Austin-Travis County Interim Health Authority Dr. Mark Escott has issued new control measures in an attempt to contain the spread of COVID-19 at nursing homes, assisting living and other long-term care facilities.

The city is tracking clusters at eight such facilities, across which 96 residents and 67 staff have tested positive for the disease. Fifteen residents and at least one staff member have died, Dr. Escott said during a press conference earlier today. These clusters account for nearly 60% of the county's overall deaths, and one facility has more than 35 residents who have tested positive for COVID-19.

"This is very concerning for us," Dr. Escott said at a press conference earlier today. "We have to do better."

The control measures, issued yesterday, require facilities to check all employees, patients, visitors and volunteers for symptoms and high temperatures prior to entry and check patients at least once a shift. Any unexplained fever must be reported to Austin Public Health, and in the case of a confirmed diagnosis of COVID-19, the facility must notify all patients, staff and next of kin.

If a facility develops a cluster—two or more cases among staff and patients—the city is working with the state to deploy a strike team of additional personnel and equipment to help contain the outbreak.

Dr. Escott said that there has been "a constant struggle with staffing" at long-term care facilities, an issue that is exacerbated by the coronavirus pandemic.

"That imbalance"—between sick residents in need of more care and staff shortages—"is only contributing to the furthering of the spread of this disease in these facilities," Dr. Escott said, adding that the city's priority is to respond quickly after the first cases are reported by a facility and, ideally, to help facilities without cases maintain that status.

On April 9, Texas Gov. Greg Abbott announced an emergency rule to temporarily allow more nurse aides to work at long-term care facilities temporarily, even if they haven't completed the full certification program.

Dr. Escott said he doesn't know if this rule has had an impact on staffing at area facilities but that he expects it to moving forward.

The city has not released the names of long-term care facilities that are seeing clusters, but it has identified clusters in other settings, including at the Salvation Army's downtown shelter and among a group of University of Texas-Austin students who traveled to Cabo San Lucas during their spring break.

"Privacy considerations are important," Dr. Escott said.

At an Austin City Council work session yesterday, Dr. Escott said residents will need to observe social distancing and wear masks when in public for at least a year. At today's press conference, he added that these measures will be necessary until herd immunity is achieved, such as by the introduction of a vaccine, and will be especially important for populations at higher risk of complications, such as those over 65 and with other medical conditions.

"If we can effectively cocoon people and prevent those who have a higher risk of being hospitalized or of needing a ventilator or dying then we can have more transmission in the community without as much effect on the health care system," he said, introducing a new term into our pandemic glossary.

These control measures follow the city's announcement last month that it had convened a nursing home task force that has set up isolation facilities to house nursing home residents who have tested positive for COVID-19, but do not require hospitalization, or have been discharged from hospitals.