Governor J.B. Pritzker said today, May 4, that if people are being “persistently defiant” of his executive orders, “I do think local law enforcement needs to step in.” Reports indicate that 1,000 dispersal orders were entered in Chicago over the weekend, and about 60 parishioners attended a church service on Sunday after losing a motion for a temporary restraining order on Saturday.
Some good signs are that the Illinois Department of Public Health (IDPH) reported the lowest death rate today in two weeks, that the infection rate has been reduced to 1.2, and that the alternative care facility at McCormick Place is being deconstructed.
Measures to Open the Illinois Economy
One measure being used to determine if the economy is ready to open is whether the number of COVID-19 infections and/or the number of hospitalizations has peaked and has shown a downward trajectory for 14 consecutive days. In the last 10 days, Gov. Pritzker has seemed to put his focus on the trend in hospitalizations.
Gov. Pritzker has also repeatedly said that other measures include whether testing, tracing and treatment are in place. In addition, he says it is critical that an adequate amount of Personal Protection Equipment (PPEs, e.g., face masks, gowns, etc.) be available.
Below are data showing the trends in infections, hospitalizations, and testing.
The Number of Infections and Hospitalizations
Evanston: The number of Evanston residents who have tested positive for COVID-19 increased by 8 cases today, May 4, for a total of 391 cases, according to information provided by the City of Evanston. The trend is shown in the above chart.
To date, a total of 11 Evanstonians have died due to COVID-19.
Chicago, Cook County and Illinois: For Chicago, the number of confirmed COVID-19 cases grew from 24,864 yesterday to 25,866 today; the cases in Cook County grew from 42,324 yesterday to 43,776 today; and the number of cases in Illinois grew from 61,499 yesterday to 63,840 today. The trend is shown in the first chart in the chart box.
Gov. Pritzker said that there were 2,341 new confirmed cases reported in the last 24 hours in Illinois. The trend of new cases is shown in the second chart in the chart box.
The number of deaths in Illinois due to COVID-19 increased by 46 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 2,662. This was the lowest number of deaths since April 19, and it follows reports of 142 deaths on April 28 and 140 on April 29. Gov. Pritzker said, “When I saw this number today, I was hopeful that this was the beginning of a trend that I’ve been praying for.” He pointed out, though, that it is important to look at data for a three- or four-day period.
Hospitalizations in Illinois: Gov. Pritzker reported that the number of hospitalizations due to COVID-19 in Illinois was 4,493 today, down from 4,953 on April 30 and 5,063 on April 29. The number of COVID-19 patients occupying ICU beds was 1,214, down from 1,290 last week. Today, 763 people are on ventilators, about 20 fewer than the high of last week.
Gov. Pritzker has said the number of hospitalizations is a key factor that he would consider in deciding whether to open the economy. He said he wanted to see that number peak and then decline for 14 successive days.
The State’s hospitals have capacity to handle the numbers of patients reported above. As of May 4, there were 10,950 hospital beds open, 941 ICU beds open, and 2,354 ventilators available.
Adequacy of Testing
There are two measures to assess the adequacy of testing discussed by researchers: 1) the number of tests given in relation to the population; and 2) the percentage of people who test positive for COVID-19.
The Number of Tests in Illinois: Both Gov. Pritzker and IDPH Director Dr. Ngozi Ezike have repeatedly said that testing is critical to opening up the economy and doing so in a manner that protects the health and safety of the people. More than a month ago, Gov. Pritzker established a goal to give 10,000 tests per day. Last week, the State surpassed that goal, but both he and Dr. Ezike say that more testing is needed. They have not yet set a new goal.
In the first five days of April, there was an average of 5,152 COVID-19 tests administered in Illinois each day. In the five days between April 29 and May 3, there was an average of 15,365 COVID-19 tests administered in Illinois each day. On May 4, the number of tests reported in the prior 24-hour period was 13,824 tests.
The number of COVID-19 tests in Illinois has gone up substantially.
Some researchers say that on a nationwide basis the minimum number of COVID-19 tests to safely open the economy is 500,000 per day, which would require about 150 tests for every 100,000 people.*
For Illinois to meet that target, it would need to give about 19,500 tests per day. On May 3, there were a total of 19,417 COVID-19 tests administered in Illinois. Gov. Pritzker said today that the State needs to “vastly increase” its testing, which seems to indicate that the State’s goal is much higher than that.
Some researchers put the number of tests needed at more than ten times that amount.**
The Percent Positive Test Rate: There are many undiagnosed cases of COVID-19, because there has been limited testing capacity. Both Gov. Pritzker and Dr. Ezike have acknowledged that that confirmed number of COVID -19 cases reported daily by IDPH grossly understates the actual number of COVID-19 cases, because it does not capture people who have shown mild symptoms, or have are asymptomatic and who have not qualified for testing.
One measure used by researchers is to assess whether the amount of testing is adequate is to look at the percent of people who test positive on COVID-19 tests. The World Health Organization suggests that a test positive rate should be between 3% and 12%. A test positive rate greater than 10% likely reflects that there is an inadequate amount of testing and that it should be increased to cast a wider net.***
In the first five days of April, there was an average positive test rate was 20.4%. Between April 29 and May 3, the average positive test rate was 17.54%.
On May 4, the test positive rate was 16.9%. The trend is shown in the third chart in the chart box.
Illinois’s test positive rate is still above 10%.
The Rate of Infection: Another measure that shows how the spread of the virus is being contained is to measure how many people, on average, are being infected by a single person. Gov. Pritzker said the rate of infection was 3.5 at the time the Stay-at-Home order was entered. It is 1.2 today on a Statewide basis, he said. The goal is to have the rate of infection below 1.0.
Deconstruction of McCormick Place
The State recently converted McCormick Place into an alternative care facility with about 3,000 beds that could care for people with less serious cases of COVID-19. Before moving ahead with that project, Gov. Pritzker said every model that estimated the bed need to treat COVID-19 patients in Illinois projected that Illinois would need many additional beds. A good sign is that the State is now planning to deconstruct the portions of McCormick place that were set up to treat patients with COVID-19.
One hall with 500 beds is in the process of being deconstructed, Gov. Pritzker said. He added, “We’re keeping a portion of it working in case of a surge,” but the last part of it, which is equipped to handle more serious cases, will be taken down in the next few weeks.
Only about 30 people were treated in the facility. Gov. Pritzker said the fact that the State has not had to use the facility more than it has “is an indicator of the success of entering the Stay-at-Home orders and getting people to adhere to them.”
Beloved Church Loses Bid for a TRO
Last Thursday, the Beloved Church in Lena and its pastor filed a lawsuit in federal court in Rockford, alleging that the Stay-at-Home order precluded the congregation from attending church services, in violation of their First Amendment right to freedom of religion. As part of their suit, the Beloved Church sought a temporary restraining order that would block enforcement of the Stay-at-Home order and permit them to hold worship services.
On Saturday evening the Court denied the request for a TRO. The Court held that the Stay-at-Home order passed Constitutional muster in light of the continuing threat posed by COVID-19, and because the order permitted “relatively robust avenues” for prayer and fellowship.
The pastor went forward with church services on Sunday, with about 60 people in attendance.
Gov. Pritzker said, “It’s important to get together with your fellow parishioners and your pastor, but we’ve asked people to do it in groups of less than 10,” and using social distancing, and “have provided other suggestions on ways people can get together.”
When asked if he would seek to have the Stay-at-Home order enforced against the Church, Gov. Pritzker said, “We have always asked local law enforcement to enforce these violations, and the best way to do that is a reminder to the pastor and the parishioners that they are putting themselves and others in danger by holding services.”
When pressed if he would ask for enforcement measures beyond dispersal, Gov. Pritzker said, “If people are persistently defiant, they can be put in jail. I’m not suggesting that’s the best answer or the first answer, but it is something that’s an option for law enforcement.”
Dispersal Orders in Chicago
Over the weekend police reportedly issued 1,000 dispersal orders in Chicago. Gov. Pritzker said, “To the extent people are gathering in groups, they’re going to spread the virus and they’re going to cause us to go back into a previous executive order or a more stringent lockdown than what we’ve had.
“I want to remind everybody it’s a mistake.” He said since there is no vaccine and no known treatment, and “the only way to defeat this virus is by obeying social distancing, by obeying the orders that have been put in place.
“If people are being persistently defiant, I do think local law enforcement needs to step in, but it’s up to the mayor, and it’s up to local law enforcement to make the decision.”
When Will People Know of the Plan?
Gov. Pritzker said people will not need to wait until May 30 to know what the plan is to loosen up more restrictions of the Stay-at-Home order. While saying he will be guided by the data and metrics, he said he would be giving people a view into how the phases might work, and how many phases there would be, and would happen in each phase. He did not say when he would provide this information.
*Ashish Jha, MD, MPH, the Faculty Director of the Harvard Global Health Institute, and two colleagues conclude in an April 18 article “Why we need at least 500,000 tests per day to open the economy – and stay open,” that on a nationwide basis at least 500,000 tests a day are needed to succeed with the opening of the economy and to stay open. They add that number “is probably too low” and “we likely need many more.” Link: https://globalepidemics.org/2020/04/18/why-we-need-500000-tests-per-day-to-open-the-economy-and-stay-open/?referringSource=articleShare
That is about triple the number being administered now, and it would require about 150 tests per day per 100,000 people.
** Other researchers put the number much higher. A report, “Roadmap to Pandemic Resilience,” published by the Edmond J. Safra Center for Ethics at Harvard University, recommends massive scale testing for COVID-19, together with supported isolation as the path to open up the nation’s economy. The report, updated on April 20, has 23 authors, with expertise in many different disciplines.
The Safra Center report says, “We need to deliver 5 million tests per day by early June to deliver a safe social reopening. This number will need to increase over time (ideally by late July) to 20 million a day to fully remobilize the economy.” Link: https://ethics.harvard.edu/files/center-for-ethics/files/roadmaptopandemicresilience_updated_4.20.20_0.pdf
*** See article by Ashish Jha cited above.