Less distancing may come at 'substantial cost' in lives, UT COVID modeler says

Austin's most visible health authorities—Dr. Lauren Ancel Meyers and Dr. Mark Escott—appeared in front of both Austin City Council and Travis County Commissioners Court on Tuesday to present data that shows reducing social distancing right now will come "at a substantial cost."

Gov. Greg Abbott said Monday that he will allow movie theaters, restaurants and retail shops to reopen at limited capacity on Friday with an executive order that overrides the authority of local jurisdictions.

Dr. Meyers presented updated modeling from UT-Austin's COVID-19 Modeling Consortium at a council work session, during which she said it looks like the state is "on the verge of really relaxing social distancing."

The consortium found that, if the region reopens fully—even with social distancing maintained at 50%—there will be a surge of COVID-19 cases in June that will quickly overwhelm local hospital capacity and lead to, conservatively, 2,900 deaths from the virus alone. Thousands of other people would likely die from other causes as a result of not being able to get treatment at overwhelmed hospitals.

In this scenario, the peak would pass quickly—by early summer—and could possibly lead to herd immunity, because so many residents would likely contract the virus, Dr. Escott told commissioners later.

Alternatively, if the region continues under local "stay home-work safe" orders through fall 2021, the number of COVID-19 hospitalizations will never rise above the current rate and deaths will likely be capped at 80. Right now, Travis County is reporting 77 hospitalized patients and 42 deaths from the coronavirus.

"That would require lockdown for 555 days, which we know is not going to be a plausible or probable public health strategy," Austin-Travis County Interim Health Authority Dr. Mark Escott said earlier today.

The consortium modeled two other scenarios, both of which account for the reissuing of local stay home-work safe orders if hospitalizations exceed 100 new cases in a given day. The difference between them is the level of "cocooning," or the isolation of populations at high risk of being hospitalized with COVID-19 or dying from it.

These scenarios show an oscillating caseload, rising and falling as public policy responds to the threat level. If cocooning is maintained at 95%, the total death toll by fall 2021 is estimated to be 2,900. COVID-19 fatalities would not change in this scenario, but the option to reinstate stay home-work safe orders could significantly reduce deaths from other causes that would result if hospitals are overwhelmed.

Dr. Meyers invoked a metaphor that has lately become associated with the pandemic response: the hammer and the dance. The hammer is a fast, aggressive response, such as stay-home orders, intended to control the outbreak. The dance—a longer-term containment strategy—follows.

"This is a hammer," Dr. Meyers said of the oscillating scenarios, which rely on the option of reinstating stay home-work safe orders if hospitalizations begin to rise once businesses reopen. "The only thing we can do is lock down. Maybe in the months ahead, as we learn more about people's behavior and consequences, we can take a more nuanced approach, but that will require much more data and much more time to plan."

At 80% cocooning, however, the model predicts a much higher death toll, in excess of 6,500.

In response to the updated modeling, local officials stressed the need to achieve effective cocooning rates as a result of the governor's reopening plan, which both the mayor and county judge worry is too much too soon. "There's so many things we can do to protect vulnerable populations," Dr. Meyers said. "We can't do all those things by May 1st."

All graphs from The University of Texas at Austin COVID-19 Modeling Consortium