How Chicago's Top Doctor Assesses the COVID Risk of Traveling to Different States

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How should you decide if you should go to a certain location as travel picks up while the U.S. continues to navigate the coronavirus pandemic?

Chicago's top doctor shared her process for making recommendations Tuesday, saying what she includes in her consideration is the spread of COVID-19 in the particular area one might be thinking about visiting.

Chicago Department of Public Health Commissioner Dr. Allison Arwady gave details on her process in response to a question during a Facebook Live broadcast on Tuesday. A viewer said he had a funeral to attend in Milwaukee and needed to bring his 80-year-old aunt. Both of them are fully vaccinated, he said, but noted that he wasn't sure about all the other attendees and wondered if he should be concerned for his aunt.

"This is exactly a question that I think a lot of us are thinking about," Arwady said in response. "And the good news is that if you are fully vaccinated and your aunt is fully vaccinated, you know, broadly your protection is very good. And you're right, you know, if you're not sure about all the others… you are going into a situation that could have some risk. I don't know your aunt, I don't know what underlying condition she has, but she's 80 so that is kind of a higher-risk situation."

Arwady said that her recommendation would "broadly" be to go to the funeral, based on the information given, particularly if it's someone the aunt was close with.

"When I am helping people make these decisions individually, I sometimes actually take a look at the area where someone's going to be traveling to have a sense of that," she said, noting cases across the U.S. are up about 5% before diving into specific areas.

Arwady recommended researching each state or region's rolling average number of new cases per day, adjusted for population, as well as trendlines in how much new cases have gone up or down in a particular area in recent days before deciding to travel there.

"Wisconsin looks really good up here," she said, highlighting that the state was seeing fewer than 10 cases per day per 100,000 people and that Milwaukee County in particular was averaging 19 cases a day total - roughly two per 100,000 people.

"And that's generally flat over the last 14 days; they're not having a big surge, would not have a major concern," she said. "If, though, you were like, 'Should I go to a funeral that's down, you know, in Springfield, Missouri, here?' I would have some worry because Missouri and Arkansas, parts of western Colorado, Nevada, are having some trouble."

Arwady said the state of Arkansas was up to 17 cases per 100,000 people per day, which would be the equivalent of Chicago seeing more than 400 or 450 cases a day, calling that "back in… worrisome range." Cases in Arkansas have also gone up 121% and hospitalizations are up 42%, she added.

"I would have some worry, like if I were going to travel to Arkansas, I would be putting a mask on, right, like I think especially if there were someone who I was particularly concerned about," she said, adding that Arkansas and Missouri are two of the county's "least vaccinated" states and among the states seeing the highest increases in cases.

"Florida and Nevada are having a little bit of trouble too, up 63% in Florida. But then, you know, most of the country continues to do reasonably well here, we're seeing some big increases: Nebraska is up 137%, South Carolina 145%," Arwady said. "But the numbers are still pretty low and low numbers mean, you know, the chance of being exposed to somebody is still on the lower side."

Arwady said Illinois and Wisconsin are both "doing really well," with the former averaging two cases per 100,000 people and the latter averaging one, the same as Chicago.

"So that's one of the things that I actually look at when I'm making recommendations and thinking about, you know, masks or risk," she said.

Arwady's comments came exactly one week after Chicago turned its emergency coronavirus travel order into an advisory after no states were on the list requiring travel restrictions for the third consecutive update.

CDPH announced on June 29 that in more than a month, no state had reached the 15 cases per day per 100,000 residents threshold, which would be the "orange" tier in which unvaccinated travelers are required to quarantine or provide a negative COVID test upon arrival in the city.

The last time a state had reached the orange tier was May 18, the department said, and all U.S. states and territories remained in the less restrictive "yellow" tier of the travel order.

The travel order shifted to an advisory as a result, but the city said the emergency guidelines can be reinstated at any time "if significant surges are seen in any state."

And on Tuesday, Arwady said that some states could be added to the advisory again in the next update.

"There are a number of states, two or three, that are likely to go back on our travel advisory, right, where they are actually having significant surges, not just of cases but of hospitalizations from COVID," she said.

Chicago's travel advisory is slated to next be updated on July 13, with any changes taking effect that Friday.

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