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Why Austin officials are worried about COVID-19 hospitalizations even though we're in 'good shape' now

Austin officials had their third press conference in six days on Monday to discuss concerning trends in COVID-19 caseloads and hospitalizations.
While current hospital capacity is in "good shape," Austin-Travis County Interim Health Authority Dr. Mark Escott said, he is concerned that that data points to a coming surge.
Although local jurisdictions are unable to enforce masking or interfere with the state's reopening plan, Austin Mayor Steve Adler and former Travis County Judge Sarah Eckhardt pleaded with residents to recommit to wearing masks and social distancing while in public to slow the spread of the virus, which they said is picking up speed.
The city also updated its local Stay Home-Work Safe order to "strongly encourage" businesses to operate at 25% capacity or less.
Austin Public Health also advanced the local threat level on Monday from stage 3 to stage 4, according to the five-stage system its staff developed with the COVID-19 Modeling Consortium at the University of Texas. At this stage, it recommends residents limit social interactions to groups of 10 or fewer and avoid unnecessary trips.
Below, we answer some questions about how we got here, why officials are worried and what the future holds.
Mayor Steve Adler, former Travis Co. Judge Sarah Eckhardt and Austin-Travis County Interim Health Authority Dr. Mar… https://t.co/MW6ZXzDmAx— Emma Freer (@Emma Freer) 1592249751.0
Why were we upgraded to the next stage of COVID-19 risk?
The trigger for the upgrade was that the county hit a rolling 7-day average of at least 20 new hospital admissions daily on Sunday.
While Dr. Escott said at the press conference that there is currently plenty of hospital capacity in the five-county region, he added that an increase in daily hospitalizations indicates an alarming trend.
Why are local officials so focused on this rolling average of new hospital admissions?
With the help of the UT consortium, local health authorities and elected officials arrived at what they have called a trigger point. Once daily new hospital admissions exceed 20, on average, the region either needs to pull back on reopening or prepare for a surge.
"Epidemics don't grow in a gradual way," consortium director Dr. Lauren Ancel Meyers told Austonia last week. "What happens is they look really flat and then suddenly they bend upwards and they become very alarming very quickly."
We've heard about a coming surge for months. But right now there are 129 COVID-19 patients hospitalized and a regional capacity of 4,300 beds. This seems like plenty, even if caseloads are increasing, right?
The 4,300-bed total is the maximum capacity provided under APH's surge plan and includes interventions such as field hospitals. The number of staffed hospital beds in the region is lower: 3,356, according to the state department of health.
Most of these beds are currently occupied by non-COVID patients, such as those being treated for cancer, recovering from heart attacks and dealing with injuries. The current occupancy rate is 70%, Dr. Escott said at the press conference.
So the total number of available hospital beds is 842, per the state data. ICU capacity is 115 beds, and there are 389 ventilators available.
This may seem like a comfortable surplus; at 20 new hospitalizations a day, on average, it would take around 42 days to fill up those available beds, assuming no one was discharged. But local officials stressed that, as the virus spreads, it will do so at an exponential rate—not an incremental one.
"Our hospitals are in good shape right now," Dr. Escott said, urging residents in need of health care not to avoid or postpone seeking it. The concern is in three to five weeks, if this trends continues, he said.
You wrote about increased testing recently. Shouldn't we expect an increase in the number of confirmed cases to follow?
Earlier this month, APH expanded access to its free testing service to asymptomatic residents following mass protests against police brutality. Thousands of residents took advantage.
But local health authorities say there is other evidence—such as increased hospitalizations and a rising positive rate among those who are tested—that the virus is gaining speed.
Hospitalizations are "the most reliable, though slightly delayed, indicator of the changing rate of spread," according to a May 18 report by researchers at the COVID-19 Modeling Consortium at the University of Texas at Austin.
Dr. Escott also raised concern about the increasing rate of positive COVID-19 test results. During a press conference last week, he said the local positive rate had recently jumped from around 5% to 9.3%.
"Once we enter this trajectory, it's very difficult to get out," he said.
The county's COVID-19 dashboard charts hospitalization data. Recently, there has been an uptick.
(Travis County COVID-19 Public Dashboard)
What can local officials do to slow this surge?
Texas Gov. Greg Abbott has prevented municipalities from instituting stay-home orders in conflict with the state's rules or mandating public masking. As a result, city and county governments are legally only able to make recommendations for how residents might respond.
To this end, the city of Austin amended its Stay Home-Work Safe order to strongly encourage—"because we can't mandate it," Adler said Monday—that reopened businesses operate at a minimal indoor capacity and provide services remotely, as much as possible, such as through curbside delivery.
And local officials have repeatedly stressed the need for residents to adapt their behavior—wearing masks and social distancing, chief among them—voluntarily.
"The best that we can provide as government officials is the best information," former Eckhardt said at the Monday press conference, "so that we can all make the best individual choices."
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Popular
(Bob Daemmrich)
Embattled incumbent Attorney General Ken Paxton beat out Land Commissioner George P. Bush on Tuesday in the Republican primary runoff as Texas GOP voters picked a beleaguered candidate with legal and personal scandals over the last remaining Bush to serve in public office. Decision Desk called the race early for Paxton, about 40 minutes after polls closed.
Paxton has faced a securities fraud indictment for seven years. More recently, the FBI began investigating him for abuse of office after eight of his former top deputies accused him of bribery. He also reportedly had an extramarital affair. Paxton denies all wrongdoing.
Bush, who has served for seven years as the state’s land commissioner, campaigned on restoring integrity to the attorney general’s office and hit Paxton for his legal and ethical troubles. He also criticized Paxton’s legal acumen, saying some of his lawsuits were frivolous, including one that he filed to overturn the 2020 results in four battleground states where former President Donald Trump lost.
But none of Bush’s attacks gained traction with socially conservative voters in the runoff, who said they preferred Paxton’s combative style to Bush’s more civil and polished approach. Voters cited Paxton’s frequent lawsuits against the Biden administration on immigration and COVID-19 policies, as well as his efforts on hot-button social issues like abortion and LGBTQ rights.
While Bush had supporters who embraced his vision of a more diverse Republican Party that welcomed people of different viewpoints, a majority of voters tied him to his family’s center-right, pro-business politics. That approach is not conservative enough for today’s Texas GOP, which has largely turned against establishment candidates. His opponents rallied around a call to “end the Bush dynasty” and lambasted Bush for his rightward shift during the campaign.
In the lead-up to the runoff, Bush said he supported state investigations into families that provided gender-affirming health care to transgender children, and he made border security a priority issue.
Paxton hit Bush for his change of tone, resurfacing 2014 comments from Bush in which he expressed support for the Texas Dream Act, a 2001 law that allows undocumented immigrants to receive in-state tuition at public universities. Bush now says he supports the Republican Party of Texas’ platform to repeal the law.
The race was also noteworthy for its negative campaigning. Paxton’s camp created an attack website titled GeorgePBushFacts.com that denounced him as a “RINO establishment darling who has sold out Texas” and hit him for his office’s management of Hurricane Harvey relief funds and its handling of the redevelopment of the Alamo.
Bush struck back with KenTheCrook.com, which proclaimed “it’s time to fire Ken Paxton” and detailed several legal and ethical issues that have plagued Paxton, including the FBI investigation, his securities fraud case and his reported extramarital affair.
But none of the attacks stuck to Paxton, who continued campaigning with socially conservative groups while avoiding head-to-head encounters with Bush where he could expose himself to attack.
Bush, who had challenged Paxton to five debates in the runoff and pledged to take the battle to the incumbent, was frustrated in his attempts to draw out Paxton. He also received no help from the two defeated candidates in the Republican primary, former Texas Supreme Court Justice Eva Guzman and U.S. Rep. Louie Gohmert, R-Tyler, who refused to endorse in the race.
Things got worse for Bush as a slew of GOP officeholders, including Lt. Gov. Dan Patrick, released their endorsements of Paxton. Bush had been fighting an uphill battle since last year, when Trump rebuffed his request for an endorsement and instead sided with Paxton.
Paxton never took his foot off the pedal, continuing to file immigration lawsuits against the Biden administration and wading into legal battles over LGBTQ rights during the campaign. He frequently went on cable news shows to attack the Biden administration’s policies and lumped in Bush as the state’s “liberal land commissioner” with a “woke” agenda.
Paxton also fought back against those who questioned his ethics or legal acumen. When the state bar announced it was investigating a complaint against him for professional misconduct, Paxton called it a political attack and denounced the members of the disciplinary committee looking into the complaint as “leftist” Democratic sympathizers.
As the runoff election neared, polls showed Paxton with a strong lead over Bush. One poll found that 40% of Republican primary voters said they would never vote for Bush.
Paxton closed out the campaign confidently, attending packed meetings of conservative voters. Bush released a late flurry of negative attack ads against Paxton but did not gain the boost he needed.
Last week, Bush’s camp told reporters it would not have media availability on Election Day, a clear sign it did not expect a positive outcome. Paxton’s team, meanwhile, planned an election day watch party just north of Austin.
Paxton will face the winner of the Democratic runoff – either Brownsville lawyer Rochelle Garza or former Galveston Mayor Joe Jaworksi – in the November general election, where the odds are in his favor, as no Democrat has won a statewide seat in Texas since 1994.
(Uvalde ISD)
Nineteen kids and two adults are dead after a shooting at Robb Elementary School in Uvalde, Texas—a small town an hour and a half west of San Antonio—on Tuesday afternoon.
Abbott said the suspect, 8-year-old Salvador Ramos, is believed to have been killed by the police. The Uvalde Police Department said the shooting began at 11:43 a.m. Tuesday.
“What happened in Uvalde is a horrific tragedy that cannot be tolerated in the state of Texas,” Abbott said. “He shot and killed—horrifically, incomprehensibly.”
Texans are grieving for the victims of this senseless crime & for the community of Uvalde.
Cecilia & I mourn this horrific loss & urge all Texans to come together.
I've instructed @TxDPS & Texas Rangers to work with local law enforcement to fully investigate this crime. pic.twitter.com/Yjwi8tDT1v
— Greg Abbott (@GregAbbott_TX) May 24, 2022
According to University Health Hospital officials, a 66-year-old woman and 10-year-old girl arrived in critical condition. Uvalde Memorial Hospital reportedly received 13 children for treatment and two individuals who were already deceased. At the time, it was believed 14 had died in this shooting.
The shooter prompted a lockdown at the elementary school of just under 550 students, with San Antonio Police sending SWAT, and Eagle chopper and Crime Scene Investigators.
According to White House press secretary Karine Jean-Pierre, President Joe Biden has been briefed on the tragedy and “His prayers are with the families impacted by this awful event, and he will speak this evening when he arrives back at the White House.”
At 19 deaths, it is the deadliest school shooting in Texas and one of the deadliest in the U.S. since 26 at Sandy Hook Elementary lost their lives. This is the U.S.'s 213th mass shooting of 2022.