Austin-Travis County Interim Health Authority Dr. Mark Escott reported that the local COVID-19 caseload, related hospital admissions and positivity rate continue to climb reaching the Stage 5 threshold. With "the one-two punch" of Christmas and New Year's Eve on the horizon, and the lingering "Thanksgiving effect," he implored Austinites to help reduce spread—but held off on recommending a move to Stage 5.

"We do need people to wear their masks, to socially distance, to wash their hands and not go out if they're sick," he said Tuesday. "If people do that, then we don't need to make a recommendation to close things down."

The key indicator for Stage 5, according to Austin Public Health's risk-based guidelines, is a moving daily average of 50 or more COVID-related hospital admissions. Travis County crossed this threshold on Monday.

At Stage 5, APH guidelines recommend Austinites avoid all gatherings outside of the home and avoid any nonessential trips.

However, Escott said he and his public health colleagues plan to monitor the situation for several days before making a recommendation on the current risk level and other restrictions, such as another shutdown.

Escott would like to avoid such a scenario and said that the next steps would be to ask state officials to close a loophole that allows certain bars to remain open and to curtail extracurricular activities at area schools, both of which have been traced to recent cases.

The overall positivity rate in Travis County is now 9.9%, which is nearly double what it was last month. It is especially high—nearly 25%—among the 20-29 age group, according to APH data, which Escott attributed to bars that allow for crowded, face-to-face interactions sans masks.

"We have many bars that are not behaving well," he said, listing 25 establishments that have recently been cited—some multiple times—for violating local and state pandemic rules. They include Unbarlievable on Rainey Street, Yellow Jacket Social Club on East Fifth Street and Rose Room at the Domain.

In the last week, more than 1,400 students and staff at Travis County school districts have quarantined due to possible exposure to the coronavirus. Escott cited basketball as well as social gatherings among students and parents—a soccer team photo shoot, a parents' trip to Fredericksburg—as a major cause of these new cases.

A vaccine update

As the caseload continues to grow in Austin and around the state, healthcare providers are working to administer COVID vaccines from Pfizer and Moderna, which promise the best line of defense against future spread.

Travis County hospital facilities received 13,650 doses of the Pfizer vaccine last week. Area pharmacies and private practices were added to the mix this week, when an additional 18,325 doses—mostly from Moderna—will be distributed.

In addition to frontline healthcare workers, EMS first responders—including Escott, who also serves the EMS System Medical Director—are first in line to receive the current vaccine supply. Next week, long-term care facilities such as nursing homes will begin to administer vaccines to residents on-site through a state partnership with Walgreens and CVS.

These populations have been prioritized because they will help bolster our healthcare system in case of a worsening surge and protect those at highest risk of hospitalization and death. People 50 years of age and older have accounted for 94% of Travis County's 522 COVID deaths.

There are approximately 80,000 healthcare workers and 205,000 residents 50 years of age and older or with underlying conditions in Travis County.

"By focusing on a relatively small number of people and getting them vaccinated effectively, we can decrease the threat of overwhelming our healthcare system relatively quickly," Escott said.