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We are not ready to re-reopen

I don’t know who needs to hear this, but…

Texas COVID-19 hospitalizations have declined the most significantly — 4,144 Tuesday, down from 10,893 on July 22 — but new cases, positive test rates, daily deaths and viral spread are all dropping. They are dropping enough that one Texas modeler, Spencer Fox of University of Texas at Austin, went so far as to say he thinks that Texas may have seen the worst of the pandemic — as long as people continue to wear masks and keep their guard up.

A number of other health experts warned against lifting restrictions, noting that the coming Labor Day weekend, the expected resumption of schools and seasonal weather changes have the potential to cause a resurgence like Texas experienced earlier in the summer. They also said the amount of transmission, although improved, is still way too high.

“I don’t want to be Debbie Downer, but we’ve been surprised before,” Catherine Troisi, an infectious disease epidemiologist at the UTHealth School of Public Health, said last Friday. “It’s a double-edged sword when things start looking better. The virus is still out there, but people think things can go back to normal.”

Troisi added that some experts are hesitant because of the state’s data reporting problems, because it’s possible some other issue will surface. Those problems include under testing, coding errors that caused backlogged results and combining positive diagnostic and antibody tests.

Chris Amos, a Baylor College of Medicine quantitative scientist, said “the timing could not be worse for rolling back.”

“Given the number who test positive reflect perhaps 10 times as many individuals who have not been tested but are positive,” said Amos, “there remains a large pool of individuals who can spread COVID-19 if they begin interacting with many others, and particularly if we allow large groups to start coming together again.”

Amos acknowledged that optimism about opening up is natural given the slowing of COVID-19’s spread. The spread is measured by a value, known as reproductivity, that suggests a slowing or growing of the virus. Over 1 means each infected person transmits it to an average of more than one person and the epidemic grows; under 1 means the virus is transmitted to less than one person and the epidemic won’t sustain itself.

The value for the state overall has been under 1 since July 20.

According to Amos’ calculations, if the state maintains the current trend, with the number around 0.87, it would take 38 days to reduce the COVID-19 burden by another 50 percent.

It’s important to keep reducing that burden before students resume in-person classes, Amos said. He and others advised against a one-size-fits-all approach.

“Not every community or county in Texas is experiencing the same burden of disease,” said Angela Clendenin, an epidemiologist with the Texas A&M School of Public Health. “In some places, it may be justified to roll back some restrictions whereas in others, it’d be ill-advised to do so. It will be critically important that rolling back restrictions does not send the message that we are somehow ‘all clear.’”

See here for the background. The basic fact remains that we are still at levels well above where we were in early June, when we first re-opened. There’s no question that if we re-reopened like we re-opened the first time around, we will get the same result. To me, three things are clear. One we shouldn’t change anything until we are back at early-June levels. Two, we should have sensible objective metrics that we can actually measure with accuracy and that we stick to, unlike the first time around. And three, give some discretion back to local jurisdictions so that the counties with a sufficiently low infection rate can be more open (though still within state guidelines) while those that aren’t ready for that kind of openness can continue to do what they need to do to get there. All of this should be screamingly obvious after what we just went through, but I see no reason to believe that Greg Abbott or Dan Patrick have learned anything from that experience.

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