(Roschetzky Photography/Adobe)

Note: This article was updated July 31.

To help make sense of all the information emerging about COVID-19 in Austin, we're answering a few big questions:


Is the COVID situation improving?

Travis County is now reporting a daily average of fewer than 40 new COVID-related hospital admissions, which is the threshold for a Stage 3 risk assessment.

(Austin Public Health)

Yes. The average numbers of new confirmed COVID-19 cases and related hospitalizations have been in steady decline over the last week.

Austin-Travis County Interim Health Authority Dr. Mark Escott attributed the deflating surge to residents' commitment to wearing their masks, social distancing and avoiding unnecessary activities.

"It takes the will of the people to control the disease," he said Friday.

If things are getting better, why are we still at Stage 4 of Austin Public Health's risk-based guidelines?

Although the average number of daily new COVID-related hospitalizations dropped below the threshold for a Stage 3 risk designation on Thursday, the city remains at Stage 4 of APH's risk-based guidelines.

"We've seen over and over again that when we rush to open things, if we don't have the appropriate protections in place, it leads to cases surging and shutting the city down again and we do not want to be in that situation moving into the fall," Escott said Thursday.

Local health officials later clarified that, in addition to new hospitalizations, they consider the metro's ICU occupancy rate and overall positivity rate when assessing risk.

APH reported an overall positivity rate of around 9.4% for the week ending July 25, but this does not include every test conducted in the county. Escott said he is looking for a positive rate of less than 8%—and ideally less than 5%—before he will consider further reopenings.

"If our priorities are getting children back in the classroom, making it a safe situation for students and teachers, then we've got to get lower than we are right now," Escott said on Friday.

What does this mean for schools?

Politically, it remains unclear.

Currently, schools are allowed to offer virtual-only instruction for up to eight weeks.

After that, state leaders—including Gov. Greg Abbott, Attorney General Ken Paxton and the Texas Education Agency—say local health authorities can only shut down schools if there's evidence of a COVID-19 outbreak, and not as a preventative measure.

If school boards decide to keep their campuses closed for other reasons, they may risk losing state funding, despite previous guidance from the TEA to the contrary.

Escott, who earlier ordered all public and private schools in Austin and Travis County to remain closed for the first three weeks of the school year, said he doesn't think the TEA commissioner is best suited to make decisions about public health.

"I think the decision to withhold funding is contrary to what the National Academies of Sciences have recommended, and many others," he said Friday, "because it pressures schools to put students in the classroom where it may not be safe."

What is going on with testing? 

APH is reporting a decline in demand for COVID-19 testing as the surge deflates, and while turnaround times are improving, they are still too long for effective contact tracing.

As a result, APH is considering offering rapid antigen testing, which Escott called "the ultimate solution" on Friday.

Like the genetic tests currently offered by APH, antigen tests detect the presence of an active infection—and offer results in 15 minutes.

The antigen tests are marginally less sensitive than the genetic ones, but Escott said it's worth the tradeoff.

"It's probably good enough," he told county commissioners on Tuesday. "So we can get a whole lot better control over this for future outbreaks than sending off tests that are going to take three or four or 10 days."

Some private testing sites, including Remedy and Texas MedClinic, already offer antigen testing in the Austin area.

Is hospital capacity expanding? 

While overall hospital capacity is improving, ICU beds are "still very limited," according to a statement issued by APH on Thursday.

Austin's three hospital systems—Ascension Seton, Baylor Scott & White and St. David's HealthCare—reported a collective ICU occupancy rate of 83% on Tuesday, the last available update.

In addition to limited capacity, Escott said, ICU personnel are also stressed and fatigued.

Are we also seeing a decrease in fatalities?

No. While new reported cases and hospital admissions are in decline, Travis County's COVID-19 case fatality rate—defined as reported deaths per confirmed cases—is creeping up.

With 266 deaths and 20,465 cases reported as of Thursday evening, the case fatality rate is now around 1.3%, up from 1.1% on July 9.

Escott attributed the increase to the portion of older residents—about 50%—among patients hospitalized with COVID-19 in the last couple weeks. People over 60 account for 12% of confirmed COVID-19 cases but 83% of reported deaths, according to APH data.

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