'We are starting to see the beginnings of a surge,' Escott says, as county marks record new COVID-19 cases
"Certainly based on our modeling, as well as some of the other dynamics that we're seeing in the community, including increasing risk-taking behaviors, decreasing use of masks and social distancing, anecdotally, we certainly expect to see a surge begin to happen," Dr. Escott said.
Yesterday, Austin Public Health recorded a new record for the number of new confirmed cases: 86.
"This is about two to three weeks after the reopening of the state, and this is about the time we'd expect to see an increase in cases as a result of that change in policy," Dr. Escott said.
Another piece of evidence suggestive of a surge is an increasing rate of positive COVID-19 test results.
Since Austin Public Health in mid-April debuted a public enrollment system, which allows residents to sign up for free testing at drive-thru sites, the testing capacity has increased—although resources are still limited. Up until mid-May, the positive rate was hovering around 3% to 4%, but last week it was 8.5%.
"Again, this indicates to us that we are starting to see the beginnings of a surge," Dr. Escott said.
County commissioners spoke about news coverage showing hoards of revelers congregating at Lake Travis and bars on Rainey and Sixth streets; the mayor has, on social media, asked people to be more cautious.
"The public is hearing mixed messages," Dr. Escott said, with one side pushing for economic recovery and the other urging confinement. "We've got to be in the middle somewhere."
A sharp increase in cases could overwhelm the local healthcare system and force a second economic shutdown. To avoid this outcome, Dr. Escott stressed the need for continued caution and urged residents to wear masks while in public, and to practice social distancing.
"We're seeing what happens when we're successful at prevention because it's not real yet to the community. They don't know people by name who have been hospitalized with COVID-19 or died," he said. "I know all the names."
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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?<p>Not quite.</p> <p>Local health officials have identified hospital admissions as a key metric because it is not affected by reporting delays or testing shortages.</p> <p>"It's a good predictor of actual case burden in the community," Austin-Travis County Interim Health Authority Dr. Mark Escott said Tuesday.</p> <p>The number of COVID-related hospitalizations in the Austin metro has held steady for the last 10 days. </p> <p>"The trend has been relatively flat," Escott said. </p><p><br>Since the start of the month, the average number of hospitalized COVID patients has declined 44%, from 146.8 on Sept. 1 to 82 on Sept. 29. </p> <p>But the average number of new cases reported each day has increased 42%—from 78 to 111.1—over that same time period. </p> <p>Escott has attributed these diverging trend lines to the increasing number of cases among young people, who are much less likely to require hospitalization than older patients. </p><img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ1MTI3Ni9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxMTk4MDI4NH0.XxvY7wkBOfT-BtHF8JhtIGX0Dv8apitlsV-JZMb53pA/img.png?width=980" id="f2149" class="rm-shortcode" data-rm-shortcode-id="e69fc96d61833754a62b5ea7a5e9cb3e" data-rm-shortcode-name="rebelmouse-image" />
What is a "twindemic"?<p>It's time to add another word to your pandemic vocabulary.</p><p>Health experts have raised concerns of a "twindemic," when the COVID pandemic inevitably overlaps with the annual flu season, which begins in October.</p><p>Last year's flu season was particularly bad, Escott said last week, and local ICUs hit capacity from flu patients alone.</p><p>"Our hospitals cannot handle surges of both," he said. "We're going to have to ration care."</p><p>Escott has encouraged Austinites to <a href="https://austonia.com/flu-season-austin" target="_self"><u>get vaccinated</u></a> before the flu season intensifies this winter. </p><div class="rm-shortcode" data-rm-shortcode-id="187ed35bc13596eb1d0e6e1e0ba084ea"><div class="fb-post" data-href="https://www.facebook.com/austinpublichealth/posts/3992955670717819"></div></div>
What is going on with schools?<p>Austin ISD is preparing to reopen <a href="https://austonia.com/austin-school-reopening" target="_self"><u>for in-person learning</u></a> next week, following in the footsteps of other area districts, including Eanes ISD and Round Rock ISD.</p><p>Escott is supportive of AISD's reopening plan, which follows Austin Public Health guidelines to start capacity limits at 25%. He said there is no evidence that disease transmission is occurring in classrooms or <a href="https://twitter.com/AustinISD/status/1310716756374237186" target="_blank">while students are passing in hallways</a>.</p><p>"For those who are concerned about putting teachers at risk, I'm married to an educator, and she went into school today," Escott told the AISD board of trustees on Monday. </p><p>He added that the risk of transmission appears to be limited to extracurricular and social activities, where students may not be wearing masks or adhering to social distancing guidelines. </p><p>In total, local primary and secondary schools that have already reopened have reported 24 COVID cases among students and 21 among staff since mid-August, according to APH data shared Tuesday. An additional 116 people have been identified as "close contacts" of impacted students and staff. </p><p>The University of Texas at Austin <a href="https://austonia.com/ut-austin-spring-semester" target="_self"><u>announced this week</u></a> that it is planning on a spring semester structured "in much the same way" as the current term. </p><p>In a community-wide email sent on Monday, President Jay Hartzell commended students for making adjustments, which he wrote have helped keep the university's COVID numbers "as low as possible."</p><p>Since the current semester began on Aug. 26, the university has reported more than 700 cases among students and fallen short of its stated goal to test 5,000 asymptomatic community members a week. </p><p>Hartzell said the university is working out "some kinks" in its proactive testing program, including not requiring a second confirmatory test for students' whose rapid tests return positive results, allowing for walk-up testing without an appointment and debuting a new incentive program, details of which are forthcoming.</p>
What metrics would help determine a drop to a Stage 2 level of risk?<p>The number of new COVID hospitalizations each day would need to fall below 10, on average, and the local positivity rate would need to drop to 3% or lower for local health officials to recommend a move to Stage 2 of <a href="https://austonia.com/austin-covid-stage-3" target="_blank">their risk-based guidelines</a>, Escott said.</p><p>At this lower level, recommended restrictions would loosen. Social gatherings would be allowed to increase from 10 people to 25, and residents would be allowed to resume non-essential trips and return to work at reopened businesses.</p><p>Travis County is currently reporting 12 new COVID-related hospital admissions each day, on average.</p><p>The overall positivity rate was 4.4% last week, but disparities remain across demographic groups, with Latino residents returning a positivity rate of 8%. </p>
What about testing?<p>Demand for testing has declined post-surge. </p> <p>Escott said last week that testing sites administered by APH are testing about 2,000 people a week despite having the capacity to test more than a thousand people a day.</p> <p>It is important to note, however, that the testing numbers reported by APH do not include the positive results from <a href="https://austonia.com/rapid-covid-test" target="_self"><u>rapid antigen tests</u></a> because of CDC guidance that they be considered "probable" and not "confirmed." </p> <p>Like the genetic, or polymerase chain reaction tests, administered at APH testing sites, rapid antigen tests detect positive infections. They also provide results in about 15 minutes, which is central to their appeal.</p> <p>While they are marginally less accurate, rapid antigen tests are in fairly wide use. Some private testing sites in the Austin area report that <a href="https://austonia.com/coronavirus-test" target="_self"><u>the majority of the tests</u></a> they conduct are rapid due to patient demand. </p> <p>Between Aug. 6 and Sept. 24, a total of 2,174 positive rapid antigen test results were reported in Travis County, according to APH. The department would not release information pertaining to the number of positive antigen tests performed overall. </p> <p>During that same time period, 6,648 COVID cases were confirmed by positive genetic test results in Travis County. </p> <p>If the cases detected by rapid antigen testing were considered "confirmed" rather than "probable," the local caseload between Aug. 6 and Sept. 24 would have increased by about a third. </p>
What is post-COVID syndrome?<p>Nine months into the COVID pandemic, doctors across the world are reporting that the virus has become a chronic condition—post-COVID syndrome—for some patients, known as long-haulers.</p> <p>"As people recover from the initial infection, studies are starting to show that in some patients, it might actually take weeks or even months to return to baseline health," Dr. Esther Melamed, an assistant professor of neurology at Dell Medical School, said in a press release issued Tuesday. </p> <p>Long-hauler symptoms may include difficulty breathing, headaches, memory problems, overwhelming fatigue and persistent loss of taste and smell, as well as worsening of pre-COVID conditions, such as diabetes and mood disorders. </p><video controls id="8e12e" width="100%" class="rm-shortcode" data-rm-shortcode-id="ccc522351e8e55862283aed7dc73050d" expand="1" feedbacks="true" mime_type="video/mp4" shortcode_id="1601497346135" url="https://roar-assets-auto.rbl.ms/runner%2F19818-Melamed-Post-COVID-Syndrome---Media.mp4" videoControls="true"> <source src="https://roar-assets-auto.rbl.ms/runner%2F19818-Melamed-Post-COVID-Syndrome---Media.mp4" type="video/mp4"> Your browser does not support the video tag. </video>
What is the status of federal coronavirus relief funding?<p>Local and state governments must spend all of the federal coronavirus relief dollars they received through the CARES Act by the end of the calendar year, despite the ongoing nature of the pandemic and <a href="https://www.cnbc.com/2020/09/29/pelosi-mnuchin-set-to-talk-as-.html" target="_blank" rel="noopener noreferrer"><u>the absence of additional relief packages</u></a> passed by Congress. </p> <p>"We must continue to provide testing and contact tracing," APH Director Stephanie Hayden told Austin City Council on Tuesday. "Those efforts have really helped us as a city and a county… We have to just flag it for you all that federal funding is slated to end this December."</p> <p>Texas Gov. Greg Abbott announced on Friday that the state will allocate $171 million of CARES Act funding to help renters <a href="https://www.texastribune.org/2020/09/25/texas-rent-help-evictions/" target="_blank" rel="noopener noreferrer"><u>avoid eviction</u></a>.</p> <p>The Travis County Commissioners Court discussed last week how best to meet the December deadline. As of mid-September, the county has spent less than one-fifth of the federal relief dollars it received through the CARES Act, although the remainder has been allocated.</p>
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By Patrick Svitek
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