SPRINGFIELD – Masks will be required at all Illinois long-term care facilities, day cares and Pre-K-12 schools, Gov. J.B. Pritzker announced Wednesday amid a nationwide surge of COVID-19.

“Every time we think we know where this virus is headed, it changes and it shifts,” Pritzker said at a COVID-19 briefing in Chicago. “For example, unlike before, people 29 years old and younger accounted for 12% of hospitalizations. All across the nation, we are seeing young people with no underlying conditions now on ventilators. I want to say specifically to young adults: Please do not think that the worst case scenario can’t happen to you. It can happen. It is happening. Get vaccinated.”

Illinois Department of Public Health Director Dr. Ngozi Ezike said youth hospitalizations and infections have been rising.

About 5.5% of COVID-19 cases were among those who are younger than 10 years of age in January, Ezike said, but that number increased to 15% last month. Approximately 13% of cases in January were among those 10-19 years old, increasing to 23% in July. Hospitalizations for those 20 years old and younger have tripled from 2.5% to 7.8% in that time span.

“And yes, while most children who get COVID have fewer symptoms than adults, they absolutely can still get COVID-19 and they can absolutely spread it to others,” Ezike said, noting many cases of the virus have spread at youth camps this summer.

The masking requirement extends to indoor but not outdoor activities and sports.

While Pritzker said masks are important in schools, especially for students who are not yet eligible for the vaccine, the best approach to limiting the spread of COVID-19 is getting vaccinated. It’s also the best way to limit severe illness and death.

In Illinois, 6.5 million people are fully vaccinated, or 51.2% of the population, while 73% of the population that is older than 12 years of age has received at least one dose of the vaccine. The state averaged 28,180 vaccine doses administered each day over the past seven days.

Of the millions of fully vaccinated individuals, just 714 have spent time in the hospital with COVID-19, according to IDPH. Since January, 180 vaccinated individuals have died of COVID-19 symptoms, accounting for just 2.58% of the COVID-19-related deaths this calendar year. That number increased by 11 from the state’s reporting of the numbers last week.

That’s about 0.01% of vaccinated individuals who have been hospitalized for the virus and 0.003% who have died of complications.

“The overwhelming majority of cases, the hospitalizations, the deaths are among those who are not vaccinated,” Ezike said. “And the majority of transmission is also among the unvaccinated. …But the key is that we actually have the tools to turn the tide on the next wave. And that next wave wants to threaten us if we don’t avail ourselves of these tools.”

Pritzker said there are two routes to enforcing the mask mandate, including civil liability for schools not enforcing the mandate and the removal of recognition status by the Illinois State Board of Education.

IDPH also announced Wednesday it is making free COVID-19 testing available to K-12 schools across the state through the SHIELD Illinois saliva-based test developed by the University of Illinois Urbana-Champaign. The test can detect the virus and its variants in those with or without symptoms.

The testing would allow close contacts of a COVID-19-positivie individual to stay in the classroom as long as they test negative. Funding comes from federal COVID-19 relief packages.

By Oct. 4, all Illinois state employees working in congregate facilities will be required to receive the COVID-19 vaccine.

The order covers certain employees at the Departments of Human Services, Veterans’ Affairs, Corrections and Juvenile Justice working in congregate facilities, and Pritzker said the state has reached out to the unions representing those employees to work out the details.

Illinois is also requiring universal masking in private long-term care facilities and “strongly encourages owners of private facilities to join the state in adopting vaccination requirements,” according to the governor’s office.

Pritzker’s announcement came as 1,165 people were hospitalized for COVID-19, including 246 in intensive care unit beds and 94 on ventilators as of Tuesday night

The state’s seven-day average case positivity rate for COVID-19 was 4.4% as of Wednesday, while the state reported another 18 deaths, a high since June 24. That brought the death toll to 23,476 since the pandemic began with another 2,428 deaths reported with probable links to COVID-19.

Pritzker said the state is “evaluating every day” the trajectory of the virus and other potential mitigations that may be needed.