Austin physicians today face the real possibility of triage—deciding who receives care based on need or likely benefit—as the COVID pandemic threatens to overrun hospitals and spill into the convention center.
"Once our hospitals are overwhelmed, the best possible care can no longer be provided to each patient," Travis County Medical Society President Dr. John Abikhaled said in a video release this week. "Terrible decisions will have to be made about who receives care, and who does not."
COVID-19 Urgent Message for our Community youtu.be
Hospitals have triage policies in place, but the hope is they won't have to use them, Texas Medical Association President Dr. Diana Fite told Austonia.
"We are not at that point yet with COVID-19," she said.
But Austin officials worry that it may be close. Austin-Travis County Interim Health Authority Dr. Mark Escott recently tweeted, "Please help avoid the need for other doctors and I having to make a choice on who gets life saving care ... We are 2-3 weeks away from those kinds of decisions."
In the aftermath of the 2009 H1N1 pandemic, the National Academy of Medicine was tasked with developing guidelines for pandemic ethics. Each state then developed its own recommendations for how to allocate vaccines, supplies, ventilators and other resources.
These recommendations, along with guidance from industry associations, helped hospitals develop their own pandemic protocols, Dr. Fite said.
Dr. Diana Fite, Texas Medical Association president and Houston ER physician
Hospital ethics typically revolve around end-of-life decisions—when to stop treatment for a patient who is no longer benefiting from it. But in the case of a pandemic, the focus is on the scarcity of resources—how to choose which patients get treated when demand outpaces supply.
"Public health ethics do differ from, sort of, everyday clinical ethics because there's an idea that we're trying to save the great number of people from a disease," said Dr. Devan Stahl, an assistant professor of religion at Baylor University, where she teaches bioethics and medical humanities.
Dr. Devan Stahl, assistant professor of religion at Baylor University
The best pandemic ethics policies have a few hallmarks, Dr. Stahl said:
- Triage decisions should be made by an independent team, rather than the treating physician.
- They should focus on the patient's likelihood of surviving the hospital stay rather than quality-of-life judgments, which are more subjective.
- And they should avoid deprioritizing care for entire groups—such as patients over a certain age, as happened in Italy, or for patients with disabilities, who are protected under federal civil rights law.
"Those kinds of policies, I think, are blatantly discriminatory," Dr. Stahl said.
The case for transparency
Hospitals are often reluctant to share their ethics policies with the public—for fear of backlash or misinterpretation.
Austonia reached out to the three major hospital systems—Ascension Seton, Baylor Scott & White Health and St. David's HealthCare—to learn more about their policies, but none were made available.
However, BSW provided a statement explaining that patients are informed, upon admission, of their right to access information about the hospital's ethics policies.
So far, the hospital system has "not seen a major change in the number or types of issues coming to our clinical ethics committees as a result of the pandemic," the statement says.
Dr. Stahl said that even though hospitals tend to guard the details of their policies around allocation of care, she favors transparency. "Unlike other hospital policies, this is a public health concern," she said.
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A $500 million mixed-use development spanning 1,400 acres is coming to Southeast Austin, near Tesla’s headquarters at Giga Texas.
Plans for the development by Houston-based real estate firm Hines include 2,500 houses along with multi-family and townhomes, and commercial land. Hines is partnering with Trez Capital, Sumitomo Forestry and Texas-based Caravel Ventures.
The development, which is known as Mirador, will be located off the 130 Toll and Highway 71, which the developers say provides easy access to the Circuit of the Americas Formula 1 racetrack and other Austin attractions like restaurants, parks and live music venues.
Hines also boasts amenities like a 60-acre lake, over 600 acres of greenbelt, community parks, trails and a swimming pool.
“As Austin continues to grow into the tech epicenter of Texas, coupled with a supply-constrained market, the demand for new housing is at its highest,” Dustin Davidson, managing director at Hines, said. “Mirador will be critical in providing more options for Austin’s growing population and we are excited to work alongside our partners given they each provide a unique and valued perspective in single-family development.”
The local housing market has been hot in recent years, with home sales accelerating earlier in the pandemic. In July 2021, the Austin metro area hit its pricing peak at $478,000. As Austonia previously reported, the area has been expected to see the Tesla effect, with the new workforce driving up demand for housing and other services.
The single-family houses are expected to be developed over the course of six years, in phases. Construction on the homes is expected to start this year and home sales will begin in 2023.
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Editor's note: This story summarizes Sports Illustrated's story detailing Michael Center's involvement in the Varsity Blues college admissions scandal, based on interviews with SI's Jon Wertheim. Additionally, Austonia received comments from Michael Center, included in this story.
Confined to his couch, former Longhorns tennis coach Michael Center praised his players via FaceTime after the program he built produced the Longhorns’ first national championship in 2019—a bittersweet moment as Center faced federal charges as part of the Varsity Blues college admissions scandal.
His name dragged through the mud, Center was fired, arrested by the FBI and sentenced to six months in a Central Texas federal prison after pleading guilty to two charges related to mail fraud. And over a year after his release, Center told Sports Illustrated he doubts he was the only one in burnt orange involved.
When the Varsity Blues scandal broke out to the public in 2019, the investigation was a perfect storm for nationwide attention: Hollywood glamour, blue blood conspiracy and faith in the tried-and-true American education system came to a head as 33 movie stars and other elites were found guilty of paying more than $25 million to pave their children’s way into eight colleges, including the University of Texas.
UT was one of eight schools caught in the college admissions scandal. (Laura Figi/Austonia)
The figure behind Varsity Blues, “college consultant” Rick Singer, would plead guilty to four felony counts for faking SAT scores and bribing coaches at prominent universities for his elite clients—but not before throwing Center under the bus.
Singer's client, private equity executive Chris Schaepe, was looking for a way to bend UT's tight admissions policies for his son, who was seeking a position oddly as a manager on UT’s basketball team. Through a middleman, Singer contacted Center, who eventually agreed.
Schaepe's son hadn't played tennis since his freshman year of high school. It was a detail that Center says passed through plenty of hands before he was admitted, including "academic support staff, the compliance office, the sports supervisor and, ultimately, the athletic director," SI's Jon Wertheim writes.
No one in the entire athletic department, including seven "risk management and compliant services department" employees, was named, implicated or punished. After an internal investigation, Center was the only one named in the Varsity Blues "subterfuge" in a September 2019 UT news release signed by the university president.
He told Austonia he was never contacted by the university during the investigation, and when the NCAA interviewed him for its investigation, he says it cleared him of any violations.
“I almost fell out of my chair,” Center said. “I literally couldn’t breathe. There’s no college coach in America—much less at a state school, much less a coach of a nonrevenue sport—who can admit an athlete without consulting other people in the athletic department. What they were asking people to believe, it’s just impossible.” SI said Center's assertion was backed by multiple UT coaches and administrators at other schools.But why would the Forty Acres be complicit?
Center said UT’s then newly named athletic director Steve Patterson made clear that Center suddenly was responsible for more than building a successful tennis program. He was to be a "fundraiser first and coach second" and he would need to find donors to fund a new tennis facility. Patterson admitted to SI that he wanted his coaches to find donors and said the department was "$15 million in the red" when he started in 2013, though he denies any knowledge of the false tennis recruitment.
Center said he knew he would be "considered a team player" if he let in the son of a Silicon Valley magnate. And sure enough, Schaepe immediately began pulling out his wallet, donating $100,000 to UT tennis and a six-figure check to the school's communication program.
"I never entered this as a way to profit. This was a fundraising mission where I made a terrible mistake at the end,"
Months after Schaepe's son was admitted, Center agreed to meet Singer at the Austin airport and found himself accepting a backpack filled with $60,000 in cash meant for him, personally. He said he immediately knew he had made a mistake. He told SI “I put the money in my basement and gave most of it away.”
“Why did I do it?” Center told Sports Illustrated. "I go to bed and wake up each day asking myself the same question. I had to convince myself that I somehow deserved the money."
Once in court, Center showed texts with UT's compliance official and mentioned Chris Plonsky, a department executive involved in "overseeing men’s tennis, compliance, academic support (which generates letters of intent) and the Longhorn Foundation," according to SI.
“I knew I had to answer for my guilt,” Center said. “But I was like, 'Man, schools are going to get hammered.'"'
INMATE 77806-112 but out on Sunday: Actor Felicity Huffman in prison uniform outside low-security Federal Correctional Institution in Dublin to visit actor husband William H. Macy & their daughter. Huffman admitted to paying $15K to have fixer boost daughter’s SAT score. 📸: @TMZ pic.twitter.com/9jALmqnA0U
— Henry K. Lee (@henrykleeKTVU) October 21, 2019
But Center was the only Longhorn to go down for the crimes. “I was no rogue actor,” Center said. “And this wasn’t my word against their word. There were signatures that went along with it. That’s the system... There wasn’t one point in the process where I thought people wanted to learn the whole truth.”
Back at home in Austin, Center watched as actress Felicity Huffman served just eleven days for her part in the scandal. Some served up to five months; others simply paid a fine, and others, like Singer, await sentencing.
And because the prosecution chose to blame individual coaches, framing schools as victims in the case, universities like UT have received less than a slap on the wrist for their possible involvement.
“I was always taught that actions have consequences,” Center said. “What I’ve come to realize is that, yes, for some people actions absolutely do have consequences. Serious, heavy ones. For others, actions can have no consequences at all.”
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