On May 5, 2020, Illinois Governor J.B. Pritzker unveiled “Restore Illinois,” a 5-phase public health plan to reopen Illinois. The plan endeavors to best support Illinoisans’ health and health care systems and save the most lives.  Under the Governor’s plan, Illinois is divided into 4 regions – Northeast; North-Central; Central; and Southern – in which each region will be able to move through the 5 phases separately.

Beginning May 1, all of Illinois moved into Phase 2 when the Governor’s modified, extended stay at home order took effect, allowing some businesses to reopen. The earliest any Illinois region can move into Phase 3 is May 29. For up-to-date information regarding Illinois and other states’ plans to reopen non-essential businesses, see our COVID-19 Response Team’s interactive map, available here. 

While no firm timetable for entrance of Illinois’ regions into each phase was given, Governor Pritzker highlighted a reliance on science and data as guides for when to ease social distancing and economic restrictions imposed during the pandemic. Each region must meet certain benchmarks tied to testing, hospital capacity, and the growth rate of COVID-19 cases in order to move into a new phase.

The 5 phases for each 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, drive in movies, 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 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. All gatherings limited to 10 or fewer people are allowed. Face coverings and social distancing are the norm.

Phase 4 – Revitalization: The rate of infection among those tested and the number of patients admitted to the hospital continues to decline. All gatherings of up to 50 people 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.

The announcement of Illinois’ phased reopening plan comes as many health care facilities across the state prepare to resume elective surgeries and procedures next week.  Under recently issued elective surgery and procedures guidance, the Illinois Department of Public Health set forth specific criteria under which a facility can resume such procedures beginning on May 11.  In addition to meeting certain facility requirements, all three of the following resource conditions must be met in order for elective procedures to be permitted:

• Hospital availability of adult medical/surgical beds exceeds 20% of operating capacity for adult medical/surgical beds

• Hospital availability of ICU beds exceeds 20% of operating capacity for ICU beds

• Hospital ventilator availability exceeds 20% of total ventilators

Further, elective procedures may be suspended again by the Illinois Department of Public Health in the event of a rapid resurgence or a second wave of COVID-19 or decrease in statewide hospital COVID-19 testing levels.

While the COVID-19 outbreak has been mild in Illinois relative to the state’s population size, Illinois’ current average daily testing rate and positive test ratio are not meeting the estimated minimum testing targets and recommended positive test ratio of 10% or less that are recommended by the Harvard Global Health Institute and World Health Organization as a means to contain the outbreak through a strategy of testing, tracing and isolating positive cases and their contacts.