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Under Governor J. B. Pritzker’s Restore Illinois plan, the Northeast Region is on track to move from Phase 2 to Phase 3 in about 8 days. Evanston is in the Northeast Region, along with the rest of Cook County and eight other counties.
To move to Phase 3, the Northeast Region must meet benchmarks relating to hospitalizations, testing, and tracing.
The Number of Infections and Hospitalizations
One metric being used to determine if a region may move to Phase 3 is that there be no overall increase in hospital admissions for 28 days, and that hospitals in the region have an unused bed capacity of at least 14%.
While the Restore Illinois criteria focus on the number of hospitalizations, rather than new COVID-19 cases, the number of new cases is still important, because about 30% of the people who test positive for COVID-19 are hospitalized, said Dr. Ngozi Ezike, the Director of the Illinois Department of Public Health.
The data below show new COVID-19 cases in Evanston, Cook County, and Illinois, and the number of hospital admissions in the Northeast Region.
New COVID-19 Cases
New cases and deaths of Evanstonians: The number of Evanston residents who have tested positive for COVID-19 increased by 17 cases today, for a total of 613 cases, according to information provided by the City of Evanston. The trend is shown in the above chart.
To date, a total of 25 Evanstonians have died due to COVID-19.
New cases and deaths in Cook County and Illinois: Today, there were 1,311 new confirmed cases of COVID-19 in Cook County and 2,268 in the State. The trend, which has wide variations from day to day, is shown in the smaller chart above.
Since May 1, there have been 31,001 new confirmed cases of COVID-19 in Cook County and 49,761 new confirmed cases in Illinois.
Dr. Ezike said the high number of new cases is due to more tests being administered in the State.
The number of deaths in Illinois due to COVID-19 increased by 87 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 4,607.
Hospital Admissions/Capacity in the Northeast Region
IDPH posts summary information showing how the Northeast Region is doing in terms of meeting the criteria to move to Phase 3. The data shows that as of May 21:
- Hospital admissions have declined by 45.7% in the Northeast Region since May 1. This is on track to meet the criteria.
- The Northeast Region has available 19.4% of its medical/surgical beds, 21.3% of its ICU beds, and 63.7% of its ventilators. This is on track to meet the minimum capacity of 14%.
- The test-positive rate, using a seven-day rolling average, is 16.8%, which is below the maximum of 20% stated in the plan.
IDPH does not report data showing whether any region is meeting or on track to meeting the criteria for tracing.
Gov. Pritzker said, though, that the Northeast Region is on track to meeting all the criteria to move to Phase 3 at the end of this month.
Adequacy of Testing
The Restore Illinois plan does not set a goal in terms of the number of tests that must be given in a region to advance to less restrictive phases. Rather, to move from Phase 2 to Phase 3, a region must have testing available “for all patients, health care workers, first responders, people with underlying conditions, and residents and staff in congregate living facilities.”
The plan does not state how IDPH will determine if a Region is meeting this criterion.
The Number of Tests in Illinois
In a May 7 study, the Harvard Global Health Institute (HGHI) estimated that Illinois needed to be administering 64,167 tests a day in order to safely open the economy.*
When asked about this number on May 7, Gov. Pritzker said, “I don’t think 64,000 is adequate for the State of Illinois. I think we’re going to need many more tests than that.”**
While the State has almost quadrupled the number of tests it has been administering in the last six weeks, the average per day between May 17 and 21 is 22,074, still far short of the target of 64,167 set by HGHI.
In the last 24 hours, there were 29,307 COVID-19 tests administered in Illinois, the highest number yet, said Dr. Ezike.
The Percent Positive Test Rate
One measure used by researchers to assess whether the amount of testing is adequate is to look at the percent of people who test positive on COVID-19 tests. According to the World Health Organization and some researchers, a test-positive rate greater than 10% likely reflects an inadequate amount of testing. ***
In the Restore Illinois plan, one criterion to move from Phase 2 to Phase 3 is that a region have a test positive rate below 20%. In determining whether this criterion is met, IDPH says it will use a seven-day rolling average.
IDPH reported today that the test positive rate for the Northeast Region was 16.8%, down 5.2 percentage points in the last 14 days.
While the Northeast Region meets the criteria of the Restore Illinois Plan, it is still higher than the maximum threshold recommended by WHO and some researchers.
The Restore Illinois plan provides that a Region must meet the criterion for contact tracing to move from Phase 2 to Phase 3. The requirement stated in the plan is “Begin contact tracing and monitoring within 24 hours of diagnosis.”
IDPH has not posted information on its website to show if the Northeast Region is meeting these criteria.
On a Statewide basis, Gov. Pritzker said on May 18, “Only about 29% of our known cases are engaged in a tracing process.”
*Ashish Jha, MD, MPH, the Faculty Director of the Harvard Global Health Institute (“HGHI), and two colleagues conclude in a May 7 report, “HGHI and NPR publish new state testing targets” that on a nationwide basis 900,000 tests for COVID-19 are needed by May 15 to open the economy. They also provide estimates of the tests each state should be ready to provide by May 15. For Illinois, they say that 64,167 tests a day are needed. Link to HGHI’s report: https://globalepidemics.org/2020/05/07/hghi-projected-tests-needed-may15/
HGHI’s report said it was publishing its results in partnership with NPR, and it provides a link to the article that published HGHI’s results in a little more detail. The article notes that other organizations have estimated that Illinois needs 44,898 tests per day (Los Alamos) and 96,342 tests per day (MIT). What the various models have in common is that they show that the number of COVID-19 tests currently being administered on a daily basis in Illinois is very low. Link to the article: https://www.npr.org/sections/health-shots/2020/05/07/851610771/u-s-coronavirus-testing-still-falls-short-hows-your-state-doing
A report, “Roadmap to Pandemic Resilience,” published by the Edmond J. Safra Center for Ethics at Harvard University, concludes that on a nationwide basis the nation needs to be doing 5 million tests per day by early June to deliver a safe social reopening. ” Link: https://ethics.harvard.edu/files/center-for-ethics/files/roadmaptopandemicresilience_updated_4.20.20_0.pdf
**Governor Pritzker explained, “We want people to be safe when they go to work. We want people to be safe when they go to school. People want to be safe in all their activities and they want to know that others have been tested around them.” He said it was important “nobody is without an opportunity to get a test.”
*** See above article by Ashish Jha, MD, MPH.
On May 15, Gov. Pritzker said, “Overall, the positivity rate can be an indication of how wide spread COVID-19 infections are among our population. We all want the positivity rate to come down which would indicate a declining number of people getting sick from the virus.”
In its May 20 report, “CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening America Up Again,” CDC recommends using a maximum positive test rate of 20% to move to phase 1, a maximum positive test rate of 15% to move to phase 2, and a maximum positive test rate of 10% to move to phase 3. Link: https://www.cdc.gov/coronavirus/2019-ncov/downloads/php/CDC-Activities-Initiatives-for-COVID-19-Response.pdf