What Could Trigger the State to Restart COVID-19 Restrictions?

From the onset of the COVID-19 pandemic, Illinois followed the science and listened to public health experts by putting mitigations in place and then deliberately and gradually lifting many of them. As other states see their cases and positivity rates surge, Illinois has one of the lowest positivity rates in the nation because we let public health guide our decisions.

Even so, the virus is still out there and as mitigations are lifted, it is likely that cases will rise. The administration is committed to being fully prepared for any resurgence and transparent with the public as to what that planning looks like. Just as Illinois took a gradual and regional approach to safely reopen our state, Governor Pritzker and the Illinois Department of Public Health have put forward a deliberate plan that will utilize several layers of mitigations to combat a resurgence of COVID-19 and prevent uncontrollable spread.

This plan recognizes that the state is in its strongest position to combat the virus since the pandemic began, with a robust testing operation regularly yielding more than 30,000 tests per day, expanded tracing operations with 1,450 contact tracers, a growing stockpile of personal protective equipment, and hospital surge capacity. The plan also accounts for months of additional data and research as public health experts reach a greater scientific understanding of this virus and how it spreads.

This updated guidance establishes a menu of mitigation options organized by risk level. The following health metrics will be used to determine when the spread of the virus in a region requires additional mitigations:

What Could Cause a Region to Become More Restrictive?

Sustained increase in 7-day rolling average (7 out of 10 days) in the positivity rate

AND ONE OF THE FOLLOWING:

Sustained 7-day increase in hospital admissions for a COVID-19 like illness
Reduction in hospital capacity threatening surge capabilities (ICU capacity or medical/surgical beds under 20%
Three consecutive days averaging greater than or equal to 8% positivity rate (7 day rolling)

Mitigations will be applied on a regional basis based on the Emergency Medical Services (EMS) Regions that have traditionally guided IDPH in its statewide public health work. Expanding to 11 regions allows for a more granular approach in this phase of the response to COVID-19. The new regions follow county lines to account for counties that are in more than one region of the EMS system. The new regions are as follows:

1. NORTH: Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside, Winnebago
2. NORTH-CENTRAL: Bureau, Fulton, Grundy, Henderson, Henry, Kendall, Knox, La Salle, Livingston, Marshall, McDonough, McLean, Mercer, Peoria, Putnam, Rock Island, Stark, Tazewell, Warren, Woodford
3. WEST-CENTRAL: Adams, Brown, Calhoun, Cass, Christian, Greene, Hancock, Jersey, Logan, Macoupin, Mason, Mason, Menard, Montgomery, Morgan, Pike, Sangamon, Schuyler, Scott
4. METRO EAST: Bond, Clinton, Madison, Monroe, Randolph, St. Clair, Washington
5. SOUTHERN: Alexander, Edwards, Franklin, Gallatin, Hamilton, Hardin, Jackson, Jefferson, Johnson, Marion, Massac, Perry, Pope, Pulaski, Saline, Union, Wabash, Wayne, White, Williamson
6. EAST-CENTRAL: Champaign, Clark, Clay, Coles, Crawford, Cumberland, De Witt, Douglas, Edgar, Effingham, Fayette, Ford, Iroquois, Jasper, Lawrence, Macon, Moultrie, Piatt, Richland, Shelby, Vermillion
7. SOUTH SUBURBAN: Kankakee, Will
8. WEST SUBURBAN: DuPage, Kane
9. NORTH SUBURBAN: Lake, McHenry
10. SUBURBAN COOK: Suburban Cook
11. CHICAGO: City of Chicago

All public health criteria included in this document are subject to change. As research and data on this novel coronavirus continue to develop, this plan can and will be updated to reflect the latest science and data.

Once a region meets the resurgence criteria, the following tiered menu of mitigation options will be considered. If sustained increases in health metrics continue unabated, further mitigations could be added from additional tiers.

Actions to Combat a Resurgence of COVID-19

Triggers: (1) sustained increase in positivity rate and A) sustained increase in hospital admissions or B) reduction in hospital capacity threatening surge capabilities; or (2) ≥ 8% positivity rate over three consecutive days (7 day rolling)

SETTING

TIER 1

TIER 2

TIER 3

Bars and restaurants

Reduce indoor dining capacity and suspend indoor bar service

Suspend indoor dining and bar service

Suspend in-person dining; takeout only

Hospitals

Reduce elective surgeries and procedures; limit visitation at hospitals; implement twice daily bed-reporting

Suspend elective surgeries and procedures; implement surge capacity; assess need to open Alternate Care Facility

Open Alternate Care Facility

Meetings, social events and religious gatherings

Additional limits on gatherings and room capacity

Greater limits on gatherings and room capacity

Strictest limit to gatherings and room capacity

Offices

Institute remote work for high risk individuals; continued emphasis on telework for as many workers as possible

Reduce office capacity with recommendations to resume remote work where possible

Institute remote work for all non-essential workers

Organized group recreational activities & gyms*
(fitness centers, sports, etc.)

Reduce indoor capacity

Suspend organized indoor recreational activities

Suspend organized indoor and outdoor recreational activities

Retail*

Reduce in-person capacity

Suspend in-person non-essential retail; online and curbside pick-up available for all

Suspend all non-essential retail; only essential retail open (i.e. grocery stores, pharmacies)

Salons and personal care*

Institute temporary location shutdown tied to outbreak

Institute temporary shutdown tied to outbreak with possible broader mitigations

Suspend salon and personal care operations

* Optional measures based on a region’s on-the-ground condition. This list is not exhaustive and other industries may be added if indicated by the data.