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April 6th, 2020:

We don’t really know how many COVID-19 patients there are in Texas hospitals

For a variety of reasons, the data is hard to get a handle on.

Be like Hank, except inside

Texas is bracing for a pandemic that is projected to kill tens of thousands of people across the U.S., but health officials and state leaders are struggling to provide the public with timely updates on how many people are infected and how many hospital beds and ventilators are available for the critically ill.

Other states across the country have been providing coronavirus hospitalization figures for weeks. On Friday, Gov. Greg Abbott announced that 827 people have been hospitalized in Texas. But the true number of cases is likely far higher than the official tally due to a shortage of reliable tests and delays in delivering results, which can take up to 10 days.

Even with the limited number of confirmed positives, Harris County’s top epidemiologist says it feels like her team is constantly behind.

“It’s become overwhelming,” said Dr. Dana Beckham, director of the county’s Office of Science, Surveillance and Technology, which traces the steps of people who test positive for COVID-19 to determine how they got the disease and who they may have infected. “We’re always behind the eight ball.”

The county’s epidemiologists were pulling 12-to-16-hour days, seven days a week and they still couldn’t keep up, Beckham said. They brought in more workers – roping in other county government employees and hiring outside contractors – to prevent burnout and alleviate stress, tripling the number of people working in the unit to about 65.

It’s still not enough, she said.

As health officials scramble to mitigate the worst pandemic in generations, the level of detail released by Texas lags behind that of some counties and cities.

The Texas Department of State Health Services publishes a daily update of the official number of confirmed coronavirus cases — there were 5,330 statewide as of Saturday and 90 deaths. But the agency doesn’t routinely publish other key measurements that could show the potential for strain on Texas’ health care system in the coming weeks.

[…]

The 827 hospitalized coronavirus patients in Texas are confirmed COVID-19 cases — not suspected cases in which patients are exhibiting symptoms but have no test results, said Chris Van Deusen, a spokesman for DSHS.

Front-line health care workers in the Houston area have told the Houston Chronicle that many patients who should be tested and hospitalized are slipping through the cracks. They also worry that patients admitted with other conditions, such as a heart attack, who also are showing symptoms of the virus may not show up in overall counts.

Unconfirmed COVID-19 cases are likely taking up a significant number of hospital beds. According to the Southeast Texas Regional Advisory Committee, an organization tasked with tracking medical resources in Houston and the surrounding area, as of Thursday more than 700 patients with COVID-19 symptoms — which includes confirmed and suspected cases — had been hospitalized in Harris County alone.

More than 240 were being treated in intensive care units in the county, which has about 4.7 million residents. There were 480 patients on ventilators as of Thursday and 684 additional ventilators were available.

“Currently, we do not have any hospitals reporting that they are nearing capacity,” Darrell Pile, SETRAC’s chief executive officer, told the Chronicle in an email. “Available beds can actually rise if a hospital opens a closed wing, or opts to use beds in the recovery room or other specialty areas to care for inpatients.”

Van Deusen said the state health department had initially collected statistics on suspected cases from hospitals, but by Tuesday had only received reports on 629 patients statewide, raising questions about the accuracy of the state’s figures.

“Hospitalization reporting is a work in progress, and we’re definitely still refining the process,” Van Deusen said.

There’s too much to summarize, so I’d advise you to read that story and also this story about why the official reported numbers of COVID-19 cases in Texas is likely an order of magnitude too low. We’re not doing much testing, which means we can’t really track where the disease is trending, and we’re really just guessing about our hospital capacity and the potential for it to be overwhelmed. We can’t really tell if the local stay-at-home orders, which are now two weeks old, or the previous orders closing schools and canceling public events, which are coming up on four weeks’ duration, have had any effect on flattening the curve. The peak of the outbreak is likely still three or four weeks from now, so whatever the numbers are today, they are going to be a lot higher in the near future. That best-case IHME study Abbott is touting projects four to five thousand deaths in Texas; as of Sunday the official count was 127. That count is also likely low, for the same reasons – not everyone who needs it is getting tested, COVID-19 may be one of several causes of death but not the “official” one, etc – but the point is, we’re barely on the upswing of the curve. We have a lot of staying at home yet to do.

No school accountability ratings this year

No surprise.

Texas public school districts and campuses will not receive accountability ratings in 2020 due to the novel coronavirus pandemic, state education officials said late Thursday.

The announcement is a mere formality after Texas Gov. Greg Abbott last month canceled the state’s annual standardized tests, commonly known as STAAR, which largely serve as the basis for calculating accountability ratings issued in an A-through-F grade format. All Texas public schools will be labeled “not rated: declared state of disaster” for 2020.

“While we continuously work to ensure our ‘A-F’ accountability system paints an accurate picture of school performance, these unprecedented circumstances have forced all of us to change and adapt,” Texas Education Commissioner Mike Morath said in a statement.

[…]

State officials have not yet decided if or how state accountability ratings will be issued in 2021.

Under Texas’ current accountability system, many ratings are partially based on students’ year-over-year growth, as measured by performance on state standardized tests. With no tests administered in 2020, the Texas Education Agency cannot use its current method of evaluating academic growth.

Districts and high schools also are partially rated on measures of college, career and military readiness from the prior year’s graduating class. Many exams used to measure post-secondary readiness have been canceled or changed for the Class of 2020, which would significantly impact academic accountability ratings in 2021.

Terry Faucheux, an associate with the Austin-based education consulting firm Moak, Casey & Associates, said state officials likely would need to make several tweaks to the current accountability system before ratings could be issued in 2021. If state leaders move forward with an accountability framework next school year, she expects to see a proposed system no later than February or March 2021.

“It would be a very difficult lift to get that past the Legislature and federal government to scrap STAAR altogether and not do accountability for another year,” Faucheux said.

STAAR tests were waived three weeks ago, and at this point it seems likely that schools will not reopen till the fall, so this was just acceding to reality. The Lege will have the task of figuring out how to do accountability ratings in 2021, given that 2020 was basically a wash. Depending on how big a fight that turns into, it could have a ripple effect on other business the Lege needs to attend to, not least of which is redistricting. Expect the next session to be quite the whirlwind.

If you’re wondering what effect the cancellation of accountability ratings for 2020 might have on the ongoing takeover of HISD by the TEA, which is currently held up in court, the answer is basically none, though if Wheatley had made standard this year it might have increased the level of skepticism that a takeover was called for. Any districts that were in peril of the same fate will get a one-year reprieve, as HISD did to a limited extent following Harvey.

RIP, Ronnie Earle

The iconic former Travis County District Attorney has passed away.

Ronnie Earle

Ronnie Earle, who served as Travis County district attorney for more than 30 years and was best known for prosecuting some of Texas’ top politicians and for championing the community justice system, died Sunday after a long illness. He was 78.

“He was a great guy,” said friend and former Austin Mayor Bruce Todd. “He always wanted to get things right and he had a good sense of what was right for community. That was what he always wanted to be the goal and objective.”

Todd said Earle’s health has been declining for some time.

Through the county’s Public Integrity Unit, which he founded, Earle prosecuted some of the state’s top politicians — including then-Texas Attorney General Jim Mattox, then-U.S. Sen. Kay Bailey Hutchison and then-U.S. House Majority Leader Tom DeLay — with mixed success.

A jury acquitted Mattox and the case against Hutchison became a high-profile failure when charges were dismissed. DeLay was convicted of a money laundering charge, but that conviction was later overturned by the Texas Court of Criminal Appeals.

But closest to Earle’s heart were his efforts at the forefront of community justice, a catchall name for programs that had caught on in prosecutors’ offices nationwide that aim to attack crime by, in his words, “engaging the community in its own protection.”

Earle established programs for crime prevention, alternative sentencing and the reintegration of former offenders into society. He also brought officials from a range of fields together.

He also ran for Lt. Governor in 2010 but lost in the primary. The late and lamented Public Integrity Unit was a weird way of prosecuting crimes committed by state officials, but it worked pretty well, and we have seen quite clearly since the Republicans killed it off that we didn’t have any better alternatives at hand. If the PIU were still a thing, we would get some kind of resolution to the Ken Paxton saga, not this ridiculously drawn-out process that has been at the mercy of Paxton’s cronies in Collin County and may yet end up in a forfeit. Whatever you think of the case against him, that ain’t no way to do justice. Ronnie Earle would have handled it better. Rest in peace, sir.