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Opinion | Paul Schimpf: Use hospitalization rate, not positivity, to assess mitigation
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Opinion | Paul Schimpf: Use hospitalization rate, not positivity, to assess mitigation

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Earlier this week, Illinois Gov. J.B. Pritzker imposed new COVID-19 restrictions on businesses in the Illinois Department of Public Health COVID-19 Region 4 (Randolph, Monroe, St. Clair, Madison, Washington, Bond and Clinton counties). He based these actions on the aggregate COVID-19 positivity rate for Region 4 that had risen above an 8% threshold.

Gov. Pritzker states that these restrictions will not be lifted until Region 4’s positivity rate drops below 6.5%. While I agree that it is important to monitor the positivity rate for our region, I believe that the COVID-19 hospitalization rate is a much better barometer for determining what mitigation efforts are needed.

When Gov. Pritzker first announced a statewide response to the COVID-19 pandemic back in March, he explained the purpose of our actions as an attempt to “flatten the curve” so that hospital capacity would not be overwhelmed. The hospital admission rate metric directly relates to our regional hospital capacity. This metric and the amount of COVID-19 patients occupying intensive care unit beds allow us to evaluate whether our hospitals remain in position to treat patients. From July 5 through Aug. 29, the COVID-19 hospitalization rate for Region 4 has remained relatively steady and does not indicate that our region’s hospitals are in danger of being overrun by COVID-19 patients.

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On the other hand, the positivity rate, while a useful metric to assess whether public health officials need to increase the amount of COVID-19 testing, is not an accurate forecaster of whether our hospital capacity is about to be overwhelmed.

IDPH’s own data backs up this assertion. From July 5 through Aug. 28, as the Region 4 positivity rate climbed from 4.8% to 10.4%, the hospitalization rate only increased by two patients from an average of four admissions per day to six. On Aug. 29, it dropped back down to five admissions per day.

I also question whether the positivity rate accurately depicts the amount of COVID-19 present in our southwestern Illinois communities. The COVID-19 positivity rate does not represent the amount of positive individuals in our communities. Instead, the positivity rate simply gives the percentage of administered COVID-19 tests that come back positive.

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Furthermore, the positivity rate is also based on test results — not individual patients. This means that one COVID-19 positive individual who is tested at multiple times during their treatment will contribute a significant number of positive test results to the positivity rate calculation. And even that data may still be incorrect. On Aug. 29, the New York Times published an article arguing that the methodology for COVID-19 testing likely generates positive results from statistically insignificant genetic virus fragments.

In addition to problems with data accuracy, I also believe that IDPH is making a mistake by including data from state facilities in its positivity calculation. The individuals generating these positive test results are confined to their facilities and not members of the general public. Not only are these individuals not a part of community spread, but the general public has no ability whatsoever to influence behavior at these facilities. Their test results should not be included in the positivity data pool.

Adjusting a flawed plan is a sign of strength and leadership, not weakness. Gov. Pritzker should recognize that his mitigation plan announced July 15 was mistaken by making mitigation measures contingent upon the least reliable metric, the positivity rate. Instead of using the positivity rate, Gov. Pritzker owes it to the struggling small business owners of Illinois to update his mitigation plan and use the COVID-19 hospitalization rate as the benchmark for any new restrictions to combat the novel coronavirus in our communities.

State Sen. Paul Schimpf, R-Waterloo, represents the 58th Legislative District in Illinois.

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