All four regions of the State moved to Phase 4 of the Restore Illinois Plan today, and under the plan may open more businesses and activities, subject to guidelines approved by the Illinois Department of Public Health. In sharp contrast to what is happeping in many states throughout the country, the number of new Covid-19 cases and the number of hospitalizations in the Illinois have declined significantly since early May.

In announcing that all regions of the State would move to Phase 4, Governor JB Pritzker said, "We've seen what's happened in other states that have allowed politics or short-term thinking to drive decision-making. Many other states are now seeing significant increases in cases, hospitalizations, and intensive care bed usage and they're being forced to move backward and stay at home - that's not the story in Illinois. Here, we have been gradually restoring business and leisure activities in a highly deliberate manner, guided by doctors' advice. Illinoisans are following the mitigations that we can each do ourselves, like wearing face coverings, keeping 6 feet distance between us, and washing our hands frequently. It's because of the people of Illinois that we're seeing a trajectory of relative success where other parts of the country are not."

 Today CDC reported there were 40,588 new COVID-19 cases in the nation, the highest number of new cases reported in a single day.  On a nationwide basis, the average number of new COVID-19 cases in the last seven days is 33,667 per day, compared to an average of 21,596 in the first seven days of June, or a 53% increase.

New COVID-19 Cases in Evanston, Cook County and Illinois

The data below show the number of new confirmed COVID-19 cases in Evanston, Cook County, and Illinois. The number of new cases is important because about 30% of the people who have COVID-19 are hospitalized, said Dr. Ngozi Ezike, Director of Illinois Department of Public Health. In addition, people who have COVID-19 are infectious and may spread the disease.*

New cases and deaths of Evanstonians: There were 2 new confirmed COVID-19 cases of Evanston residents today, June 26. The total number of confirmed COVID-19 cases of Evanstonians remains at 779. Of those, 29 are active.

Over the last seven days, the City reported an average of 2.3 new COVID-19 cases per day. For the seven days prior, there was an average of 2.0 new cases per day. The trend is shown in the above chart. 

No Evanstonians lost their lives to COVID-19 in the last six days. The total number of Evanstonians who have died due to the virus is 68.

According to data provided by IDPH on June 21, 49 residents or staff of long-term care facilities in Evanston have died due to COVID-19. Thus, 70% of the deaths of Evanstonians due to COVID-19 were of residents or staff at long-term care facilities. Two facilities account for 35 of the deaths.

New Cases and deaths in Cook County and Illinois: There were 413 new cases of COVID-19 in Cook County in the last 24 hours, and 857 in the State. For the last five days, the number of new cases in the State have been 462, 601, 715, 894 and 857.

The number of new cases in the State is still much lower than the 3,137 new cases reported on May 1, and the 1,622 reported on May 29, the day the State moved into Phase 3.

Between June 22 and June 26, the average number of new COVID-19 cases per day in Cook County was 378, and in the State, it was 706. The trend is shown in the smaller chart above.

The number of deaths in Illinois due to COVID-19 increased by 39 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 6,847.

Hospital Admissions and Surge Capacity in the Northeast Region

One important metric to determine how well a State or region is containing the pandemic is whether the number of hospitalizations for people with COVID-19 is declining or increasing.

A key metric used to determine whether a region is prepared to deal with a potential surge in COVID-19 cases is whether the hospitals in the region have available bed capacity to serve additional COVID-19 patients if there is a surge. The State has used having a 14% bed capacity as a target.

IDPH reports that in the last 28 days hospitalizations in the Northeast Region declined by 79%. IDPH does not report the number of hospitalizations in the Region, but there is a downward trend.

The Northeast Region has available 33% of its medical/surgical beds, 43% of its ICU beds, and 74% of its ventilators. This easily meets the minimum capacity of 14%.

On a Statewide basis, the number of hospitalizations due to COVID-19 was 3,336 on May 29 (the date the State moved to Phase 3 of the Restore Illinois plan). As of midnight on June 25, the number had declined to 1,516. The second chart in the chart box shows the trend in hospitalizations since May 29.

Adequacy of Testing

Widespread testing is essential to controlling the spread of the COVID-19 virus and to open an economy safely.

     Test-Positive 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 said on May 15 that the test-positive rate should be below 5% before opening an economy. A higher test-positive rate reflects that there is an inadequate amount of testing. **

IDPH reported that the test-positive rate for the Northeast Region as of June 26 was 5%, down 1 percentage point in the last 14 days.

The Northeast Region meets the rate recommended by WHO.    

On a Statewide basis, the test positivity rate on June 26 was 2.8%. The average for the last five days was 2.7%.

       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. On the same day, Gov. Pritzker said, “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 since the beginning of April, the average number of tests per day between June 22 and June 26 is 26,034, still far short of the target of 64,167 set by HGHI.

On June 26, there were 30,425 tests, following yesterday’s all-time high of 31,686.

Contact Tracing

Widespread contact tracing is also essential to controlling the spread of the COVID-19 virus and to open an economy safely.

In its criteria to move from Phase 3 to Phase 4, the Restore Illinois plan provides with respect to this criterion: “Begin contact tracing and monitoring within 24 hours of diagnosis for more than 90% of cases in region.” Dr. Ezike said this is an “internal goal.”

IDPH has not monitored whether any region of the State met this criterion.

On a Statewide basis, Gov. Pritzker said on May 29 that contact tracing was only being done on about 30% of the known cases, far short of the 90% goal. IDPH has not provided more recent data.

On June 23, Gov. Pritzker said he was not in a positon to provide metrics regarding the amount of contact tracing being done, but would do so in a future news conference.

On June 25, the Governor’s Office said in a prepared statement that the State “continues to build up its statewide contact tracing capacities, increasing the ranks of contact tracers by 20% since June 1 for a total of over 550 active contact tracers across the state. 250 new tracers will join their ranks in the coming weeks as Illinois continues to scale up operations, including using new technology to multiply the state's effectiveness in its contact tracing efforts.  

Cook County has received about $41 million in grant funding from IDPH to rapidly scale-up its COVID-19 contact tracing program in suburban Cook County. The County recently said it would not have contact tracing fully in place until the fall.

What Businesses and Activities Can Open in Phase 4

Today, all Regions of the State moved to Phase 4 of the Restore Illinois Plan. Under the plan, the following activities or businesses may open up in accordance with guidance approved by IDPH:

Gatherings: All gatherings of 50 people or fewer are allowed with this limit subject to change based on latest data and guidance

Travel: Travel should follow IDPH and CDC approved guidance

Health care: All health care providers are open

Education and child care: P-12 schools, higher education, all summer programs, and child care open with IDPH approved safety guidance

Outdoor recreation: All outdoor recreation allowed

Manufacturing: All manufacturing open with IDPH approved safety guidance

“Non-essential” businesses: All employees return to work with IDPH approved safety guidance; Employers are encouraged to provide accommodations for COVID-19-vulnerable employees

Bars and restaurants: Open with capacity limits and IDPH approved safety guidance

Personal care services and health clubs: All barbershops, salons, spas and health and fitness clubs open with capacity limits and IDPH approved safety guidance

Entertainment: Cinema and theaters open with capacity limits and IDPH approved safety guidance

Retail: Open with capacity limits and IDPH approved safety guidance

Guidance for the opening of many businesses and activities is summarized here. Guidance for opening schools is summarized here.

The guidelines include wearing face coverings, maintaining a six-foot physical distance between individuals unless otherwise permitted, frequently washing hands, and limiting capacity in certain businesses.

Under the Restore Illinois Plan, a Region of the State could be placed back into Phase 3, based on the following factors:

  • Sustained rise in the COVID-19 test positivity rate
  • Sustained increase in hospital admissions for COVID-19 like illness
  • Reduction in hospital capacity threatening surge capabilities
  • Significant outbreak in the region that threatens the health of the region

Phase 5 is the last phase of the Restore Illinois Plan. A region may move to Phase 5 if there is a vaccine, effective and widely available treatment, or the elimination of new cases over a sustained period of time through herd immunity or other factors.

Free Covid-19 Tests on June 29

The City of Evanston’s Health and Human Services Department is partnering with AMITA Health St. Francis Hospital to offer COVID-19 health screening and testing events to Evanston residents at the James Park Field House parking lot, located on Mulford Street west of Dodge Avenue and the Levy Senior Center, on the following days while supplies last on Monday, June 29, 3 p.m. to 5 p.m. For more information about COVID-19, please visit cityofevanston.org/covid19 or call/text 847-448-4311. For convenience, residents may simply dial 311 in Evanston.

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Footnotes

* IDPH reports only the number of COVID-19 cases which have been confirmed through a test. The number does not include people who are infected, but who have not been tested, which may include people who are asymptomatic or who have minor symptoms. Any person who is infected, whether symptomatic or asymptomatic, may spread the disease. On June 25, the Director of CDC said that the center’s best estimate is that for every case that is reported there are actually 10 other infections.

** 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

***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 each day 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/

And link to accompanying article: https://www.npr.org/sections/health-shots/2020/05/07/851610771/u-s-coronavirus-testing-still-falls-short-hows-your-state-doing

On June 23, the RoundTable asked Dr. Jha by email if he had updated his estimates of needed tests, and if his May 7 estimate of about 64,000 tests per day for Illinois was still a reasonable estimate. The RoundTable has not yet received a response.