Illinois Gov. J.B. Pritzker on Thursday announced he is extending the statewide stay-at-home order amid the coronavirus pandemic. Read Pritzker's full statement on Illinois' state-at-home extension below:
To start, let me explain a bit about the role of modeling in my decision making. Since the outbreak of COVID-19, I’ve taken into consideration a variety of models from researchers across the world, some of which you’ve seen in the public sphere – and in these models, there are often widely different projections about the state of Illinois.
Some of this disparity is the result of methodological differences, but much of it is also due to data access and quality. The earliest coronavirus models we had in the United States had to rely upon data from other countries applied to our national landscape – and certainly, there was real benefit in those early days of getting educated estimates of what the virus’ effect on Illinois would look like regardless of where that early data came from. But the picture that gets painted by modeling gets better when it’s based off of what’s actually happening on the ground in Illinois, data that can only be gathered with the passage of time.
We now have what we didn’t have two months ago: an understanding of what COVID-19 cases, deaths, hospitalizations, ventilator and ICU usage look like every day in Illinois.
Even so: two months is not a lot of time in the world of modeling – that’s important, because the very essence of a model is that it gets smarter over time. How? You consistently test past predictions against current reality and then adjust projections accordingly. Or, to put it simply, the more facts you have – like, exactly how many people went into the hospital with COVID-19 on a certain date – the better your ability to predict outcomes on any later date.
Notice I say it becomes better – because it never is exact. There is no crystal ball available to us. There are only estimates. Illinois is the proud home to some of the finest researchers and research institutions in the world – and still, it is always the case that different modeling teams come to different conclusions.
So, I undertook a project to give me the best possible approximations of future COVID-19 illnesses in Illinois that would then allow me to make decisions about what resources we would need to keep Illinoisans alive and recovering and what urgency would be required in decisions about whether to initiate new mitigation strategies or extend existing ones, like the Stay at Home order. I have known from the start that even the “best” projections are going to have a great deal of variance, but knowing the boundaries of that variance informs my decision making. So we convened top researchers from the University of Illinois at Urbana-Champaign, Northwestern School of Medicine, the University of Chicago, the Chicago and Illinois Departments of Public Health, along with outside consulting groups. They worked as a cohort under Civis Analytics using the most comprehensive data available for the entire state.
Suffice to say, the findings we’re discussing today about the state of Illinois were put together by some of the best scientists, doctors, and researchers from some of the best institutions in the world.
I want to look first at the projected fatalities. As you can see from the graphs next to me, Illinois is now looking at a peak or plateau of deaths per day between late April and early May. Why a range instead of an exact day? Well, everyone wants to look at the median line as a guide – that nice, clear line that cuts through the big shaded section on all the models circulating online. But reality is not quite so simple. Look at the actual deaths from the past few weeks on the graph next to me and look at the median projections going forward. Reality swings up and down, sometimes drastically, a fact that can’t be captured with a simple median line. What we have to consider is the whole shaded area – that shaded area shows the range that researchers are 95 percent confident things will land. That’s a shaded area you would see, in differing shapes, on every model.
To be clear, the fact that the variance is large doesn’t make a model a less useful tool – but it’s just that. A tool. I worry that people think “the model” is some miraculously accurate view into the future that is going to tell us exactly what we need to do. It’s not. It won’t. I guarantee that the model we’re sharing today will change in the coming days as projected numbers about those days are replaced actual numbers. A model is an imperfect tool that we use to add context to the actual numbers we can chart every day: cases, deaths, hospitalizations, positive test rates, ventilator and ICU usage.
I also want to explain a bit about this change in our estimated “peak” in cases. The concept of “flattening the curve” only just entered our common vocabulary in the last few months, and it’s really crucial to understanding our approach.
Weeks ago, many models, both those produced by our in-state experts, and those from around the nation, predicted an early- or mid-April peak for Illinois, but as the weeks have progressed those models have come to look quite different. That’s not because those models were bad models. Instead it’s because their inputs got better as time went on, real-time data came in, and importantly, Illinoisans protected each other by staying home. Human behavior is exceptionally difficult to measure, and even harder to predict, so that last part about staying home has made all the difference in our progress.
Also – and this is important – the most sensible and responsible use of a model in a public health crisis like this one is to pay close attention to the worst-case scenario. In other words, when building out hospital beds, purchasing and acquiring PPE and ventilators, and making decisions about mitigation efforts – public officials should assume that the worst end of the model range could happen and take that into account in planning.
A pushing out of our estimated “peak,” is a natural consequence and the best indicator of flattening the curve. That’s what you’re aiming to do: slow down the rate of transmission, which leads to a slower rate of increase over a longer period of time – hence, a later and lower peak. Pushing the peak further down the line might not sound like good news, but I promise you, it saves lives.
And make no mistake, Illinois has saved lives. By staying home and social distancing, we have kept our infection and death rates for the months of March and April thousands below the rates projected had we not implemented these mitigation strategies. The good people of this state have allowed our healthcare professionals the ability to treat patients to the best of their ability without having to make dark choices – very real choices that doctors in other countries faced – about who lives, and who dies. That is a heroic act – carried out by all of you.
Your efforts to protect your families, protect your communities, protect each other, have also given us another tool: time. Time to build up our hospital capacity in terms of beds, ventilators, and healthcare workers. Time to prepare for the kind of surge that could could occur any time as a result of a virus from which no one is immune.
And capacity we built: In August of 2019, back in a world that had never heard of COVID-19, Illinois had an average of about 26,000 total hospital beds statewide. As of today, our total bed count in existing hospitals is more than 31,000. Back in August, we had about 2,000 ventilators – that number is now more than 3,200. And we are building our healthcare workforce too. There are now 5,000 out-of-state and former medical professionals who have applied for temporary licenses to join Illinois’ fight against COVID-19.
We’ve built up our hospital capacity significantly – but if we let up now, we would have nowhere near the kind of hospital capacity we would need. The projections are clear – if we lifted the Stay at Home order tomorrow, we would see our deaths-per-day shoot into the thousands by the end of May and that would last well into the summer. Our hospitals would be full and very sick people would have nowhere to go. People who otherwise might have won their fight against COVID would die because we wouldn’t be able to help them through. No amount of political pressure would ever make me allow such a scenario in Illinois.
So the numbers present us with only one choice. Next week, I intend to sign an extension of our Stay at Home order, with some modifications, through Saturday, May 30th.
To everyone listening – we are in possibly the most difficult part of this journey. I know how badly we all want our normal lives back. Believe me, if I could make that happen right now, I would. But this is the part where we have to dig in and understand that the sacrifices we’ve made as a state to avoid a worst case scenario are working! And we need to keep going a little while longer to finish the job.
On a more optimistic note, my team and I are finalizing our next-step principles for safely moving toward reopening in phases. We are making progress building out testing and launching our contact tracing initiative, so that as soon as the time does come for our new normal, we can be ready. We’ll be sharing more on that in the days and weeks ahead.
On another optimistic note, May will look somewhat different than March and April. Since implementing our original Stay at Home order, I’ve listened to Illinoisans across the state and elected officials of both parties and business leaders, and I’ve continued to consult with doctors, scientists, and experts here in Illinois and across the world on how best to keep people safe. My intention as always is to put your health and safety first as we make some practical adjustments based on what we’ve learned the first 5 weeks of the Stay at Home order.
The new and modified executive order will take effect on May 1, and I want to lay out some of those changes for you now.
Because we are bending the curve, surgi-centers and hospitals will be able to begin scheduling the non-life-threatening surgeries that had been delayed so we could maximize statewide capacity for COVID patients. Facilities will need to meet specific criteria, including proper PPE, ensuring enough overall bed and ICU availability, and testing of elective surgery patients to ensure COVID-19 negative status. The Illinois Department of Public Health is issuing exact specifications to healthcare facilities statewide.
We are allowing some elective procedures to resume for the benefit of patients and our hospital systems. But make no mistake: the first priority for our health care system continues to be the health and safety of all Illinois residents. That means preserving bed capacity for COVID patients no matter where they come from. As I’ve said before, we value all lives equally, and that includes the men and women in our corrections facilities. If we find that hospitals are refusing to live up to this obligation, the Director of the Department of Public Health has the authority to investigate and enforce this policy, and will not hesitate to do so.
Also starting on May 1, retail stores that are not currently on the list of essential businesses may take orders online and over the phone and offer pick-up and delivery. We’ve made it more explicit that greenhouses and garden centers may remain open with specified social distancing measures in place.
We will begin a phased re-opening of some of our state parks under the guidance of the Department of Natural Resources for activities, such as hiking and fishing, and boating with no more than two people. Social distancing must be maintained in all activities.
We’re also strengthening some of the public health measures in the order to limit the spread of this virus as much as possible.
Starting on May 1, any individual over the age of two and able to medically tolerate a face-covering or mask will be required to wear one when in a public place where they can’t maintain a six-foot social distance. Face coverings work and we need all Illinoisans to do their part here.
For our essential businesses, including manufacturers, we are issuing new requirements on social distancing and new caps on occupancy.
Again all of these things won’t take effect until May 1 – a week from tomorrow. And they are only minor modifications – what we can do safely – while keeping our stay at home restrictions in place as we manage through to the next phase.
I know that even with these changes, this Stay at Home order leaves many restrictions in place. In the coming weeks, as we get to the point of working our way down the other side of our peak, there will be more to do to get people back to work and open up more. Understand that these are not choices made arbitrarily – these changes are what the data says we can offer the people of Illinois without risking so much viral transmission that our hospitals become overrun. That said, if we start to see crowds and people violating the order or breaking the rules, I will need to bring back these restrictions. I’m hopeful we won’t need to do that.
Folks – this is a battle you never asked to fight. I know that. I also know our doctors and nurses and healthcare professionals never asked to lead us through a pandemic. Our essential workers never asked to man the frontlines of society. Our small businesses never asked to sacrifice their bottom line to an invisible enemy.
I see your pain. And I am so, so sorry for it. But for every person who wants to go to dinner, or hang out with friends in a park, or swing open their salon doors – there is a family mourning the death of someone they love. There is a parent, a child, a friend who would give anything to have their greatest strain be the difficulties of staying home and not the unimaginable pain of a life lost too soon.
I’m not in the business of comparing suffering – in a pandemic, everyone is allowed to hurt. But we have the opportunity to prevent the pain of loss from touching the lives of thousands. We have the opportunity to follow the leadership of the countless nonprofits, and community leaders, and families across Illinois who have demonstrated their courage, and their empathy, and their willingness to help.
Illinois has the best people in the world. I’ve said all along that I will fight like hell for you. I’m asking you to hold on for a little while longer, to help make sure we ALL see it to the other side of this struggle.
One day I pray this virus will be a memory – but the strength we found together will be something we carry with us forever.
