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May 23rd, 2020:

Hidalgo extends stay-at-home order

Well, sort of.

Judge Lina Hidalgo

Harris County Judge Lina Hidalgo on Thursday issued new guidelines urging residents to stay home when possible, even as Gov. Greg Abbott reopens most businesses.

The extended Stay Home, Work Safe order is in effect through June 10, though it bears little resemblance to the original directive in March that closed most businesses and ordered residents to remain at home.

San Antonio and Bexar County extended their own stay-home guidelines through June 4.

Abbott’s orders reopening Texas businesses override any rules from local officials. The governor also barred cities and counties from enforcing facemask requirements, as Hidalgo had attempted.

The county judge said her order reminds residents to keep practicing social distancing.

“I don’t want the community to get the message that we’re done,” Hidalgo said. “We may well be in the eye of the hurricane. There’s still no cure, no vaccine.”

[…]

Hidalgo on Thursday also unveiled a series of guidelines meant to protect employees returning to their jobs and help businesses create safe workplaces. They include staggering shifts to avoid congregating workers, taking employees’ temperatures, providing face coverings and never requiring anyone to come to work if they feel ill.

Retail firms should clean and disinfect shops before reopening and give employees a break every hour so they may wash their hands or take other safety precautions, she said. Employers also should keep attendance of all workers on-site each day, so contract tracing can easily occur in the event of an outbreak.

State Rep. Armando Walle, whom Hidalgo appointed the county’s coronavirus recovery czar, said it is hoped the worker guidelines will prevent outbreaks like those discovered at meatpacking plants in the Texas Panhandle.

You can see the amended order here. It heavily references the most recent gubernatorial executive order, and encourages everyone to continue social distancing. The fact of the matter is that while the daily new case average is holding steady, that means it isn’t decreasing. We’re not getting any closer to having no new cases. That means that another increase in the new case rate could still happen, because the disease hasn’t gone away. If we don’t want a spike to happen and we do want to reopen, we have to keep being careful and keep exercising caution. We’re not past this, we’re choosing to live with it. It’s up to us to make sure we don’t regret that choice.

Are we headed towards a coronavirus spike?

One set of researchers thinks we may be.

Houston is one of several cities in the South that could see spikes in COVID-19 cases over the next four weeks as restrictions are eased, according to new research that uses cellphone data to track how well people are social distancing.

The updated projection, from PolicyLab at Children’s Hospital of Philadelphia, found that traffic to non-essential businesses has jumped especially in Texas and Florida, which have moved aggressively to reopen.

In Harris County, the model predicts the outbreak will grow from about 200 new cases per day to more than 2,000 over the next month.

“Some areas—particularly in the south—that have moved more quickly to reopen are showing a higher risk for resurgence,” the researchers wrote in a blog post. “If people in Houston and Palm Beach, Fla., for example, aren’t being cautious with masking in indoor crowded locations and with hygiene and disinfection, local governments may need to intervene again should they lose control of the epidemic.”

[…]

The PolicyLab research is tracking 389 large counties across the country with active outbreaks. It found that projections are best in places that are relaxing restrictions selectively in areas with fewer cases and less transmission.

“Given these cautious actions by our governments, we have already seen that the predicted resurgence has not occurred in most places that are beginning to reopen—rather, daily cases are either plateauing or falling,” the researchers wrote. “But the picture our models are painting for Texas and Florida provide ample evidence to others who would choose to move too quickly. We see these concerns even as we adjust for additional testing capacity that might have inflated our forecasts.”

See here and here for more on the predictions, and here for an earlier press release about their model. As far as I can tell, their model depends on “social distancing measures, defined by travel to non-essential businesses”. They say their data comes from a variety of publicly-available sources, but that’s about as much detail as I can find. I’m not an expert in any way, so I’m in no position to critique this. Fortunately, Dr. Peter Hotez is an expert, and he shared some thoughts about this in Friday’s Chron.

I understand the importance of opening up the economy. The worry that I have is that we haven’t put in place a public health system — the testing, the contact tracing — that’s commensurate to sustain the economy.

Some models show fairly dire predictions for Houston. I’m referring to the Children’s Hospital of Philadelphia model that shows that by the summer, if we’re only at about 50% of the social distancing, we’re doing now, Harris County could see a steep surge in the number of patients coming into the hospitals and intensive care units.

It’s a model. It’s only as good as the assumptions that it’s based on, and we know the assumptions are not robust. But it gives me pause for concern that unless we have that health system in place, we could be looking at an epidemic that’s far greater than the one we’ve gone through.

Let’s say we’re opening up as as we are now. The way a surge works is, it’s not as if we’re going to see a gradual increase in cases. The models say things will look good for weeks. At first, it’s a flat curve, then it’s flat, it’s flat, and only after all that do you start seeing a steep, steep increase.

That’s what worries me. In those flat weeks we’ll get this sense of complacency, and then people are going to start going into the bars. Forget about one quarter occupancy in the bars. Poison Girl, on Westheimer, is going to be full. And so are all the other places all across Houston.

So: How do we fix that? I think it’s having a health system that’s larger and more extensive than what’s being proposed. We’re going to have to do extensive testing in the workplace so that you’d know if your colleagues have COVID-19 — especially asymptomatic COVID-19.

The number of contact tracers has to be far greater than the numbers that I’m seeing. Gov. Abbott says that Texas has around 2,000 and plans to hire 2,000 more. But consider that Gov. Cuomo in New York State is hiring 17,000 contact tracers. A state that’s quite a bit smaller is hiring a much larger number.

We also still don’t have that syndromic-monitoring system in place that you and I have talked about — an app that would allow Houstonians to report how they’re feeling, or that would track temperatures, like the Kinsa electronic thermometer app.

We should be bringing in our best engineering minds out of the oil and gas industry, out of NASA, out of the Texas Medical Center to put in place an app-based system — maybe make a hybrid between the kinds of things being put out there by Apple or Google or Kinsa, or the kinds of things they’re doing in Australia. We can design one that works for our culture, works for our system. But we’re not assembling the engineers to put that in place.

We don’t even have an epidemiological model for the city of Houston. There’s one for Dallas, put out by UT Southwestern and the University of Texas. Austin’s put out one. But I haven’t seen one for Houston.

So I’m worried that if people are going to start piling into bars and restaurants, and we don’t see the numbers going up, within a couple of weeks from now, it’ll be business as usual. Everybody will feel good, will be saying, “Hey, I’m not seeing the cases go up.”

And it’s going to really accelerate starting in the fall. This is not only true of Houston; it’s true of cities across the U.S. It would happen right before the 2020 election, so I worry about a lot of instability and how we mitigate that.

So there you have it. Keep it up with the social distancing and staying at home, avoid crowds, and wear a mask. We all have a role to play.

The 2020 Kinder Houston Area Survey

We were a pretty optimistic bunch earlier this year, in the Before Times.

Houstonians are expressing a deeper sense of mutual trust, compassion, and solidarity than ever before, with many also calling for policies that will reduce inequalities and improve public schools, according to a recent Rice survey. Houston Area Survey.

“We’re a different population. We see the world differently than we did five to 10 years ago,” said Stephen Klineberg, founding director of the Rice’s Kinder Institute for Urban Research and an emeritus professor of sociology.

The Kinder Area Survey, which was conducted between Jan. 28 and March 12, got responses from 1,001 Harris County residents, and results were released Monday during the Kinder Institute’s annual luncheon which was held virtually for the first time because of the COVID-19 pandemic.

Klineberg, who has conducted the survey for the past 39 years, said this year’s survey has been one of the most remarkable — coming just days before the novel coronavirus jolted the Houston community and the world, and showing that Houston residents were hopeful for their city, but ready for a change.

[…]

More Houstonians than ever are also calling for government programs to address inequality, according to the survey. Sixty-one percent said government should take action to reduce income differences, 72 percent favored federal health insurance for all Americans, and 79 percent said the government should ensure residents who want to work can find employment. The numbers have increased from a decade ago, when they stood at 45 percent on income differences, 60 percent on healthcare for all, and 64 percent on employment.

Klineberg said the responses indicated the growing inequalities when it comes to health care and economic opportunities, which disproportionately affect the city’s black and Hispanic communities.

Houstonians are also more trusting of those around them, less fearful of crime and have shifted their views on what constitutes a crime. Seventy percent rejected the suggestion that possession of small amounts of marijuana should be treated as a crime — up from 44 percent in 2003 and 34 percent in 1995.

You can see the 2020 Kinder Houston Area Survey data here. I have to wonder what the data would have looked like if the survey had been conducted a month or so later, but that’s not important now. This survey is a treasure, and even if the timing was a bit weird this year it’s still a wealth of knowledge about our region. We’re so lucky this has been a thing for so long. Check it out.