There are still many new COVID-19 cases in Illinois, but the number of new cases may be starting to plateau. A high percentage of the new cases are Latinx people, who, like black people, are being disproportionately impacted by the COVID-19 pandemic.
Metrics to Open the Illinois Economy
One metric being used to determine if the economy is ready to open is whether the number of hospitalizations for COVID-19 has peaked and has shown a downward trajectory for 28 days. Governor J.B. Pritzker’s Restore Illinois plan seems to put more of an emphasis on the number of hospitalizations rather than the number of new COVID-19 cases, but the number of new cases is still important because about 30% of the people who test positive for COVID-19 are hospitalized.
Another key factor that the Restore Illinois plan adds is whether the percent-positive test rate is below a threshold, and declining.
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 12 cases today, May 5, for a total of 409 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 26,606 yesterday to 27,440 today; the cases in Cook County grew from 45,223 yesterday to 46, 689 today; and the number of cases in Illinois grew from 65,962 yesterday to 68,232 today. The trend is shown in the first chart in the chart box.
Dr. Ngozi Ezike, Director of the Illinois Department of Public Health, said that there were 2,270 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 139 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 2,974.
Hospitalizations in Illinois: Gov. Pritzker reported that the number of hospitalizations due to COVID-19 in Illinois is 4,832, up from 4,780 on May 5 and 4,493 on May 4, but down from 4,953 on April 30 and 5,063 on April 29. The number of COVID-19 patients occupying ICU beds was 1,231 today, down from 1,266 yesterday. Today, 780 people are on ventilators.
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 Dr. Ezike have repeatedly said that testing is critical to opening up the economy and to do 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 last five days the number of tests administered per day was 15,312.
The number of COVID-19 tests administered in Illinois on a daily basis has gone up substantially. But Gov. Pritzker said has said that the State needs to “vastly increase” its testing.
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.
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 positive-test rate over 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%. In the last five days the test positive test rate was 17.6%.
The trend is shown in the third chart in the chart box.
To move from Phase 2 to Phase 3 under the Restore Illinois plan, a region must have a test-positive rate below 20%. The threshold is higher than some researchers say is the minimum.
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 State-wide basis, he said. The goal is to have the rate of infection below 1.0.
The Impact on Black and Latinx Communities
The COVID-19 pandemic has been having a disproportionate impact on Black and Latinx communities.
Dr. Ezike said today, “Many vulnerable populations are being affected by this pandemic, and none more than the Latinx population. … Latinx communities across Illinois are being hit hard by this virus.”
Data presented by IDPH show that 25.3% of the people who have tested positive for COVID-19 are Latinx, 19.5% are black, and 21.7% are white. The percentages of each group are likely higher because the race/ethnicity of 26% of the people who tested positive for COVID-19 is not known.
In Illinois, 61% of the population is white, 17% of the population is Latinx, and 15% is black.
Gov. Pritzker said that the Latinx population also has “the highest test positive rate of any demographic group in Illinois,” or in other words a higher percentage of Latinx people are testing positive on the COVID-19 tests than other groups. “Of the people who provided demographic information and who self-identified as Hispanic, 16,000 tested positive for COVID-19 out of 26,000 tests given,” said the Governor. “That’s a positivity rate of 60%. That’s nearly three times our State average.”
As summarized above, a high test-positive rate indicates there are many people in the community who have COVID-19, but who have not been tested. This creates a risk of spreading the virus.
Dr. Marina Del Rio, the Director of Social Emergency Medicine at the University of Illinois, Chicago, pointed to another metric. She said a high percentage of the new COVID-19 cases in Illinois are Latinx. “COVID-19 has had a profound impact in the Latino community,” she said. “Latinos represent more than 40% of the new cases reported in the State of Illinois over last week, and our numbers are continuing to grow.
“Many of us are unable to stay home because we work in essential areas of the economy, including factories, health care, public transportation service and public safety and are at a higher risk of exposure to COVID-19 and bringing it home to our families.”
Gov. Pritzker said, “Decades of institutional inequities and obstacles of members of our Latinx families are now exemplified in this pandemic.”
He summarized efforts to make testing more available in Latinx communities and said one-third of the testing facilities in the State were now in areas where there is a significant Latinx population.
Dr. Ezike emphasized that tests for COVID-19 are available free of charge.
*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.