Beginning Jan. 3, anyone age 5 and older looking to dine, drink, work out or gather indoors in large groups in suburban Cook County must first show proof that they are fully vaccinated against COVID-19, per a new order issued by the Cook County Department of Public Health (CCDPH) Thursday morning.

The order goes into effect the same day as a nearly identical order covering the city of Chicago. Four suburban Cook County townships with their own health departments — including Oak Park — are not impacted by the CCDPH order. Oak Park, however, indicated on Wednesday that it was likely to follow suit if the CCDPH took this action.

The new order comes amid a dramatic increase in newly detected COVID-19 cases believed to be related to the arrival of the omicron variant, which has caused what CCDPH Co-Lead and Senior Medical Officer Dr. Kiran Joshi called “a surge on top of a surge” that began with the arrival of the delta variant earlier this year and never fully receded. A staggering increase in infections in the last week includes 3,236 new cases reported by the CCDPH on Dec. 21, the highest single-day total since the start of the pandemic.

“These numbers are beginning to mirror what we were seeing a year ago,” Joshi said, referencing what had been the virus’ peak of prevalence in November and December 2020. “We really are in the midst of a surge that compares to that last winter surge.”

LINK: COVID-19 data from Cook County Department of Public Health

The rolling seven-day average for new cases recorded by the CCPDH was 2,179 as of Dec. 22, just off last winter’s peak of 2,228 on Nov. 11, 2020, and the county actually recorded a pandemic-high average by that metric on Dec. 18 of this year (2,290). Joshi also said there was concern about how the surge in cases could impact hospital capacity, and a CCDPH press release said as of Dec. 23, just 10.8% of Intensive Care Unit (ICU) beds were available.

A graph tracking new confirmed cases of COVID-19 in suburban Cook County as of Dec. 22, 2021. Cook County Department of Public Health

Vaccinated individuals, however, continue to enjoy robust protection against all variants of the virus. Omicron now represents more than 73% of new cases nationwide, according to the Centers for Disease Control and Prevention (CDC), but there is no evidence that vaccinated individuals are any more susceptible to serious health complications caused by the new variant. CDC data continues to show that, overall, vaccinated individuals are five times less likely to become seriously ill due to COVID-19 and 14 times less likely to die

All three of the approved COVID-19 vaccines are widely available through pharmacies and medical providers in Cook County, and the vaccine is available free to anyone who wants one throughout the United States. All individuals age 5 and older are currently eligible for the vaccine.

The new mitigation measures, which were announced by Cook County Board President Toni Preckwinkle and the CCDPH’s two lead officials at a press conference, Joshi and Dr. Rachel Rubin, apply to “customers of indoor settings where food or drink are served for on-premises consumption, like restaurants, bars, and entertainment venues, and in fitness facilities.”

Rubin read off a litany of locations where proof of full vaccination rules will apply, but in general the rule applies to any indoor space where people would be unmasked for anything other than a very brief period of time.

A person is fully vaccinated, as defined by the CDC, when they are at least two weeks beyond the date they received the second dose of the Pfizer-BioNTech or Moderna vaccines, or one dose of the Johnson & Johnson vaccine. Full vaccination does not include a booster shot as of Dec. 23, but Rubin said that if CDC guidance changes to require a booster, the local measure would change as well.

There are some facility exceptions to the new rule, including houses of worship, schools (which set their own mitigation policies) and charitable locations like soup kitchens. Carry-out and delivery dining establishments are also not included in the new measure.

The rule will take effect Jan. 3 to allow businesses time to organize their enforcement efforts. Employees of those establishments should also be vaccinated, according to the CCDPH, but any employee who is unvaccinated can continue to work provided they show proof of a negative COVID-19 test on at least a weekly basis.

And while the order does not take effect until after the Christmas and New Year’s holidays, Joshi said businesses could put their own rules in place sooner and “we encourage businesses to do that.”

“We are definitely encouraging businesses to reconsider large New Year’s Eve and other events during the holiday season,” Rubin added. “We do not encourage large gatherings over the holidays, especially with unvaccinated individuals.”

In order to comply with the new rule, customers do not necessarily need to show their physical CDC COVID-19 vaccine card. Digital photos of the card, a copy of another immunization record or an app that shows proof of vaccination are all acceptable. All forms of proof of the vaccine must be accompanied by a second form of identification, however, to verify the person’s identity.

Businesses, for their part, must post signage at every entrance informing customers of the policy. Those businesses are also mandated to create a written policy for how they will enforce the new rules.

The CCDPH will enforce the new policy using its on-staff health inspectors, called sanitarians, for routine compliance checks, and by responding to complaints. As the CCDPH is doing to enforce the statewide mask mandate, Rubin said businesses would first be contacted directly and given guidance on how to comply, but that information on repeat offenders would be shared with the state attorney’s office.

Asked if she was concerned that businesses would be reluctant to comply with the new measures, Preckwinkle said it was in everyone’s best interest to do their part to push through the latest surge in cases.

“We’re in the midst of a healthcare crisis and everyone has to row,” she said, adding that the county did not want to force businesses to close temporarily, as it had during pre-vaccine spikes.

“We hope that people will comply,” she added later. “It’s in their interest, it’s in the interest of their customers … I’m hopeful that the overwhelming majority of those businesses that are in these categories will comply.”