Austin public health officials expect to start the activation process to open the convention center as a field hospital in the next week or two due to the COVID-19 surge.

"It seems very clear to us that we are going to run out of hospital beds," Austin-Travis County Interim Health Authority Dr. Mark Escott said on Wednesday.

Over the last month, the average number of new COVID cases confirmed in Travis County increased 98% to 537. The average number of COVID-related hospital admission grew even more rapidly, increasing 140% to 77 in that same time period.

Between Monday and Tuesday, the average number of COVID-related hospitalizations jumped from 77 to 83 daily, pushing Travis County deeper into the red zone of Stage 5.

The COVID-19 Modeling Consortium at the University of Texas at Austin projects the Austin metro will exceed its ICU capacity by Jan. 15 if transmission continues at its current rate. Nearly 90% of ICU beds at the metro's three hospital systems—Ascension Seton, Baylor Scott & White Health and St. David's HealthCare—are occupied, as of Tuesday afternoon.

(COVID-19 Modeling Consortium at the University of Texas at Austin)

This surge in hospitalizations is likely fueled by holiday gatherings.

Typically, it takes about two weeks after an event to see the impact it has on the local caseload and hospitalization numbers. The Austin metro is "smack in the middle" of seeing the impact of Christmas gatherings, Escott said, and will likely see hospitalizations continue to increase over the next week as New Year's gatherings reveal their own impact.

"I had one case investigator mention this morning every single person he investigated was directly related to a holiday gathering," Austin Public Health Chief Epidemiologist Janet Pichette said.

The local positivity rate is also rising sharply. It is now 17.8%, up from 15.5% on Tuesday and 12.7% last week. Escott said it could exceed 20% in the next week if residents do not change their behaviors now.

The high rate of community transmission, combined with the presence of a new, more contagious variant of COVID-19 and a higher number of families opting into in-person learning this semester, has raised concerns about the spread of COVID-19 in schools.

"Those three things are going to lead us to have outbreaks related to schools that we may not have seen in the past," Escott said.

Because the Texas Education Agency has tied state funding of public schools to in-person operations, local officials have avoided ordering another shutdown. But Escott reiterated his recommendation that families opt into virtual learning for the next two weeks, at least, if they are able to. His own teenage children attended school in-person last semester but will now be learning from home.

This is not the only incident in which local officials have bristled at the state's pandemic response in recent weeks. The Texas Supreme Court recently blocked Austin-area orders that restricted dining in and drinking at restaurants over the New Year's weekend.

"We have reached the limits of what we can do under state law and through executive orders," Escott said. "We would encourage the state to reassess its plans."

With most areas of the state in surge and record numbers of hospitalizations and deaths, he argued it is time for the state to consider stronger policies. "It(s strategy) is clearly not working," he said.