Are cashiers “heroes”? We’re missing the point when we use this terminology.
It’s right there in black and white: contact tracing is a key part of Illinois Gov. JB Pritzker’s “Restore Illinois” plan. To move from Phase 2 to Phase 3, permitting the opening of child care, retail, and gatherings of 10 or fewer people, requires the beginnings of “contact tracing and monitoring within 24 hours of diagnosis.” To move from Phase 3 to Phase 4, permitting the opening of restaurants, personal care services, health clubs, and schools, as well as gatherings of 50 or fewer people, requires fully scaled-up contract tracing, that is, “for more than 90% of cases in region.”
But as I wrote last Saturday at the Chicago Tribune, however crucial contact tracing is, the state has provided virtually no information on its timing or its progress in implementing the program.
Only just today did the Department of Public Health provide a press release on the topic (can I take credit for this?), informing residents that county public health departments will actually be running the initiative, with funding and technical support from the state, and with Partners in Health in an advisory role. Two specific counties will be “immediately” piloting the program. The governor further stated at today’s (Monday’s) press briefing that at present 29% of diagnoses are “engaged in a tracing process” and “that’s a number we want to push as high as possible, to the industry standard of over 60%.”
Despite this, last week Pritzker announced that “all regions across the state are now on track to meet the metrics needed to move into the next phase of reopening.”
How does this make sense? With only 11 days until the first possible “Phase 3” date, and with only a 2-county pilot program in place, how can the state be on track to meet its Phase 3 contact tracing requirement?
And how does a verbal target of aiming for “the industry standard of 60%” match up with the Phase 4 requirement of 90%?
What’s more, the state provides regular updates to metrics in the areas of testing and hospital admissions and resources, but no updates on contact tracing.
It’s as if they’ve forgotten about these requirements.
Has the state abandoned them, that is, continuing to strive for additional capacity but no longer requiring implementation/scaling to move to the next phase?
And, if so, why is the state not revising its plan, but instead simply treating them as if they don’t exist?
My guess: the governor knows there is tremendous pressure to revise other components of the plan: the inclusion of very geographically distinct counties adjacent to “collar counties” in the same region as Chicago, the continued closure of restaurants until Phase 4, the limitation on gatherings to 50 persons regardless of the capacity of a given facility, and so on. Were he to revise the contact tracing component, he would further increase calls for revisions of other sorts. So long as no one with any particularly strong voice or much political power calls him on this, he continues to be enabled to insist that his plan is unchangeable, set in stone, rather than risking opening it up to the sort of negotiation which he insists is impossible because he is guided solely by “science” and “data”.
Now, this is an admittedly cynical answer, but I can’t make sense of this any other way. And, much as I hate for it to be true, as it implicates a wide range of bureaucrats as well in this convenient omission, it does, at the same time, offer some firmer reason to believe that, however painfully delayed Phases 3 and 4 are implemented, however many restaurants and other small business will shut down, it will at least not be delayed even further.
Readers on other platforms will know that I have been sewing facemasks. My current count is 120 given away; I have a further 20 that are waiting for homes, plus, of course, the ones for our family. I’d been saying, “it makes me feel useful,” especially knowing that my writing at Forbes on retirement isn’t catching many eyes when it’s a stretch to tie things to the pandemic. But I realize that I had been treating it as something of a magical act: if I sew face masks, then things will work out OK.
In the meantime, the CDC’s initial insistence that face masks had no use, and failure to explain themselves sufficiently since then, has now resulted in far too many people rejecting face masks (“the CDC said there’s no point, so clearly the requirement now is just government overreach”). And at the same time, when I go to the store, I see lots of people with manufactured disposable face masks of the sort that we’re told are “reserved for healthcare workers.” The city is sponsoring giveaways — again of disposable masks; another group has sourced fabric masks out of Vietnam. It all leads me to question the utility of the masks I’ve been sewing.
Separately, the other day, in response to a lawsuit, Pritzker added “gathering for religious observance in groups of less than 10” to the list of permitted activities in the state of Illinois. And the neighboring diocese, in fact, permits coming to church for silent prayer; in the Archdiocese of Chicago, everything is shut down tightly, with no indicator that this will change, only a vaguely-worded statement that the archdiocese is “engaged in planning” on the matter.
And now Pritzker has released his “Restore Illinois” plan. I’m not happy. More specifically, it’s so discouraging I feel as if I’ve wasted my time battling the broken threads and birds’ nests of my 60s-era sewing machine, that only a move out-of-state would actually solve anything.
On the one hand, the plan is to be based on regional benchmarks. That’s a plus, I suppose, but my suburban town is lumped in with the city, so it doesn’t help me.
Here are the phases:
Right now, we are in “Phase 2” — a retroactive description of the governor’s changes to his stay-at-home order, with small loosenings of restrictions (curbside pickup rather than complete closure for non-essential stores).
Phase 3 would permit the reopening of “non-essential” businesses and manufacturing; retailers may open with capacity limits; barbershops/salons may open with restrictions; health and fitness clubs can provide outdoor classes. Healthcare providers may also re-open. Heavy, heavy restrictions remain including no gatherings of more than 10, no schools. “Limited child care and summer programs open with IDPH approved safety guidance” — and no further explanation about what this might mean. (Currently there are daycares open for essential workers — would these need-based restrictions remain? Or would the requirements be so stringent that it would effectively result in providers declaring they can’t meet them?) Some elements that I had hoped would be a part of a next-phase, such as outdoor dining, are not here. And a limit of 10 persons is unnecessarily restrictive in cases such as, for example, religious services in buildings large enough to accommodate more than that with wide spacing between individuals or family groups.
In order to declare Illinois (or a region thereof) in Phase 3, the state will require:
- Less than a 20% positivity rate (that is, percent of tests which are positive),
- No increases in admissions for 28 days,
- Available capacity of 14% of ICU beds, hospital beds generally, and ventilators,
- Testing widely available,
- and the implementation of contact tracing procedures (I think – that’s how I interpret “begin contact tracing and monitoring within 24 hours of diagnosis”).
The measurement starts as of May 1, so that the earliest a region can be declared in Phase 3 is May 29, even though, for all but the Northeast (Chicagoland) region, the benchmarks could well be met sooner but for that seemingly-arbitrary requirement, according to a tracking document which the state, it seems, intends to update regularly. And how long would Phase 3 last? The two additional requirements to move to Phase 4 are for testing to be available to all, regardless of risk factors or symptoms, and “begin contact tracing and monitoring within 24 hours of diagnosis for more than 90% of cases in region” — which I why I’m understanding the Phase 3 requirement to be more about contact tracing being underway.
But what would the timeline look like for contact tracing? According to The Southern, the initiative “likely won’t begin in earnest until sometime in late May.” How long would it take to reach this 90% benchmark? I’m not finding anything further on timing in the scanty reports on the initiative, not even speculation of how long it could last, but knowing bureaucracy, this seems a monumental hurdle. (Massachusett’s program is referred to as a model; their program has been running for a month and includes 17,000 people, including infected people and their contacts, relative to 70,271 positive tests so far.) Even discarding my skepticism, how long do Pritzker and his advisors actually have in mind when they set this marker for the transition to Phase 4?
Phase 4 removes many restrictions but keeps many more. Schools are open, all outdoor recreation allowed, bars and restaurants are open, etc. However, crucially, there continue to be capacity limits on theaters, restaurants, and retail, and no gatherings of over 50 people are permitted.
And Phase 5? To permit gatherings of over 50 will require that
Either a vaccine is developed to prevent additional spread of COVID-19, a treatment option is readily available that ensures health care capacity is no longer a concern, or there are no new cases over a sustained period.
Separately, the document indicates that the last condition may be met through “herd immunity or other factors” and that the treatment must be “effective and widely available” so as to suggest that the demand goes well beyond the moderate effects of the new drugs or ventilator-avoiding methods thus far.
And this is where it all seems to lose touch with reality. We may never have a vaccine, certainly not for a year or even much longer; and the threshold for an “effective” treatment is undefined but we may not have something that meets these requirements.
The clarifications at today’s press conference (via Capitol Fax) don’t help, either. Pritzker seems to suggest that “treatment” is “a very successful treatment” or, separately, a “highly effective treatment.” Asked about schools having more than 50 students, he says,
There would be strict IDPH guidelines for schools and we talked about this early on when we were trying to figure out if we needed to close schools or not, that, could you have classrooms of [garbled] kids meeting, if the restriction was 50 for example. And would that work and so the answer is IDPH is going to be working with schools on how they can best do this coming into the fall assuming that we’re in phase four.
Does Pritzker actually have a plan? Has he given serious consideration to how his phases will actually work in the real world? It certainly doesn’t appear as if he has a real answer with respect to children (neither “the data shows the risk to children is virtually nonexistent” nor “we’ll ask schools to come up with as many precautions as possible and eliminate assemblies and other gatherings”). Is he relying on the emergence of a game-changing treatment over the summer?
And nowhere in this plan is a mention of nursing homes and assisted living communities. When will their residents be able to see their families again, or even gather within the community? For those with cognitive issues, this is not merely about being patient but about their well-being.
Democrats are praising the plan, again according to Capitol Fax, with Senate President Don Harmon calling it “forward-looking” and Comptroller Susan Mendoza, “carefully-thought-out” and “science-based.” But there are so many holes — and, no, there is no reference to any sort of footnoted, detailed second document.
The bottom line is that this document is a serious disappointment. Using labels such as “recovery,” “revitalization,” and “restored” is nothing more than a cruel joke as long as the plan is so vague and unrealistic.
Today marks the start of the mask-mandate in Illinois. All persons over age 2 must wear a face mask in any public place in which they cannot maintain a six-foot distance from others — that is, indoors while shopping and in any crowded outdoor place.
Tutorials exist all over the internet: Save the manufactured masks for healthcare workers; use fabric. Use tightly-woven cotton, if possible. Add a non-woven inner layer via an opening for a filter, or a third layer of flannel. The Illinois mandate does not specify that one must wear a “face mask” per se but a covering of the nose and mouth, so that improvised options such as a bandana are also acceptable.
The Chicago Tribune has reported on various mask giveaways such as the group Masks4Chi which is importing fabric masks from Vietnam, as well as various community distribution efforts (which appear to be oriented around manufactured one-time masks). And, of course, large numbers of home sewers have been making masks and selling or giving them away — to nursing homes and assisted living communities, grocery store baggers, anyone they come across who’s in need. (Yes, I’m one of them — my current tally is 118 given away, and another dozen in various stages of completion — and it surprises me that the giveaway efforts don’t have a parallel organized effort to collect donations for the general public.)
Does Gov. Pritzker have the legal authority to mandate mask-wearing?
To be honest, I’m not sure. Downstate Rep. Darren Bailey filed suit against the stay-at-home order’s extension, and won a court victory, for himself, and subsequently Rep. John Cabello of Machesney Park filed suit calling for the same ruling to be applied to all Illinoisans. Are their legal arguments valid? I’ll be honest — I am not seeing reporting that answers that question. Instead, Pritzker and others react as if the pursuit of the greater good of public health prohibits even the asking of that question, though, at the same time, Pritzker has, in breaking news, rescinded a part of his executive order that prohibited religious gatherings, in reaction to a separate lawsuit. (Previously, even drive-in services were prohibited; now they will be allowed.)
And a Chicago Tribune editorial today called for the legislature to meet. Not only could they legislatively affirm Pritzker’s orders, but they could attend to other pressing state business, including the deadline on Monday for placing on the November ballot an amendment to end gerrymandering of General Assembly districts. The editorial notes that a one-time meeting would be sufficient for the legislature to enable virtual meetings; alternatively, Pritzker could use his power to convene the GA elsewhere — columnist John Kass suggests, for more-than-sufficient social distancing, the United Center. Of course, Kass also suggests that, behind the scenes, it’s House Speaker Michael Madigan calling the shots, and refusing to meet, so that Pritzker takes the heat.
What’s more, I’m seeing on Facebook plans to circumvent the mask requirement. After all, the ruling provides an exemption for those who cannot medically tolerate a mask. Claim to those who question you that you’re exempt for medical reasons, further insist that your medical privacy rights prohibit their questioning the specific ailment you have and, voila, you can skip the mask.
But here’s the bottom line: even if you object to the mandate, you should still wear a mask.
Yes, the CDC was foolish in its prior insistence that there is no value in mask-wearing, and, though I’ve speculated elsewhere as to why they did so, I’ve not seen a definitive (and convincing) explanation for this, nor for why, on April 3, they changed their recommendations. But even the Illinois Policy Institute, ordinarily an opponent of Pritzker, states plainly:
The point of wearing a mask is to protect others. The idea is that if one person is an asymptomatic carrier of COVID-19, wearing a mask will limit their ability to transmit the virus to others.
Folks, I’ve been sewing face masks since so early on that when I first picked up fabric and notions I was able to get not only elastic but also “fun” Marvel print cotton fabric straight off the store shelves. Perhaps I’ve spent enough years as an international retirement actuary to have had on my radar more than others that we can reasonably look at what’s going on in other places, and early on it was clear that places like Hong Kong and Taiwan had both a firmer control on the coronavirus than elsewhere and had a practice of wearing masks. (Yes, I first blogged about this on my personal blog on March 16, in which I speculated about whether face mask-wearing could ever take root in the U.S.; four days later, I had convinced myself that sewing was the right thing to do, even though the calls were mostly for healthcare workers. When did I first don a face mask myself when going out to the store? I’m not sure.)
It might feel that wearing a mask gives a “win” to Pritzker, that you’re sacrificing your freedom. I get that.
But face mask-wearing is important to protect those around you, in the event, however unlikely you consider it to be, that you have yourself been unknowingly infected. And even if you judge it impossible to have been infected, face mask-wearing is a visible way to encourage those around you to wear masks, so that any one of your friends, neighbors, or fellow shoppers who is unknowing infectious, will wear a face mask and protect those around them.
I suspect that those who protest this order nonetheless consider themselves to be good citizens who care about the welfare of others, even if they’d rather it not be mandated. I, too, wish we had all adopted mask-wearing practices without a mandate. But that’s where we are. And, to be honest, I am at least glad not to be the “weirdo in a mask” any longer.
Whether state budget holes which include pension contributions are filled by the federal government is only a part of the bigger question of how those holes are filled.