Even though most communities continue to practice social distancing, health system strategy leaders are preparing their plans to restart elective procedures and services. To safely restart, leaders must be confident that their communities and organizations are on the downslope of the Covid-19 curve. While the White House's proposed gating criteria discourages the opening of elective surgeries without a 14-day decrease in the number of cases and positive tests, the recommendation could be unnecessarily prohibitive, particularly to communities who do not meet the criteria but also lack enough Covid-19 hospitalizations to warrant an elective surgery shutdown.