One hundred and ninety two Illinoisans lost their lives to COVID-19 in the last 24-hours, the highest number recorded to date, said Dr. Ngozi Ezike, Director of the Illinois Department of Public Health. 

As more businesses and local governments appear to be reopening in defiance of Governor J.B. Pritzker’s executive orders, the Governor said the State may consider enforcing the orders by withholding federal funds and pulling licenses.

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-9 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. Ezike.

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 15 cases today, for a total of 514 cases, according to information provided by the City of Evanston. The trend is shown in the above chart. 

To date, a total of 17 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 936 new confirmed cases of COVID-19 in Cook County and 1,677 in the State.

Since May 1, there have been 19,883 new confirmed cases of COVID-19 in Cook County and 31,786 new confirmed cases in Illinois. The trend is shown in the smaller chart above.

The number of deaths in Illinois due to COVID-19 increased by 192 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 3,792.

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 13:

  • Hospital admissions have declined by 20.7% 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, 18.8% of its ICU beds, and 63.3% 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 20.7%, which is slightly higher than the maximum of 20%.

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.”**

Between May 8 and 12, the average number of tests administered per day In Illinois was 18,530. Today, the number was 17,688 tests.

Both numbers fall 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 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 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 13, IDPH reported that the test positive rate for the Northeast Region, was 20.7%.

Violators of the Executive Orders May be Penalized

At today’s briefing, Gov. Pritzker addressed a situation in which some businesses and some local governments appear to be defying his executive orders by reopening faster than permitted or adopting their own plans that permit businesses to open faster than the Restore Illinois plan.

The Governor said, “I know this is hard. I know that people are hurting. This virus has taken many lives, and destroyed many livelihoods. COVID-19 has turned our world upside down, stolen our sense of normalcy and stability. I want this to end just as much as you do. If I could take away the pain and the loss that you’re feeling right now I would do it in a heartbeat.

“This virus is still among us. This pandemic is not over. And to pretend otherwise in a misguided attempt to reclaim what we’ve lost will only make this last longer. There are no easy decisions in a pandemic. Every choice has consequences.

“I know leaders across the State are struggling with these choices. I have sympathy for them in that struggle. But what I don’t have sympathy for is those so intent on disregarding science and logic, so afraid to tell their constituents what they may not want to hear, they put more people’s lives at risk.

“Here’s what I want to say to those leaders who weren’t elected to do what’s easy. We’re elected to do what’s right. For the small minority of businesses that choose to ignore the medical doctors and the data and to ignore your legal obligations for the residents of your communities, there will be consequences.

“Businesses and individual professionals that are licensed by State agencies will be held accountable for breaching public health orders. Counties that try to reopen in defiance may not be reimbursed by FEMA for damages they cause, because they ignored the law. Local law enforcement and the Illinois State Police can and will take action.

“But there is no consequence the State could impose that is greater than the harm that you will do to your own communities.

“One-hundred and ninety-two Illinoisans lost their lives to this virus in the past 24 hours.

“How is that not real to you? More people will get sick, get admitted to the hospital and die if we don’t stay the course and follow the guidance the experts have provided to the elected officials out there, or playing to the crowd that ignores science and carries symbols of hate.”

When asked if he would withhold federal aid to municipalities that defy his stay-at-home order, Gov. Pritzker said, “We would consider that."

When asked about several counties that authorized re-openings of businesses, he said he was not just talking about federal funds, but that business that ignore the executive orders will be held accountable by the Department of Professional Regulation. “They will be held accountable by any licensing body, liquor commission, Liquor Control Commission, and others. There are enforcement mechanisms here that we will be using against them.”

He said the Restore Illinois plan is trying to keep people healthy and safe, and it also makes sure that health-care institutions have the capacity to care for people who will get sick. “As things reopen in the economy, if you do it too fast, you’re going to see an over running of the healthcare system,” he said.

A Gaping Hole in the Budget

Yesterday, Gov. Pritzker asked the State legislature to return to Springfield and adopt a comprehensive plan to support families, small businesses and towns, and to address the budget. Today, legislative leaders said they would return to Springfield. 

Almost one month ago, on April 15, Gov. Pritzker said budget experts were estimating that the State would have a $2.7 billion shortfall in revenues for this fiscal year and a $4.6 billion shortfall in revenues for the next fiscal year.

Today, the Governor said it was vital to obtain support from the federal government to help with the comprehensive plan and the State’s budget. “There is no chance that we won’t have to suffer severe damaging cuts to higher education, K-12 education, the basic services that people need if we don’t get any support,” he said. “That’s what’s going to happen to our State. We’re going to see just an enormous hole, where we’ve made so much progress.”

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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.