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April 23. This afternoon, Governor J.B. Pritzker announced that he will extend the Stay-at-Home order, with some revisions, until May 31. In doing so, he explained how he relied on the modeling done by a team of experts that projected thousands of deaths if the order were not extended. A chart estimating a) what would have happened if the current Stay-at-Home order had not been entered, and b) what would happen if the current Stay-at-Home order was ended on April 24, is shown above.

COVID-19 Infections Are Still Increasing

The number of Evanston residents who have tested positive for COVID-19 increased by 12 cases today, April 23, for a total of 273 cases, according to information provided by the City of Evanston. The trend is shown in the first chart in the chart box. 

To date, a total of 8 Evanstonians have died due to COVID-19.    

For Chicago, the number of confirmed COVID-19 cases grew from 14,394 yesterday to 15,073 today; the cases in Cook County grew from 24,546 yesterday to 25,811 today; and the number of cases in Illinois grew from 35,108 yesterday to 36,934 today. The trend is shown in the second chart in the chart box.

Dr. Ngozi Ezike, Director of Illinois Department of Public Health, said there were 1,826 new cases reported in Illinois in the last 24 hours. The trend of new cases is shown in the third chart in the chart box.

The cases between April 9 and 13 increased on an average of 7.8% each day over the total on the previous day. The average percentage increase between April 14 and 18 is 5.7% each day over the total on the previous day. The average percentage increase between April 19 and 23 is 4.9%.

The five day average is decreasing – in part because the denominator (i.e., the number of cases) is increasing.

The number of residents of Illinois who have died due to COVID-19 has increased to 1,465.

Extending the Order

Gov. Pritzker began his presentation on April 23 by discussing the models and projections that he has taken into account in making his decision to extend the Stay-in-Place order, with some modifications.

“I undertook a project to give me the best possible approximations of future COVID-19 illnesses in Illinois that would then allow me to make decisions about what resources we would need to keep Illinoisans alive and recovering and what urgency would be required in decisions about whether to initiate new mitigation strategies or extend existing ones, like the Stay-at-Home order,” he said. “I have known from the start that even the ‘best’ projections are going to have a great deal of variance, but knowing the boundaries of that variance informs my decision making. So we convened top researchers from the University of Illinois at Urbana-Champaign, Northwestern School of Medicine, the University of Chicago, the Chicago and Illinois Departments of Public Health, along with outside consulting groups. They worked as a cohort under Civis Analytics using the most comprehensive data available for the entire state.”

Sergei Maslov, a Professor of Bioengineering at the University of Illinois Urbana/Champaign, said the team conducted several analyses at Gov. Pritzker’s request. He said if no Stay-at-Home order had been entered, “the number of deaths would have been at 20 times as they are today,” and the State “would have seen as many as 30,000 deaths.” In addition, he said, the order “prevented the state health system from collapse.”

The team also analyzed what would happen if the Stay-At-Home order were lifted on April 24. He said the mathematical models “can predict the current number of infected individuals which we cannot measure due to the limited testing capacity. The models predict that the number is at least 10 times larger than the number of new positive tests announced every day. Furthermore, it will remain higher even after the peak of the epidemic.

“When there’s so many infected individuals, relaxing social distancing too early would start a second wave in the epidemic,” said Dr. Maslov. “Unlike the first wave, the second wave would be started by thousands of individuals, and we would see an increase in hospitalizations and deaths. The second wave would quickly surpass the ability of our hospital system to respond.”

The top chart accompanying this article illustrates the projections of the team.

Gov. Pritzker said, “I want to look first at the projected fatalities. As you can see from the graphs next to me, Illinois is now looking at a peak or plateau of deaths per day between late April and early May.”

But he noted, “The projections are clear. If we lifted the Stay-at-Home order tomorrow, we would see our deaths-per-day shoot into the thousands by the end of May, and that would last well into the summer. Our hospitals would be full, and very sick people would have nowhere to go. People who otherwise might have won their fight against COVID-19 would die because we wouldn’t be able to help them through. No amount of political pressure would ever make me allow such a scenario in Illinois.  

“So the numbers present us with only one choice. Next week, I intend to sign an extension of our Stay at Home order, with some modifications, through Saturday, May 30th.”

He said the Stay-at-Home order would make some changes.

Surgi-centers and hospitals will be able to begin scheduling non-life-threatening surgeries that had been delayed in order to maximize statewide capacity for COVID patients. The facilities, though, will need to meet specific criteria.  Some elective procedures will also be permitted to resume.

Retail stores that are not currently on the list of essential businesses may take orders online and over the phone and offer pick-up and delivery.

Greenhouses and garden centers may remain open with specified social distancing measures in place.

There will be a phased re-opening of some state parks under the guidance of the Department of Natural Resources for activities, such as hiking and fishing, and boating with no more than two people. Social distancing must be maintained in all activities.

Any person over the age of 2 and able to medically tolerate a face-covering or mask will be required to wear one when in a public place where they cannot maintain a six-foot social distance.

For essential businesses, including manufacturers, there will be new requirements on social- distancing and new caps on occupancy.

Gov. Pritzker acknowledged that these “are only minor modifications,” but held open the possibility that “as we get to the point of working our way down the other side of our peak, there will be more to do to get people back to work and open up more.

“I see your pain,” said the Governor. “And I am so, so sorry for it. But for every person who wants to go to dinner, or hang out with friends in a park, or swing open their salon doors, there is a family mourning the death of someone they love. There is a parent, a child, a friend who would give anything to have their greatest strain be the difficulties of staying home and not the unimaginable pain of a life lost too soon.

“I’m not in the business of comparing suffering. In a pandemic, everyone is allowed to hurt. But we have the opportunity to prevent the pain of loss from touching the lives of thousands. We have the opportunity to follow the leadership of the countless nonprofits and community leaders and families across Illinois who have demonstrated their courage, and their empathy and their willingness to help.”

In the meantime, he said his team is continuing to build up testing and to launch a contact tracing initiative, which are both essential to open up the economy.