Heading to ‘high’ risk? City, county public health chiefs split in predictions for Chicago area’s COVID-19 future

Masks would be urged for all residents in indoor public spaces in counties that rise to the high risk level. One of Cook County’s top doctors says she doesn’t expect the county to hit that level anytime soon. But Chicago’s Dr. Allison Arwady has said it “could happen potentially even in the next few weeks.”

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Dr. Allison Arwady and Dr. Rachel Rubin

Commissioner of the Chicago Department of Public Health Dr. Allison Arwady, left, in March; Dr. Rachel Rubin, senior medical officer at the Cook County Department of Public Health, right, in April.

Anthony Vazquez; Pat Nabong/Sun-Times file

Despite a steady increase in COVID-19 cases and slower gains in hospitalizations, one of Cook County’s top public health officials said Wednesday it’s “unlikely” that the county will rise to the high risk level for coronavirus spread set by federal authorities.

That encouraging news from the county’s Dr. Rachel Rubin came one day after Chicago Public Health Commissioner Dr. Allison Arwady predicted just the opposite, saying the county’s risk level could worsen “potentially even in the next few weeks.”

Equally uncertain is the question of whether masks are in our future.

Illinois’ most populous county is already in the “medium” transmission level along with 22 others marked yellow statewide in the color-coded rating system implemented by the U.S. Centers for Disease Control and Prevention. That means older people and the immunocompromised are urged to mask up in public settings indoors in almost a quarter of the state, including the entire Chicago area. 

The face-covering recommendation would extend to all residents in counties that rise to the orange “high” risk level, regardless of their age or immune system issues. That hasn’t happened during the latest spike — and Rubin says she doesn’t expect it to happen here anytime soon. 

Dr. Rachel Rubin

Dr. Rachel Rubin, senior medical officer for the Cook County Department of Public Health, participates in a discussion at the Cook County Health Professional Building in 2020.

Ashlee Rezin/Sun-Times

“Currently, the number of reported cases of COVID-19 in suburban Cook County is increasing, but the other metrics — hospital admissions and staffed hospital beds occupied by COVID-19 patients — remain at low levels, which means Cook County is unlikely to reach the threshold of high transmission,” the senior medical officer for the Cook County Department of Public Health said in a statement. 

Counties are flagged for medium risk when they report more than 200 cases per 100,000 residents over a seven-day period. The Cook County case rate is nearly 338. 

COVID transmission is considered medium in counties marked yellow.

COVID transmission is considered medium in counties marked yellow.

Illinois Department of Public Health

The risk level is considered high when a county reports 10 or more new hospital admissions per 100,000 residents in a week, or if COVID patients are occupying more than 10% of intensive care unit beds. Those figures are at 8 and 2.5%, respectively, in Cook County. 

During a livestreamed Q&A Tuesday, Arwady pointed to that hospital admission rate as an indicator Cook County could go orange, “which I definitely think could happen potentially even in the next few weeks.”

But even if that happens, no city mask mandate would be considered unless hospitals “were getting threatened” by the influx of COVID patients, the city’s public health commissioner said.

Statewide, 1,083 COVID patients were hospitalized Tuesday night, a figure that has doubled in the past month. At the height of the Omicron crisis in January, more than 7,300 beds were occupied by coronavirus patients each night. 

Chicago hospitals have seen a 10% bump in patients since last week, but they’re still near a pandemic low along with COVID deaths, a lagging indicator. 

“While our hospital numbers remain as good as they are, we’d have to see twice as many Chicagoans getting hospitalized to need to be thinking about mandates,” Arwady said. “Nevertheless, it is a point of concern.”

Chicago Public Health Commissioner Dr. Allison Arwady

Chicago Public Health Commissioner Dr. Allison Arwady, pictured at a news conference last November.

Pat Nabong/Sun-Times file

Rubin did not say whether the county is considering another mask mandate. Nor did the office of Gov. J.B. Pritzker, who has held only one news conference devoted to his administration’s pandemic response since he lifted the statewide mandate at the end of February. 

Rubin did say “it is highly recommended to get vaccinated and when eligible to get the booster shots.”

About 19% of Chicagoans still haven’t gotten a shot. For help finding one, visit vaccines.gov

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