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By Dr. Patrick J. Crocker
The things we worry about. All the what-ifs that haunt our collective minds. Those without anxiety can't always understand the concerns of those who suffer, because those anxious thoughts are only part of our individual psyche. The conundrum is that those things we worry over are not usually in our future, it's the things we never thought of that jump up like a jack-in-the-box to bite us.
Today it's COVID-19, the invisible viral boogey-man raging across the world that fuels the personal and family strain.
It's shocking that we have gone from "it's a hoax" from the naysayers to a $2 trillion rescue plan and global spread in just three short weeks. And one of our greatest fears is possibly not being with our loved ones as they fight the disease or die alone. The toll can be tremendous, and long lasting. Relationships can be permanently distorted by worry about things that probably won't happen.
While the viral threat is real, the extent of it remains poorly understood. Testing and data collection of the general population is inadequate to answer our questions. How many of us have the disease already? What is our personal risk? What is the actual fatality rate? The collected world data seems to hover around 2% or so, depending on whether the healthcare system breaks down. But if we understood the actual extent of spread it may actually be less than half that, maybe a lot less. Not knowing the answers makes the stress even worse.
New data from Iceland indicates almost half of their patients who tested positive had no symptoms. The encouraging news here is that maybe the virus may not be a life-threat to as many as we think and those worst-case scenarios will never come to pass. The study also provides important direction for us on the value of distancing. Treat everyone as possibly infected until this mess passes.
Anxiety leads to panic, and panic is contagious. So what is it we should worry about? I believe it is our first responders and hospital medical staffs. The modern day heroes that are placing their own lives on the line trying to save the rest of us. These warriors need to feel protected and be protected. But they are scared and at risk. The lack of personal protective equipment, masks, and gowns are staggering concerns. We are sending our soldiers into battle without their tools and this could spell disaster. What can we do?
Prioritize that supply of personal protective equipment. Email your senator and congressional representative today to push our leadership to supply it. Practice social distancing as described by the CDC. Hands to face may be the greatest threat so hand washing is critical. Do these things and take comfort in knowing you're doing the best you can to protect yourself and others. And that it will likely be enough.
We can also find coping mechanisms for our worries. Social distancing doesn't mean isolation. Call your friends, Facetime and Skype, it is reassuring to see the faces of your loved ones. Staying glued to the TV watching the news isn't. Limit that news time to once a day. Get outside and go for a walk. Exercise. Both help. With your kids at home play some family board games. Try some daily quiet meditation time focusing on inner peace while turning off the viral noise.
The Serenity prayer offers guidance. "God grant us the serenity to accept the things we cannot change, the courage to change the things we can, and the wisdom to know the difference."
(Dr. Patrick J. Crocker is former chief of emergency medicine at Brackenridge Hospital and Dell Children's Medical Center. He also is the author of "Letters from the Pit" and "More Letters from the Pit: Stories of a Physician's Odyssey in Emergency Medicine," coming this spring.)
After reaching Stage 4 last week of Austin Public Health's risk-based guidelines, Austin-Travis County is now at the Stage 5 threshold with a seven-day average of 50 hospitalizations and dwindling ICU capacity.
While unenforceable under Gov. Greg's Abbott order against local mandates, vaccinated individuals are asked to choose drive-through and curbside options, outdoor activities, social interactions with limited group sizes, as well as social distance and wearing masks indoors. Partially or unvaccinated individuals are asked to avoid gatherings, travel, dining and shopping, choose curbside and delivery options, as well as wear a mask on essential trips.
Flashing back to early-pandemic times, hospitals are at critical capacity—the 11 county Trauma Service Region of 2.3 million people is fluctuating at 16 staffed beds, according to APH.
In a statement on behalf of Ascension Seton, Baylor Scott & White Health and St. David's Healthcare, a spokesperson said that hospitals are asking residents to "help us and each other" by getting vaccinated and continuing to utilize safety practices to slow the spread of the virus.
According to the statement, a "longstanding" nurse staffing challenge combined with the recent COVID-19 spike is putting "extraordinary pressure" on hospital systems.
Along with the unmitigated spread of the virus in unvaccinated, the more contagious Delta variant is also to blame for the spike in cases. The seven-day moving average of COVID hospitalizations in the Austin area reached the Stage 5 threshold of 50 on Friday, triggering local health officials to ask residents to take action.
Local hospitals have a "surge plan" that includes utilization of "all available patient care space and employees within our hospitals and in other settings" that will go into effect when capacity is hit, according to the statement.
The hospitals are working on sourcing supplemental staff and emphasized that emergency care will still be available but it may involve patient transfers "in order to provide the most appropriate care."
Healthcare systems have hit this threshold previously during the pandemic: the city held an alternate care site at the Austin Convention Center from January to March of this year.
"Our responsibility during this pandemic continues to be balancing our readiness to care for patients with COVID-19, while making sure patients who depend on our hospitals receive needed and timely care," the statement said. "We do not want to see necessary non-COVID care delayed as it was during the early stages of the pandemic."
This story has been updated to after publication to include that Austin has reached the Stage 5 threshold.
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Austin legend Willie Nelson will perform at the Texas Capitol today, his first large performance since the pandemic began, closing out a four-day long march across Central Texas to build support for federal voting protections.
Organized by The Poor People's Campaign, the march began in Georgetown on Wednesday and will end with a 10 a.m. rally at the Capitol featuring appearances from former U.S. Congressman Beto O'Rourke and Rev. Dr. William Barber.
Willie Nelson (with Charlie Sexton & friends) will play a free concert at the Poor People's Campaign march for democracy & justice in Austin this Saturday! https://t.co/zZSA0BpbWA
Sign up to join us and see Willie at 10am Saturday: https://t.co/KrDPIFIvST
— Beto O'Rourke (@BetoORourke) July 29, 2021
The rally calls on Congress to "stop attacks on democracy" by ending the filibuster, pass all provisions of the For the People Act, restore the 1965 Voting Rights Act, raise the federal minimum wage to $15 per hour and pass permanent protections for all 11 million undocumented immigrants.
Nelson denounced election law proposals gaining traction in red states, such as Senate Bill 1 and House Bill 3 in Texas, which 55 House Democrats foiled by fleeing to Washington, D.C., on July 12.
The bills would require additional ID verifications for mail-in ballots, allow partisan poll watchers "free movement" and prohibit elections officials from sending absentee ballot applications to voters who didn't request one.
"Laws making it more difficult for people to vote are unAmerican and are intended to punish people of color, the elderly and disabled," Nelson said. "If you can't win by playing the rules, then it's you and your platform–not everyone else's ability to vote."
The march is in the spirit of the Selma to Montgomery March of 1965, led by Dr. Martin Luther King Jr., which protested the blocking of Black Americans' right to vote by Jim Crow laws.