Abstract

The first cases of the novel severe acute respiratory syndrome coronavirus 2 infection were discovered in the United States and Canada in early 2020. The illness has rapidly spread during the past few months. State/provincial and local governments implemented shelter-in-place orders in March 2020 in reaction to the virus, and non-essential ambulatory care, including allergy/immunology services, was drastically reduced. There is a need to assist the allergy/immunology doctor in resuming services when constraints on the delivery of basic ambulatory care are lifting and incidence of new infections and fatalities may be plateauing or reducing. We present a flexible, algorithmic bestpractices planning approach on how to prioritise services, in 4 stratified phases of reopening according to community risk level, and highlight key considerations for how to safely do so, given that coronavirus disease 2019 will circulate within our communities for months or longer. The choice of what services to provide and how quickly to go forward is left up to the individual clinician and practise, functioning in compliance with local and state laws regarding the amount of optional ambulatory care that may be offered. Given that this is a changing situation, there may be forward movement through the phases—and even backward movement—and there should be clear communication with staff and patients before and after all changes.