While Austin residents have successfully slowed the COVID-19 caseload doubling rate, clusters are growing at long-term care facilities and among those who have returned to work. Testing also remains inadequate, Dr. Mark Escott told Austin City Council at a Tuesday morning work session.

The local doubling rate—or the time it takes for the COVID-19 caseload to double—is more than 19 days, nearly twice what it was a month ago, said Dr. Escott, Austin-Travis County interim health authority. "This is not the result of luck," he added, attributing the slowdown to community efforts to flatten the curve and urging residents to continue to stay home and practice social distancing.

But the number of confirmed cases continues to grow—if more slowly.

Austin Public Health is tracking clusters of COVID-19 cases at 15 long-term care facilities, such as nursing homes and homeless shelters, where 335 cases have been confirmed and 30 people have died. One nursing home, which remains unnamed, has 95 confirmed cases—23 staff and 72 residents—of which 16 have resulted in death.

City staff are also focused on containing the spread of COVID-19 among the city's homeless population. The city leased three hotels to serve as isolation and protective lodging facilities as part of its surge plan, and APH Director Stephanie Hayden told council this morning they are being used to isolate people without housing. All three are at capacity. The Salvation Army's downtown shelter closed last month due to an outbreak of the coronavirus, but reopens today.

New cases are also emerging among workers who cannot stay home, such as those in the healthcare, construction and grocery industries. "The people who are getting sick right now are generally the people who are working right now," Dr. Escott told council members.

Testing remains limited, although the city's new public enrollment system has helped connect hundreds of residents to testing. Since it launched in late April, 4,500 residents have signed up for testing and around 1,900 have been scheduled. Of those, 735 have already been tested, with 16 receiving positive results—a rate of 2.18%, which is much lower than previously recorded, Dr. Escott said.

Additionally, Dr. Escott said the city is working to increase access, with a goal of 2,000 tests a day. He could not provide a timeline for when this may be achieved but mentioned the city is working with the University of Texas to offer more widespread antibody testing and with testing companies to increase capacity, such as by using 3-D printers to manufacture swabs.

"We hope that the situation will continue to improve," Dr. Escott said. "But again we're not where we need to be."