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* Gov JB Pritzker’s press secretary Jordan Abudayyeh sent me a detailed response to some questions that I and others have raised about the governor’s Restore Illinois plan…
REGIONAL MAP
One of the points of the critics is that the regions are too big and it’s holding areas with few cases back.
• But right now, every region is in the green and on pace to move forward to the next phase, so this criticism doesn’t really hold up.
• We’ve heard criticisms from the suburbs that they don’t want to be grouped in with the city, but their own hospital capacity numbers are very similar to the city. If you look at a snapshot of numbers from this weekend of hospital capacity by the 11 EMS regions, pasted at the bottom of this email, you’ll notice that the capacities in the regions that have been grouped together for Restore Illinois are quite similar.
• We recognize the different experiences that more rural counties in the Northeast region have in comparison to the City of Chicago — but in terms of their EMS hospital capacity breakdown, they don’t have dramatically more capacity to handle moving forward before the rest of the region.
5.17 Hospital Data:
*This data is reflective of a snapshot in time on May 17thNortheast Region:
• Southwest Suburbs/EMS Region 7
o ICU Beds: 23.9%
o Med/Surg Beds: 23.5%• West Suburbs/EMS Region 8
o ICU Beds: 19%
o Med/Surg Beds: 19.8%• Northwest Suburbs/EMS Region 9
o ICU Beds: 24.5%
o Med/Surg Beds: 20.5%• North(east) Suburbs/EMS Region 10
o ICU Beds: 21.8%
o Med/Surg Beds: 17.7%• City of Chicago/EMS Region 11
o ICU Beds: 21.7%
o Med/Surg Beds: 21.2%None of the EMS regions in the Northeast Region have an ICU or Med/Surge capacity above 25 percent — a number not tied to Restore, but a stage that IDPH considers with an additional level of concern. Regions 8, 9, and 10 all have at least one measure where their availability is lower than that of the City of Chicago – only Region 7 can claim otherwise, and that’s by approximately 2 percentage points.
For the remaining three regions: all the EMS regions are well above the 14 percent capacity threshold for moving forward under the Restore Illinois plan. In other words, no EMS region is holding back the other EMS region it’s grouped with.
North-Central Region:
• Rockford Region/EMS Region 1
o ICU Beds: 45%
o Med/Surg Beds: 45.8%• Peoria Region/EMS Region 2
o ICU Beds: 36.6%
o Med/Surg Beds: 36.9%Central Region
• Springfield Region/EMS Region 3
o ICU Beds: 55%
o Med/Surg Beds: 54.6%• Champaign Region/EMS Region 6
o ICU Beds: 52.2%
o Med/Surg Beds: 46.6%Southern Region
• Edwardsville Region/EMS Region 4
o ICU Beds: 39.1%
o Med/Surg Beds: 44.9%• Marion Region/EMS Region 5
o ICU Beds: 54.7%
o Med/Surg Beds: 58%14 VS. 28 DAYS
The critics want regions to move forward in 14 days, not 28. They say 28 days is too long to wait.• The experts don’t agree with those who want to move to reopening quickly.
o The shelved guidance from the CDC would have required a 14-day downward trajectory in health metrics.
o https://apnews.com/d4fb9744fb3524b6aaff1036f3ba9cd2
o The experts have said under this guidance no one is ready to move forward.• The White House plan does mention a 28-day timeline when talking about travel. So, it’s not like it’s a made-up number.
o The White House plan recommends that communities “minimize” travel in Phase 1, and that in Phase 2, after 28 consecutive days of decline, “Non-essential travel can resume.”
o In fact, the shelved CDC guide advises communities to avoid all nonessential travel in phases of reopening until the last one, when cases are at the lowest levels. Even then, the CDC is cautious and advises only a “consideration” of the resumption of nonessential travel after 42 continuous days of declining cases of COVID-19.
o It’s clear the CDC would lean on the side of longer timelines, rather than shorter ones.
But other states are using 14-day metrics• It’s important to note, that a lot (I’ll admit, not all) of the states using a 14-day timeline require a DECLINE in metrics, while our plan only requires stabilization.
• If we used a 14-day measurement Illinois wouldn’t move to the next phase anytime soon. Instead, our public health experts determined that as we phased out some restrictions if we could hold stable for 28 days (two incubation periods) we could move to a new phase.
• Also, important to note when comparing us to other states is that some of these states have peaked and are on the other side of their curve. There is no evidence that Illinois is coming off our peak or plateau yet.
o IN requires a 14-day decline in cases – IL would not meet that metric at this time
o KY requires a 14-day period of decreased cases
o NY requires a 14-day decline in hospitalization rates
o NC requires a decline in multiple metrics
o UT requires decreasing trends for 1 week and observe a decreasing trend for 5 weeks to reach a normal risk level.• Not every state is using 14 days
o WA uses a 21-day metric
o Washington state did three weeks with this reasoning: “The state will stay in every phase for a minimum of three weeks. During that time, the Department of Health and the Governor will re-evaluate the above indicators and determine if the state should remain in the current phase, advance to the next phase or return to the previous phase. No phase will last less than three weeks before moving to the next phase, in order to allow one complete disease incubation period plus an additional week to compile complete data and confirm trends.
o https://www.governor.wa.gov/sites/default/files/SafeStartWA_4May20_1pm.pdf• We don’t pretend it’s a good thing that there’s such a patchwork of requirements and phases across the nation. In a scenario of proper national governance — one where the CDC playbook doesn’t get shelved — we wouldn’t have a situation where Illinoisans can hop across the border into Missouri or Indiana and live a different lifestyle. The rules might be different, but the consequences are the same.
• Data lags and it could take longer to see the impact of lifting mitigation measures appear in the data. More time means we know more, especially since moving to the next phase doesn’t require a decline.
o Scientists learn new things about this virus constantly — to date, research indicates that symptoms tend to appear for people, on average, approximately 5 days after infection — but hospitalization looks to be around 8 days (former FDA commissioner). Given that infections that lead to hospitalizations are the driving concern of all our mitigation efforts, 14 days — less than one infection → hospitalization cycle — isn’t a lot of time to make sweeping decisions about reopening.
o The novel virus is still being studied and there are discussions about how long the incubation period might need to be adjusted: https://www.businessinsider.com/wuhan-coronavirus-symptoms-24-days-after-infection-2020-2o Study showing that the impacts of the 14 day quarantine aren’t usually reflected two weeks later: https://www.cebm.net/covid-19/is-a-14-day-quarantine-effective-against-the-spread-of-covid-19
posted by Rich Miller
Monday, May 18, 20 @ 2:09 pm
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Some way, some how, we have to get this governor some sort of face saving victory. Maybe the news of a potential vaccine can get him to the third leg of the ‘T’.
Comment by Blue Dog Dem Monday, May 18, 20 @ 2:17 pm
BDD - Because this is only about saving face for our gov, really? Hundreds of dead people every week and you think this is about Pritzker saving face. That does not speak well for you.
Comment by Froganon Monday, May 18, 20 @ 2:25 pm
Thanks for trying to get answers, Rich, but the gov’s office addressing continuing concerns over hospital capacity when millions of dollars were spent on the McCormick Place overflow field hospital only to see it shut down is not particularly persuasive.
Comment by Responsa Monday, May 18, 20 @ 2:34 pm
“Some way, some how, we have to get this governor some sort of face saving victory. Maybe the news of a potential vaccine can get him to the third leg of the ‘T’.”
Not sure a guy with a 76% Covid approval rating needs face saving.
Comment by Chicago Cynic Monday, May 18, 20 @ 2:39 pm
Again why set on May 1? Nothing special with May 1. How about a rolling 28 day average, a rolling 14 day average when you meet the criteria. Heck even give a three day lag like they do with other metric.
The obtuse May 1 metric because golf and boats can’t hold up.
Comment by Cool Papa Bell Monday, May 18, 20 @ 2:41 pm
May 1 — like the gov has said — was a new phase where some restrictions were lifted. It’s not rocket science.
Comment by Suzzz Monday, May 18, 20 @ 2:49 pm
“millions of dollars were spent on the McCormick Place overflow field hospital only to see it shut down is not particularly persuasive.”
At the beginning of the crisis, no one know if there were going to be enough ICU beds for the cases that were being modelled. I would rather build a field hospital at federal expense and then close it down when it was determined to be unneeded than scramble to build something when the hospitals were overwhelmed. Think of McCormack Place as our version of a Navy hospital ship.
Comment by Huh? Monday, May 18, 20 @ 2:52 pm
Not having to use McCormick Place was a huge victory for the governor. Don’t understand how anyone cannot see that. While we still have a huge problem, he and his team prevented a New York situation from happening here.
Comment by Rachel Monday, May 18, 20 @ 3:01 pm
Chicago cynic. Point well taken, but the one thing for sure, you don’t pay the states bills with approval ratings.
Comment by Blue Dog Dem Monday, May 18, 20 @ 3:02 pm
- Suzzz - Monday, May 18, 20 @ 2:49 pm:
It might as well be to the crowd that can’t read for comprehension or think critically.
Comment by Precinct Captain Monday, May 18, 20 @ 3:14 pm
“We’ve heard criticisms from the suburbs that they don’t want to be grouped in with the city, but their own hospital capacity numbers are very similar to the city.”
OK, but factors beyond capacity are at play in moving through his phases. And Cook is very different than the collars on those factors. C’mon.
Comment by Tawk Monday, May 18, 20 @ 3:46 pm
==Again why set on May 1? Nothing special with May 1.===
May 1 is the only day since April 22 that the infection rate did not exceed the previous day’s rate. It is also the only day since April 22 that the new case (daily) infection rate exceeded the cumulative rate.
Comment by CapnCrunch Monday, May 18, 20 @ 3:57 pm
@ Suzzz and Precinct
I know what he said. (see golf and boats)
But to more clearly spell it out and show comprehension he wanted to see how letting two people at a time go golfing and two people in a boat at once could impact things? Critical thinking is that boating and golfing two at a time across a state of millions will have zero impact on the curve, plateau, positivity rate or whatever he was tracking.
See I used my own critical thinking skills.
Comment by Cool Papa Bell Monday, May 18, 20 @ 3:58 pm
==We recognize the different experiences that more rural counties in the Northeast region have in comparison to the City of Chicago — but in terms of their EMS hospital capacity breakdown, they don’t have dramatically more capacity to handle moving forward before the rest of the region.==
Many people in rural counties with few cases (where I live) focus on the low number of cases and beg to be considered separately from their more urban neighbors. They forget (or ignore) the reality that we do not have the hospital or ICU capacity; we rely on hospitals in the larger population centers.
In addition, people travel to shop, eat, work, play…the governor’s large regions reflect reality.
Comment by Pot calling kettle Monday, May 18, 20 @ 4:05 pm
* the governor’s large regions reflect reality. *
The Chicago area has 67% of the population and 90% of the deaths, so yes, there is a difference.
Comment by DailyGrind Monday, May 18, 20 @ 4:15 pm
Madison County had met all of the governor’s standards for moving into Phase 3 before May 1. Yet the governor gave no credit for any time before May 1. So it’s completely unfair to make this region wait another 28 days. Especially when federal guidelines are 14 days. And JB has whined about the federal government not having a national plan for reopening. He doesn’t follow any of the existing federal guidelines anyway.
Comment by Dave W Monday, May 18, 20 @ 4:46 pm
I’m not a huge fan of the 28-day period either. But I’m willing to give the Governor the benefit of the doubt, at least for now, and wait to see how this all plays out.
Comment by Saul Goodman Monday, May 18, 20 @ 5:16 pm
Yet the governor gave no credit for any time before May 1
This was explained above. Please read.
Comment by Jibba Monday, May 18, 20 @ 6:04 pm
Wouldn’t it be so much easier for everyone if the Governor would explain exactly who or what guidance he relied on in developing his plan? Even this information doesn’t explain it. It’s just a bunch of information pulled together from a bunch of sources, but never says that is what was used to establish the plan or the metrics. Until this Governor (and his spokesperson) are more transparent, no one should stop asking the questions.
Also, given what happened over the weekend, the travel information seems like more double-talk.
Comment by OOO Monday, May 18, 20 @ 6:05 pm