Paused Texas reopening may not be enough to stop surge of COVID-19: 'We need to go back,' UT epidemiologist says
Gov. Greg Abbott's announcement that he would pause the reopening process for Texas at its current Phase 3 may not be enough to slow the spread of the coronavirus, according to University of Texas Health epidemiologist Katelyn Jetelina.
"You're going to have to go back" to Phase 1, Jetelina said, if the state hopes to get a hold of the rapidly spreading virus.
The source of the surge
In barely a week, Gov. Greg Abbott went from saying Texas had "abundant" hospital capacity for additional COVID-19 patients to "pausing" Texas' reopening and suspending elective surgeries.
The coinciding of Memorial Day and the Black Lives Matter protests with the beginning of Phases 1 and 2 of reopening, respectively, makes it hard to pinpoint the true origin of the recent surge in cases. But cases started growing, based on data Jetelina studied, when the state moved to Phase 2 of reopening and allowed restaurants to open at 50% capacity, bars to reopen at 25% capacity and salons start doing business again.
"I really think we need to go back on our reopening phases, which is unfortunate, but this growth started way before Phase 3 reopening," she said.
A predictable curve
The effects of reducing social distancing on the spread of the virus have been predicted as far back as mid-May, Austin Public Health told Austonia Thursday. Before the state began reopening, Austin stood at a social distancing rate of 95%, but experts at UT predicted that if that reduced to 50%, the city would see the exponential rise in cases happening in June.
"You can see that so far [the model] has been really, unfortunately, quite accurate," Austin-Travis County Interim Public Health Authority Dr. Mark Escott told the Travis County Commissioners Court earlier this week. "We also have the potential that it could increase faster with projections—now that we have the potential, if we don't change substantially by the middle of July, [we could exceed] our threshold of capacity for our health care system."
Hospital capacities by region in Texas with the top of the chart, 1, representing full capacity. Each region represents a separate Trauma Service Area, which are used to analyze how different parts of the state are affected by the spread of the coronavirus and other hospitalizations. (Katelyn Jetelina)
Jetelina said suspending elective surgeries, which Abbott did for four large Texas counties—including Travis—on Thursday, will be a huge help to hospitals that have seen beds filled up in recent weeks.
When hospital capacity cracks 70%, that's when public health officials start to worry, Jetelina said. When it cracks 80%, that's when hospitals begin to need "surge centers." Austin's three main hospital systems said Wednesday that together the three networks are at 71% total capacity and 70% ICU capacity.
But Abbott's decision to pause the state's reopening will not do much to slow the spread of coronavirus, Jetelina said, especially since the governor has yet to release an official Phase 4 plan.
If Texas wants to truly "flatten the curve" again, Jetelina said, Texas leaders must reinstate protocols that require social distancing, like lowering restaurant capacity to 25% and closing bars and beauty salons.
"Really anywhere that people are coming together and conversing, especially if face masks are not required or mandated, you're just going to get human-to-human spread so much easier than if these places weren't open," she said, adding later, "if that means bars need to be closed or at least [reduce] capacity, then so be it. It's just a matter of getting as far away from each other as possible."
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The surge in Austin's COVID-19 cases is overwhelming the public health system trying to fight community spread.
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Austin's COVID-19 fatality drops as treatment improves, testing expands, cases among young people rise
The mortality rate for COVID-19 patients—defined as reported deaths per confirmed cases—in Austin has dropped from 3.6% at the end of April to 1.8% on June 22, a decrease that the city attributes both to better treatments and to a rising number of cases among young people, who are more likely to recover.
Travis County COVID-19 mortality by age<div class="flourish-embed flourish-chart" data-src="visualisation/2950699" data-url="https://flo.uri.sh/visualisation/2950699/embed"><script src="https://public.flourish.studio/resources/embed.js"></script></div><p>Austin Public Health began offering its free service to residents regardless of symptoms on June 5, following mass protests against police brutality, and many residents have taken advantage of the opportunity.</p><p>Between June 15-21, more than 3,000 people were tested by APH, up from 2,400 the week prior.</p><p>More testing means the number of confirmed COVID-19 cases is closer to the actual number—and the death toll is proportionally smaller.</p><p>Dr. DeVry Anderson, chief medical officer of St. David's South Austin Medical Center, said the falling mortality rate is also due to <a href="https://austonia.com/Coronavirus/austin-coronavirus-hospitals/higher-exposure-for-health-care-workers" target="_self"><u>better treatment options</u></a> for COVID-19 patients who are hospitalized.</p><p><span></span>These treatments include:</p><ul><li>convalescent plasma therapy</li><li>the antiviral drug remdesivir</li><li>improved ventilator management</li></ul><p>Another development is that doctors are more familiar with how to treat COVID-19 patients than they were in early March.</p><p>"Having physicians and staff that have gotten, not comfortable, but now understand how to treat and care for these patients, I think it's seamless in the way we transition those [patients] to higher levels of care," Dr. Anderson said.</p>
Travis County COVID-19 mortality by race<div class="flourish-embed flourish-chart" data-src="visualisation/2950719" data-url="https://flo.uri.sh/visualisation/2950719/embed"><script src="https://public.flourish.studio/resources/embed.js"></script></div><p>Deaths also vary by race and ethnicity, with a larger proportion of Black and Hispanic residents who contract COVID-19 dying from it.</p>
Travis County COVID-19 mortality by ethnicity<div class="flourish-embed flourish-chart" data-src="visualisation/2950729" data-url="https://flo.uri.sh/visualisation/2950729/embed"><script src="https://public.flourish.studio/resources/embed.js"></script></div>
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Austin Mayor Steve Adler issued a "Stay Home, Mask, and Otherwise Be Safe" order, effective from noon today until Aug. 15, requiring all individuals to wear masks and social distance. The order prohibits outdoor gatherings of more than 10 people.
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Texas Gov. Greg Abbott issued an executive order Thursday requiring all Texans to wear masks "over the nose and mouth" in public spaces. It applies to counties with at least 20 confirmed COVID-19 cases and reverses the governor's previous policies.
Exceptions<p>The governor's order provides some exceptions to the mask mandate, including:</p><ul><li>People who are under 10 years old or have a medical condition or disability that prevents them from wearing a mask.</li><li>While eating, exercising outside, swimming, voting or driving alone or with a member of the same household.</li></ul><div>See a full list of the exceptions <a href="https://open.texas.gov/uploads/files/organization/opentexas/EO-GA-29-use-of-face-coverings-during-COVID-19-IMAGE-07-02-2020.pdf" target="_blank">here</a>.</div>
A reversal<p>This order represents a reversal for Abbott, who previously refused local jurisdictions the right to mandate masks and limit gatherings despite repeated pleas that he do so.</p><p>Earlier this week, Travis County Judge Sam Biscoe <a href="https://austonia.com/Coronavirus/austin-surge-" target="_self">sent Abbott a letter</a> asking the state to enforce mandatory masking, prohibit social gatherings of more than 10 people, roll back business occupancy and allow local officials to issue stay-home orders as needed.</p><p>"In summary, the rapid increase in cases has outstripped our ability to track, measure and mitigate the spread of disease," he wrote.</p><p>Austin Mayor Steve Adler, along with the mayors of eight other large Texas cities, also sent Abbott a letter, <a href="https://austonia.com/Coronavirus/texas-face-masks" target="_self">on June 16</a>, asking for the authority to impose a mask requirement.</p><p>The next day, Abbott allowed local jurisdictions to require businesses to mandate masks among employees and customers.</p><p><em>This story is developing and has been updated.</em></p>
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The coronavirus pandemic has altered or canceled summer plans for many. We asked you earlier this week, "What are your travel plans this summer?" The majority voted "staying home."