Pritzker’s ‘Restore Illinois’ plan: Full text

Click here to view the original “Restore Illinois” documents released by Gov. J.B. Pritzker’s office as a PDF.

An Introduction

From the beginning of the new coronavirus pandemic, Illinois’ response has been guided by data, science, and public health experts. As community spread rapidly increased, Governor Pritzker moved quickly to issue a Disaster Proclamation on March 9, restrict visitors to nursing homes on March 11, close bars and restaurants for on-site consumption on March 16, move schools to remote learning on March 17, and issue a Stay at Home order on March 21. This virus has caused painful, cascading consequences for everyone in Illinois, but the science has been clear: in the face of a new coronavirus with unknown characteristics and in the absence of widespread testing availability and contact tracing, mitigation and maintaining a 6-foot social distance have been the only options to reduce the spread and save as many lives as possible.

Millions of Illinoisans working together by staying at home and following experts’ recommendations have proven these mitigation and social distancing measures effective so far. The result has been a lower infection rate, fewer hospitalizations, and lower number of fatalities than projected without these measures. Our curve has begun to flatten. Nevertheless, the risk of spread remains, and modeling and data point to a rapid surge in new cases if all mitigation measures were to be immediately lifted.

Now that Illinois is bending the curve, it is vitally important that we follow a safe and deliberate path forward to get our Illinois economy moving. That path forward is not what everyone wants or hopes for, but it will keep Illinoisans as safe as possible from this virus as our economy is reopening.

Restore Illinois is about saving lives and livelihoods. This five-phased plan will reopen our state, guided by health metrics and with distinct business, education, and recreation activities characterizing each phase. This is an initial framework that will likely be updated as research and science develop and as the potential for treatments or vaccines is realized. The plan is based upon regional healthcare availability, and it recognizes the distinct impact COVID-19 has had on different regions of our state as well as regional variations in hospital capacity. The Illinois Department of Public Health (IDPH) has 11 Emergency Medical Services Regions that have traditionally guided its statewide public health work and will continue to inform this reopening plan. For the purposes of this plan, from those 11, four health regions are established, each with the ability to independently move through a phased approach: Northeast Illinois; North-Central Illinois; Central Illinois; and Southern Illinois.

The five phases for each health region are as follows:

Phase 1 – Rapid Spread: The rate of infection among those tested and the number of patients admitted to the hospital is high or rapidly increasing. Strict stay at home and social distancing guidelines are put in place and only essential businesses remain open. Every region has experienced this phase once already, and could return to it if mitigation efforts are unsuccessful.

Phase 2 – Flattening: The rate of infection among those tested and the number of patients admitted to the hospital beds and ICU beds increases at an ever slower rate, moving toward a flat and even a downward trajectory. Non- essential retail stores reopen for curb-side pickup and delivery. Illinoisans are directed to wear a face covering when outside the home and can begin enjoying additional outdoor activities like golf, boating and fishing while practicing social distancing. To varying degrees, every region is experiencing flattening as of early May.

Phase 3 – Recovery: The rate of infection among those surveillance tested, the number of patients admitted to the hospital, and the number of patients needing ICU beds is stable or declining. Manufacturing, offices, retail, barbershops and salons can reopen to the public with capacity and other limits and safety precautions. Gatherings limited to 10 people or fewer are allowed. Face coverings and social distancing are the norm.

Phase 4 – Revitalization: The rate of infection among those surveillance tested and the number of patients admitted to the hospital continues to decline. Gatherings of 50 people or fewer are allowed, restaurants and bars reopen, travel resumes, child care and schools reopen under guidance from the Illinois Department of Public Health. Face coverings and social distancing are the norm.

Phase 5 – Illinois Restored: With a vaccine or highly effective treatment widely available or the elimination of any new cases over a sustained period, the economy fully reopens with safety precautions continuing. Conventions, festivals and large events are permitted, and all businesses, schools and places of recreation can open with new safety guidance and procedures in place reflecting the lessons learned during the COVID-19 pandemic.

Until COVID-19 is defeated, this plan also recognizes that just as health metrics will tell us it is safe to move forward, health metrics may also tell us to return to a prior phase. With a vaccine or highly effective treatment not yet available, IDPH will be closely monitoring key metrics to immediately identify trends in cases and hospitalizations to determine whether a return to a prior phase may become necessary.

Phase 1: Rapid Spread

WHAT THIS PHASE LOOKS LIKE

COVID-19 is rapidly spreading. The number of COVID-19 positive patients in the hospital, in ICU beds, and on ventilators is increasing. The public health response relies on dramatic mitigation measures, like stay at home orders and social distancing, to slow the spread of the virus and prevent a surge that overwhelms the health care system. With a Stay at Home order in place, only essential businesses are in operation and activities outside of the home are limited to essentials, like grocery shopping.

WHAT’S OPEN?

Gatherings: Essential gatherings, such as religious services, of 10 or fewer allowed; No non-essential gatherings of any size

Travel: Non-essential travel discouraged

Health care: Emergency procedures and COVID-19 care only

Education and child care: Remote learning in P-12 schools and higher education; Child care in groups of 10 or fewer for essential workers

Outdoor recreation: Walking, hiking and biking permitted; State parks closed

Businesses:

• Manufacturing: Essential manufacturing only
• “Non-essential” businesses: Employees of “non-essential” businesses are required to work from home except for Minimum Basic Operations
• Bars and restaurants: Open for delivery, pickup and drive-through only
• Entertainment: Closed
• Personal care services and health clubs: Closed
• Retail: Essential stores are open with strict restrictions; Non-essential stores are closed

HOW WE MOVE TO THE NEXT PHASE

Cases and Capacity:

• Slowing of new case growth
• Availability of surge capacity in adult medical and surgical beds, ICU beds, and ventilators
• Testing:
• Ability to perform 10,000 tests per day statewide
• Testing available in region for any symptomatic health care workers and first responders

Phase 2: Flattening

WHAT THIS PHASE LOOKS LIKE

The rise in the rate of infection is beginning to slow and stabilize. Hospitalizations and ICU bed usage continue to increase but are flattening, and hospital capacity remains stable. Face coverings must always be worn when social distancing is not possible. Testing capacity increases and tracing programs are put in place to contain outbreaks and limit the spread.

WHAT’S OPEN

Gatherings: Essential gatherings, such as religious services, of 10 or fewer allowed; No non-essential gatherings

Travel: Non-essential travel discouraged

Health care: Emergency and COVID-19 care continue; Elective procedures allowed once IDPH criteria met

Education and child care: Remote learning in P-12 schools and higher education; Child care in groups of 10 or fewer for essential workers

Outdoor recreation: Walking, hiking, and biking permitted; Select state parks open; Boating and fishing permitted; Golf courses open; All with IDPH approved safety guidance

Businesses:

• Manufacturing: Essential manufacturing only
• “Non-essential” businesses: Employees of “non-essential” businesses are required to work from home except
• for Minimum Basic Operations
• Bars and restaurants: Open for delivery, pickup, and drive through only
• Personal care services and health clubs: Closed
• Retail: Essential stores are open with restrictions; Non-essential stores open for delivery and curbside pickup

HOW WE MOVE TO THE NEXT PHASE

Cases and Capacity: The determination of moving from Phase 2 to Phase 3 will be driven by the COVID-19 positivity rate in each region and measures of maintaining regional hospital surge capacity. This data will be tracked from the time a region enters Phase 2, onwards.

• At or under a 20 percent positivity rate and increasing no more than 10 percentage points over a 14-day period, AND
• No overall increase (i.e. stability or decrease) in hospital admissions for COVID-19-like illness for 28 days, AND
• Available surge capacity of at least 14 percent of ICU beds, medical and surgical beds, and ventilators

Testing: Testing available for all patients, health care workers, first responders, people with underlying conditions, and residents and staff in congregate living facilities

Tracing: Begin contact tracing and monitoring within 24 hours of diagnosis

WHAT COULD CAUSE US TO MOVE BACK

IDPH will closely monitor data and receive on-the-ground feedback from local health departments and regional healthcare councils and will recommend moving back to the previous phase based on the following factors:

• Sustained rise in positivity rate
• Sustained increase in hospital admissions for COVID-19 like illness
• Reduction in hospital capacity threatening surge capabilities
• Significant outbreak in the region that threatens the health of the region

Phase 3: Recovery

WHAT THIS PHASE LOOKS LIKE

The rate of infection among those surveillance tested is stable or declining. COVID-19-related hospitalizations and ICU capacity remains stable or is decreasing. Face coverings in public continue to be required. Gatherings of 10 people or fewer for any reason can resume. Select industries can begin returning to workplaces with social distancing and sanitization practices in place. Retail establishments reopen with limited capacity, and select categories of personal care establishments can also begin to reopen with social distancing guidelines and personal protective equipment. Robust testing is available along with contact tracing to limit spread and closely monitor the trend of new cases.

WHAT’S OPEN

Gatherings: All gatherings of 10 people or fewer are allowed with this limit subject to change based on latest data & guidance

Travel: Travel should follow IDPH and CDC approved guidance

Health Care: All health care providers are open with DPH approved safety guidance

Education and child care: Remote learning in P-12 schools and higher education; Limited child care and summer programs open with IDPH approved safety guidance

Outdoor recreation: State parks open; Activities permitted in groups of 10 or fewer with social distancing

Businesses:

• Manufacturing: Non-essential manufacturing that can safely operate with social distancing can reopen with IDPH approved safety guidance
• “Non-essential” businesses: Employees of “non-essential” businesses are allowed to return to work with IDPH approved safety guidance depending upon risk level, tele-work strongly encouraged wherever possible; Employers are encouraged to provide accommodations for COVID-19-vulnerable employees
• Bars and restaurants: Open for delivery, pickup, and drive through only
• Personal care services and health clubs: Barbershops and salons open with IDPH approved safety guidance; Health
• and fitness clubs can provide outdoor classes and one-on-one personal training with IDPH approved safety guidance
• Retail: Open with capacity limits and IDPH approved safety guidance, including face coverings

HOW WE MOVE TO THE NEXT PHASE

Cases and Capacity: The determination of moving from Phase 3 to Phase 4 will be driven by the COVID-19 positivity rate in each region and measures of maintaining regional hospital surge capacity. This data will be tracked from the time a region enters Phase 3, onwards.

• At or under a 20 percent positivity rate and increasing no more than 10 percentage points over a 14-day period, AND
• No overall increase (i.e. stability or decrease) in hospital admissions for COVID-19-like illness for 28 days, AND
• Available surge capacity of at least 14 percent of ICU beds, medical and surgical beds, and ventilators

Testing: Testing available in region regardless of symptoms or risk factors

Tracing: Begin contact tracing and monitoring within 24 hours of diagnosis for more than 90% of cases in region

WHAT COULD CAUSE US TO MOVE BACK

IDPH will closely monitor data and receive on-the-ground feedback from local health departments and regional healthcare councils and will recommend moving back to the previous phase based on the following factors:

• Sustained rise in positivity rate
• Sustained increase in hospital admissions for COVID-19 like illness
• Reduction in hospital capacity threatening surge capabilities
• Significant outbreak in the region that threatens the health of the region

Phase 4: Revitalization

WHAT THIS PHASE LOOKS LIKE

There is a continued decline in the rate of infection in new COVID-19 cases. Hospitals have capacity and can quickly adapt for a surge of new cases in their communities. Additional measures can be carefully lifted allowing for schools and child care programs to reopen with social distancing policies in place. Restaurants can open with limited capacity and following strict public health procedures, including personal protective equipment for employees. Gatherings with 50 people or fewer will be permitted. Testing is widely available, and tracing is commonplace.

WHAT’S OPEN

Gatherings: Gatherings of 50 people or fewer are allowed with this limit subject to change based on latest data and guidance

Travel: Travel should follow IDPH and CDC approved guidance Health care: All health care providers are open

Education and child care: P-12 schools, higher education, all summer programs, and child care open with IDPH approved safety guidance

Outdoor Recreation: All outdoor recreation allowed

Businesses:

• Manufacturing: All manufacturing open with IDPH approved safety guidance
• “Non-essential” businesses: All employees return to work with IDPH approved safety guidance; Employers
• are encouraged to provide accommodations for COVID-19-vulnerable employees
• Bars and restaurants: Open with capacity limits and IDPH approved safety guidance
• Personal care services and health clubs: All barbershops, salons, spas and health and fitness clubs open
• with capacity limits and IDPH approved safety guidance
• Entertainment: Cinema and theaters open with capacity limits and IDPH approved safety guidance
• Retail: Open with capacity limits and IDPH approved safety guidance

HOW WE MOVE TO THE NEXT PHASE

Post-pandemic: Vaccine, effective and widely available treatment, or the elimination of new cases over a sustained period of time through herd immunity or other factors.

WHAT COULD CAUSE US TO MOVE BACK

IDPH will closely monitor data and receive on-the-ground feedback from local health departments and regional healthcare councils and will recommend moving back to the previous phase based on the following factors:

• Sustained rise in positivity rate
• Sustained increase in hospital admissions for COVID-19 like illness
• Reduction in hospital capacity threatening surge capabilities
• Significant outbreak in the region that threatens the health of the region

Phase 5: Illinois Restored

WHAT THIS PHASE LOOKS LIKE

Testing, tracing and treatment are widely available throughout the state. 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. All sectors of the economy reopen with new health and hygiene practices permanently in place. Large gatherings of all sizes can resume. Public health experts focus on lessons learned and building out the public health infrastructure needed to meet and overcome future challenges. Heath care equity is made a priority to improve health outcomes and ensure vulnerable communities receive the quality care they deserve.

WHAT’S OPEN

• All sectors of the economy reopen with businesses, schools, and recreation resuming normal operations with new safety guidance and procedures.
• Conventions, festivals, and large events can take place.