Deleon Davenport lives in South Shore but manages a restaurant in River North, and he’s seen the differences in the latest surge.
Near his home, he said, people seem to wear masks and keep their distance from strangers more. But where he works, he watches hordes of unmasked pedestrians and outdoor diners acting like the COVID-19 pandemic is over.
River North’s predominant ZIP code has nearly double the percentage of residents fully vaccinated than the ZIP code covering South Shore. But River North’s also has twice the number of new COVID-19 cases, relative to population size.
It’s part of what may seem like a surprising trend in Chicago: Some of the city’s more vaccinated areas also are seeing higher case rates.
But it doesn’t surprise Davenport because of the more carefree behavior he sees where he works.
“Seeing people without masks actually frustrates me now,” Davenport said.
The River North neighborhood is among the many new flashpoints of an emerging third surge of cases on Chicago’s North Side. From West Town and Lincoln Park to Edison Park, these neighborhoods have some of the city’s highest rates of vaccination so far, as many as 42% of residents getting at least one shot in the period studied. And yet the third surge has affected them more than some areas that suffered greatly in previous surges.
Health officials say the reasons are complex.
For one, the vaccines work well but they haven’t been injected into nearly enough people to stop the virus’s spread, even in the more vaccinated areas. Areas previously hit hard by the virus, mostly on the South and West sides, also may have higher levels of natural immunity — which is waning, and not nearly enough to stop a surge there, but perhaps can keep it from growing as fast.
At the same time, people in more vaccinated areas may be feeling a bit too optimistic about the end of the pandemic, even as a more contagious, and potentially more dangerous, variant is spreading in this part of the country. People who think that way may abandon the behaviors that helped keep their communities safer over the past year, health officials said.
“As folks in that area have started to see the people they care about getting vaccinated, even if they themselves have maybe not been vaccinated, we are seeing people just thinking like ‘We’re done,’ ” Dr. Allison Arwady, the city’s health commissioner, said in an interview.
Epidemiologists are confident that vaccination will eventually win out, protecting any area where enough people are willing to get the shots. But that’s expected to take until sometime this summer, at the earliest.
For now, the region must brace for a third surge that may look far different than the first two. Here’s what we know about it:
The surprising trend
People who study health disparities say they weren’t surprised at the way the pandemic initially unfolded.
The hardest-hit areas were predominantly Black and Latino neighborhoods whose residents typically made less money, worked jobs that put them in greater danger, had more chronic health concerns and had less access to quality health care. The director of the Centers for Disease Control and Prevention said Thursday that the pandemic revealed racial inequities in public health “that have existed for generations.”
The disparities led state and Chicago health officials to come up with special measurements to characterize areas based on their perceived vulnerability to the pandemic.
And to few people’s surprise, despite a well publicized push for equitable distribution of the vaccine, fewer Chicagoans generally have been vaccinated in the more vulnerable areas.
Less intuitive is the surge of cases in historically less vulnerable areas where vaccination rates are also higher.
The Tribune analyzed case data and vaccination data by 58 ZIP codes through the week ending April 3, looking at whether there was a statistically significant correlation. (The Loop’s five ZIP codes were combined for the analysis because of their generally smaller number of residents.)
The analysis found that, across Chicago, ZIP codes with higher vaccination rates were more likely to have higher rates of newly reported COVID-19 cases.
For example, the highest rate of cases was in the ZIP code of 60631 on the city’s extreme Northwest Side — Edison Park and part of Norwood Park.
During the week of March 28 through April 3 — the latest data available — the ZIP code recorded 91 new cases. Because the number of people living in a ZIP code varies, researchers sometimes compare ZIP codes by calculating a rate per 100,000 residents. For 60631, that rate was 308 cases per 100,000 people, the highest of any Chicago ZIP.
Entering that same week, 36% of the ZIP code’s residents had at least one shot, and 23% were fully vaccinated. Both are among the highest vaccination rates in the city.
The trend can be seen more clearly when grouping ZIP codes by their vulnerability to the pandemic: low, medium or high.
Three months ago, all three groups had roughly the same average of new weekly cases, around 120 per 100,000 residents.
But during the third surge, the low-vulnerability areas collectively began seeing their cases grow faster than the medium- and high-vulnerability areas — even as the latter two areas trailed on pace of vaccinations.
The most recent data showed that low-vulnerability areas now collectively have a rate of 189 cases per 100,000 residents. That’s much higher than the collective rates seen in medium-vulnerability areas (144) and high-vulnerability areas (126).
Is the vaccine working?
A key rule of statistics: Just because two things are happening at the same time doesn’t mean one is causing the other.
In other words, the higher vaccination rates are not directly to blame for higher COVID-19 case counts.
Real-world studies show the most-used vaccines so far — from Pfizer and Moderna — were 90% effective after two shots. Separate research on the one-shot Johnson & Johnson vaccine found it was about 66% effective at preventing moderate to severe COVID-19 and about 85% effective against the most serious illness.
No vaccine is perfect, and that’s true of these three. In Illinois as of Wednesday, 581 fully vaccinated people had tested positive for the virus more than two weeks after their last dose, resulting in 21 hospitalizations and 12 deaths, according to the state health department.
While tragic, the fatalities statistically are rare, compared with the 2.5 million people fully vaccinated in the state.
The problem isn’t with the vaccine, epidemiologists have said; it’s that not enough vaccine has been distributed. Scientists still aren’t sure exactly how many people would need to get vaccinated for the country to reach so-called herd immunity. But the state has estimated Illinois would reach it after 75% to 85% of Illinoisans had been vaccinated.
And that’s based on people reaching full immunity, which is two weeks after the last shot. For now, the state is nowhere near that.
As of Friday, just 16% of the state’s population was two weeks beyond the last shot — and just 13% of Chicagoans.
Also helping build immunity are the natural antibodies left in people who have recovered from infections, particularly within the past six months. This type of immunity is not considered as robust, nor as long-lasting, as that obtained through vaccinations, but it does help limit the virus’s spread.
A University of Chicago model estimates that about 37% of Chicagoans have some natural immunity, and that would be especially common in areas previously hard-hit by the virus.
Still, even when combining the vaccinations and natural immunity, epidemiologists say it’s not enough to extinguish the pandemic.
There are still plenty of people the virus can infect.
A new COVID fatigue
Beyond what’s going on in immune systems, health officials suspect another factor behind the surprising surges in low-vulnerability areas is what’s going on in people’s minds.
Arwady said she thinks people are now hearing about friends and family getting vaccinated — particularly those older or considered more at risk for the virus’s worst effects — and concluding the danger is past.
“I love the vaccine confidence,” Arwady said. “But we are not there yet.”
The situation is not lost on Ron Cardoza, whose River North neighborhood sits in a ZIP code with among the highest rates of vaccinations and new cases: 60654.
When asked Tuesday why he thought his area was seeing the spike, he snorted under his two face masks and said, “Here’s an example right now.” Cardoza was referring to a man walking past him on West Hubbard Street with his mask tucked below his chin.
It’s a common sight that Cardoza, 61, estimates he spots 30% to 40% of pedestrians in River North, although he isn’t sure how many of them are visiting from outside the neighborhood.
“A lot of people have decided they’re not going to wear a mask. They don’t keep social distancing,” Cardoza said. “People, I think, are fed up. They’re just fed up with COVID, and they think it’s over. And it’s not over.”
While standing on North State Street between Ontario and Ohio, a Tribune reporter counted more than a dozen unmasked people walking past in under five minutes. (The CDC has recommended mask-wearing in public even for vaccinated people, and Illinois’ mask mandate remains in place.)
Some pedestrians had their face covering hanging off an ear, while others did not have a mask anywhere in sight. Many groups traveling together were not consistent in wearing one. And customers of a coffee shop walked outside with their masks draped around their chins, even though indoor dining rules require a face covering except when eating or drinking.
Over in Lakeview, another more vaccinated but spiking neighborhood, Jennifer Moy, 33, said she has gotten vaccinated but remains wary of taking her mask off in public.
Moy works in River North and said she’s seen thicker crowds over the past few weeks in both neighborhoods, and more and more people opting for a naked face.
“A lot more people seem more comfortable; they’re not wearing masks as much,” Moy said. “I walk my dog at like 6:30 in the morning and definitely noticed way more people not wearing masks.”
For now, public health officials say they’re not ready to impose harsher restrictions, but they continue to preach that people wear masks and socially distance themselves. They’re hoping increased attention to an emerging third surge will inspire more caution.
It already has for Davenport.
“I’m ready to just stay back in the house again just because of this,” said Davenport, 44. “I want to be out and be social, but I’m too scared of those numbers right now.”