November 9, 2020

ILLINOIS HEALTH AND HOSPITAL ASSOCIATION MEMORANDUM

TO: Chief Executive Officers, Member Hospitals and Health Systems Chief Operating Officers Chief Medical Officers Chief Nursing Officers Chief Quality Officers Chief Financial Officers Emergency Preparedness Contacts Emergency Department Directors Behavioral Constituency Section Government Relations Personnel In-House Counsel Public Relations Directors

FROM: A.J. Wilhelmi, President & CEO Tim Nuding, Senior Vice President, Member Services & Corporate Finance Keneatha Johnson, Director, Quality, Safety and Health Policy

SUBJECT: IHA COVID-19 Update – November 9, 2020

Following is a brief recap of the most recent top developments.

Situational Awareness The Department of (IDPH) announced today 10,573 new confirmed and probable COVID-19 cases – the fourth straight day of more than 10,000 new cases – and 14 deaths. Following Centers for Disease Control and Prevention guidance, IDPH is now reporting confirmed cases and probable cases combined. A confirmed case is laboratory confirmed via molecular test. A probable case meets clinical criteria AND is epidemiologically linked, or has a positive antigen test. If a probable case is later confirmed, the case will be deduplicated and will only be counted once.

The total number of cases in the state is 498,560, with a total of 10,210 deaths. IDPH says that in the past 24 hours, 64,760 test specimens have been processed, with a positivity rate of 16.3%. The preliminary seven-day statewide positivity rate for cases as a percent of total tests from November 2 – November 8 is 11.4%, and the seven-day test positivity rate is 12.4%. Statewide COVID-19 hospitalizations in the past 24 hours increased from 4,303 patients to 4,409 patients, the highest daily number since May 13. Of that figure, 857 patients were in the ICU, with 376 patients on ventilators.

Tighter COVID-19 Restrictions on Three More Regions Governor J.B. Pritzker and IDPH Director Dr. Ngozi Ezike announced this afternoon that tighter Tier 2 COVID-19 resurgence mitigations will be implemented this Wednesday in Regions 5 (Southern Illinois), 7 (Kankakee and Will Counties) and 8 (DuPage and Kane Counties). COVID-19 positivity rates (now all above 13% daily and 11.5% seven-day rates) and hospitalizations continue to surge in those regions, which will join Region 1 (Northwest Illinois) with Tier 2 mitigations. The mitigations include a limit on indoor and outdoor meetings, social events and gatherings to 10 people, a reduction of the maximum party size in bars and restaurants from 10 to 6, and a limit on organized group recreational activities to the lesser of 25 guests or 25% of overall room capacity both indoors and outdoors.

COVID-19 County Warning List Grows to 75 Seventy-five counties, plus the city of , are currently reported at a warning level – Adams, Alexander, Bond, Boone, Bureau, Calhoun, Carroll, Chicago, Christian, Clay, Clinton, Coles, Cook, Crawford, Cumberland, DeKalb, Douglas, DuPage, Effingham, Franklin, Fulton, Gallatin, Greene, Grundy, Hamilton, Hancock, Iroquois, Jackson, Jasper, Jersey, Jo Daviess, Johnson, Kane, Kankakee, Kendall, Knox, Lake, LaSalle, Lee, Livingston, Logan, Macon, Madison, Marion, Mason, Massac, McHenry, Mercer, Monroe, Morgan, Moultrie, Ogle, Peoria, Perry, Pike, Pulaski, Putnam, Randolph, Rock Island, Saline, Sangamon, Scott, Shelby, St. Clair, Stephenson, Tazewell, Vermilion, Wabash, Warren, Washington, Wayne, Whiteside, Will, Williamson, Winnebago, and Woodford. That’s an increase of 26 counties from the 49 counties reported on the warning list the previous week.

State Releases Contact Tracing Data On Friday, Governor J.B. Pritzker and IDPH Director Dr. Ngozi Ezike gave an update on the state’s and local health departments’ contact tracing efforts. They reported that interviews have been conducted in connection with more than 100,000 cases statewide, and nearly 100,000 interviews have been conducted with contacts.

According to their update, the top outbreak locations are: Factory, Community Event, Church, College, and Corrections. Outbreak locations are locations where five or more cases are epidemiologically linked to a specific setting during a 14-day period. The top exposure locations are: Restaurant/Bar, School, Workplace, Hospital/Clinic, and Business/Retail. Exposure locations are locations where someone who tested positive went in the time before they were symptomatic or tested positive. To view the newly released data, go to: http://www.dph.illinois.gov/covid19/contact-tracing; also, see a summary.

CDPH COVID-19 Vaccination Plan for Chicago On Wednesday, November 4, IHA hosted a call with Drs. Allison Arwady and Candice Robinson from the Chicago Department of Public Health (CDPH), who outlined CDPH’s COVID-19 vaccination plan for Chicago hospitals. CDPH has opened enrollment for sites seeking to receive COVID-19 vaccines. Hospitals should enroll now, starting with the primary hospital site where the vaccine will be delivered and enrolling additional locations that will serve as vaccination sites for healthcare personnel. The process should be initiated and managed by the Chief Medical Officer (CMO) at each site via REDCap. Enrollment must be completed by this Friday, November 13.

Please review these documents -- CDPH Vaccination Program Provider Enrollment Overview, CDPH COVID-19 Vaccination Provider Enrollment REDCap Instructions, and CDC COVID-19 Vaccination Program Provider Agreement -- to assist in the enrollment process. If you have questions, contact CDPH at [email protected].

State of Illinois Vaccination Plan IHA is also continuously engaged with IDPH as it refines the statewide vaccination plan. Please be sure your organization has reviewed the IDPH draft plan (SARS-CoV-2/COVID-19 Mass Vaccination Guide) in preparation for the eventual distribution of COVID-19 vaccines in Illinois. Using the Illinois Comprehensive Automated Registry Exchange, the state’s online vaccination ordering system, hospitals and health systems will be required to sign the CDC COVID-19 Vaccination Program Provider Agreement and profile form, which provides guidance on vaccine administration, storage, and handling of the vaccination.

Pfizer Says COVID-19 Vaccine Highly Effective Drug manufacturer Pfizer and partner BioNTech announced today that an early analysis of data from their COVID-19 vaccine candidate, BNT162b2, shows it is more than 90% effective. The firms are continuing to accumulate safety data and currently estimate that a median of two months of safety data following the second (and final) dose of the vaccine candidate – the amount of safety data specified by the Food and Drug Administration (FDA) in its guidance for potential Emergency Use Authorization – will be available by the third week of November. Pfizer and BioNTech say based on current projections they expect to produce globally up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021.

Interim Final Rule Published on COVID-19 Vaccine and Treatment Coverage On Friday (November 6), the U.S. Departments of the Treasury, Labor, and Health and Human Services published a fourth COVID-19 interim final rule with comment period in the Federal Register (CMS-9912- IFC). This interim final rule:  Implements several aspects of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), including COVID-19 vaccine payment and administration;  Establishes Medicare add-on payments for new COVID-19 treatments under the inpatient and outpatient prospective payment systems (IPPS and OPPS);  Implements Medicaid beneficiary enrollment maintenance requirements from the Families First Coronavirus Response Act (FFCRA);  Extends the Comprehensive Care for Joint Replacement model by 6 months; and  Revises regulations specific to State Innovation Waivers.

The effective date for the majority of the provisions in the interim final rule is November 2, 2020. Comments are due January 4, 2021. See an IHA fact sheet summarizing the rule.

Biden-Harris Announce Pandemic Advisory Board Today, the Biden-Harris Transition Team announced the formation of its COVID-19 Advisory Board, made up of a team of public health experts who will advise President-elect Biden, Vice President-elect Harris, and the Transition staff on pandemic response. Serving as co-chairs are Former U.S. Surgeon General Dr. Vivek Murthy, Yale Professor and researcher Dr. Marcella Nunez-Smith, and University of California San Francisco Professor Dr. David Kessler. Dr. Julie Morita, former Chicago Public Health Commissioner was named as a member of the Board.

Next IDPH COVID-19 Update Webinar on Tuesday Because of the Veteran’s Day holiday, the Illinois Dept. of Public Health will hold its next COVID-19 Situational Update webinar on Tuesday, November 10 at 11 a.m. To register, click here.

Resources  IDPH COVID-19 webpage and Coronavirus.illinois.gov  CDC Homepage for Coronavirus Disease 2019 (COVID-19)  Chicago Department of Public Health COVID-19 webpage  IHA webpage on COVID-19

If you have questions or comments, please contact Tim Nuding, Senior Vice President, Member Services and Corporate Finance at 217-541-1164 or [email protected].