Citing a rapid uptick in COVID-19 hospitalizations due to the delta variant among the unvaccinated, Illinois Gov. J.B. Pritzker on Thursday issued a sweeping vaccination mandate for all healthcare workers, college students, schoolteachers and staff from pre-kindergarten through college, and required indoor masking for people age 2 and older starting Monday.
“Unfortunately, we are running out of time as our hospitals run out of beds,” Pritzker said. Health experts, he said, “fear the worst is yet to come for us, to put it bluntly. Because of the delta variant, hospitals are again fighting the battle that we had hoped would be behind us by now.”
The first-term Democratic governor, who has made his response to the pandemic a central theme of his reelection campaign in next year’s balloting, reissued his pleas for the unvaccinated to get inoculated, particularly after the federal Food and Drug Administration gave full approval Monday to the Pfizer-BioNTech vaccine for people age 16 and older after it had previously been approved for emergency use in the pandemic.
“Vaccination remains our strongest tool to protect ourselves and our loved ones to restore post-pandemic life to our communities and, most crucially, to maintain our healthcare system’s ability to care for anyone who walks through their doors that needs help,” Pritzker said.
He cited a sevenfold increase in intensive care usage since July and data showing that from January through July, 98% of positive cases, 96% of hospitalizations and 95% of deaths were among unvaccinated people. His administration also noted that the 20-county health region in far Southern Illinois, the state’s least vaccinated, had dropped to one available Intensive Care Unit bed earlier in the week and that other lower-vaccinated Downstate regions may have no ICU beds available by mid-September.
“My number one concern is, right now, keeping our healthcare system available, not just for people who may get COVID-19. But for people who have other problems that would take them to the hospital,” he said. “You don’t need to be an epidemiologist to understand what’s going on here. This is a pandemic of the unvaccinated.”
Employees in the healthcare and educational settings and higher education students who are unable or unwilling to receive the vaccine will be required to get tested for COVID-19 at least once per week starting Sept. 5.
A Tribune analysis of state and federal data has found that the rate of hospitalization for the unvaccinated has risen nearly sevenfold since the end of June. The weekly rate of hospital admittance for that group is now above 28 per 100,000 residents, approaching the peak of 35 last fall.
The vaccine doesn’t stop every bad case, but the analysis found that, for those fully vaccinated, the weekly hospital admittance rate is far lower, barely 2 per 100,000 residents, albeit still about four times higher than it was at the end of June, before the surge in delta cases.
Pritzker’s vaccination mandate comes amid school openings and the spread of the delta variant that has led to increased hospitalizations among younger people and the unvaccinated along with increasing reports of “breakthrough cases” among those who are vaccinated. The rise in “breakthrough cases” he attributed in part due to unvaccinated healthcare workers.
The governor had previously issued a vaccine mandate for state and private workers in congregate settings, such as nursing homes, prisons and veterans’ homes. On Thursday, he indicated a more widespread order for state workers might be forthcoming.
“There’s no doubt I want to extend this and make sure that more people are getting vaccinated throughout the state, including, especially, our state employees,” the governor said.
Pritzker earlier this month had ordered a masking mandate for students, faculty and staff in early childhood learning centers and elementary and high schools and said schools and districts that did not comply faced sanctions, including the possible loss of state funding and participation in Illinois High School Association athletics. Opponents of that mandate contended the governor’s order ran counter to a long tradition of local control by elected school boards.
The issue of vaccine mandates has been a controversial one involving government employees. Pritzker’s requirement for workers in congregate settings has been challenged by the American Federation of State, County and Municipal Employees Council 31, the state’s largest employee union. The union, which has supported vaccination, has said the issue is a matter of collective bargaining and said it wanted the same vaccination or testing option offered to educators. Pritzker said his administration is in negotiations with AFSCME on the issue.
Officials for the state’s largest public teachers’ unions — the Illinois Education Association, which represents primarily suburban school districts, and the Illinois Federation of Teachers, whose ranks include the Chicago Teachers Union — embraced Pritzker’s new mandate.
“The surge of COVID-19 cases in our state reminds us that this vaccine mandate is a public health imperative. To implement it properly, widespread education and access to vaccines will be essential. For members who cannot, or will not, get vaccinated, we are glad to see the governor has implemented weekly COVID testing,” the unions said.
Several institutions of higher education have already imposed a vaccination mandate for students, faculty and staff, including the University of Illinois system. The U. of I. developed the Shield Illinois saliva-based test for COVID-19, which is being used in 1,200 grade and elementary schools in the state.
The Illinois Retail Merchants Association said it backed Pritzker’s indoor masking requirement and urged local law enforcement agencies to assist retailers “in ensuring employees are not subjected to verbal and physical abuse” while asking local health departments across the state to uniformly enforce the mandate.
The mask mandate is “a measured approach that ensures shoppers continue to have access to needed goods, food and medicine with minimal disruption,” said Rob Karr, president and CEO of IRMA. “We ask all customers to abide by this public health order in a respectful manner.”
The Illinois Manufacturers’ Association, long aligned with Republican interests in the state, said it supported Pritzker’s vaccination and masking mandates. “We cannot cede the progress that has been made in restoring our nation’s health and economy,” said IMA President and CEO Mark Denzler.
Illinois House Republican leader Jim Durkin of Western Springs reflected longstanding GOP frustrations over the lack of legislative input into the state’s pandemic mitigation strategy by calling on Pritzker to call a special session to review the effects of past emergency orders and to “plot a course of action that will work” to curb the COVID-19 resurgence.
“You are willing to negotiate with your biggest supporters, the public sector unions, on the pandemic response, but still will not listen to the General Assembly or the residents of Illinois most impacted by your actions,” Durkin wrote in a letter to Pritzker.
In a response to the letter, Pritzker told Durkin he appreciated the GOP leaders’ support of masks in schools — not a universally held belief in the House Republican caucus — and said he would act to reach out to school superintendents to inform them that surgical KN95 masks are available to schools.
“I encourage you and members of your caucus to continue to bring ideas forward and to propose legislation that would help save lives, end this pandemic and pass in the General Assembly,” Pritzker told the Republican leader.
The issue of masks and vaccination has become a political issue for some in the Republican Party. Two of the three announced Republicans running for governor — Bull Valley businessman Gary Rabine and state Sen. Darren Bailey of Xenia — have not encouraged vaccine use.
Rabine said he previously had COVID-19 and does not need to be vaccinated, counter to recommendations from the federal Centers for Disease Control and Prevention. Rabine also has falsely contended that “thousands” of people have died from the vaccine alone.
Bailey has not said if he is vaccinated but maintained it is a personal choice issue. Bailey has unsuccessfully opposed Pritzker’s mitigation efforts and in May of last year was voted off the Illinois House floor for failing to wear a mask. Bailey likened Pritzker’s actions to that of a “tyrant” instead of engaging legislators.
A third candidate, former state Sen. Paul Schimpf of Waterloo, has been vaccinated and has encouraged inoculations. But he called Pritzker’s action a “divisive act” and said if Democrats feel a mask mandate is necessary, they should bring it to the floor of the General Assembly for consideration.
Pritzker made a pointed reference to Downstate Republican lawmakers such as Bailey who have opposed his pandemic mitigation orders in the past.
“If you’re an elected leader or from one of those highly infected communities, and you’re spending your time resisting masks instead of working to get your people vaccinated, then your definition of public service looks a whole lot different than mine,” he said.
Pritzker’s move comes as some other states have grappled with overflowing hospitals — a scenario that health officials say risks the quality of care not just to COVID-19 sufferers but also those with other ailments, from cancer to heart disease.
IDPH data shows that COVID-19 hospitalizations have risen somewhat in the Chicago area, but far more dramatically Downstate, particularly in the region consisting of 20 counties spread from roughly Mount Vernon to Illinois’ southern tip and east to the Indiana line. When adjusting for population differences, the rate of beds filled by COVID-19 patients in that region is above 37 per 100,000 residents, which is roughly triple Chicago’s rate.
That rise in hospitalizations, in turn, has affected the percentage of available Intensive Care Unit beds, particularly in the southern region, where the state reported that as of midnight Wednesday, the most recent data available, all but six of 89 staffed ICU beds were full. Two days earlier, the region had just one available ICU bed.
When averaged over the past week, the southern region’s ICU availability was just 4% of all its staffed ICU beds — far lower than the 20% threshold that the state had previously set as one marker for considering mitigations. Half of the state’s other 10 regions also averaged lower ICU availability than that threshold, including Chicago (17%), suburban Cook (17%) and North Suburban (15%).
In recent weeks, nearly all of the largest health care systems in the Chicago area have also already announced vaccine mandates for their workers, unless they get approved medical or religious exemptions. Loyola Medicine was the first big hospital system in the area to announce in July that it would require shots for workers.
In many cases, the hospital systems are not giving workers an option to test weekly instead of getting vaccinated. Advocate Aurora Health, University of Chicago Medical Center, Edward-Elmhurst Health and Sinai Chicago have said that workers who don’t get vaccinated could lose their jobs.
Northwestern Medicine said Wednesday it would require its workers to either get vaccines or be tested weekly, until Jan. 1, at which point weekly testing would no longer be an option for those without approved exemptions.
State health officials Thursday reported 4,041 new confirmed and probable cases of COVID-19.
Over the past week, the state has averaged 3,657 new cases a day — a significant jump since early July when the state was consistently averaging fewer than 1,000 cases a day.
The case positivity rate — the percentage of cases as a share of total tests — reached a seven-day average of 5.4% as of Wednesday, up from 3.4% a month ago.
As of Wednesday night, there were 2,184 COVID-19 patients in hospital beds, with a seven-day average of 2,080 people hospitalized — a level not seen since the end of April. As of Wednesday night, 489 COVID-19 patients were in ICU beds, up from 152 a month earlier.
Over the past week, the state has averaged 24,313 vaccinations a day.