* Gov. Pritzker today introduced Dr. Wayne Duffus, who is the state’s new acting chief epidemiologist. He comes from the CDC.
The governor focused today on contact tracing. Make sure to pardon all transcription errors…
But let’s start with the basics. What is contact tracing? Well it means making sure that you get notified if you’ve had contact with someone who has tested positive for COVID-19 so you can do what’s necessary to keep you and your family and your community safe. Contact tracing means we will let people know before symptoms start that they could become ill. In the context of a very infectious virus, this is our primary tool for identifying potential asymptomatic spreaders so that they can self isolate quickly and slow the spread of the virus to their contacts, keeping more people COVID-free for longer.
And that last factor is key because it demonstrates why contact tracing is so important to all of us together. It means a reduced rate of spread fewer outbreaks and an all around healthier Illinois contact tracing isn’t a new concept. It’s been around for many years and Dr Duffus will talk a bit more about that history.
The difference now is that in order to move safely back toward normalcy, Illinois, the United States and frankly the whole world must contact trace on a never before seen scale. Contact tracing has played a role in our COVID-19 response since the earliest days of this pandemic as local health departments around the state have aggressively sought out each COVID positive person to identify all their close contacts, and then encouraging those contacts to opt into monitoring programs and to follow recommendations. That was when we hit a manageable number of cases and contacts that county health department’s existing staffs could handle. Of course, as we all know, over just the last few weeks COVID-19 has reached a massive scale of spread statewide and nationwide and existing public health management infrastructure simply can’t keep pace. No doubt, as we all live through this pandemic, I think we’ll all have a lot to consider about our failure to invest in public health in this country, but we’ll save that conversation for another day.
Right now we have to deal with what’s right in front of us, and that’s getting to the other side of this crisis. Here in Illinois we’ve had more than 50,000 known cases to date, largely in just a 60 day time frame. Their contacts are 50,000 sets of family, friends, coworkers commuters classmates, and other contexts. It’s an unprecedented public health challenge. So we need an unprecedented solution to meet this moment.
To do that, Illinois will be building on our existing infrastructure and expertise to shape a massive statewide contact tracing operation, gradually building over the coming weeks, and then scaling up an army of contact tracers by the hundreds, and then by the thousands.
Right now based on our current rates of spread, we’re looking at a benchmark that could approach 30 workers per hundred thousand residents. But to be clear, that number can and will diminish if we see greater success in our public health measures, particularly our new face covering requirement.
Already we’ve identified groups of Illinois residents quickly willing to scale and be part of our efforts, undergraduate and graduate students, volunteers, retired health professionals, local health officials, community health workers and new hires. And if you’re interested in being a part of that, keep an eye out for more information on how to get involved in your community in the coming weeks.
A significant part of this program involves technology. When an individual tests positive for COVID-19, a contact tracer will reach out to them through an app, through email, a text, or a phone call. And because not everybody can or will use technology, some will require follow up even with a safe in-person visit. If the COVID positive person can’t be reached in some other way, then step two, interviewing the COVID positive person asking them to gather their contacts and retrace their steps over the past 14 days. This is what allows us to significantly slow the spread of the virus.
Because connecting with those who’ve been exposed allows us to do three important things.
One, notify them that they’ve recently been in proximity of someone who has tested positive. Two, recommend that they seek a test and self isolate. And three, offer them resources on how to access any needed assistance to prepare them for self isolation, things like alternative housing, food delivery or medication.
Privacy is an important aspect of maintaining trust in contact tracing. So to be clear contact will remain anonymous looking backward and pointing fingers doesn’t help anyone in this situation, it’s about what we do next to keep each other as healthy and safe as possible.
Remember, we aren’t reinventing the wheel here. Contact tracing has been done in every pandemic and major outbreak for many years. In fact, that’s why Dr. Duffus is an experienced expert at it.
The governor then went on to congratulate the new graduates of the Illinois State Police academy.
* Dr. Duffus…
We are using a benchmark of 30 workers per hundred thousand population. Illinois has a population of 12.7 million residents approximately. So doing the math, 12.7 million divided by 100,000 gives 127. If the benchmark is 30, you multiply that out, you get 3,810 individuals as our estimate of how many individuals will be needed.
However, note as well that these individuals do not have to work continually, because we’re driving down the numbers testing positive, because of the continuance or adherence to non pharmaceutical interventions. They don’t all have to be hired all at once. And so the numbers speak to the total over time.
It is also very reasonable to start with an initial number, say 10% of that total say 300 workers, but they’re strategically placed in the regions that are most impacted. By working with the many individuals and institutions who shall detail below, we will have the capability to surge as needed. Think of how we use the National Guard’s may think of this as a dial and not a switch.
Also by deploying technology as a first contact with individuals, the number of workers needed will be fewer. We plan to implement that virtual Call Center, which will enhance efficiencies and only the most hard to reach individuals will actually require a visit. So imagine a homeless individual somewhere with no connectivity or very skilled person to always be on the leading edge of the pandemic we’ve organized the IDPH staff into a command center of subject matter experts are tasked with reviewing data daily and be ready to make recommendations based on chosen indicators of success, the umbrella.
So, who will be engaged to assist with contact tracing Illinois? Contact tracing is a skill that can be performed by anyone who’s bright interested, and has a charming personality.
I got a nice chuckle out of that “charming personality” line.
* On to questions for the governor. How soon are they hired, how soon are they trained, how much does this cost?…
Dr. Duffus: Some of the components of training will involve as a basic computer skills, privacy and confidentiality. So you can imagine someone who’s a graduate student, for example, or someone who’s a retired professional, someone from a local health department, they don’t really have many of these skills, we would just have to tailor it for the COVID pandemic. They’re established training programs and pandemic training that’s already ongoing. And so once we identify individuals are ready and able to go we can start as soon as possible.
Dr. Duffus: Well, we’d like to start at the end of the month. We’d like to start at the end of the month I probably would do a soft rollout. So we’re getting all the pieces that we need together and trying to uncover any potential limitations that may arise before we actually roll up.
Gov. Pritzker said the cost would be “somewhere in the neighborhood of $80 million,” which is twice what Massachusetts budgeted.
* Obviously you’ve seen outside I would think when you arrived at Thomson If not, there’s a rather large crowd they’ve been here all day. They’ve also been at the state capitol. Lots of frustration. Don’t they have a point that some places in the state and I have multiple questions I could name all the people but everyone asking, why not go ahead and open the regions where the hospital bed use is low or the ventilator use is low, why not?…
So let me begin just by saying that there are a few hundred protesters today, both here and in Springfield, and they’re exercising the right to free speech and we ought to defend to the death their right to exercise that right, even when they’re wrong.
But I’d like to call everyone’s attention to the millions of Illinoisans who are staying at home and helping to keep people safe and healthy. They’re the ones who deserve to be commended today. They’re the ones who are keeping people from getting sick and dying.
As to the question of regionalization, which by the way many of the signs and the people out there are not talking about that, they’re really not. They’re just saying open everything up. They have some concept that somehow that’s going to be safe for everybody.
It is true that in areas of the state where we have a lower number of COVID-positive cases and a lower number of deaths. Those are the more likely areas that we’re opening up, and you saw that I made changes in the executive order that was put forward today. That includes things like opening up state parks which are downstate not in Cook County, and that opened up things like golf courses and other things they’re easier to open up downstate than they are in the collar counties or Cook County. And of course the same thing is true of the elective surgeries that we, it’s easier to open up those hospitals downstate to elective surgeries and many of them needed to stay solvent. And so, we are in fact looking at all of the ways in which we can take into account the local circumstances in every part of the state.
But I do also want to point out to people that well that’s true there are areas of the state that have a low case count, and a low infection rate. There are also areas of the state that’s where you would say they have a low case count, a low death count, but it’s a very high infection rate and the percentage of people who are dying is higher.
So, look at Cook County versus some of these other areas in terms of infection rate or the doubling time, and they’re doing much worse or the same as Cook County or the collar counties. And so we want to be careful, looking at this from a hospitalization and hospital region perspective, rather than simply saying, well, gee, this is Southern Illinois and therefore we should open everything up because there are only a few cases well those few cases may only be a few cases but among a very few population also so we’re being careful about this we are in fact working on the plans for opening up for working you know we’re starting with the President’s plan, Dr Fauci’s plan, thinking that you know we have to get past the peak which we’re not past downstate or in Cook County or in the collar cache we’re not past it yet.
And once we get past that, you know, consistent downward trend of those numbers, gives us the indicator let’s move to the next phase.
* What about those regions, Indiana is saying today with their plan, if that region has passed its peak, could that region, open before May 30?…
Yes, I mean we absolutely are looking at all of the hospitalization numbers. Remember it has to do with how many hospital beds are available if there’s a surge, how many ICU beds are available if there’s a surge, how many ventilators are available in that area if that surges. Because it’s one thing to say well half of our hospital beds are ICU beds are available, but if that number is 35, right, that’s a very small number. And if the population is such that the 35 beds wouldn’t be able to cover that population if there was a surge, then we can are concerned about an area so it has to do much more than, with much more than just a population in an area. It has a great deal to do with how much health care is available in that area.
* So I just want to make sure I’m hearing that right because that sounds like news to me that you’re saying before May 30, if there is a region with low hospitalization low ICU availability of ventilator that region may open?…
Yes, if it’s heading down the other side of this slide that even the national plan proposed that that is for 14 days on a downslide of those numbers. Then absolutely. Listen, I want as much as everybody else does for everybody to get back to work and for us to move toward normalcy.
But I also want to say that I’m not going to do it until we know people are safe and it isn’t going to be because some protester has a sign that says, you know, liberate Illinois.
* Can you respond to the lawsuit filed on behalf of the town of Cicero regarding the City View multi Care Center, where there has been an severe outbreak of corona virus? Attorneys believe that IDPH failed to act on complaints and should the residents there be moved to an alternative care facility like McCormick Place?…
Dr. Ezike: So again, it’s a very unfortunate situation that again, we all know that our long term care residents are the most vulnerable, they’ve suffered the heaviest losses, specifically regarding this Cicero locale. Yes, there have, there was a major outbreak there as there have been over 500 outbreaks I think through the state, so it’s a major issue. We’re looking into it. Again, people think that, oh, if we identified some cases, if somebody comes in they should be able to stop it immediately. Unfortunately, the way this virus works, the way the pandemic is working, once you already have some cases, you’re just trying to mitigate. Given that people were already spreading potentially even before they were symptomatic. People have probably already been infected before you walk in the door, and so it’s just a matter of again trying to mitigate or control so unfortunately there’s not a way to turn off the outbreak as soon as you get in, but you try again to mitigate to decrease the number of people, additional people who can get sick so again we’ll be working through that situation, along with all the other situations, and I’ll leave it to the legal team to deal with whatever lawsuits there might be pending.
And McCormick Place is an option for perhaps some of those folks. So when we think about a McCormick Place we were thinking of that as an acute care facility for people who were on their way to home. And so when you think about what nursing home patient needs are compared to what is available at McCormick Place, depending on the level of independence of the nursing home patient, it may not be a suitable location and the rooms that are currently in use, you’d have to walk you know down the aisle, you know down the hall to get to a bathroom. They’re not beds that could protect against ulcerations for people who don’t move well so thinking about these cots wouldn’t we promote bed sores in a certain population so we have to think about all those things. And in terms of could they go to McCormick Place, but again we’re working through that very difficult issue along with many of the other outbreaks that we’re doing throughout the state.
* In the new order that is effective today, you have clarified the worship services can be held with 10 people. Those who filed their lawsuit yesterday feel as if you’ve cave to that pressure, could you react to that?…
No. All we were trying to do was to make more explicit that people do have a right to gather in groups of 10 or less, you know that is the case in the other orders too, but we want to make it more explicit that you can worship in a group of 10 or less just as you could as long as you’re socially distancing to be clear. But we just want to make it more explicit as we have in some other areas of the new order.
* The numbers revealed at large Latino communities are seeing a spike in the confirmed cases in the last few days, how do you tackle that spread in their communities, especially with the challenge of language, some of the top zip codes are Latino communities…
That’s right and this problem, this challenge for communities of color is well known to all of us now right, I think we’ve paid attention to it for quite some time now, understanding that the numbers really have been increasing as we increase by the way the number of tests that we’re doing. So we’ve opened up testing centers for example in Latino community predominantly Latino communities, to make sure that we’re getting the right information, and that we’re able to identify people who need to be treated or need to be told to self isolate and so on in these vulnerable communities. And let me just, I’ll add one more thing that I’d like to turn over to Dr Ezike who pays very close attention to these numbers to just to say that one of the things that I’ve been engaged in is trying to get the message out the word out in these communities talking directly through Univision and other outlets and making sure that we’re within our message is … and trying to get the message out … trying to get the message out that people do need to pay attention to this that they need to follow the rules to stay at home, and that you know there are various ways to seek testing, and to make sure that you’re getting the right health care.
* Virtual call center and new to a computer system is on target for May 11, but we are hearing gig workers should not expect to get money by that date, and clarify what people need?
I can’t speak to what date on which they will get, what are the other cards would be charged. What I can say is that we are going to be launching that but we would ask all the gig workers something very important for people who are independent contractors who are eligible could be eligible, they need to actually file their unemployment claim now under the current unemployment system, because it will make it much easier when we actually launch the independent contractor system for them to get paid. So file now, you’ll get a rejection, and we’ve said this many times you will get a rejection because you’re not currently employed somewhere that’s eligible. And then by you know in that May 11 week that we’ll be launching gig. Sorry, independent contractor payments, they’ll be ready to go, they’ll have an account already set up.
* What about cities and towns struggling to enforce mask or face coverings. Will there be a fine, will there be arrests are the police going to get involved? [This question has been asked multiple times.]…
We’ve left that up to localities to municipalities and counties to make those decisions about how they will enforce, whether it’s, as I’ve often recommended having police tell people, pull over, ask them to please wear a mask to remind people because a lot of people still don’t know that they’re required to wear a mask. Today is the first day that that is required, a face covering is required, even though, as you know for weeks now I’ve been encouraging people to do it and many people as I see are, not the protesters of course, but many other people are wearing their face coverings. So again the enforcement will be up to local municipalities and local counties.
* Center Square wants to know about state representative Bailey’s loss of today he voluntarily withdrew his TRO in inferring that your office and others may have illegally intended, kept information from the court. If he has documents proving the state willfully committed this evidence kept the evidence, how will you respond?…
I can’t answer some hypothetical. I really don’t know what representative Bailey’s intention is by withdrawing his lawsuit. I’m glad that he did, but I know that he intends to do something else. I’m not sure, you know, again if it’s more grandstanding or what.
But there is the other the second lawsuit that takes in everyone. Do you have any update on where that stands?…
No, although I did read that that lawsuit is not intended to be adjudicated anytime soon.
* Ravinia is now cancelled. Isn’t it time to make the call on all music festivals block parties events that draw thousands? Lollapalooza let’s throw that in there too [Those are all local decisions]…
All I can tell you is that we currently have an order in place that goes through May 30 that makes it clear that gatherings of more than 10 are inappropriate or against the order. And so I can’t tell you what July or August will look like yet. And decisions will have to get made either by municipalities or by the promoters of those concert venues or large gatherings at this point.
* There have been a number of emergency cases concerning COVID-19 when it comes to parental custody. There is a real concern from both attorneys and parents and some are using your stay at home order to cite sidestep custody agreements and deny parental rights. Is this something the governor’s office or your team is looking into and how can you protect parental rights during the pandemic?…
I appreciate the question. I don’t have an answer for, I don’t know the details of it, but I certainly, now that the question has been asked, we’ll certainly look into it. The likelihood is that our legal team knows about it.
* Perhaps, is there a need for more training at grocery stores? They, especially see grocery store workers touching their face, touching the items, people don’t feel safe. Is there more training needed for sanitizing?…
Let me begin by saying that this pandemic was a surprise to everyone, including the grocery stores, the grocery store workers, everybody. And so as we worked with the, the Retail Merchants Association and connected with grocery store owners across the state, we’ve encouraged them to follow a set of guidelines. Many of them really have done yeoman’s work and getting that done and so I would say it’s absolutely true that many people can go into a grocery store and see something a worker does and say gee I wish they hadn’t done that, or wouldn’t do that. And certainly not wearing a mask is unacceptable, not wearing a face covering for somebody who’s working there and somebody who’s shopping there either. And so obviously there may be a desire for more training. And I certainly would encourage the owners of grocery stores, as well as pharmacies and other places that have been open under you know the essential business openings. And this is gonna happen to have to happen across our economy. I might say, as we’re opening retail and other things, manufacturing, professional offices and so on. People are gonna have to be trained. This is so new for everyone even wearing a mask even out face covering is so new that, you know, certain kinds of jobs are going to require gloves, and a face cover certain kinds of jobs are going to require people to have a much more sealed face covering than the kind you might wear when you’re outside on your own, taking a walk or going into the grocery store so there is going to be a lot more training that’s required.
* Mark Maxwell as well as Amy Jacobson, they’re asking, again, ventilator usage down, you sent ventilators back to California. There are open hospital beds and ICU beds, 23% of all hospital beds in use, the curve is flattening. Just one more time, why continue to lock down?…
Well they think that maybe they think that’s an accident. I think it’s an interesting pair you just threw up there. Mark Maxwell and Amy Jacobson. But I would say that I, look all I can say is this. Yeah, we, you know, we have bent the curve. That’s what’s happened. You know the saying. Whoa it’s not an accident, here the, the death, the number of deaths is that was expected is many fewer than the number of ICU beds that are filled, many fewer ventilators, many fewer needed. It’s not an accident. It’s not an accident it’s and it’s not like this, this virus has gone away, either.
It’s because people are adhering to the norms that we put out there. And we’ve asked people to wear face coverings, we’ve asked people to wash their hands we’ve asked people to stay home. It’s very difficult for everybody to have done that, but they are doing it and that is succeeding.
And so people should understand the relationship between the bending of the curve, you know the lowering of the need for ventilators, and the fact that we have these mitigation efforts that are working. So when we say well gee let’s end the mitigation efforts, guess what happens in the absence of mitigation efforts? The rate of infection goes up again, the R Naught as we’ve called it, it goes up, the number of ventilators ICU beds and hospitalizations goes up.
* Rock Cut State Park in Rockford is now open and it was initially not on your list of parks that would open. What changed in your decision to open that park?
These are decisions that are being made by the Department of Natural Resources and as they’re able to figure out how to staff these parks properly, which entrances to have open and closed and what activities can be done in a park safely.
* Politico: There’s been a lot of talk about grocery store and restaurant workers being the heroes in this pandemic, but they are still at the bottom of pay benefits and protections will the revised state budget address any of those issues?…
Oh, I hope that we will be able to recognize the heroes here. You know that we have challenges with our state budget that we’re going to have to address. But the people who have come out and done this amazing work in this very difficult time ought to be recognized and I’m looking at ways in which we could do that. I would ask employers to recognize them as well.
* Can you say whether laying off state workers or skipping payments to the state pension system are options you’re [eyeing] to fill the budget shortfalls? Also what specific things do you want lawmakers to act on when they returned to Springfield?…
I’m not looking at skipping pension payments. What was the other question that was asked, or laying off state workers, laying off workers.
Look, we have to look at everything but that is not something that we’re currently looking at. Remember in a pandemic and, this thing is ongoing, it’s not going to leave us, you need state services more than ever.
Think about the damage that’s done. If we lay off state workers in areas like DCFS or in domestic violence and challenging domestic violence and overcoming that in dealing with our healthcare system. You know this is not a time for us to further defund and further hollow out government from where it already has been in a relatively low level.
* On Wednesday Rep. Hammond said the people in her district quote boots on the ground, know more about what’s good for her district than someone governing from a podium in Chicago, in her words. What is she missing?…
Well I’ve been happy to be in contact with Rep. Hammond. Actually just in the last 24 hours I had a very nice conversation with her, exchanging ideas about how we could open things up, the ideas that she’s getting from her constituents, including as you’re implying, that they know what’s good for their area. That’s true.
I think what they don’t maybe don’t have access to is the epidemiologists and the scientists and the data. And so, you know, we’re looking at that to make sure that we’re keeping everybody safe in her district as well as every district. But you know evaluating and trying to weigh against the, we have epidemiologists and data that may say one thing, and a desire, as I do, a desire to let everybody get back to work. And so we’re we’re balancing those all the time.
* What are you planning on doing now that the East Peoria mayor said this morning he’s going to defy the stay at home extension and allow more businesses to reopen beginning today?…
People who defy the order and who simply go out, and go about their business as if there is no pandemic, and certainly leaders who are encouraging that, I would suggest that it’s a good thing that we’ve expanded testing across the state because a lot of people are going to get sick and need to be tested in those areas. And frankly it’s a good thing that we’ve left hospital beds available for people because they’re going to end up in the hospital.
* Two weeks ago you supported efforts to shut down drive in Easter service and compared cars to [garbled]. Yesterday you issued an order encouraging drive-in services. Why the change? Have your thoughts evolved, or have the lawsuits filed by charges persuaded you?…
I’m just, I’m listening to the science as its evolve. As you know, in many states there are experts and nationally there are experts who have said that it was more dangerous to do one thing than another. And, you know, as the thinking about this has evolved I obviously am listening to it.
This is a novel coronavirus should remind everybody we’re doing the best we can to make decisions as the science dictates. And so we know we want people to be able to worship, we do we want people to do it safely. We hope that the parishioners and their faith leaders will follow the guidelines that are being suggested by the science and the data.
* We know you’ve heard from people wanting your order changed or lifted. Have you heard from business owners or others supporting the order?…
Many people in fact, the vast majority of people that we hear from are people who support the order, want us to make sure that we’re continuing to evolve the order, but believe very strongly that keeping people safe and healthy is the thing that we should balance more in favor of. Today as we try to look at all the treatments that may be available, I want to remind everybody that as I have said for weeks and weeks now, that in addition to testing and tracing, having a treatment available would really make all of what we hope to do here much easier. An effective treatment that we’ve just heard recently, some have been reporting on TV on the major networks, about certain kinds of treatments that have proven effective or more effective than others, that may be receiving emergency authorization from the FDA, and I’m so pleased to see that because we all you know if you can add that to the testing and tracing. As I said, the three T’s are critically important for us to really open up the economy.
* Why has Illinois not waived the WARN Act notification requirement? As soon as businesses were forced to close they were in violation of the act for not giving 60 days notice…
We have loosened the requirements on people during this, that they are still notifying us but not required to fit entirely within the regulations of the WARN act so we haven’t done away with the WARN act, but the enforcement of it has been severely loosened and we’ve talked to many businesses that have called about that.
That was my question. I’ll be asking for more info soon.