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As Austin public health officials warn of the "Thanksgiving effect"—evidenced by a rising COVID-19 caseload and increasing hospitalizations connected to holiday gatherings—many residents want to know how they can minimize their risk of exposure in the coming weeks.
Austonia spoke to Dr. Stanley Spinner, vice president and chief medical officer at Texas Children's Pediatrics and Texas Children's Urgent Care, about how to navigate this holiday season safely.
Where is the risk?
First things first, it's helpful to know what is driving the current spike in new cases.
Spinner said the risk extends far beyond essential workers and is not necessarily concentrated where one might expect, such as in school classrooms.
"We see this from a lot of casual gatherings," he said. "That's how we're seeing more and more people getting infected.
Local case investigations bear this out.
"In our discussions with our epidemiology team, there are simply dozens and dozens of examples of entire families being infected based on Thanksgiving holidays in our jurisdiction," Austin-Travis County Interim Health Authority Dr. Mark Escott said Tuesday.
What's the most prudent course of action?
Spinner encouraged Austinites to stay within their bubbles this holiday season. He will be spending Christmas with his wife and their son's family, all of whom have avoided grocery stores and restaurants.
"We feel comfortable with that," he said, adding that the best way to minimize risk is to avoid seeing people outside of your household.
What if I get tested before attending a gathering?
Austin Public Health reported a spike in demand for COVID-19 testing the week before Thanksgiving, which officials attributed to people wanting a negative result before attending a holiday gathering.
But this isn't a failsafe method—and may lead to a false sense of security.
"The issue as far as testing … it's a snapshot," Spinner said, adding that a negative result only confirms that a person probably wasn't infected on a certain day.
A more accurate way to rule out COVID would be to get testing every day in the lead up to a gathering, which is prohibitively expensive and time-consuming for most people.
Is there anything I can do to make gathering less risky?
"If you're really looking to gather more than your immediate family together on Christmas, one approach is they all quarantine at home for 14 days," Spinner said.
With less than two weeks until Christmas, this method would require groups to have already begun their quarantine period.
The Centers for Disease Control and Prevention recently updated its quarantine guidelines, including a 10-day period as an alternative to their previous recommendation of two weeks.
"Reducing the length of quarantine may make it easier for people to quarantine by reducing the time they cannot work," the federal agency wrote on its website last month.
Although a 10-day quarantine is better than one of a shorter duration, Spinner encouraged Austinites to self isolate for the full two-week period, which he called "the gold standard."
Is it safe to travel?
This depends on how much risk one is willing to take on.
"If you really, really want to be safe, stay home," Spinner said. "That's ultimately the best approach."
For those intent on traveling, he recommended trips that require no more than one day of driving to avoid exposure at hotels or rental properties.
If that isn't an option, he suggested renting an apartment or home to avoid interacting with others. If one is required to stay at a hotel, he urged cleaning the room after checking in as a precaution.
What about flying?
Spinner discouraged air travel but offered some suggestions for how to make it less dangerous.
Most fliers who get COVID while traveling are exposed in their airport, so he encouraged fliers to wear a mask; eye protection, such as a face shield; and gloves.
He also said to avoid any public restrooms, if possible, and wipe down surfaces before using them
Still, he added, "it is a risk."
Who should be most cautious?
"The more people you have (around you) who are higher risk, the closer to the vest you should play it," Spinner said.
High-risk populations include those 65 years of age and older; people with co-morbidities, such as diabetes and suppressed immune systems; and those who are pregnant.
He encouraged everyone to be cautious because of the possibility that they could transmit the disease to others—or get sick themselves with a severe case.
"Who wants to take the chance with themselves or their loved ones?" he said. "Unfortunately, a lot of people do, but they shouldn't."
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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.