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CDC’s New Recommendations for Fully Vaccinated People
Yesterday, April 27, the Centers for Disease Control and Prevention (CDC) updated the following recommendations applicable to non-healthcare settings for fully vaccinated people:
Fully vaccinated people can:
- Visit with other fully vaccinated people indoors without wearing masks or physical distancing;
- Visit with unvaccinated people (including children) from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing;
- Participate in outdoor activities and recreation without a mask, except in certain crowded settings and venues;
- Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel
- Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States;
- Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings;
- Refrain from quarantine following a known exposure if asymptomatic;
- Refrain from routine screening testing if asymptomatic and feasible.
For now, fully vaccinated people should continue to:
- Take precautions in indoor public settings like wearing a well-fitted mask;
- Wear well-fitted masks when visiting indoors with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease;
- Wear well-fitted masks when visiting indoors with unvaccinated people from multiple households;
- Avoid indoor large-sized in-person gatherings;
- Get tested if experiencing COVID-19 symptoms;
- Follow guidance issued by individual employers;
- Follow CDC and health department travel requirements and recommendations.
Governor JB Pritzker said yesterday that the State is updating its guidance to be in line with CDC’s new recommendations.
Risk of Community Spread
The charts in the above chart box show that the seven-day average of new cases in Evanston, suburban Cook County, Chicago, and the State is trending downward. On a Statewide basis, though, hospitalizations and the usage of ICU beds are still relatively high.
In suburban Cook County, Chicago, and the State, the number of new cases per 100,000 in the last seven days is above 130. For Evanston, the number is 113. The Illinois Department of Public Health says that more than 100 cases per 100,000 indicates a risk of “substantial spread.” The CDC says that more than 100 cases indicates a risk of “high transmission.” [1, 2, 3, and 4]
For test positivity in the last seven days, IDPH uses a target of 5%. The CDC says between 5% and 7.9% represents a “moderate” risk of transmission. [1, 2, and 3]
Evanston – COVID
The City reported 12 new COVID-19 cases of Evanston residents today, the same as yesterday.
The average number of new cases per day in the last seven days is 12, up from the seven-day average of 8.3 on April 21.
In the last seven days, there was a total of 84 new COVID-19 cases of Evanstonians. The 84 new cases equate to about 113 new cases per 100,000 people in the seven-day period.
Evanston’s case positivity rate for the last seven days is 1.3%.
There has been a total of 4,501 COVID-19 cases of Evanston residents during the pandemic, 72 of which are active.
No Evanstonian has died due to COVID-19 since April 10. The number of deaths due to COVID-19 is 116.
Impact of Northwestern University. Northwestern University has posted data on its website reporting that between April 19 and April 25, there were 61 new confirmed COVID-19 cases of NU faculty, staff, and students. If the faculty, staff or students reside in Evanston, they are included in the City’s numbers. The number reported by NU, though, includes people who live outside of Evanston. 
Illinois – COVID-19
In the State, there were 2,728 new COVID-19 cases reported today, up from 2,556 yesterday.
Statewide, the average number of new cases per day in the last seven days is 2,700. The seven-day average one week ago on April 21 was 2,945, so today’s number is down by 8%. The downward trend continues.
Today’s seven-day average is up from a low this year of 1,513 on March 15. An accompanying chart shows the trend.
In the seven days ending April 28, the number of new cases per 100,000 people in the State was 149, down from 163 one week ago.
The seven-day case positivity rate for the State today, April 28, is 3.4% and the test positivity rate is 4.1%.
On a Statewide basis, the number of hospitalizations due to COVID-19 was 2,154 as of midnight on April 27, about the same as one week ago. This is up from 1,112 on March 15.
The number of patients using ICU beds is 502, up from 227 on March 15. The number of patients on ventilators is 238, up from 95 on March 15.
On a Statewide basis, there were 33 deaths due to COVID-19 in the last 24 hours, which brings the total to 21,891.
For the last seven days, the numbers of deaths in the State are 33, 22, 25, 24, 10, 29, and 33 today. The seven-day average is 25.
Variants in Illinois
IDPH is reporting a total of 2,622 confirmed cases of COVID-19 variants in the State. Of those, 1,768 are the variant first discovered in the U.K.
Vaccinations in the State
A total of 11,323,205 doses of vaccine have been delivered to providers in Illinois, including Chicago and long-term care facilities. IDPH is currently reporting that a total of 9,048,300 doses of vaccines have been administered.
As of April 28, 79% of the residents of Illinois 65 and older have had at least one dose of a COVID-19 vaccine; and 53% of Illinois residents 16 and over have had at least one dose of a COVID-19 vaccine.
1/ On Feb. 12, the CDC issued a K-12 School Operational Strategy. As part of that strategy, the report says, “CDC recommends the use of two measures of community burden to determine the level of risk of transmission: 1) the total number of new cases per 100,000 persons in the past 7 days; and 2) the percentage of nucleic acid amplification tests (NAATs), including RT-PCR tests that are positive during the last 7 days. The two measures of community burden should be used to assess the incidence and spread of SARS-CoV-2 in the surrounding community (e.g., county) and not in the schools themselves.” The CDC provides a chart to assess whether the risk of transmission is low, moderate, substantial, or high. The CDC recommends different types of mitigations depending on the risk level. If the two indicators suggest different levels of risk, the mitigations recommended in the higher level of risk should be implemented, says CDC. The table below, reprinted from CDC’s report, provides CDC’s Indicators and Thresholds for Community Transmission of COVID-219.
CDC’s guidelines are available here: Operational Strategy for K-12 Schools through Phased Prevention | CDC
2/ Number of Cases per 100,000 Population. On July 1, 2020, 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.
3/ The Test Positivity Rate. In addition, on May 26, 2020, Johns Hopkins University & Medicine Coronavirus Resource Center said on its website that “the World Health Organization (WHO) advised governments [on May 15, 2020] 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.” 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.”
IDPH says 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%.
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/ 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, 2020, 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 several 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.