Chicago is inching closer to a metric that could see the city rolling back some of its reopening progress, the city's top health official said Wednesday.
And if things get even worse from there, a return to phase three is possible.
According to Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, the city is currently averaging about 192 cases per day.
"This, if I had one number, is the number that I follow," she said, noting that "we've come a long way" as the Chicago was average about 1,000 cases per day in early May. "This is the best reflection of the burden of our disease."
The daily average currently puts Chicago in a "moderate-to-high incidence" state.
But if the number rises above 200, the city returns to what Arwady described as a "caution state" that could spark the return of certain restrictions. She noted, however, that reaching that mark won't mean an automatic rollback.
"I wanted to make the point with the mayor that we're quite close to 200 here," Arwady said. "We'll start thinking about pulling back if we need to once we're over 200. There are other things that play in there: how fast are we seeing a rate of increase? What's happening with percent positivity? Are we seeing any impact on the healthcare system?"
The larger concern comes if the city reaches an average of 400 new cases per day, which could mark a return to phase three, Arwady said.
"If we get to a point where we are up to 400 cases per day, that's the equivalent of where the states are that we are requiring quarantine for our visitors," Arwady said. "It's the equivalent of needing to go back to a phase three, really pulling back on major activities."
Chicago Mayor Lori Lightfoot echoed that sentiment, saying the city is "dangerously close" to reversing course.
"Right now we are on the precipice. We are dangerously close to going back to a dangerous state of conditions," Lightfoot said during a news conference.
Lightfoot has said in recent days that she will not hesitate to reimpose some of the restrictions put in place in the earlier months of the pandemic should coronavirus cases and metrics continue to rise - a point she reiterated on Wednesday with a strong warning.
"Some of you have joked that I'm like the mom who will turn the car around when you're acting up. No friends, it's actually worse," Lightfoot said. "I won't just turn the car around. I'm gonna shut it off, kick you out and I'm gonna make you walk home. That's who I am. That's who I must be for you and everyone else in this city to make sure that we continue to be safe."
"I don't want to be that person if I don't have to - but I will if you make me," she continued.
Arwady predicted the city will in fact rise above 200 cases per day, citing an increase in cases across the country.
"I do expect, given what we're seeing around the country, that we will likely see some additional cases here," she said.
Should Chicago's metrics drop below 100, however, the city could see further loosening of restrictions.
"If we're able to get this confirmed cases per day down below 100, which I think is possible, that's when we'll be moving ahead," she said. "We need that case number on the decline and really down below 100."
Both Lightfoot and Arwady repeated concerns that those between the ages of 18 and 29 years old are marking the biggest rise in infections.
They issued a warning to young people in particular to continue following public health guidance: avoid large gatherings and wear a face mask at all times when outside the home.
"We've got to continue to do the right things. If you are a business, we're not afraid to shut you down and we've proven that. So please step up and do the right thing. Follow the guidance that you know is in place to keep your workers, to keep your customers and to keep you safe," Lightfoot said, noting that she did not want Chicago to see a spike in cases like some states in the South and West regions of the U.S. have been in recent weeks.
"I certainly don't want to be like other places of the country where we're shutting down commerce and businesses again," Lightfoot said.
Most industries were shut down nearly entirely beginning in mid-March as cases began to climb in Illinois. Restrictions have been gradually lifted in a phased reopening framework, with Chicago entering phase four on June 26, allowing indoor service in a limited capacity at bars and restaurants, among other changes.