ASTHO Statement on Easing Public Health Measures Amid COVID-19 Outbreak

March 27, 2020

ARLINGTON, VA—Michael Fraser, chief executive officer of the Association of State and Territorial Health Officials (ASTHO), issued the following statement today in response to the ongoing national discussion about when to end or ease public health measures to reduce the risk of COVID-19 transmissions.

“Like all Americans, our nation’s state and territorial public health leaders are looking forward to ending and/or easing current restrictions on mass gatherings, non-essential business closures, social distancing, and other measures that have drastically impacted the lives of so many. As federal leaders look to reduce or ease emergency restrictions and create ‘risk categories’ for COVID-19 transmission, we believe they should consider the following measures.

“Decisions to end or ease restrictions should:

  • Be made in direct consultation and partnership with governors and their appointed state or territorial health officials, emergency management officials, and public health and healthcare partners.
  • Be data-driven and based on sound public health evidence that demonstrates that the risk of community transmission of COVID-19 in a state or territory has been eliminated entirely or is minimal and can be prevented through self-isolation.
  • Account for the capacity of the jurisdiction to rapidly stand-up a public health response to contain new cases or respond to a new COVID-19 outbreak regardless of a risk designation.

“Decisions to reduce or end restrictions on mass gatherings and social distancing will differ based on state and regional factors, including the prevalence of COVID-19, population density, healthcare system capacity, and the rate of community transmission in different states and territories. As such, federal public health officials and the administration must work collaboratively with states and territories to develop guidelines that prioritize evidence-based decisions on when and how to ease or end restrictions for specific jurisdictions.

“The use of designations ‘low-risk,’ ‘medium-risk,’ or ‘high-risk’ may be misleading when used in the context of an acute infectious disease that can quickly be transmitted person to person. This could create a false sense of security in a community designated ‘low-risk’ while also creating fear and reinforcing stigma in an area deemed ‘high-risk.’ Many factors influence disease transmission; as we have seen nationally, an asymptomatic, COVID-19-positive traveler who enters a community may quickly spread the virus unintentionally, which could change the risk designation within a single day.”


ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.