Many businesses in Knoxville and Knox County will begin reopening on a limited basis Friday under a phased, three-month plan to reboot a local economy devastated by the novel coronavirus pandemic.

Restaurants, retail stores, gyms, tattoo parlors, barbershops, offices, day care centers and churches can reopen on Friday, with social distancing measures remaining in place.

A wide range of businesses will be allowed to reopen with social distancing restrictions, capacity limitations and other guidelines in place. Each step of the three-phase plan will last at least 28 days, with restrictions gradually relaxed as each new phase is entered.

“The plan is not a return to normal before the pandemic,” Dr. Martha Buchanan, director of the Knox County Health Department, said on Monday. “We have a new normal now. This is our next new normal. We’re having to adjust to a lot of changes.”

The county won’t move from one phase to another unless a set of pandemic measurements are met, and restrictions can be tightened again depending on developments. 

Buchanan, Knoxville Mayor Indya Kincannon and Knox County Mayor Glenn Jacobs unveiled the 29-page plan at a news conference Monday in the City County Building. 

“It is not an exaggeration to say this is one of the biggest crises in our history,” Jacobs said. “I don’t think there is anyone who has not suffered in one way or another.”

Kincannon said the plan is “based on data, grounded in public health principles and informed by business leaders. It has metrics that tell us when it’s safe to move forward, when to pause and when we need to go back.”

Kincannon and Jacobs haven’t always seen eye to eye on the coronavirus response, but they were in accord on Monday.

Jacobs wanted to reopen some businesses earlier than Friday, as the counties covered under Gov. Bill Lee’s most recent executive order are doing, but deferred to Buchanan and her team. “As ready as I was to pull the trigger, the last thing that we needed was to inject more uncertainty and confusion into an already tumultuous and chaotic business environment,” he said. “‘Fire, ready, aim,’ is not a good strategy.”

Kincannon, who has been more cautious than Jacobs about increasing activity, said both administrations stand behind Buchanan’s work on the reopening plan. “We’re unified,” she said. “We’re all on the same page.”

As detailed as the guidelines are, they come with no concrete enforcement mechanisms. Officials say they are relying on businesses and their customers policing themselves.

The plan was developed by the Knoxville-Knox County Reopening Task Force, formed with representatives of the Health Department, the city and county administrations, the University of Tennessee and the business community.

Buchanan headed the task force, which included Katharine Killen, the Health Department’s deputy senior director of strategy; Stephanie Welch, the city’s chief economic and community development officer; Chris Caldwell, the county’s finance director; Khrysta Baig, the county’s benefits director; Kathy Brown, director of UT’s master of public health program; Dave Miller, president of First Horizon Bank’s east region; Mike Odom, president and CEO of the Knoxville Chamber; and Ryan Steffy, managing partner of SoKno Taco Restaurant.

In addition to their government positions, Welch and Baig have backgrounds in public health. Brown, Miller, Odom and Steffy are also the city of Knoxville’s representatives on a task force formed by the mayors of Tennessee’s four largest cities to give input on the state level.

Buchanan has reissued the county’s Safer at Home order through Thursday, with the new plan going into effect the following day. (The complete plan can be found here.)

General Provisions

Throughout the three-month restart, the Health Department emphasizes that all businesses and residents should follow five “core actions” that by now have become familiar — keeping at least 6 feet away from others when in public, wearing cloth face coverings when physical distancing cannot be consistently maintained, frequent hand washing or using hand sanitizer, cleaning surfaces, and staying home when sick.

“Consider yourself and consider the people that you interact with to potentially be infected with COVID-19, whether they’re sick or not, and take measures appropriately,” Buchanan advised.

Employers are to conduct daily medical screening of their employees by asking a series of health-related questions. The Health Department wants workers to take employees’ temperatures with no-touch thermometers when they arrive for work or get them to take their own temperatures before their shifts begin. Employees should stay home when sick and self-isolate if they are awaiting COVID-19 test results.

Different industries will have individualized requirements. Restaurant capacity, for example, will be based on the number of seats allowed by permit, while the capacity of retail stores will be based on the number of people allowed inside by building and fire codes.

The plan envisions each organization to select a COVID-19 coordinator for each of its locations to manage anti-coronavirus policies, educate employees and customers, and to work with the Health Department as needed. Employers will be given two safety signs to post in their businesses.

A multi-agency group will provide guidance to the business community and answer questions about the guidelines. The Health Department is also setting up a call center and will hold virtual training sessions. The business’ COVID-19 coordinators can sign up for a listserv at covid.knoxcountytn.gov so they can receive information and updates, including any changes to the guidelines.

Employers who select COVID-19 coordinators, display the two safety signs mentioned above and enroll in the COVID-19 communication listserv will be given the opportunity to display a certificate showing their commitment to the health of their employees and customers. 

Three Phases

The plan outlines a three-phase process for resuming relatively normal economic activity. Each phase will last at least 28 days, and the transition from one phase to the next will occur only when certain benchmarks are met.

“Each of those phases allows a relaxing of restrictions and a slow, slow, slow return to normal,” Buchanan said. “During each phase, there will be guidance for individuals, businesses and organizations.”

The first phase, which begins Friday, contains more detail than the subsequent phases. The plan’s sections on the subsequent phases are more of a framework than a finished product so they can be tailored to fit new circumstances.

Restaurants, retail stores, offices, preschools and daycares will be able to open on Friday, albeit with strict social distancing guidelines in place. 

At restaurants, for example, seating is restricted to half capacity and tables must be at least 6 feet apart. No more than six people can dine together, and patrons cannot stay inside while waiting to be seated. No buffets, self-service beverage stations or shared condiments are allowed.

Bars and the bar areas of restaurants will be closed, however. “We’ve left bars closed because bars are designed for people to gather close together and socialize, and we really don’t want that to happen,” Buchannan said.

Retail stores will have to limit the number of customers inside to half the occupancy allowed in the space by Tennessee’s Building and Fire Code.

Owners should install floor markers to encourage social distancing, change traffic flows to one-way in designated aisles and add plexiglass barriers at cash registers. 

Gyms and fitness centers will be allowed to open, but people working out will have to answer screening questions and wear masks. The guidelines allow only five members per 1,000 square feet and equipment will have to be placed or restricted so that only those at least 6 feet apart can be used.

The plan encourages churches and other places of worship to continue virtual or video services, and only core services — no Sunday school, for example — will be permitted inside buildings. Onsite services should be limited to half the seating capacity, and multiple services, which would reduce the number inside at any one time, will be encouraged. 

The Health Department does not recommend offering communion and discourages singing, both of which could more easily spread the coronavirus.

Beauty parlors, barber shops and tattoo parlors will be allowed to open as well, but must work by appointment only — no walk-ins. The Health Department recommends plexiglass barriers in stations to minimize contact between employees and customers, and it’s a requirement for nail and pedicure stations.

Theaters, libraries, senior centers, playgrounds and pools will remain closed in the first phase, as will large indoor and outdoor venues for sports and concerts. Mass gatherings — whether for business, religious, entertainment or athletic purposes — are banned.

At Monday's monthly meeting of Knox County Commission, Commissioner Larsen Jay raised questions about the way the guidelines treat different settings and events. For example, he noted that stores and churches could potentially have large numbers of people in the building as long as social distance requirements are met, but other events — like weddings or live music performances — are restricted to small groups for the next several months.

"It knocks out a huge industry, which is the event industry, which could be anybody from caterers to tent suppliers to wedding venues," Jay said. "You couldn't even have a wedding outside, even if you social distance, with a large group according to the guidelines."

Buchanan acknowledged the difficulties. "I think we're going to have to pay attention to cases from places like churches," she said. "It's a slippery slope. It's a bit of a challenge to allow churches to open, but we felt like that was something our community needed."

The second and third phases of the plan build on the first. The maximum size of social gatherings is limited to 10 in the first phase, 50 in the second and 100 in the third. Restaurant and retail store capacity will be increased incrementally as well. Industry-specific guidelines will be added through a “collaborative community process” involving business’ COVID-19 coordinators.

Progress, Compliance and Enforcement

To allow a transition from Phase 1 to Phase 2, the Health Department will track a number of metrics. Buchanan has repeatedly warned that increased commercial activity will inevitably lead to more cases of COVID-19, but she said case counts in isolation won’t be the only determining factor.

Still, the task force determined that one requirement would be a sustained reduction or at least stability in new cases for 14 days. (As if on cue, the Health Department reported on Monday that Knox County's COVID-19 case count remained unchanged overnight, the first 24-hour period without in increase since March 21.)

A cluster of cases at one location — a workplace or a church, for example — wouldn’t necessarily indicate a problem in the community at large. “It’s not just about a number,” Buchanan explained. “It’s about the number in context.”

A month under the new restrictions, she continued, will give public health officials a better grasp of the situation. “We want to give ourselves enough time to see what was the impact of the changes we made, what were the things that worked, what we need to back off on,” she said.

Testing levels, hospital capacity, ventilator availability, and the ability to rapidly conduct case investigations and monitoring are among the other requirements for loosening restrictions going forward. 

Another factor is the death rate. Knox County has only had four fatal cases, and no new ones since April 8. “Deaths from the illness show us not just the burden of the disease but the severity of the disease,” Buchanan said.

Buchanan said changes in the data could indicate that some or all restrictions need to be put back in place. The key, according to Buchanan, Jacobs and Kincannon, is how seriously the public takes the social distancing precautions. 

There is no enforcement mechanism under the plan. Jacobs said the market would police business owners who want to skirt the plan’s directives.

“If you see businesses that aren’t doing something, or are doing something, you don’t feel comfortable about, and aren’t doing things they should do, I think they’re going to be punished because people aren’t going to go and it will get out,” he said.

Kincannon said she’s talked to numerous business owners who have told  her it would be in their best interest to follow the guidelines. “They care deeply that their customers stay healthy and their staff stay healthy, because that’s not just the right and humane thing to do, it’s also good for their business,” she said.

If the data show the activity from reboot has caused a wave of new cases, the Health Department can retreat to a more restrictive phase, and the clock would start over again. Even if all goes according to the plan, social distancing, masks and other measures to slow the spread of the coronavirus will be part of daily life in Knoxville and Knox County for at least the next three months.

“We still have a long way to go before we fully open our road to recovery,” Buchanan said.

CLARIFICATION: This article has been updated to note that Knox County's total case count remained unchanged overnight on Sunday. According to Dr. Martha Buchanan, the Health Department director, four new cases involving Knox County patients were added to the total and an equal number removed because the patients live elsewhere.