to significantly decline. If those guidelines become loosened, Nevada could reach another peak later down the road.
“What we learned over a hundred years ago during the influenza pandemic of 1918, is that social distancing measures are extremely effective, especially when human behavior is our only intervention,” said Melissa Peek-Bullock, a state epidemiologist for the Nevada Division of Public and Behavioral Health. “We are currently battling an invisible enemy and social distancing measures have helped to flatten our curve. What we learned is that when social distancing measures are loosened too soon and without a layered approach, resurgence of the viruses is eminent.”
Large gatherings could prolong shutdown
Washoe County Health District has been seeing instances where groups of people are gathering, which they said can put the community more at risk. During the reopen Nevada protest held in Carson City on April 18, many were not keeping six feet apart or wearing face coverings.
“I am concerned that if people are not social distancing, like we’re asking them to, that they can be contributing to further spread of the disease,” Health Officer Dick said. “I think that some of the congregation that took place down there does pose a risk for spread of disease. But that said, that’s not the only place that people have been congregating. We saw the news of some arrests that were made for illegal street racing. I know that there were people that were congregating at those events that were going on as well.
“While you may not agree with the actions that have been taken with some of the business closures, if you can at least help protect other people from getting sick,” Dick said.
If people aren’t following social distancing guidelines and continue to gather in large groups, Sisolak warned that he is prepared to scale back reopenings.
Moving forward
While in the thick of the pandemic, it can be difficult to feel hopeful. However, Mayor Schieve echoes the point: this is not going to last forever.
The Nevada Hospital Association has been studying the infrastructure of hospitals since the pandemic started. The Executive Director of Community Resilience, Dr. Christopher Lake, was happy to report that COVID-19 hospitalization trends in Nevada have decreased over the past two weeks. COVID-19 ICU admissions and the need for ventilators has declined.
“The hospital infrastructure, which is a critical infrastructure here in the state of Nevada obviously, has plenty of capacity to handle anything at this point that comes our way in the next few days or weeks,” Lake said.
All of the experts agree that rigorous social distancing and emergency directives got Nevada to where it is now, and they made it clear that these guidelines must continue to be followed.
Governor Sisolak:
“The early model showed the potential for deaths in the tens of thousands if we didn’t take immediate and aggressive action, but Nevadans took this seriously and I’m proud of you. You’ve been staying home for Nevada, you’re wearing face coverings and protecting your families. You are the reason we have avoided thousands of deaths and a breakdown of our healthcare system. You heeded the calls, followed the directives and saved lives. Yes, you saved lives.”
Sisolak said, however, Nevadans can’t take their parachutes off just yet.
