For more than a week, Illinois has been leading the nation in the number of new COVID-19 cases, as a second surge of the virus spreads to every corner of the state.
By several metrics, this surge already appears to be more severe than the initial coronavirus outbreak in the spring — and data suggest it’s still a long way off from reaching its peak.
Here’s what we know — and don’t yet know — about the second surge.
Why is there a surge?
Many experts have blamed the current surge on COVID-19 fatigue — the idea that people have become more lax with personal restrictions as the pandemic drags on, and that those behaviors are now catching up with us.
Epidemiologist Dr. Sadiya Khan believes that fatigue is playing a part and also points to get-togethers and holidays that started at the beginning of September, just a few weeks before cases started to pick back up in Illinois.
“For Cook County, when cases started increasing it was right around after Labor Day, and then around Halloween there were many gatherings,” she said. “As temperatures have gotten cooler, many of those gatherings have been indoors.”
But it’s still hard to determine what’s driving the surge. That’s partly because contact tracing, which could illuminate how and where COVID-19 is spreading, is so far behind. That’s especially true in Cook County, and Chicago.
Is this surge different?
It’s still too early to tell all the ways in which this surge might be different than the first one.
What’s already clear, however, is that racial disparities continue to be a persistent problem.
Since October, Latino residents in Chicago have seen more than double the case positivity rate of white Chicagoans. Latinos are testing positive at a rate of at 28%, versus a 12.8% rate for whites. Black residents are seeing a 14.2% positivity rate.
But Chicago’s Department of Public Health notes it’s seeing dramatic increases across all races, ethnicities and age groups.
“I think one of the most striking things [about this surge], is that it’s happening across all ages,” Khan said. “So it’s not about blaming kids for going to school or young adults for going to bars.”
But similarly to the first surge, while cases are spreading among younger people, those over 70 years old have seen the most deaths since October, according to the city’s COVID-19 dashboard.
Will there be enough hospital beds for the sickest patients?
Many hospitals throughout Illinois are running out of beds in their intensive care units, or ICUs. Those beds are reserved for the sickest patients, whether they have a severe case of COVID-19 or another serious condition. Doctors say ICU beds are typically already packed with people who have heart attacks, strokes and major blood clots.
Now add a pandemic, with COVID-19 patients who might have longer stays in the ICU than a typical critically-ill person, and the winter flu season that has barely taken off.
“The challenge is what do we do with all of those patients and the COVID patients,” said Dr. Eve Bloomgarden, an endocrinologist at Northwestern Memorial Hospital near downtown Chicago. She’s part of IMPACT, an advocacy group of medical providers that was created during the pandemic.
The group predicts that, given the current pace of COVID-19, hospitals throughout Illinois could run out of ICU beds in about two weeks.
Statewide, there were only 28% of ICU beds left as of Thursday, according to the Illinois Department of Public Health. Patients who have COVID-19 are only using just over a quarter of all ICU beds, which means other people who are critically ill are using most of them.
Some regions of the state have more room for patients than others. In Region 7, which includes Will and Kankakee counties south of Chicago, hospitals only had a combined 23 ICU beds available for patients as of Thursday.
There are three other regions in the southern half of the state that each had 50 or fewer ICU beds left as of Thursday, state data show.
There are more ICU beds in larger metro areas, which tend to have teaching and research-focused hospitals with specialists. As of Thursday, there were 188 ICU beds left in suburban Cook County, and in Chicago, 256 beds were available, or about 24% of all ICU beds in the city.
But it’s not just ICU beds IMPACT is concerned about, Bloomgarden said.
Being able to staff those beds with specialized doctors, nurses and other providers is key to treating the sickest patients. And unlike in the spring, when COVID-19 first surged and hospitals were able to woo temporary nurses with big paychecks from different parts of the U.S., that talent pool is tied up because the virus is rampant everywhere.
Will there be enough room in hospitals for non-critical COVID-19 patients?
That’s another concern among doctors: non-ICU beds in hospitals statewide are filling up, too.
In the spring, many hospitals canceled non-urgent surgeries to make space for an expected deluge of COVID-19 patients. But this time around, many hospitals haven’t stopped procedures such as hip replacements — they are a key way hospitals make money — and patients are back seeing their doctors in person.
“That wiggle room … is gone,” Bloomgarden said.
And there’s another worry: She also said she’s hearing about more health care workers getting exposed to the virus as the number of coronavirus cases rise.
“The perfect storm is going to happen quickly,” Bloomgarden said. “What we’re all worried about is … we just hit this tipping point where we really run out of the ability to manage all of these patients. And even if we have beds … an ICU patient is so complicated that a bed is the least critical piece of it. It’s the unit, the amount of people that goes into keeping these patients alive, and also from keeping [other] patients from going to the ICU.”
Norwegian American Hospital, a small medical center in Humboldt Park on the West Side that treats many low-income people of color, was unable to transfer three patients this week to other hospitals because they didn’t have space or resources for them. One patient had COVID-19, but the other two were just really sick and needed a higher level of care, said Norwegian vice president Heather Khan. She added that each patient improved.
“I think we’re going to have problems across the system with the number of beds, period,” Khan said. “We started to see the crunch this week. It just happened really suddenly. We were fine last week.”
She said this wave of COVID-19 so far is different than the first, when Norwegian struggled to transfer patients to other hospitals. This time, patients are sick enough to be hospitalized, but not so sick many need to be on life-saving ventilators to help them breathe.
As of Thursday, 72% of all ventilators in Illinois were available for patients, according to state data. Of the ventilators being used, around 31% of the breathing machines were taken up by patients who had COVID-19.
What do we know about testing?
Information on when to get tested has shifted as experts have learned more about how the virus works.
Currently, the Chicago Department of Public Health advises people to get tested 5 to 9 days after being exposed to COVID-19 or engaging in a high-risk activity (like being a large crowd of people). That’s unless you have symptoms, in which case you should get tested right away.
Getting a COVID-19 test should be free of charge, whether you’re insured or not. But it depends where you get the test. Some doctor’s offices will charge you a fee to “evaluate” whether you need a test.
You can find state- and city-run testing sites here and here. But be forewarned: The surge in cases recently has led to long waits and places being booked day in advance throughout the Chicago region.
What can I do now?
Officials in Illinois, Chicago and suburban Cook County are asking people to stay home. Unlike in the spring, the restrictions on life and businesses are mostly voluntary — for now.
On Thursday, Chicago Mayor Lori Lightfoot announced a “Stay-At-Home Advisory” that will go into effect Monday morning at 6 a.m. Illinois Gov. JB Pritzker also warned Thursday that he could be issuing a stay-at-home order soon. That could mean restrictions are legally mandatory, instead of being voluntary.
The guidelines urge residents not to have any social gatherings or leave home except essential trips, such as going to school or work, getting groceries or visiting a doctor. They also advise against anyone entering your home unless they are an essential worker, the city said.
The state guidance urges residents to work from home for the next three weeks if they can.
Experts have also asked residents to resist the urge to hold group gatherings over the holidays, and limit get-togethers to the people in your household.