The Northeast Region, which includes Evanston, is only about nine days away from moving to Phase 3 of the Restore Illinois plan. As reported in an article posted on this site yesterday, restrictions will be loosened for many businesses and activities in Phase 3.

On May 20, Governor J. B. Pritzker announced a significant change to the plan that would allow restaurants and bars to be open for “outdoor seating” in Phase 3.

Evanston had only 3 new COVID-19 cases reported yesterday, the lowest number since April 16.

Outdoor Seating for Restaurants and Bars

Gov. Pritzker said all regions in the State are on track to move to Phase 3 of the Restore Illinois plan at the end of this month. 

The plan currently provides that in Phase 3, restaurants and bars “will be open for delivery, pickup, and drive-through only.” On May 20, Gov. Pritzker said another option for restaurants and bars in Phase 3 would be to open for “outdoor seating.”

The Governor explained, “The local diner, the corner bar with friendly servers and bartenders and owners are known to the whole community. Tragically, they were some of the first and hardest hit by this pandemic. To date, my administration has delivered tens of millions of dollars of assistance to small businesses, including to bars and restaurants. The industry employs hundreds of thousands of people in every corner of our State, and financial assistance isn’t enough. So it’s been important to me to reopen them, but only if it can be done in a way that keeps its employees and customers safe.

“Given what is known about how this virus spreads in closed spaces, our public health experts made the decision early on that bars and restaurants should not open their regular indoor food service, and that’s still the case, until we reach phase four.

“That has turned out to be a good public health decision. We have to put public health first. And that means the safety and peace of mind of consumers and employees alike. But the epidemiologists now believe that summer offers us an opportunity, if proper precautions are taken by businesses and their patrons. So after listening to and working with restaurant industry representatives, together with our epidemiologists, today I’m announcing an additional option for bars and restaurants interested in resuming operations earlier.

“Opening for outdoor seating when Phase 3 begins – likely for everyone just nine days from now – with the right restrictions, tables six feet apart and away from the sidewalks, masks and distancing measures for staff and other precautions, the experts believe that these services can open at a risk comparable to other outdoor activities, and give our hospitality industry a much needed boost as they work to keep their businesses on their feet during this terrible crisis.”

He encouraged municipalities and mayors to help restaurants expand their outdoor-seating options.

Sam Toia, President of the Illinois Restaurant Association, said between 20% and 25% of all restaurants are projected to close permanently due to COVID-19. He said permitting outdoor dining options will be a benefit to many restaurants. He encouraged municipalities to help out by creating outdoorseating. “Let’s close down the streets, let’s expand sidewalk cafés that use parking lots and public ways. Let’s show the world how innovative Illinois can be,” he said.

During his remarks, Gov. Pritzker provided an interpretation of the provision of the Restore Illinois plan that allows all gatherings of 10 people or fewer in Phase 3. He indicated that these gatherings are not subject to social distancing. He said, “If you want to go enjoy a picnic in the park or walk with nine other people, you can just remember to wear a mask or face covering when social distancing can’t be maintained.”

On another issue, Gov. Pritzker said he withdrew an emergency rule which would have allowed fines up to $2,500 to be imposed on businesses that reopened in violation of his stay-at-home order. He said the intent of the rule was to provide a tool for law enforcement to issue a citation to the businesses, and it was less draconian than pulling a liquor license. He added that he will work with the State Legislature to create an enforcement tool.

The Criteria under Restore Illinois to Move to Phase 3

To move to Phase 3, the Northeast 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 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 Restore Illinois criteria focus 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 3 cases today, for a total of 596 cases, according to information provided by the City of Evanston. The trend is shown in the above chart. 

To date, a total of 22 Evanstonians have died due to COVID-19. IDPH reports that 16 residents or staff of long-term care facilities in Evanston have lost their lives due to the virus.

New cases and deaths in Cook County and Illinois: Today, there were 1,522 new confirmed cases of COVID-19 in Cook County and 2,388 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 29,690 new confirmed cases of COVID-19 in Cook County and 47,493 new confirmed cases in Illinois.

Dr. Ezike said the high number of cases is due to more tests’ being administered in the State.

The number of deaths in Illinois due to COVID-19 increased by 147 in the last 24 hours, bringing the total number of deaths due to COVID-19 in Illinois to 4,525.

Hospital Admissions/Capacity in the Northeast Region

IDPH posts 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 20:

  • Hospital admissions have declined by 44.5% in the Northeast Region since May 1. This is on track to meet the criteria.
  • The Northeast Region has available 18.7% of its medical/surgical beds, 20.8% of its ICU beds, and 64.4% of its ventilators. This is on track to meet the minimum capacity of 14%.
  • The test-positive rate, using a 7-day rolling average, is 17.4%, which is slightly below the maximum of 20% stated in the plan.

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

Adequacy of Testing

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.”

The plan does not state how IDPH will determine if a Region is meeting this criterion. 

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.*

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.”**

While the State has almost quadrupled the number of tests it is administering in the last six weeks, the average per day between May 16 and 20,822, still far short of the target of 64,167 set by HGHI.

Gov. Pritzker said today that the State of Illinois is administering more tests per person than any other state in the country.

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. According to the World Health Organization and some researchers, a test-positive rate greater than 10% likely reflects that there is an inadequate amount of testing. ***

In the Restore Illinois plan, one criterion to move from Phase 2 to Phase 3 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.

As of May 15, IDPH reported that the test positive rate for the Northeast Region was 17.4%, down 5.2 percentage points in the last 14 days.

The seven-day rolling average for the State is 10.3%, said Dr. Ezike.

While the Northeast Region meets the criteria of the Restore Illinois Plan, its test-positive rate is still significantly higher than the maximum threshold recommended by WHO and some researchers.

Contact Tracing

The Restore Illinois plan provides that a Region must meet the criteria for contact tracing to move from phase 2 to phase 3. The requirement stated in the plan is: “Begin contact tracing and monitoring within 24 hours of diagnosis.” 

IDPH has not posted information on its website to show if the Northeast Region is meeting these criteria.

On a Statewide basis, Gov. Pritzker said on May 18, “Only about 29% of our known cases are engaged in a tracing process.”

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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.

On May 15, Gov. Pritzker said, “Overall, the positivity rate can be an indication of how wide spread COVID-19 infections are among our population. We all want the positivity rate to come down which would indicate a declining number of people getting sick from the virus.”

In its May 20 report, “CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening America Up Again,” CDC recommends using a maximum positive test rate of 20% to move to phase 1, a maximum positive test rate of 15% to move to phase 2, and a maximum positive test rate of 10% to move to phase 3. Link: https://www.cdc.gov/coronavirus/2019-ncov/downloads/php/CDC-Activities-Initiatives-for-COVID-19-Response.pdf