The number of confirmed COVID-19 cases of Evanstonians increased by 18 cases in the last 24 hours, for a total of 532 cases since early May. At his briefing this afternoon, May 14, Governor J. B. Pritzker said that the Northeast Region is now on track to move to Phase 3 at the end of this month.

The Restore Illinois Plan

In the Restore Illinois plan, the State is already in Phase 2 of the five-phase plan. There are four regions of the State, and each region may move through the remaining phases at its own pace, depending on when they meet the criteria to do so. Evanston, along with the rest of Cook County and eight other counties, is in the Northeast Region.

To move to Phases 3 and 4, a 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 and then to Phase 4, 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 criterion focuses 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 18 today, for a total of 532 cases, according to information provided by the City of Evanston. The trend is shown in the above chart. 

To date, a total of 18 Evanstonians have died due to COVID-19. Of the persons who lost their lives due to the virus, at least 13 were residents or staff of long-term care facilities in Evanston.

New cases and deaths in Cook County and Illinois: Today, there were 2,057 new confirmed cases of COVID-19 in Cook County and 3,239 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 21,934 new confirmed cases of COVID-19 in Cook County and 35,025 new confirmed cases in Illinois.

Dr. Ezike said the high number of cases is due to more tests’ being administered in the State. She added that there are far, far more people who have COVID-19 in the State than have tested positive, because the amount of testing has been limited.

The number of deaths in Illinois due to COVID-19 increased by 138 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 3,928.

Hospital Admissions/Capacity in the Northeast Region

IDPH has begun to post 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 14:

  • Hospital admissions have declined by 23.3% in the Northeast Region since May 1. This is on track to meet the criteria.
  • The Northeast Region has 17.3% of its medical/surgical beds, 18.6% of its ICU beds, and 63.4% of its ventilators available. This is on track to meet the minimum capacity of 14%
  • The test positive rate, using a 7-day rolling average, is 19.9%, which is slightly below the maximum of 20%.

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 the criteria to move to Phase 3 at the end of the month.

Adequacy of Testing

Researchers often use two measures to assess the adequacy of testing for COVID-19: 1) the number of tests given in relation to the population; and 2) the percentage of people who test positive on COVID-19 tests.

The Number of Tests in Illinois

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.” To move from Phase 3 to Phase 4, testing must be “available in region regardless of symptoms or risk factors.”

The plan does not state how IDPH will determine if these criteria are being met.

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.”**

In the last five days, the average number of tests administered per day In Illinois was 19,145. Today, the number was 22,678 tests.

The amount of tests falls far short of the target of 64,167 set by HGHI.

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. 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 Restore Illinois plan, one criterion to move from Phase 2 to Phase 3 and from Phase 3 to Phase 4 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 for the last 14 days.

The 20% threshold is double what some researchers say should be the maximum.

As of May 14, IDPH reported that the test positive rate for the Northeast Region was 19.9%.

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Footnotes

*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.