Dec. 1: Thirty-one New COVID-19 Cases in Evanston, 12278 in the State – Evanston RoundTable

There was a significant jump in thenumber of new COVID-19 cases today in Evanston, Suburban Cook County, Chicago,and the State, compared to the average number of new cases in the prior fourdays. On a Statewide basis there were 12,542 new cases today, compared to anaverage of 7,229 in the prior four days.

Governor JB Pritzker said one reason forthe increase may be there were 133,444 tests today, compared to an average of64,955 in the prior four days. He added that part of the increase may be due toa spread of the virus due to travel and gatherings over the Thanksgivingholiday.

A surge in cases may be felt withinfive to 10 days after a holiday, and it may have an impact for as long as 28days.

Dr. Ngozi Ezike, Director of theIllinois Department of Public Health, said, We're seeing cases increase becausealthough so many people are wearing masks and being compliant, theres stillmany that aren't. So many people make difficult choices to forego Thanksgivingin a traditional way and observe virtual Thanksgivings in the hopes ofpreventing an ICU Christmas. But many did not. Many people are staying home asmuch as possible, but others are not. And these actions of moving about andmixing up households do allow the virus to spread more quickly, which meansthere's more opportunity for more cases."

Dr. Ezike said the chances thathospitals and health care workers will be overwhelmed would be reduced ifpeople followed the mitigations in place, wore masks, and maintained six feetof distance.

Prioritiesfor Vaccines

While the briefing was in progress,the CDC was meeting to consider the allocations of the initial shipments of vaccinesthat still have to be approved, and who should be vaccinated first.

A panel of experts advising the CDCsaid long-term care residents and at-risk health care workers should get thefirst corona virus vaccines. The CDC is scheduled to decide by tomorrow.

Gov. Pritzker said this afternoon thatthe State was currently anticipating that it will receive 109,000 doses of vaccinesin the first shipment. Assuming each person would need two shots, that would beenough to vaccinate 45,000 people.

Gov. Pritzker said the first prioritywould be to vaccinate health care workers and then health care workers inlong-term care facilities. He said as soon as the CDC is able to deliver itsrecommendations about priority, we'll be able to take that into considerationin the way that we prioritize how the vaccines will be distributed acrossIllinois.

Gov. Pritzker said because the initialshipment will have only a limited number of doses, they will go almost all tohealth care workers. If there are enough doses, then they would go to thosein long term care facilities, the staff and the residents.

What I know is that we're going to befocusing on those populations that are most vulnerable, and also the people whotreat the most vulnerable, not just healthcare workers, but others who may workwith the most vulnerable, said Gov. Pritzker. Weve sometimes called themessential workers. We want to make sure that they're vaccinated as well.

Dr. Ezike said some of the high riskworkers or essential workers may include people who work in the ICU, or thepeople cleaning the room of a COVID patient, or the people stocking the shelvesin the grocery stores. There's a lot of people who are essential or criticalto making sure that life can continue, she said.

We absolutely will look at areas, regionsthat have had a large number of deaths per capita. We already know that AfricanAmericans are most likely to die. We have to be very intentional and lookingat all of these issues.

We're going to have months of trying to getthis vaccine out and we will continue to adjust, Dr. Ezike added, We willjust be adjusting the distribution and the allocations to try to get as many ofthose high risk people up front, but knowing that the goal is to get it toeveryone and hoping that there's going to be the will of the people to actuallyreceive it.

EVANSTON: 31 New COVID-19 Cases Today

Therewere 31 new confirmed COVID-19 cases of Evanston residents today, an increasefrom 8 yesterday. The average number of new cases per day in the last seven daysis 22.3. For purposes of comparison, on Oct.12, the seven-day average was 5.6.

Therehas been a total of 2,353 COVID-19 cases of Evanston residents during thepandemic, 331 of which are active. An accompanying chart shows the trend. [1]

Inthe last 7 days, there were a total of 156 new COVID-19 cases of Evanstonians.That equates to about 207 new cases per 100,000 people in the 7-day period. TheStates 7-day target is 50 per 100,000.

Thetest positivity rate over the last 7 days is 4.2%. The rate is up from 2.8% onNov. 1.

NoEvanstonian is reported to have died due to COVID-19 in the last 24 hours. Thenumber of deaths due to COVID-19 remains at 88.

The Impact of NU on Evanstons Increase inCases

AllNorthwestern University (NU) students, staff and faculty who live in Evanston andwho test positive for COVID-19 are included in the case numbers reported above,according to the City. If NU students,staff or faculty live outside Evanston, they are not included. [2]

NorthwesternUniversity has posted data on its website reporting that between Nov. 20 and Nov.26 there were 50 new confirmed COVID-19 cases of students, staff and faculty,which includes those who live outside of Evanston. Between Nov. 23 and 29, NU says there were 27cases. The City claims it does not know how many of these cases are people who livein Evanston. [2].

SUBURBAN COOK COUNTY, CHICAGO ANDILLINOIS

Severalkey metrics used by IDPH to measure the spread of COVID-19 are the trend of newcases, the number of new cases per 100,000 population, and the test positivityrate. Another key metric is the numberof hospitalizations due to COVID-19 and hospitals capacity to care for a surgeof new patients.

First, NewCases.In Suburban Cook County, there were 2,388 new COVID-19 cases today, and 2,565in Chicago, for a total of 4,953. Yesterday the reported cases were 1,175 forSuburban Cook County and only 384 in Chicago, for a total of 1,559.

In the State there were 12,542 new casesreported today, a big jump from the prior four days which had new cases of 7,574,7,873, 7,178, and 6,190.

Theaverage number of new cases per day in the last seven days is 9,521. This isdown from 12,343 on Nov. 13. While the trend has been down, the number of newcases is still very high.

Forpurposes of comparison, the average of new cases per day over the seven daysending on May 1 was 2,565, which was the previous high for the State, until theincreases in the last month. The 7-day average today is more than three timesthat.

Thetrends of new cases in Suburban Cook County, Chicago and the State are shown inaccompanying charts. One significant point is that the 7-day average of newcases for each of these public bodies has been flat or declining since aboutNov. 13. Whether the jump in cases today foretells a change in that trendremains to be seen.

Second, NewCases per 100,000 Population.This criterion measures the level of contagion in an area and whether it is ata level that can be contained and suppressed. IDPHs target is that there befewer than 50 new COVID-19 cases per 100,000 people in a geographic area in a7-day period. Harvards Global Health Institute (HGHI) and the Edmond J. SafraCenter say that a stay-at-home order is necessary when the weekly cases exceed169. [3]

Inthe 7-days ending Dec. 1, the number of new cases per 100,000 people were as followsfor the areas indicated:

-SuburbanCook County: 493 (compared to 97 on Oct.1 )

-Chicago:422 (compared to 86 on Oct. 1)

-Illinois:511 (compared to 111 on Oct. 1)

Thenew cases are four times the number for the week ending Oct. 1, and each is atleast eight times IDPHs target.

Anaccompanying chart shows the trend in the number of new cases during the weekending Dec. 1, compared to the number of new cases for the weeks ending Oct. 1and Nov. 24. [4]

Importantly,the chart shows that while the number of new cases per 100,000 is still veryhigh, the number of new cases per 100,000 on Dec. 1 is lower than the number onNov. 24 for Suburban Cook County, Chicago, and the State. The seven-day trend of new cases is still declining.

Third, a Test Positivity Rate. IDPHs target is that the test positivity rate be5% or less, although HGHI and other leading experts say it should be 3% orless. If a communitys test positivityrate is high, it suggests that the community is not testing enough and notlocating people who have milder or asymptomatic cases and who may be spreadingthe virus. [5]

Themost recent 7-day test positivity rates as of Nov. 30 are as follows:

-SuburbanCook County: 12.4%

-Chicago:11.5%

-Illinois:12.2%

Eachpositivity rate has been declining in the last 10 days. But each is still morethan double IDPHs target and each is almost four times that of other leadingexperts. An accompanying chart highlights the rates.

Fourth, HospitalAdmissions and Surge Capacity.There were 2,836 hospitalizations due to COVID-19 in Suburban Cook County andChicago as of Nov. 30, up from 1,456 on Nov. 1.

IDPHreported that as of Dec.1, Suburban Cook County has a surplus capacity of 24%of medical/surgical beds and 20% of ICU beds; and Chicago has a surpluscapacity of 22% of medical/surgical beds and 25% of ICU beds. IDPHs target is 20%surplus capacity.

Ona Statewide basis, the number of hospitalizations due to COVID-19 was 5,835, asof midnight on Nov. 30. The number is down from an all-time high of 6,171 on Nov. 23. A chart in the chart boxshows the trend.

Forpurposes of comparison, the highest number of hospitalizations due to COVID-19 inthe spring was 4,868 on May 6. The number of hospitalizations today is almost1,000 more than the peak last spring.

Thenumber of patients using ICU beds is 1,195, up from 347 on Sept. 1. Patients onventilators is 721, up from 142 on Sept. 1.

Ifadditional hospital beds are needed in Suburban Cook County and Chicago, thecontingency plan is to increase bed capacity by doing the same things that weredone in the spring, Gov. Pritzker said on Nov. 10.

Fifth: Numberof Tests: Theaverage number of tests per day in the last seven days is 91,591. This ishigher than HGHIs mitigation level testing target, but about only about 45%of the amount needed to meet HGHIs suppression level testing target. [6].

Thenumber of new tests reported today was 133,444. This includes antigen tests.

Sixth: Delaysin Getting Test Results:Public health experts convened by HGHI and Edmond J. Safra Center say testresults should be obtained within 24 hours.

Dr.Ezike said on Nov. 12 that 53% of the lab tests come back in 48 hours, an indicationthat the results on almost half of the cases are coming in later. With thesurge in the number of tests being administered, the lag time is gettinglonger, said Gov. Pritzker on Nov. 25.

Asaliva test developed at the University of Illinois can produce results in 3 to6 hours, and it is being used at U of I, Champaign. [7] Gov. Pritzker said the plan is to expand thismethod of testing across the State, especially to other college campuses.

Thenew antigen tests being distributed by IDPH can generate results in 15 minutes.

Seventh: ContactTracing. Widespread contact tracing isalso essential to control the spread of the COVID-19 virus. IDPH posted data onNov. 27 showing the amount of contact tracing done in the period Aug. 1 throughNov. 21.

ForSuburban Cook County, contact tracers attempted to interview 16% of the peoplewho tested positive for COVID19, and interviewed 12% of them. Of the closecontacts identified by the people who tested positive, contact tracersattempted to call 62% and interviewed 55%

ForChicago, contact tracers attempted to interview 31% of the people who testedpositive for COVID19, and interviewed 16% of them. Of the close contactsidentified by the people who tested positive, contact tracers attempted to call61% and interviewed 34%.

Deaths: There were 125 deaths Statewide in the last 24hours, and a total of 12,403 deaths due to COVID-19 during the pandemic.

Forthe last seven days the number of deaths in the State, as adjusted, are 155,131, 66, 107, 57, 85, and 125 today.

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FOOTNOTES

1/ Antigen Tests. The Illinois Department ofPublic Health announced on Oct. 15 that is including both molecular (PCR) andantigen tests in the number of statewide total tests performed in Illinois, andthat it is including the positive test results on antigen tests in theconfirmed COVID-19 cases reported. Previously, due to the limited numberof antigen tests and limited information about antigen test accuracy, antigentests were not included in the total number (which comprised less than 1% oftotal tests performed).Antigen tests, like BinaxNOW, are now becomingmore readily available, therefore, IDPH will include both molecular and antigentests in its total number of tests starting October 15, 2020, said theIllinois Department of Public Health.Dr. Ngozi Ezike, Director of IDPH,said on October 30, You have COVID if you come up with a positive on the antigentest. Gov. JB Pritzker said it is very, very likely that a person hadCOVIC-19 if they test positive on an antigen test. The States plan is toadminister 3 million antigen tests provided by the federal government by theend of this year.

Dr.Michael Mina, assistant professor of epidemiology and assistant professor ofimmunology and infectious diseases at the Harvard T. H. Chan School of PublicHealth, said an antigen test detects if there is an antigen which is one of theproteins in the virus, while the PCR test looks for the RNA of the virus.

2/Northwestern University Covid-19 Cases. Ike C.Ogbo, Director ofEvanstons Health & Human Services Department, told the RoundTable that theCOVID-19 cases reported by the City include cases of faculty, staff andstudents attending Northwestern University who live in Evanston. The RoundTableasked the City in an FOIA Request to provide the number of NU students whotested positive for COVID-19 and who live in Evanston. The City refused toprovide the data. On Oct. 26, the RoundTable appealed the Citys decision tothe Public Access Counselor of the Attorney Generals Office. On Nov. 13, theCity filed a response claiming it does not have any records showing the numberof NU students who tested positive for COVID-19 and who live in Evanston.

TheRoundTable has asked Northwestern University on two occasions to provideinformation breaking out the number of new COVID-19 cases of its faculty, staffand students by residency in Evanston. NU did not respond to either request.

3/ Number of Cases per 100,000 Population. OnJuly 1, a network of research, policy and public health experts convened byHarvards Global Health Institute and Edmond J. Safra Center published a KeyMetrics for COVID Suppression framework that provides guidance to policy makersand the public on how to target and suppress COVID-19 more effectively acrossthe nation. The targets for new Covid-19 cases per 100,000 people are asfollows (these are converted from cases per day to cases per week): a) lessthan 7 cases: on track for containment; b) 7 to 63 cases: community spread,rigorous test and trace program advised; c) 70 to 168 cases: acceleratedspread, stay-at-home orders and/or rigorous test and trace programs advised;and d) 169+: tipping point, stay-at-home orders necessary. The article is available here: https://globalepidemics.org/key-metrics-for-covid-suppression/

IDPHprovides these categories and ratings: 1) minimal less than 50 cases per100,000 in a week; 2) moderate between 50 and 100 cases per week; and 3) substantialmore than 100 cases per 100,000 in a week.In its Metrics for School Determination of Community Spread, IDPH saysthe target is 50 cases per week per 100,000 people.

4/Calculations. The RoundTable calculated the number of cases per 100,000 usingcase data provided by IDPH and assuming that the population of Suburban CookCounty is 2.469 million, that the population of Chicago is 2.710 million, andthat the population of Illinois is 12.671 million.

5/The Test Positivity Rate. On May 26,Johns Hopkins University & Medicine Coronavirus Resource Center said on itswebsite that the World Health Organization (WHO) advised governments [on May15] that before reopening,rates of positivity in testing (i.e., out ofall tests conducted, how many came back positive for COVID-19) should remain at5% or lower for at least 14 days.

JohnsHopkins explains, The rate of positivity is an important indicator, because itcan provide insights into whether a community is conducting enough testing tofind cases. If a communitys positivity is high, it suggests that thatcommunity may largely be testing the sickest patients and possibly missingmilder or asymptomatic cases. A lower positivity may indicate that a communityis including in its testing patients with milder or no symptoms. Link: https://coronavirus.jhu.edu/testing/testing-positivity

The Harvard Global Health Institute (HGHI)says, A network of research, policy, and publichealthorganizationsconvened by Harvard and MIT called the TTSICollaborativehas agreed on a 3% test positive rate or below as a keyindicator of progress towards suppression level testing. This targets broad andaccessible testing for symptomatic and asymptomatic people. Out of the positivetests that do not come from hotspot testing, at least 80% should come fromcontact tracing.

Whilestating the test positivity target is 5% or less, IDPH provides thesecategories and ratings: 1) Minimal test positivity rate is equal to or lessthan 5%: 2) Moderate test positivity rate is between 5% and 8%; and 3)Substantial test positivity rate is over 8%. In its Metrics for SchoolDetermination of Community Spread, IDPH says the target is 5%.

6/How Much Testing Should be Done. The HarvardGlobal Health Institute posted a paper showing testing targets as of October 1,2020. The targets for Illinois are 438 tests per 100,000 people to meet themitigation target and 1,602 tests per day to meet the suppression target.The paper says that Illinois 7 day average of testing is 564 tests per day.Link to paper: https://globalepidemics.org/october-1-testing-targets/

MitigationLevel Testing: In an earlier paper, HGHI says for mitigation level testing,The focus is on reducing the spread of the virus through broad testing ofsymptomatic people, tracing and testing a recommended 10 contacts per new caseand isolating positive contacts, and social distancing, mask wearing orstay-at-home orders as necessary.

Thereis a challenge with this approach: As states open up, mitigation level testingis often not sufficient to prevent new outbreaks.

Withstrict social distancing orders in place, cases go down, but then spike back upagain as a state loosens restrictions. It's a rollercoaster of recurringoutbreaks that creates great uncertainty, for example around reopeningbusinesses, schools, and other vital parts of the economy.

SuppressionLevel Testing: HGHI says, Suppression level testing allows a state orcommunity to quickly find and isolate new cases before they lead to a wideroutbreak, with an aim of keeping new case levels at or near zero.

Thisrequires large, proactive testing -- including regular testing of asymptomaticpeople in high-risk environments such as nursing homes, colleges, and parts ofthe service industry -- paired with rapid contact tracing and supportedisolation (TTSI), as well as other measures.Several states are workinghard to build and maintain this type of response, including Massachusetts, NewYork and Connecticut.

Suppression level TTSI programs reduceuncertainty and allow life to return to something closer to normal -- but stillinclude mask-wearing, social distancing, handwashing and other measures. It iseasier to do when case counts are relatively low or on the decline.

Linkto HGHIs report: https://globalepidemics.org/july-6-2020-state-testing-targets/

7/ Saliva-based Tests. On Aug. 19, theUniversity of Illinois received emergency use authorization from the Food andDrug Administration to run a saliva-based COVID-19 test. The saliva test isless expensive, faster, and requires significantly less raw materials thantraditional testing, said Gov. JB Pritzker. If ongoing research continues toyield positive results, this has potentially game changing implications for ourState-wide testing complex as well as for testing on a national level,particularly for our high risk communities and settings.

Thistype of scalable product would allow us to mass deploy testing, and bettertrack and contain the spread of COVID-19. We're already working to deploy thisto more public universities across the State over the next weeks and months andexploring rolling this out to do testing potentially for K-12 schools and evenmore testing at our long-term care facilities, said the Governor.

Dr.Martin Burke, who put the research team together that developed the test, said thatin a trial run in July, they were able to get very fast test results, in manycases in 3 to 6 hours, which enabled them to rapidly isolate people who wereinfected with the virus and to contact trace. They were able to reduce the testpositivity rate from 1.5% to 0.2% during the month, he said.

Dr.Burke said speed is the key. The test is very well suited to scalabilityand the cost is about $10 a test. He added that the University has capacity toadminister 20,000 tests a day. Link: https://evanstonroundtable.com/Content/City-News/City-News/Article/Illinois-rapid-saliva-test-for-COVID-19-now-operating-under-FDA-Emergency-Use-Authorization/15/26/18440

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Dec. 1: Thirty-one New COVID-19 Cases in Evanston, 12278 in the State - Evanston RoundTable