About

Chicago-based COVID-19 Coalition

Context

  • COVID-19 is a disease to which the word population has never been exposed and has a high infection rate that is accelerated during close social contact. The disease has a 2 - 14 day incubation period with a median of 5 days from infection to symptoms. 25% of infections occur when someone asymptomatic is in close contact with a susceptible person. 80% of people develop mild symptoms and are unaware they are infected. They remain infectious to others for 6 to 14 days.

  • High susceptibility combined with transmission by people with mild or no symptoms results in rapid spread of new cases. Globally, about 1% of all cases die. These deaths occur among 5 to 10% of COVID patients who have more severe infections that require hospital care.

  • About 2.5% of all patients require an ICU bed and mechanical ventilation. Those who die usually die about 10 to 15 days after developing symptoms. Those who survive typically require 4 to 7 days on a ventilator. While these patients remain infectious and on a ventilator, they must be kept in specific hospital rooms with negative airflow ventilation and staffed by highly skilled ICU physicians and staff.

  • With new cases occurring daily, the limited number of dedicated beds that can be used to treat COVID patients creates capacity constraints based on available ICU beds, ventilators, extracorporeal membrane oxygenation (ECMO) equipment, and trained ICU staff.

  • Personal protective equipment (PPE) prevents medical personnel from inhaling respiratory droplets from infected patients or contact with contaminated surfaces in isolation areas. PPE shortages increase the risk of staff infection, thus increasing the risk of clinical staff shortages which further limits system capacity.

Challenges to Overcome

We currently cannot predict the magnitude of the COVID epidemic in Illinois or its implications for our collective health system response necessary to minimize deaths

  • We don’t know the total numbers of cases as there has not been population screening for COVID in Chicago or in any other part of the US. Increased availability of tests in the past week have changed the case mix of those being tested, but the current numbers in Illinois still represent only a relatively small subset of overall cases who are symptomatic and have access to a testing facility. Test centers are now facing supply shortages in test supplies, which may limit our ability to test over the next 2 to 6 weeks.

  • Without reliable epidemiologic estimates, there is great uncertainty in the likely rates of ICU bed occupancy and consumption of PPE. If beds and PPE are used more quickly than anticipated, severely ill patients will not receive the life-saving treatments needed for their survival and the death rate will rise briskly as has happened in several other countries.

  • Better population level and geographic estimates of COVID for the Illinois region can help to inform thoughtful public policy to prevent new cases and strategic actions in healthcare and other sectors to manage needed resources


Health systems cannot predict and manage supply chain needs and bottlenecks without knowing the total projected COVID patients or capacity constraints of other neighboring health systems

  • Individual health systems operate independently to manage their COVID supply chain requirements, consumption, and bed control. Most systems have contingency plans for increasing the availability of negative airflow rooms, staff, and supplies but there is limited communication of supply shortages or projections across systems of care. In addition it is unclear if all health systems are adequately forecasting supply chain burn rate or future dates of deficiencies, particularly in the setting of uncertain projections of the new case rate. Lastly, It is unclear if policy makers are aware of the level of risk of different supply shortages and their implications on the case fatality rate.

  • There is need for a mechanism for real time coordination of health systems within our region to make optimal use of limited resources. Collecting, aggregating, forecasting, and communicating supply chain burn rates and projected bottlenecks within and across facilities could help catalyze creative solutions for increasing supplies that prevent impacts on patient care

There are no known direct anti-viral treatments for COVID. Healthcare approaches focus on providing supportive care for complications of pneumonia. For severe cases, we are in need of new treatment innovations that improve survival and other outcomes.

  • Our understanding of the COVID disease course and effective COVID treatment strategies continues to evolve rapidly. Lab-based COVID anti-viral research may identify novel targets for reducing or slowing the rate of infection or virulence, or attenuating the body’s severe inflammatory response in patients who develop severe disease. Compassionate use of existing anti-viral or immunologic therapies may unveil new evidence for how to improve outcomes. Lessons from other countries, regions and states can guide our initial efforts. However, this form of data collection and information sharing is inherently incomplete and too slow.

  • More rapid, ‘real-time,’ data collection and knowledge dissemination approaches are needed to guide tailored treatment and mitigation efforts and provide researchers and innovators opportunities to add to our understanding of COVID.