New procedures and protocols

In the past few months, Austin's major hospital networks—Ascension Seton, Baylor Scott & White Health and St. David's HealthCare—have had time to stock up on personal protective equipment, implement protocols that reduce risk of exposure and finesse treatment.

Emergency departments have implemented universal masking, visitor restrictions, mandatory temperature checks and more regular cleaning, Dr. Jeffrey said. "We've had a lot of time to think about these protocols and put them in practice," he added.

At St. David's South Austin Medical Center, staff have spaced out the chairs in its waiting rooms, transitioned to a wireless keyboard for patient check-in, switched to disposable blood pressure cuffs and cohorted patients suspected to have COVID-19 away from those who are seeking care for other reasons.

"We feel very, very comfortable that we're prepared to care for patients as they present," Chief Medical Officer Dr. DeVry Anderson said. "And really care not just for COVID patients but for all patients that are presenting with both routine and emergent conditions."

Lower mortality for patients

Another positive development is that treatment for COVID-19 patients is improving, as evidenced by a lower mortality rate—now down to 1.7%, from 3.6% in early June—despite increasing hospitalizations.

Dr. Anderson attributed this shift to a number of factors, including convalescent plasma therapy, access to the antiviral drug remdesivir and more familiarity with how the disease progresses."Having physicians and staff that have gotten, not comfortable, but now understand how to treat and care for these patients, I think it's seamless in the way we transition those [patients] to higher levels of care," he said.

Ventilator management is also better, with patients who may have been put on a ventilator before now being treated with high-flow oxygen and simple position changes—laying on their side instead of their back—to positive effect. "This is where it's nice to not be the first group going through [this]," Dr. Jeffrey said.

​Higher exposure for health care workers

But challenges remain, including the continued rationing of PPE, making sure patients don't avoid the ER for fear of the coronavirus and staffing concerns should area hospitals reach capacity.

"I think that's where we would see a situation like we did in New York and in Michigan, where we're going to be getting nurses from other states to come in and help us out," said Serena Bumpus, director of practice for the Texas Nurses Association.

There is also the question of whether doctors and nurses will get COVID-19 themselves—especially considering their increased exposure to sick patients—and further strain staffing levels.

But Bumpus said the danger may not be where people expect: "Our health care workers, with the amount of PPE that they do have access to and that they're wearing inside the hospital, they actually might be more protected than they are out in the general community because the community is not masking fully and maintaining social distancing and washing their hands."