San Luis Obispo County Public Health Officer Penny Borenstein chose a fitting metaphor to describe the coastal county's approach to gradually easing the shelter-at-home restrictions triggered by COVID-19.

"I think of this as sort of a building tide," Borenstein explained on May 1, moments after local officials released a 64-page SLO County START Guide (Steps to Adapt and Reopen Together). "We'll release some [restrictions]—and kind of see how it goes. Release a little more—and see how it goes. And ultimately, if we're still in a safe and good place, we'll get back to this new normal."

A panel of five medical experts, including epidemiological and infectious disease specialists, authored the document, while a "project team" of county administrators and members of the Central Coast economic think tank REACH solicited input from more than a dozen sectors—from downtown associations, to agriculturalists, to schools and colleges.

"These doctors synthesized national and state guidelines," said Andrew Hackleman, vice president of strategy at REACH, "and we took that and got stakeholder input to help guide the development of the different phases and standards."

The work took place as SLO officials anticipated that Gov. Gavin Newsom would eventually amend his statewide shelter order and hand over COVID-19 governance to local jurisdictions. On May 4, Newsom initiated that process.

While announcing that the state would ease restrictions on some retailers and manufacturers as early as May 8 to allow their partial reopening, Newsom also opened the door for counties to make a case for their locally developed plans.

Counties that have pushed for this, like SLO—whose state and local representatives were among the first in California to ask Newsom for local control—will be required to submit "containment plans" to the state documenting their ability to sufficiently test for the virus, conduct contact tracing, and handle surges at hospitals. If the state agrees, it indicated it may allow those counties to move forward with plans that are more permissive than the state's current framework.

At a May 4 press conference, Borenstein said she's confident SLO County can take the reins. With low case and hospitalization numbers, an expanded ability to test, and ample hospital capacity, local leaders are confident about moving into Phase I of a three-phase process.

If SLO gets the green light, it will allow the partial reopening of most businesses and some community facilities. These include retail stores, offices, manufacturers, body art facilities, restaurants, bars, beverage tasting rooms, movie theaters, museums, places of worship, K-12 summer school, gyms, pools, parks, playgrounds, beaches, trails, and campgrounds.

The START guide includes a set of draft guidelines that residents and employers will be in some cases required, and in other cases asked, to adhere to.

"What you will see in this document at this time are best-practices guidelines. ... Some things will be musts and some things will be recommendations," Borenstein said on May 1. "You will not find absolutes in this plan, but again, it's designed to give our business partners, our organizations, our places of worship, the best ideas of how to begin planning in the days and weeks to come."

Some guidelines apply to all businesses, like displaying COVID-19 signage, enforcing 6-foot social distancing, reducing customer numbers, and encouraging or requiring face coverings.

Others are sector specific. Restaurants will have capacity limits to ensure 6-foot distancing between parties. Bars may have to install Plexiglas to separate bartenders from customers, and customers from each other. Hotels won't have breakfast buffets, and their guests will be asked how they're feeling when they check out. Gyms will need to disinfect equipment after every use and implement midday halts to conduct thorough cleanings of their facilities. Events—parties, concerts, shows, sporting events—of more than 10 people are prohibited.

While reopening will likely be difficult, most business owners realize it's in their best interest to proceed cautiously, REACH's Hackleman told New Times.

"There was a lot of understanding, because what would be even more damaging to them would be to open and then have to close again [due to a COVID-19 outbreak]," he said. "That would be devastating."

Phase II allows body massage and sauna facilities to reopen, loosens some of the business guidelines, and allows gatherings of up to 50 people. Phase III—the final phase—eases social distancing for non-vulnerable populations, fully reopens schools and businesses, and allows entertainment and sporting venues to reopen.

Moving to the next phase requires positive health conditions to be present for 30 consecutive days. Conversely, the county can be forced to go back phases if negative health circumstances arise.

Positive indicators include no significant increases in cases (especially of cases not linked to a source) for 14 days; an ability to handle a 30 percent surge in critically ill patients; and an ability to test 100 percent of symptomatic people and conduct contact tracing for at least 90 percent of positive cases. The negative indicators are essentially inverses of the positive indicators.

Borenstein said that moving slowly is the only way forward in the face of a virus that's killed more than 60,000 Americans to date.

"We don't want to have wasted all the hard work our community has done over a period of weeks," she said. "The reason to move slowly is to lift the veil, allow our businesses to come back, to restore their incomes, to get out of the house, but to do so in a stepwise fashion." Δ

Assistant Editor Peter Johnson can be reached at pjohnson@newtimesslo.com.