There were 1,081 tests done on Wednesday, for example. A day earlier, it was 1,244, an all-time high. 

“It seems like every day we’re breaking records,” said Dr. Aaron Rossi, CEO of Reditus Laboratories, which does the testing. 

Records being shattered because the cases keep coming and coming. Rossi worries for how long. 

“I think the worst is yet to come. That’s the scary part," Rossi said. 

Data backs up that prediction.

“We continue to see an increase in new cases and our positivity rate,” said Jessica McKnight, who runs the McLean County Health Department. 

Both datasets have been ticking higher for weeks, and on Friday, The New York Times identified Bloomington as the metro area with the second-fastest growing case rate in the U.S., on a population-adjusted basis. 

On the frontlines of the pressure cooker are hospitals, which have undergone an ebb and flow of caseloads since the pandemic started in the spring. They adapted. Now they're bracing for another round. 

“The local and statewide (COVID-19) data is very concerning, especially when you consider that number of hospitalizations tend to lag behind high new case numbers,” said Colleen Kannaday, president of Carle BroMenn Medical Center in Normal and Carle Eureka Hospital in Eureka. “With overall case numbers growing in our community, we know that we could be looking at a larger volume of hospitalized patients in the weeks to come.” 

Case in point: On Thursday, 21 COVID patients were in the Normal hospital. During the first COVID surge in the spring, the high was about 10 COVID patients, said Melissa Reidy, clinical coordinator. 

OSF HealthCare St. Joseph Medical Center cases also are up, said St. Joseph President Lynn Fulton, and while they have not had to scale back elective procedures, that's always a possibility. Those resumed in May after being suspended when COVID struck Central Illinois in March. But Fulton added, “that decision is fluid and could change if cases continue to increase.”

COVID cases are also up at some of its doctors’ offices and urgent care locations “but we are able to keep up and have capacity to serve,” Fulton said.

'The numbers don't lie'

Still, at a statewide level, there are worries about enough beds to handle a spike in sick people. During his daily press briefing broadcast from Chicago on Thursday, citing hospital capacity concerns, Gov. J.B. Pritzker chastised local officials across Illinois who have declined to uphold his mitigation measures. 

Illinois’ strategy breaks the state into 11 regions. Region by region, the entire state has been subjected to new mitigation measures in recent months that closed restaurants and bars to indoor service and limited gatherings to no more than 25 people. Since then, four regions of the state — those encompassing southern and northwestern Illinois and the south and western suburbs of Chicago — have been placed under slightly more stringent restrictions, limiting gatherings to no more than 10 people and outdoor tables at restaurants and bars to no more than six. But local law enforcement officials in some communities have publicly declared they will not enforce the restrictions, and many restaurants and bars continue to offer inside service. 

Pritzker also criticized leaders in neighboring states for failing to implement appropriate restrictions that he says have caused cases to climb in border-city regions. All 11 of Illinois’ regions are reporting test positivity rates in the double digits, ranging from 12.5% in southern Illinois to 18.9% in northwestern Illinois near the Iowa and Wisconsin borders. 

“With many community leaders choosing not to listen to the doctors, we are left with not many tools left in our toolbox to fight this. The numbers don’t lie,” Pritzker said. “If things don’t take a turn in the coming days, we will quickly reach the point when some form of a mandatory stay-at-home order is all that will be left. With every fiber of my being, I do not want us to get there. But right now, that seems like where we are heading.” 

Paul Skowron, CEO of Warner Hospital & Health Services in Clinton, and medical director Dr. Annilee Rohrscheib illustrated their concern over the spike in COVID-19 cases in DeWitt County by posting a message to the community on Warner’s Facebook page on Friday.

“Help us help you. The recent increase in the amount of COVID testing and the related increase in the amount of COVID health care treatment that Warner Hospital is providing is putting a severe strain on our staff’s ability to keep up the pace. All surrounding hospitals are feeling the same as Warner Hospital.”

“We do all we can to keep our employees safe so that we are here for you, but we need your help,” the message continued. “The cold weather and the holidays are coming.”

“Please, follow the guidelines of wearing a mask, keeping your distance, and increased hand washing,” Skowron and Rohrscheib said. “Limiting the time of interaction with others and space are important especially over the holiday season.”

'Any one of them could be positive'

For health officials, testing is a key component. 

Rossi, the CEO at Reditus, said the increase in people being tested began two to three weeks ago and is happening at all testing sites in Illinois. He said Reditus has been able to keep up because the company has hired more staff and more people are pre-registering at testdirectly.com/McLean.

Among those Wednesday were Bloomington residents Jacob Elterich, 27, and D.J. Olker, 25. Both work at Country Financial upgrading employees’ computers.

“People bring their computers to us,” Elterich said. “We have face-to-face time with people every day. We want to make sure we’re not spreading stuff.”

“We come into contact with 10 to 15 people a night,” Olker said. “Any one of them could be positive. We would like to know that as soon as possible.”

Elterich and Olker were both wearing masks and said they disinfect computer keyboards and use hand sanitizer.

“I want to make sure I can continue to live my life and see my parents and make sure I’m not passing something to others,” Elterich said.

Both said they’ve been tested at the fairgrounds site 10 times over the past several months and the lines have grown recently. On Wednesday, they waited in line for about 90 minutes.

“It’s been harder recently because the lines have been longer,” Elterich said. “It sucks for us because I don’t want to spend our lunch break in line.”

Olker added, “It’s obviously a difficult situation. There is no good solution.”

Meanwhile, at the Reditus lab in Pekin, where COVID tests are processed for several testing sites, an average of 12,000 tests are handled each day, double the numbers of three weeks ago, Rossi said.

Positivity rates also have increased to 15% to 16%, compared with about 6% three weeks ago, he said.

A long time since March

The testing has provided a wealth of data lacking when the pandemic took root. Health care providers also have had to make countless adjustments along the way since spring. 

Back then, the Community Health Care Clinic in Normal, which serves low-income and uninsured individuals, quickly switched to telemedicine and staff got a “crash course” in how it functions.

“Closing was never an option,” said its executive director, Mike Romagnoli. “Our patients are the vulnerable population. They need us.”

The clinic’s pharmacy is a vital lifeline, providing medicine to its more than 1,100 patients.

“Diabetes doesn’t know there’s a pandemic,” says Romagnoli.

The dental clinic closed for about eight weeks but other functions continued. The pharmacy has a drive-up window where people can pick-up prescriptions. It also has become, in effect, the clinic’s front desk as people also come through with questions.

“It can get really busy,” said pharmacy technician Ana Manriquez. “It’s challenging but at the same time it’s rewarding because people are grateful for us.”

The clinic lost some volunteers when universities switched to all-remote classes in spring and some of its older volunteers, who are at high risk for complications if they get COVID-19, have not been able to return, said Romagnoli.

But the clinic’s core staff of 12 has remained healthy.

“I don’t want to break that streak,” said Romagnoli, noting, “if a couple of us go down, that limits what we can do. … I should have ‘Be careful’ tattooed on my forehead.”

The rise of telemedicine 

One of the keys to maintaining staff health has been limiting the number of people coming inside the clinic by using telemedicine.

Telemedicine involves meeting patients virtually through a secure platform called Doxy. In many cases, it is a video conference between patient and medical provider. For those without internet access, “it’s just a regular old phone call,” said Romagnoli.

Telemedicine has some advantages beyond limiting the spread of disease. Patients don’t have to worry about transportation to the clinic or taking time off work, said Romagnoli. Even after the pandemic is over, he said, “we’re going to keep it in our arsenal,” especially for people with chronic diseases.

Dr. Heather Schweizer, director of physician practice with OSF HealthCare Saint James-John W. Albrecht Medical Center in Pontiac, said: “Our clinics are busy but keeping up with the demand. We’re offering video visits in addition to in-person visits.”

“We are seeing patients with COVID via video or in-person visit, depending on what the patient needs,” Schweizer said. “We strongly encourage our patients to reach out to us as we will be there to care for them at this time of need.”

At Carle BroMenn Medical Center in Normal, staffing patterns have been adjusted and COVID patients are not just being cared for in intensive care unit rooms but in other rooms as well, Reidy said. In rooms with patients with more severe cases of COVID, special air filters are used. 

The staff also has an adequate supply of personal protective equipment, including new goggles that arrived this week.

“For any sort of emergency, we have a surge plan or protocol that is a step-by-step plan to handle a surge in patients,” Reidy said. The plan includes housing some patients in rooms that don’t normally have overnight patients, she said. The plan also would call for two patients in a room when appropriate, she said. Currently, all of BroMenn’s rooms are private.

Stephanie Paxton, director of Chestnut Family Health Center in Bloomington, said her facility is prepared as COVID-19 cases continue to rise. The center has ramped up its telemedicine services and recently conducted a drill on being a point of dispensing vaccine, once it becomes available..

The center sees about 2,200 patients annually, primarily Medicaid recipients, at or below 200% of the poverty level.

“We’ve been able to keep up with volume … and meet patient needs,” said Paxton.

Lori Laughlin, director of marketing and communications for Chestnut Health Systems, said, “The biggest challenge early on was it came up so suddenly and we had to put protocols and procedures in place and ramp up telemedicine. … We’re in a good place now.”

The center provides “wrap-around services” to its patients, providing a case manager to help people with food insecurity and/or housing issues or difficulty paying for medication – “anything that could impact their ability to access service or follow treatment recommendations,” she explained.

What comes next? 

Regarding the possibility of a COVID vaccine later this year or early next year, McKnight said, “It is remarkable the progress being made toward a COVID-19 vaccine, however, even after COVID-19 vaccines are approved, we will not immediately see the world go back to ‘normal.’”

“Per CDC guidance, 80% of the population will need to be vaccinated to achieve herd immunity,” McKnight continued. “There will be limited availability of the vaccine at first, and it is very likely that two shots will be needed to be most effective. Even with the availability of a vaccine, it will still be important for us to continue using the tools in our toolbox that reduce our chance of being exposed to the virus, such as wearing our masks and social distancing for some time in order to protect ourselves and others."

With a projected surge in cases on the horizon, Liz Davidson, chief nursing officer at OSF HealthCare Saint James-John W. Albrecht Medical Center in Pontiac, said: “COVID is real. Those who have experienced this illness, even without serious complications, relay that it was the ‘sickest they have ever felt.’ Everyone needs to remember the 3Ws: wear a mask, watch your distance and wash your hands.”

Rossi, the testing official, said he's also worried about COVID fatigue. Colder weather is making it more difficult for people to socially distance and some people aren’t wearing masks, he said. 

“I think people are over the whole virus thing,” Rossi said. “That’s what concerns me.”

Said Rossi: “When the virus spreads, it’s very contagious. It’s hard to get under control …  People should be wearing a mask and taking all the precautions that are necessary.”