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Updated May 4 10:44 a.m.:
If it seems like you've been seeing more people out and about lately in Austin, you're not wrong.
The data analytics firm Unacast now has the county performing at a C- on its social distancing scoreboard. Just a month ago the firm was grading Travis County as an A-. Unacast uses data from public data sets as well as tens of millions of devices.
<p>According to the scoreboard, Travis County has a 40%-55% reduction in average distances traveled, a 65%-70% reduction in nonessential visits and a less than 40% "decrease in encounters density compared to national baseline," which is currently graded as a C for its 74%-82% decrease in the same category. </p><p>Austin is in good company—there is currently only one county in Texas earning more than a B—Presidio, which has an A-. The state overall<a href="https://www.unacast.com/covid19/social-distancing-scoreboard?view=state&fips=48" target="_blank"> scored a D-</a>.</p>
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Austonia staff
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Reports that indicate the new coronavirus may be mild or asymptomatic in up to 80% of cases have driven demand— in Austin and around the world—for antibody tests, which claim to be able to determine whether or not a person has had COVID-19.
<p>People are seeking out these tests in the hope that, as is the case for<a href="https://www.jhsph.edu/covid-19/articles/achieving-herd-immunity-with-covid19.html" target="_blank"><u> many viruses</u></a>, having COVID-19 will make people immune to it in the future—at least for a while. The problem is that even if <a href="https://www.reuters.com/article/us-health-coronavirus-testing-roche-hldg/roche-wins-us-nod-for-covid-19-antibody-test-aims-to-boost-output-idUSKBN22F02Q" target="_blank">the tests work</a>—and <a href="https://austonia.com/Coronavirus/testing-austin" target="_blank">some may not</a>—is that <a href="https://www.scientificamerican.com/article/what-immunity-to-covid-19-really-means/" target="_blank"><u>no one really knows</u></a> how the virus affects the immune system of survivors.</p><p>COVID-19 prompts the formation of antibodies in patients who have been exposed to it. "[T]his is what is referred to as an immunologic response," Dell Medical School Chief of Pathology Dr. Edward Weir wrote in an email. But he added that the effectiveness of these antibodies and the duration of any immunity they may confer remains to be seen.</p><p>Until these questions are answered, health officials<a href="https://www.facebook.com/ATCEMSOMD/?__xts__%5B0%5D=68.ARCVEMUOyxVYiuI92m0B5-Cs6T2xCz_rowdl9qB91CPD3FFQSuHm3ORNF1f5xaOOYfT226Q_ceoVys82zCRc9lbe6KbHZV3ICatS6kYZczGq90sZLa6TIUUuM367aVY-XdJTYn6Mj0z3_u6G5oSy34KDOJlrO_BkS2w0jWFMqLhYLvKXpstwEKa9-FhfGhrgGXYZwhuKUrZkncw812WVJvXb2G3hUlGdlkiX1fcDlnVN6CLERnK2oTYafURmyGKUp9sRXZIK-Sjjg81KBYgDryFuToTTRkhujy9r6JQLQDl-u8XJeayMr5-fU_Svk3LU-FioIJmJyEslYwDW1aHXPQ&__xts__%5B1%5D=68.ARC2arAueHmbotOpkhAupg3vgGsjcFj3krA3XBrgEvxg4FBXb_qEd87SLLldqpXGyAe2R8UiU4rrZ6eUuDOYszynctORPWb3F-6NKpdoVy_cUp_NcDY0oRioCXJ4M459nZnb9OXO1_xlU-U3_loXFj11YTPVyhi6ukJVRM9g8xlsDjDtQHny86wb6hNAJ1jiNEFA8gYz8tc2SEmoGKocI5slxrVUPUYdREjtHQKu-HXROv0W6X6PS1LrH6if0RkZYYsARaBdeqrVK2yQ5A_jMqa2QtVrraYF4ffBNnUSSw036RZyv_PQ-Qm7c7OjgPF4Hqz3RXImaB--DEg4EoMXQw&__tn__=kC-R&eid=ARA_IQhYu4I-dPfM9guLgAVaMt-PhQZc4fHF7nelMZM0JM74s-j6xEBcT3j0PoSeOezMliv9wGPuL4RH&hc_ref=ARQ9yxMufROUyTc2Y4jbs0ppPsHnMg19UJCSujPWlh8q761kD50r_1UqaNA31Ecxx9s&fref=nf" target="_blank"> have advised caution</a>. </p><p>"I think a baseline expectation should be that this concept of social distancing, personal hygiene, the public masking … is going to have to continue until we reach herd immunity by one method or another," Austin-Travis County Health Authority Dr. Mark Escott said during an April 22 press conference. </p><p>Herd immunity is achieved when a majority of a population is immune to a disease, either because they've been vaccinated against it or have survived it themselves. </p><p>But the latter route, at least in the case of COVID-19, would come at great cost, according to experts.</p><p>Dr. Lauren Ancel Meyers, who leads the University of Texas at Austin COVID-19 Modeling Consortium, told Austin City Council members Tuesday that herd immunity might be attainable, but as the result of "<a href="https://sites.cns.utexas.edu/sites/default/files/cid/files/austin_covid-19_optimized_relaxation_of_social_distancing_0428020.pdf?m=1588082043" target="_blank"><u>a catastrophic second wave</u></a>," if this disease proves to be immunizing.</p><p>Last week, Travis County Judge Sarah Eckhardt said 750,000 people in the region would need to be affected to achieve herd immunity. At the current mortality rate of 2.2%—and with a functional healthcare system not yet overwhelmed by COVID-19 cases—that would lead to 16,500 deaths.</p><p>"We don't want full-on herd immunity because our hospital capacity cannot absorb that," Eckhart said during an April 22 Commissioners Court meeting. "It would mean lots of death, literally." <br/></p><p>So far, <a href="https://austin.maps.arcgis.com/apps/opsdashboard/index.html#/39e4f8d4acb0433baae6d15a931fa984" target="_blank"><u>Travis County reports</u></a> 1,756 confirmed COVID-19 cases. Austin-Travis County Interim Health Authority Dr. Mark Escott has said the caseload is likely seven or eight times as high as the confirmed number due to inadequate testing.</p><p>If the total caseload is seven times the number of confirmations—12,292—it would still amount to less than 1% of the population in Travis County. </p><p>In contrast, around 70% of the population would likely need to be immune—either by recovering from COVID-19 or receiving a vaccine—to achieve herd immunity, said Dr. Gypsyamber D'Souza, a professor at the Johns Hopkins Bloomberg School of Public Health. </p><p>"We're very far from achieving herd immunity," Dr. D'Souza said in a phone interview. "We won't get there in 2020."</p><p>There's also a chance, she added, that repeated surges could lead to hundreds of thousands of deaths nationwide, overwhelmed hospitals, and still not reach the exposure threshold needed to protect the herd.</p><p>In the meantime, health authorities have stressed the importance of long-term containment efforts to avoid a surge in cases and allow time for researchers to develop a vaccine that can enable herd immunity and minimize the loss of life. </p>
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Bobboz/Adobe Stock
"We really went from concept to implementation in less than three weeks," said Chris Merdon, NTT Data's senior vice president of public sector. (Bobboz/Adobe Stock)
Returning Austin from pandemic lockdown to some measure of normalcy will require improved contact tracing, the practice of identifying and isolating anyone infected with COVID-19.
But with an insufficient supply of testing kits and a limited amount of manpower, this is easier said than done. Tech giants like Apple and Google have announced their own solutions—all of which seem weeks or months away from availability—that come with concerns about security and the use of personal data.
<p>Austin won't have to wait long. City officials recently rolled out a new set of <a href="https://covid19.austintexas.gov/s/?language=en_US" target="_blank"><u>digital tools</u></a> focused on making this process more efficient.</p><p>Austin residents who suspect they might be infected with COVID-19 can now download a mobile app or visit a dedicated website to determine if testing is necessary after answering a series of questions, the <a data-linked-post="2645821215" href="https://austonia.com/austins-public-covid-19-online-testing-enrollment-system-is-live" target="_blank">city of Austin announced last week</a>. The system is part of a comprehensive platform built by Plano-based technology firm NTT Data, a Fortune 50 company.</p><p>"The reality is, this happened very quickly. We really went from concept to implementation in less than three weeks," said Chris Merdon, NTT Data's senior vice president of public sector. The software was built using Salesforce's PaaS [platform as a service], marking the first time the company has used it for COVID-19 contact tracing. </p><p>"The advantage of Salesforce is that it's able to scale quickly," Merdon said, making it easier to expand the city's contact tracing initiatives as necessary.</p><p>Prior to the platform being implemented, a physician would screen patients to decide if testing was needed. Then, further coordination was required to determine when and where to send people to testing sites—not to mention contacting those infected or potentially exposed. But now most of those steps have been automated, allowing city officials to focus their efforts elsewhere.</p><p>"If a recommendation to get tested is made, you are provided with a QR code and directed to the nearest of five testing centers located throughout Austin," he explained, adding that the platform is able to schedule appointments every 15 minutes. After being tested, people are automatically sent an email notifying them when results are available through the contact tracing website. Those who test positive will also receive instructions on what to do next, and will be prompted to fill out a survey to help identify who they may have come into contact with in the past few days or weeks.</p><p>In addition to speeding up the screening process, <a data-linked-post="2645744786" href="https://austonia.com/Coronavirus/officials-will-debut-new-covid-19-testing-enrollment-system-to-expand-access-tracking" target="_blank">the new platform will allow</a> officials to more easily find infection hotspots and better distribute limited resources like test kits or personal protective equipment where needed. Austin Public Health officials anticipate initially testing up to 2,000 people per week. That figure is expected to grow as the supply of test kits, and the number of labs processing results, increase. But the city wouldn't be able to ramp up without the new contact tracing platform. </p><p><strong>Security and privacy concerns</strong></p><p>Much of the discussion about contact tracing technology has centered around the partnership announced April 10 between <a href="https://www.apple.com/newsroom/2020/04/apple-and-google-partner-on-covid-19-contact-tracing-technology/" target="_blank"><u>Google and Apple</u></a> to produce a comprehensive solution that regional health organizations can connect to their own efforts. This has caused <a href="https://www.technologyreview.com/2020/04/14/999472/how-apple-and-google-are-tackling-their-covid-privacy-problem/" target="_blank"><u>concerns about security and privacy</u></a> of personal data, despite <a href="https://www.cnet.com/news/apple-and-google-say-they-will-shut-down-covid-19-tracking-tools-once-pandemic-ends/" target="_blank"><u>claims</u></a> by both companies that such data would not be harvested or used outside of the COVID-19 contact tracing efforts. </p><p>Merdon said that protecting personal information was at the top of the list of priorities for the city and for NTT Data. The city's platform is fully encrypted and HIPAA compliant, with data stored on a FedRAMP-certified data center at Salesforce. He said the overall approach to the city's platform is also completely different from what Google and Apple are building.</p><p>"We are partnering with government to jointly develop the [platform], while the data itself will actually be owned by the government," he said. "The Google/Apple model is a little bit different because they are developing the application themselves without a government partner. They're retaining ownership of the data and then making it available to government partners."</p><p>The Google-Apple approach to contact tracing involves using Bluetooth technology from smartphones to track when people may have encountered one another. But participation requires downloading an app and opting in, to some degree. </p><p>Justin Harvey, CEO and founder of Austin-based Spatial Cinematic, said that the data being collected by Google-Apple's platform doesn't include locations, only contacts. Since each smartphone has a unique identifier, what's happening is that the platform will log when your smartphone comes within a specific distance of another smartphone. People typically carry their mobile devices everywhere, so this could provide a more accurate and comprehensive way to track and identify those exposed to the virus. Collected data is stored on a smartphone rather than a central database.</p><p>"The only data that's leaving the device is data from someone who has self-reported as positive," Harvey said. </p>
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Stephanie Schwartz
Ian Voelzel, Westlake Animal Hospital's medical director, demonstrates veterinary telemedicine for the author's dog, Mateo. (Stephanie Schwartz)
It all started with an idea about Carfax reports, but for horses.
Steven Carter and Price Fallin had a friend who spent a lot of money on a high-performance horse, and it turned out that before the sale, the seller had medicated the horse to hide some problems. The group thought it would be good to have health records before a horse purchase—and in 2015, they founded Horse Facts.
<p>Carter said that as part of this business, he and Fallin spent a lot of time in equine veterinary practices. There they observed that many people were traveling great distances, even across several states, to take their horse to the vet. The two partners then created an equine <a data-linked-post="2645619144" href="https://austonia.com/telemedicine-offers-health-care-at-a-social-distance" target="_blank">telemedicine</a> product. And word spread.</p><p>"Through pure luck, some small animal vets found my phone number," said Carter, "and they would call, and literally every call they would say, 'Are these the horse guys?'"</p><p>Carter and Fallin renamed their business TeleVet in 2016, and they went on to serve mostly small-animal vets, along with a few large-animal vets and one vet that does telemedicine for 50,000 pigs. </p><p>In January, about 100 veterinary practices used TeleVet. As the <a data-linked-post="2645676614" href="https://austonia.com/Coronavirus/what-austin-needs-to-know-about-hospitals-ventilators-and-the-citys-new-surge-plan-2645676614" target="_blank">coronavirus pandemic</a> hit the U.S., that number rose quickly to over 1,000 practices. The company recently announced it is offering veterinary practices a free month of service during the pandemic.</p><p>TeleVet's system allows veterinarians to interact with animal owners through video, texts and phone calls. States set guidelines for veterinary telemedicine, and Texas requires that a veterinarian have an established relationship with an animal before treating it, which means having previously examined that pet in person. </p><p>Carter said that an increase in veterinary telemedicine was poised to happen, even before the pandemic.</p><p>"I think the veterinary practices as a whole knew that telemedicine was something on the radar," he said, "but they often thought they would put it off for a year or two."</p><p>Due to the rapid increase in demand, TeleVet is accelerating planned expansions to its platform. To bring in the necessary resources, the startup is raising more funding, after closing a $2 million seed round in January. </p><p>Ian Voelzel, veterinarian and medical director of Westlake Animal Hospital, said that he had been considering telemedicine before the coronavirus pandemic, but not all vets at the clinic were on board. Now the practice is using both TeleVet and curbside service to continue to treat its patients. </p><p>It is working well, allowing the staff to feel safe about coming to the practice for procedures that must be done in-house, such as a recent surgery on a cat's broken leg. Which is not to say that there are no challenges to veterinary telemedicine.</p><p>"Our patients don't talk," Voelzel said. "We are trying to get the information through the owner—a third party, basically."</p><p>He expects telemedicine to be a part of the clinic's practice even when social distancing requirements have relaxed. Voelzel said the platform is great for checkups after an operation, as well as a triage to determine whether an animal needs to be seen in the clinic.</p><p>There is a limit, however. Voelzel said that manipulating the limb of an injured animal, for example, can produce a dangerous reaction. Dogs with ear infections can also be very protective. There is an art, and sometimes the involvement of sedatives, to being able to examine an animal. </p><p>"Some things we can't train the owner to do," he said.</p>
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