Since the beginning of October, new cases of COVID-19 are up 150% in Illinois, deaths are up 83% and hospitalizations 73%. All signs point to a "meaningful and sustained increase in transmission of this virus," Gov. J.B. Pritzker said on Oct. 29, and "we can expect worse to come."

University of Chicago chief epidemiologist Emily Landon acknowledged at Pritzker's press conference that it was not a happy occasion for her to speak, but she urged people to take experts' current recommendations at face value, explaining that inconsistencies and inconsistent data are not evidence of a conspiracy but "evidence of changing knowledge in epidemiology."

"In different situations, different metrics mean different things," she said. "Everyone is trying to use the best information available to make the best possible decisions. There are and will be disagreements about the details. There's no one measure or metric but rather an understanding of the needs and the pain in the community, both from the virus as well as the consequences."

Months into the pandemic, she reiterated every study's findings that masks reduce the risk of getting COVID-19. So does common sense, she observed, because health care workers would all get it if they did not wear them while caring for infected patients. Studies of those workers' antibodies show that they have only had the disease slightly more often than the wider population, Landon said.

She added that there is growing evidence that those who catch the coronavirus while wearing the mask are less likely to get as sick, which many medical experts think may be causing the second wave's lower mortality rate. A study out of Kansas found that areas with mask mandates had lower rates of coronavirus transmission and mortality rates than those without them, she said, showing that masks are important.

"No matter what you hear, masks are important, and masks are safe," she said, recalling that construction and health care workers, artists and other workers have been wearing masks forever without complication, especially as winter comes.

Heating systems make air drier, which allows the coronavirus to spread more easily. Landon said there have been numerous super-spreader events in settings with unmasked contact with people in a closed, crowded space.

"Many modelers have shown the indoor ventilation in most buildings is not sufficient to prevent the transmission of COVID when people aren't wearing masks," she said. "So it seems that limiting indoor gatherings when people don't wear masks is a key part of preventing COVID transmission, and it is. 

"Bar and restaurants are one of a few places where people congregate, and they can't really wear a mask and eat and drink," she continued. "Unfortunately, their employees and the restaurants and the businesses are the casualties here, but there's no way around it." 

It's not just models, she said. Data from Guangzhou, China, early in the pandemic showed that recirculated air from an HVAC system spread the coronavirus from one family to multiple others in a restaurant. One-quarter of COVID-19 cases in Louisiana in August were related to bars and restaurants. More than 100 cases were linked to a Michigan bar in a week. Twenty-nine restaurants started clusters in Minnesota over the summer.

"Shutting down bars and restaurants and putting in mask mandates changed the trajectory of the pandemic in Arizona, Texas, Florida, San Diego, Washington, D.C., Illinois — I could go on," Landon said.

"This isn't the fault of any particular restaurant. In fact, the proprietors of these places do everything that they can to prevent this from happening, but the reality is that a restaurant can be perfectly safe from 6-8 p.m. and become a super-spreader event from 8-10. It all depends on whether or not someone with COVID walks in the door."

Some people have the coronavirus and are asymptomatic, she noted, and Illinois cannot do enough random COVID-19 testing to find everyone. And contact tracing for those people who have the disease but do not know because they are asymptomatic is impossible. 

Small gatherings in homes are just as risky as restaurants, Landon said, and as cases go up in Illinois, social bubbles need to get smaller: "COVID thrives on this unmasked contact indoors, and so that's what we've got to stop."

Getting a drink from a coffeeshop, seeing a doctor or going to the library in a mask are not going to spread COVID, but eating communally with coworkers will, she said, as will an in-person book club with wine and appetizers. Do it over Zoom, she advised. Halloween parties can become super-spreader events, as can Thanksgiving gatherings.

In addition to the Illinois and Chicago departments of public health, Landon recommended a website from Brown University, mycovidrisk.app, which uses data on a local basis to help people lower their risk and empower them to make their own decisions.

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