The 7-day average of Evanston’s new COVID-19 cases continues to remain at about 30 per day, while the number of new cases in the State continues to decline. Hospitalizations continue to decline regionally and in the State. The number of deaths in the State remains high.

At briefings last week, Gov. JB Pritzker and Dr. Ngozi Ezike – while recognizing that Illinois was moving in the right direction – expressed concerns about a potential surge in cases after the holidays. They continued to urge people to wear masks, socially distance, and to celebrate the holidays in-person only with the people with whom they have been isolating.

Vaccine Priority Groups

The CDC’s Advisory Committee for Immunization Practice (ACIP) voted yesterday, Dec. 20, to recommend the next two groups (Phase 1b and Phase 1c) to receive a vaccine after people in the Phase 1a priority group receive the vaccine to prevent COVID-19.

 The Phase 1a Priority Group, which consists of healthcare workers and residents of long-term care facilities, contains an estimated 24 million people.

The Phase 1b priority group includes people who are 75 and older and “frontline essential workers” that includes first responders, teachers, public transit workers, grocery store employees, and U.S. Postal Service employees.  An estimated 49 million people are in the Phase 1b group.

The Phase 1c priority group includes people ages 65 to 74, and people ages 16 to 64 with underlying health conditions, and other essential workers such as those working in transportation, food service, finance, and communications positions. This group includes an estimated 129 million people.

CDC’s Director Dr. Robert Redfield is expected to decide soon whether to accept ACIP’s recommendations on the new priorities.

The federal government estimates that there will be enough doses of vaccine to vaccinate 20 million people in December, 30 million in January, and 50 million in February.

Yesterday Admiral Brett Giroir, Assistant Secretary of Health, said he thought that anyone who wanted a vaccine would be able to have one by June.

Vivek Murthy, President Elect Joe Biden’s pick for Surgeon General, said yesterday he thought a more realistic timeline would be that it would be mid-summer or late fall before the vaccine makes its way to the general public.

 

EVANSTON:  27 New COVID-19 Cases Today

There were 27 new confirmed COVID-19 cases of Evanston residents today.

The average number of new cases per day in the last seven days is 30.  For purposes of comparison, on Oct. 12, the seven-day average was 5.6.

There has been a total of 2,941 COVID-19 cases of Evanston residents during the pandemic, 455 of which are active. An accompanying chart shows the trend. [1]

In the last seven days, there was a total of 210 new COVID-19 cases of Evanstonians. That equates to about 279 new cases per 100,000 people in the seven-day period. The State’s seven-day target is 50 per 100,000.

The test positivity rate over the last seven days is 5.9%. The rate is up from 2.8% on Nov. 1.

One Evanstonian died due to COVID-19 in the last 72 hours.  The number of deaths due to COVID-19 remains at 92.

The Impact of NU on Evanston’s Increase in Cases

All Northwestern University (NU) students, staff, and faculty who live in Evanston and who test positive for COVID-19 are included in the case numbers reported above, according to the City. NU students, staff, and faculty who live outside Evanston are not included. [2]

Northwestern University has posted data on its website reporting that between Dec. 14 and Dec. 20, there were 28 new confirmed COVID-19 cases of faculty, students . The number includes those who live outside of Evanston. The City claims it does not know how many of these cases are people who live in Evanston. [2]

SUBURBAN COOK COUNTY, CHICAGO, AND ILLINOIS 

Several key metrics used by IDPH to measure the spread of COVID-19 are the trend of new cases, the number of new cases per 100,000 population, and the test positivity rate.  Other key metrics are the capacity of hospitals to care for a surge of new patients, and the number of deaths.

First, New Cases.  In Suburban Cook County, there were 907 new COVID-19 cases today, and 1,013 in Chicago, for a total of 1,920, down from 2,579 on Friday.

 In the State, there were 4,699 new cases reported today, the lowest number since Oct. 27.

Statewide, the average number of new cases per day in the last seven days is 6,990. This is down from an all-time high of 12,380 on Nov. 17, and also down from the seven-day average of 8,550 one week ago on Dec. 14. While the trend has been declining, the number of new cases is still very high.

For purposes of comparison, the average of new cases per day over the seven days ending on May 1 was 2,565, which was the previous high in the spring. The seven-day average today is more than double that.

Second, New Cases per 100,000 Population. This criterion measures the level of contagion in an area and whether it is at a level that can be contained and suppressed. There are several benchmark numbers.  IDPH’s target is that there be fewer than 50 new COVID-19 cases per 100,000 people in a geographic area in a seven-day period. Harvard’s Global Health Institute (HGHI) and the Edmond J. Safra Center say there is “accelerated spread” if the number is between 70 and 168. [3]

In the seven days ending Dec. 21, the number of new cases per 100,000 people was as follows for the areas indicated:

       Suburban Cook County: 344 (compared to 97 on Oct. 1)

       Chicago:  333 (compared to 86 on Oct. 1)

       Illinois:  386 (compared to 111 on Oct. 1)

The new cases in each area are more than six times IDPH’s target.

An accompanying chart shows the trend in the number of new cases during the week ending Dec. 21, compared to the number of new cases for the weeks ending Oct. 1 and Dec. 14. [4]

The chart shows that the number of new cases per 100,000 on Dec. 21 are down from where they were on Dec. 14 for Chicago, Suburban Cook County and the State.

Third, a Test Positivity Rate. IDPH’s target is that the test positivity rate be 5% or less, although HGHI and other leading experts say it should be 3% or less.  If a community’s test positivity rate is high, it suggests that the community is not testing enough and not locating people who have milder or asymptomatic cases and who may be spreading the virus. [5]

The most recent seven-day test positivity rates are as follows:

       Suburban Cook County:  10.9% (as of Dec. 17)

       Chicago:  10.9% (as of Dec. 17)

       Illinois:  9.3% (as of Dec. 21)

Each positivity rate is about double IDPH’s target, and each is three times that of other leading experts. An accompanying chart highlights the rates.

Fourth, Hospital Admissions and Surge Capacity. There were 2,307 hospitalizations due to COVID-19 in Suburban Cook County and Chicago as of midnight on Dec. 20, up from 1,456 on Nov. 1. The number of hospitalizations has, however, been declining since Dec. 1.

IDPH reported that, as of Dec. 20, Suburban Cook County has a surplus capacity of 19% of medical/surgical beds and 19% of ICU beds; and Chicago has a surplus capacity of 19% of medical/surgical beds and 19% of ICU beds. IDPH’s target is 17% surplus capacity.

On a Statewide basis, the number of hospitalizations due to COVID-19 was 4,460 as of midnight on Dec. 20. This is down from an all-time high of 6,171 on Nov. 23. A chart in the chart box shows the trend.

For purposes of comparison, the highest number of hospitalizations due to COVID-19 in the spring was 4,868 on May 6.

The number of patients using ICU beds is 981, up from 347 on Sept. 1. The number of patients on ventilators is 546, up from 142 on Sept. 1.

Deaths: On a Statewide basis, there were 98 deaths due to COVID-19 in the last 24 hours, which brings the total to 15,299.

For the last seven days, the numbers of deaths in the State are 117, 145, 180, 181, 108, 78, and 98 today. The seven-day average is 130. For purposes of comparison, in the spring, the highest seven-day average was 118.

…………………………….,

FOOTNOTES

1/ Antigen Tests. The Illinois Department of Public Health announced on Oct. 15 that is including both molecular (PCR) and antigen tests in the number of statewide total tests performed in Illinois, and that it is including the positive test results on antigen tests in the confirmed COVID-19 cases reported.  Dr. Ngozi Ezike, Director of IDPH, said on Oct. 30, “You have COVID if you come up with a positive on the antigen test.” The State’s plan is to administer 3 million antigen tests provided by the federal government by the end of this year.

Dr. Michael Mina, Assistant Professor of Epidemiology and Assistant Professor of Immunology and Infectious Diseases at the Harvard T. H. Chan School of Public Health, said an antigen test detects if there is an antigen which is one of the proteins in the virus, while the PCR test looks for the RNA of the virus.

2/ Northwestern University COVID-19 Cases. Ike C. Ogbo, Director of Evanston’s Health & Human Services Department, told the RoundTable that the COVID-19 cases reported by the City include cases of faculty, staff, and students attending Northwestern University who live in Evanston. The RoundTable asked the City in an FOIA Request to provide the number of NU students who tested positive for COVID-19 and who live in Evanston. The City refused to provide the data. On Oct. 26, the RoundTable appealed the City’s decision to the Public Access Counselor of the Attorney General’s Office. On Nov. 13, the City filed a response claiming it does not have any records showing the number of NU students who tested positive for COVID-19 and who live in Evanston.

The RoundTable has asked Northwestern University on two occasions to provide information breaking out the number of new COVID-19 cases of its faculty, staff and students by residency in Evanston. NU did not respond to either request.

 3/ Number of Cases per 100,000 Population. On July 1, a network of research, policy and public health experts convened by Harvard’s Global Health Institute and Edmond J. Safra Center published a Key Metrics for COVID Suppression framework that provides guidance to policy makers and the public on how to target and suppress COVID-19 more effectively across the nation. The targets for new COVID-19 cases per 100,000 people are as follows (these are converted from cases per day to cases per week): a) less than 7 cases: “on track for containment;” b) 7 to 63 cases: “community spread,” rigorous test and trace program advised; c) 70 to 168 cases: “accelerated spread,” stay-at-home orders and/or rigorous test and trace programs advised; and d) 169+: ”tipping point,” stay-at-home orders necessary.  The article is available here: https://globalepidemics.org/key-metrics-for-covid-suppression/

IDPH provides these categories and ratings: 1) “minimal” – fewer than 50 cases per 100,000 in a week; 2) “moderate” – between 50 and 100 cases per week; and 3) “substantial” more than 100 cases per 100,000 in a week.  In its Metrics for School Determination of Community Spread, IDPH says the “target” is 50 cases per week per 100,000 people.

4/ Calculations. The RoundTable calculates the number of cases per 100,000 using case data provided by IDPH and assuming that the population of Suburban Cook County is 2.469 million, that the population of Chicago is 2.710 million, and that the population of Illinois is 12.671 million.

5/ The Test Positivity Rate. On May 26, Johns Hopkins University & Medicine Coronavirus Resource Center said on its website that “the World Health Organization (WHO) advised governments [on May 15] that before reopening, rates of positivity in testing (i.e., out of all tests conducted, how many came back positive for COVID-19) should remain at 5% or lower for at least 14 days.”

Johns Hopkins explains, “The rate of positivity is an important indicator, because it can provide insights into whether a community is conducting enough testing to find cases. If a community’s positivity is high, it suggests that that community may largely be testing the sickest patients and possibly missing milder or asymptomatic cases. A lower positivity may indicate that a community is including in its testing patients with milder or no symptoms.”  Link: https://coronavirus.jhu.edu/testing/testing-positivity

The Harvard Global Health Institute (HGHI) says, “A network of research, policy, and public health organizations convened by Harvard and MIT called the TTSI Collaborative has agreed on a 3% test positive rate or below as a key indicator of progress towards suppression level testing. This targets broad and accessible testing for symptomatic and asymptomatic people. Out of the positive tests that do not come from hotspot testing, at least 80% should come from contact tracing.”

While stating the test positivity target is 5% or less, IDPH provides these categories and ratings: 1) “Minimal” – test positivity rate is equal to or less than 5%: 2) “Moderate” – test positivity rate is between 5% and 8%; and 3) “Substantial” – test positivity rate is over 8%. In its Metrics for School Determination of Community Spread, IDPH says the target is 5%.