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Daily Archives: June 11th, 2020


In spite of several representatives wanting to parse out their areas for reopening away from the guidelines, the basic plan is as fair as you can get. There appears to be some leeway for easements but the overall plan makes sense whether it is universally liked or not. MA

By MARY HANSEN  MAY 8, 2020

 

RESTORE ILLINOIS PLAN, OFFICE OF THE GOVERNOR

Editor’s Note: As of May 29, Illinois is in Phase 3 of the plan, modified to include restaurants offering outdoor seating; and some offices, salons, barbershops and gyms can open with capacity restrictions and public health precautions. Read more here. 

Illinois is in Phase 2 of Restore Illinois – the five-step plan Gov. J.B. Pritzker unveiled this week to reopen schools, colleges, parks and businesses, while addressing the coronavirus pandemic.

Some state parks are open. More shops can operate to fill online and pick up orders, and in some places, residents can go to a drive-in movie theater. While the stay-at-home order still applies to the whole state, Pritzker said going forward, that will change as it’s a regional plan.

“Reality on the ground looks different in different areas of the state,” Pritzker said at a recent press briefing.

Some Republicans and business groups have criticized the regions for being too vast and the timeline too slow, wreaking further havoc on the economy.

Pritzker defends the plan, saying he’s basing it on guidance from public health and medical experts, and that he consulted with business leaders, mayors and officials from around the state.

Dr. Mark Dworkin – a professor of epidemiology at the University of Illinois Chicago School of Public Health – said Pritzker’s approach is ‘thoughtful,’ but alternatives are possible.

“Especially with no major science behind what we’re doing, but just trying to use expert opinion and good judgment,” he said. “But we should beware of a situation where we’re talking about our politicians because… they are preset to disagree with whatever the other group is.”

An explanation of the phases is below and in the governor’s plan. Movement between the next two phases depends on a region keeping the share of new positive tests low for two weeks, hospital admissions have to be stable for nearly a month, and the region has to have enough hospital beds and equipment to respond to a surge in new COVID-19 patients. Testing must also be expanded and contact tracing robust.

But there’s a catch to moving on from Phase 4, the one before mostly returning to normal: the state could be here for months.

“Until we have a vaccine or an effective treatment or enough widespread immunity that new cases fail to materialize – the option to return to normal doesn’t exist,” Pritzker said.

Debate Over Regions

The plan combines the 11 regions the Illinois Department of Public Health established for Emergency Medical Services into four: Northeast with Chicago and its suburbs; North-Central Illinois from the border with Wisconsin down to Peoria and Bloomington; Central Illinois from Danville to Quincy, including Springfield and Champaign-Urbana, and finally Southern Illinois, including the Metro-East and Carbondale.

 

Illinois House Minority Leader Jim Durkin and his fellow Republicans took to Zoom this week to criticize it, saying that there is not enough local control over moving from phase to phase.

“I’m here to raise a warning flag that Watseka, Illinois is very different than Quincy, not only just four hours away,” he said. “The plan is set up in an unworkable way.”

The cities he references are both in the Central Illinois region. Durkin went on to say that the plan would destroy many small businesses and manufacturers.

State Rep. Ryan Spain, who was at the virtual press conference, is a Republican from Peoria, where he says hospitalization rates, new cases and intensive care unit capacity have all been meeting the governor’s benchmarks to start loosening more restrictions.

“We have been meeting them now for the last four weeks,” he said. “So that takes me to the third problem, which is the arbitrary establishment of some of the time periods included in the governor’s plan.”

Spain took issue with May 1 as the start date for IDPH to track metrics. That means no region can open up more until the end of the month.

Pritzker defended the designation, saying that is when some regulations loosened, such as allowing more retail stores to open.

On the region size, public health experts NPR Illinois interviewed said the larger population size in the regions could ensure that smaller or single outbreaks don’t cause big swings in the metrics the public health department is tracking.

“When you get that number of people to assess, you’ve got a good denominator on which to make decisions,” said Dr. Jerry Kruse, CEO of SIU Medicine in Springfield and dean of the Southern Illinois University School of Medicine.

Timeline

Pritzker has faced criticism for using a 28-day timeframe between phases, while other states, including New York, are using 14 days. Two weeks is thought to be the incubation period for the coronavirus.

Dworkin, the UIC epidemiologist, said four weeks – or two incubation periods – is more cautious.

“It’s giving you more comfort that when you make that change, you’re that much more sure what’s going on,” he said.

 

That could mean there is less of a chance for moving backward and having to institute more restrictions.

Dworkin said he understands living with restrictions until a vaccine or treatment is available is uncomfortable.

But the alternative is worse – more infections and deaths until herd immunity is reached.

“Why would we take the hose off of the fire?” Dworkin asked. “What would we expect to happen if we did that, because we’re tired of holding the hose? We can expect the fire to burn faster and harder than it was with the water on it.”

According to the metric tracker on IDPH’s website, all the regions except Chicago are on track to meet criteria to move on to Phase 3 at the end of May.

Phases

The state is divided into four regions, and each can move forward – or backward – through the five phases of the plan as they meet certain medical benchmarks:

Phase 1 (Illinois began in March) : Broad stay-at-home order, with only grocery stores, pharmacies and other essential businesses open. Bars and restaurants are only open for pick-up and delivery orders. Only essential manufacturers can operate.

To move to the next phase: The growth of new cases must slow, and surge capacity of hospital beds and ventilators must be available. Testing must be available for any healthcare worker or first responder with symptoms, and 10,000 tests done daily statewide.

Phase 2 (Began May 1) : Stay-at-home order continues, but more retail stores can open to fill online and pick-up orders, similar to restaurants. Face coverings are required where social distancing isn’t possible, and some outdoor activities, such as boating, fishing and golfing, are allowed.

To move to the next phase: A region must keep the share of new positive tests at 20% or below for two weeks, with no major spikes. Hospital admissions for COVID-19 have to be stable for 28 days, and the region has to have 14% of hospital beds and equipment available to respond to a surge in new COVID-19 patients. Testing availability must expand to anyone with underlying conditions, as well as residents and staff as nursing homes, jails and other congregate settings. Contact tracing begins within 24 hours of diagnosis.

Phase 3: Offices, salons and barber shops can open, with capacity limits and other safety precautions. Face coverings are still required. Any gatherings of 10 or fewer are allowed.

To move to the next phase: The positivity rate and hospital admission criteria are the same as moving from Phase 2 to Phase 3. Testing must be available for anyone, regardless of symptoms. Contact tracing must begin within 24 hours for more than 90% of the cases in the region.

Phase 4: Childcare centers and schools, as well as bars and restaurants can reopen, all with safety guidelines from the Illinois Department of Public Health. Any gatherings of 50 people or fewer are allowed. Travel resumes.

To move to the next phase: A vaccine or effective treatment must be widely available. Alternatively, a region has reached herd immunity and there are no new cases over a sustained period of time.

Phase 5: Conventions, large events and festivals are permitted. All businesses, schools and recreation can resume with safety guidance.

 


Apparently many of us are caught up in the minutiae of how to protect oneself and others from COVID-19. The one fact that seems to escape us is the lack of testing. Testing will not prevent COVID but it will identify people who may have it or perhaps have come in contact with the disease. The key to getting back to relative normal is: TESTING, TESTING, TESTING, TESTING. The second part is contact tracing if someone is positive for the virus-Contact tracing is the process of contacting the person(s) who the infected person has come in contact with.

Testing for COVID-1

Guidance on Interpreting COVID-19 Test Results pdf icon[610 KB]external icon: A guide for interpreting test results and determining what actions to take.

Two kinds of tests are available for COVID-19: viral tests and antibody tests.

  • A viral test tells you if you have a current infection.
  • An antibody test tells you if you had a previous infection.

An antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies. We do not know yet if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last.

Who should be tested

To learn if you have a current infection, viral tests are used. But not everyone needs this test.

  • Most people will have mild illness and can recover at home without medical care and may not need to be tested.
  • CDC has guidance for who should be tested, but decisions about testing are made by state and localexternal icon health departments or healthcare providers.
  • If you have symptoms of COVID-19 and want to get tested, call your healthcare provider first.
  • You can also visit your state or local health department’s website to look for the latest local information on testing.
  • Although supplies of tests are increasing, it may still be difficult to find a place to get tested.

Results

  • If you test positive for COVID-19 by a viral test, know what protective steps to take if you are sick or caring for someone.
  • If you test negative for COVID-19 by a viral test, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. The test result only means that you did not have COVID-19 at the time of testing.

This is by no means a complete preventative method, there remains the hand washing, masking and other everyday precautions.

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