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Looks like Texas didn’t even have to sue to keep Title 42 from ending

A different Trump judge already put it in the bag for them.

A federal judge in Louisiana plans to temporarily block the Biden administration from ending Title 42, a pandemic-era health order used by federal immigration officials to expel migrants, including asylum-seekers, at the U.S.-Mexico border.

The temporary restraining order is expected in a lawsuit brought by Louisiana, Arizona and Missouri after the Centers for Disease Control and Prevention announced it would let the order expire May 23. The details of such a restraining order were not available late Monday.

“The parties will confer regarding the specific terms to be contained in the Temporary Restraining Order and attempt to reach agreement,” according to minutes from a Monday status conference in the case.

See here for the background. Sure is convenient to have a Trump judge for all purposes, isn’t it? Daily Kos has more.

Texas sues to stop the end of Title 42

Just another day at the office of destruction for Ken Paxton.

Best mugshot ever

Texas Attorney General Ken Paxton filed a lawsuit against the Biden administration on Friday to halt the Centers for Disease Control and Prevention from lifting Title 42, a pandemic-era health order used by federal immigration officials to expel migrants, including asylum-seekers, at the U.S.-Mexico border.

Title 42, which was enacted in March 2020 by the Trump administration, has been used 1.7 million times to expel migrants. Many of them have been removed multiple times after making repeated attempts to enter the U.S.

The CDC has the authority to enact orders like Title 42 under the 1944 Public Health Service Act, which gives federal officials the authority to stop the entry of people and products into the U.S. to limit the spread of communicable diseases. Part of the reason the agency is planning to lift the order soon is that COVID-19 cases have been decreasing and vaccinations have become widely available. The order is set to expire on May 23.

Paxton’s lawsuit argues that the Biden administration didn’t follow the administrative procedure laws needed to halt Title 42. The suit adds that if the Biden administration follows through with lifting the order, Texas will have to pay for social services for the migrants who enter the country.

“The Biden Administration’s disastrous open border policies and its confusing and haphazard COVID-19 response have combined to create a humanitarian and public safety crisis on our southern border,” the lawsuit says, which was filed in the Southern District of Texas in Victoria.

U.S. Health and Human Services Secretary Xavier Becerra, who is named as a defendant in the lawsuit, said on Thursday during a virtual event with the Council on Foreign Relations that health orders are not immigration policies.

“You don’t use a health law to deal with a migration challenge. You use migration laws to deal with migration challenges. You can’t use the cover of health to try to deal with a migration challenge,” he said.

[…]

The state has filed at least 20 other lawsuits in Texas-based federal courts, most of them led by Paxton, against the Biden administration over everything from federal mask mandates to halting the long-disputed Keystone XL pipeline. Judges appointed by former President Donald Trump have heard 16 of the cases and ruled in favor of Texas in seven. The other nine are pending, as of last month.

A majority of these lawsuits have been filed in courts in which the judge was appointed by Trump.

I mean, we could just wait until the combination of Democratic cold feet and empty both-siderism appeals forces Biden to back off anyway, but Paxton has never been one to wait for things to happen when he can find a friendly Trump judge to make them happen for him. Looks like I picked a bad day to quit sniffing glue. The Chron has more.

Biden administration to appeal airplane mask mandate order

Good.

U.S. President Joe Biden’s administration said on Tuesday it would appeal a judge’s ruling ending a mask mandate on airplanes if public health officials deem it necessary to stem the spread of COVID-19.

The Centers for Disease Control and Prevention, to whom the administration was deferring, said that it would continue to study whether the mandates were still needed. The mandates apply to planes, trains and other public transportation and, prior to Monday’s ruling, had been due to expire on May 3.

“We will continue to assess the need for a mask requirement in those settings, based on several factors, including the U.S. COVID-19 community levels, risk of circulating and novel variants, and trends in cases and disease severity,” a CDC spokesperson said in a statement on Tuesday.

The Justice Department said it would appeal Monday’s ruling by U.S. District Judge Kathryn Kimball Mizelle that the 14-month-old directive was unlawful, if the CDC determined the mandate was needed to protect public health.

See here for the background. For what it’s worth, the public still supports masking on airplanes. Airlines and their employees have not been very fond of it, which is understandable given the amount of petulance and rage they have had to deal with from unhinged mask-haters. Maybe they shouldn’t be so quick to let any of those folks back on board, but that’s just my opinion. It’s true that airplanes have excellent filtration and ventilation, which make them pretty safe from a COVID transmission perspective, though not entirely. And getting on and off the airplane, not to mention being in the airport, is much riskier. Masking up is still your best bet. Slate and Vox have more.

Mask mandate lifted for planes and trains

And other forms of mass transportation.

The Biden administration will no longer enforce a U.S. mask mandate on public transportation, after a federal judge in Florida on Monday ruled that the 14-month-old directive was unlawful, overturning a key White House effort to reduce the spread of COVID-19.

Soon after the announcement, all major carriers including American Airlines AAL.O, United Airlines UAL.O and Delta Air Lines DAL.N, as well as national train line Amtrak relaxed the restrictions effective immediately. Read full story

Last week, U.S. health officials had extended the mandate to May 3 requiring travelers to wear masks on airplanes, trains, and in taxis, ride-share vehicles or transit hubs, saying they needed time to assess the impact of a recent rise in COVID-19 cases caused by the airborne coronavirus. Read full story

Industry groups and Republican lawmakers balked and wanted the administration to end the 14-month-old mask mandate permanently.

The ruling by U.S. District Judge Kathryn Kimball Mizelle, an appointee of President Donald Trump, came in a lawsuit filed last year in Tampa, Florida, by a group called the Health Freedom Defense Fund. It follows a string of rulings against Biden administration directives to fight the infectious disease that has killed nearly one million Americans, including vaccine or testmandates for employers.

Judge Mizelle said the U.S. Centers for Disease Control and Prevention (CDC) had exceeded its authority with the mandate, had not sought public comment and did not adequately explain its decisions.

A U.S. administration official said while the agencies were assessing potential next steps, the court’s decision meant CDC’s public transportation masking order was no longer in effect. The administration could still opt to appeal the order or seek an emergency delay in the order’s enforcement.

“Therefore, TSA will not enforce its Security Directives and Emergency Amendment requiring mask use on public transportation and transportation hubs at this time,” the official said in a statement.

“CDC recommends that people continue to wear masks in indoor public transportation settings.”

The ruling came down on Monday, issued by one of the lesser Trump judges, which is honestly saying something. For us in Houston, this also means that masking at IAH and Hobby airports and on Metro buses and trains is no longer required. It continues to be “encouraged”, which means that some vaccinated people and immunocompromised people who can’t avoid being in that situation will wear them. We’ll be flying a couple of times this summer, including the trip to take daughter #1 to college, and we’ll have our KN-95s on because honestly, why wouldn’t we? It is what it is at this point. Protect yourself and hope for the best.

Studying COVID in cats and dogs

Seems like a reasonable thing to look at.

Brushing a dog’s teeth is hard enough. The dog looks at you plaintively, eyes wide with betrayal, as you insert the toothbrush and perform a quick pantomime of a tooth cleaning in the seconds before it closes its jaws—and heart—to you.

Researchers at the lab of Texas A&M veterinary epidemiologist Sarah A. Hamer have a more difficult task: they must get pets to submit to a nasal swab, something which even many humans have to be cajoled into doing. Their aim is to better understand how COVID-19 spreads from humans to their pets, and how a pet’s behavior, such as whether it shares an owner’s bed or whether it is a prolific face licker, affects that transmission.

The testing has involved more than six hundred animals—mostly in Central Texas—who live in households where at least one human has COVID. Only about a quarter of the pets from which Hamer’s team has taken samples since June 2020 have tested positive for SARS-CoV-2, the virus that causes COVID, and just one quarter of those infected pets were symptomatic. Some suffered sneezing, diarrhea, runny noses, and irritated eyes, but the most common symptom owners reported was lethargy: their dogs and cats simply seemed lazier than usual.

“It was all very mild illness, and it all sort of resolved without veterinary interventions,” Hamer said. “From our study, we have no evidence that the virus is killing pets.” (She noted, however, that there have been reports of animals with comorbidities experiencing more severe illness, just as humans might.)

Despite this relatively low threat to cats and dogs, the lab’s work is crucial for surveilling, and understanding, the coronavirus—especially because the pandemic is thought to have originated from an animal-to-human transmission event. (Hamer’s team identified the first known UK variant of the coronavirus in an animal, in March 2021.) Casey Barton Behravesh, an A&M grad who’s now an expert on zoonotic diseases with the Centers for Disease Control and Prevention, explained that when viruses jump from species to species, there is an increased risk of mutations creating new variants. The CDC has consequently funded much of Hamer’s research, providing about $225,000.

“It’s important to look at both people and animals, tracking mutations and the possible formation of variants, so we can keep a close eye on what might be happening,” Barton Behravesh said. “We don’t want to see a strain emerge that becomes more serious in terms of illness in people or animals. We don’t want a strain to emerge that can’t be detected by the diagnostic tests that we have available, or that might impact the therapeutics that are becoming available, or impact the vaccine.”

Read the rest, it’s good stuff. We know that deer can carry COVID, and since most of us will come in much closer contact with pets than with deer, it’s good to know what the risks may be. The good news is that they seem to be low, but best to stay on top of it.

More school districts dropping mask mandates

Unsurprising.

Some of Texas’ biggest school districts are lifting mask mandates for students just weeks before spring break.

Houston Independent School District, the state’s largest district, and Dallas ISD announced Monday that they would not require students to wear masks. Austin ISD announced Wednesday it would stop requiring masks.

The move comes after the Centers for Disease Control and Prevention announced that coronavirus infection rates were slowing.

“It does give people hope for this spring,” said Dallas ISD superintendent Michael Hinojosa.

All three districts enacted mask mandates in early August amid the delta variant surge and in defiance of Gov. Greg Abbott’s May executive order that says Texas schools can’t require masks.

At the time, dozens of school districts went against the governor’s order, and some were sued.

[…]

Candice Castillo, executive officer of student support services in Houston ISD, said recent data points to a dramatic downturn. In a district with about 195,000 students, there are 46 active cases, a 90% decrease in cases from the peak of omicron.

The district’s decision comes after Harris County Judge Lina Hidalgo lowered Harris County’s COVID-19 threat level from “severe” to “significant.”

“This is the right moment for us to make this decision,” Castillo said.

In Austin ISD, the district has seen a 97% decrease in cases over the last six weeks, and the current number of active cases represents less than 1% of the total student and staff population.

Stephanie Elizalde, Austin ISD superintendent, said Wednesday during an Austin ISD board meeting that the district is abiding by the CDC’s recommendations, but to keep in mind that the fluidity of the pandemic means that the mandate can come back when necessary.

See here for more on HISD lifting its mask mandate. You can feel however you want about this – I know a lot of people are still very apprehensive about easing off on precautions like masking, and I totally understand. I’m still masking in public indoor spaces, and likely will continue for the foreseeable future. But the point is, the districts got to make the decisions they thought were best, based on the status of the pandemic and the advice and guidance from the CDC. That more than anything is what we wanted and deserved. The fact that they managed to hold out in defiance of Abbott and Paxton for all this time is a victory. It could be a transient one – for sure, someone is going to file a bill next session to force school districts to bend the knee to the governor – but at least we have an election first that can affect that action. Again, that’s all we can reasonably ask for at this time.

On the matter of the still-unresolved litigation over the mandates and Abbott’s executive order banning them in the schools:

I Am Not A Lawyer, but my best guess is that SCOTx will eventually take this opportunity to decline to intervene on the grounds that there’s no longer a reason for them to get involved. I suppose they could order the lawsuits to be dismissed, but here’s where my non-lawyerness comes to the fore, because I don’t know if that’s a thing they normally do. Be that as it may, the stars have aligned for them the sidestep a politically charged case, and that I know is a thing they like to do.

We’ve had a lot of COVID

Wow.

More than half of Texans had been infected by COVID-19 as of late January, according to a nationwide blood sample survey conducted by the Centers for Disease Control and Prevention.

The survey was based on samples from 52 commercial laboratories across the country and included specimens that were collected as part of routine care and sick visits unrelated to the virus. The specimens were tested for a specific type of antibody developed in response to an infection but not vaccination.

The CDC has been regularly gathering the data since August 2020 to track the percentage of people with resolving or past infections, and how that varies across geographic areas and age groups.

The survey estimates that 14.7 million Texans — or 52.8 percent — had been infected. That’s well over the 6.5 million cases that have been publicly reported. That figure is also likely an undercount, reflecting only a portion of the new infections from the record-breaking omicron wave, during which Texas reported more than 50,000 new cases in one day.

The high number of infections underscores new CDC guidance that no longer recommends mask-wearing indoors for most of the country, including Harris County, except during times of high transmission. Addressing the rationale for the change, CDC Director Dr. Rochelle Walensky said that with “widespread population immunity, the overall risk of severe disease is now generally lower.”

About 64 percent of Texans are fully vaccinated, according to the Texas Department of State Health Services. While health experts agree that the omicron surge likely bolstered vaccine-related protection, the degree to which people are immune because of a previous infection remains unclear.

“What we don’t know for sure with COVID is how long that natural immunity lasts,” said Dr. Catherine Troisi, epidemiologist with UTHealth School of Public Health in Houston. “And there is the added question of how protective are the antibodies that you’ve made against the (variant) you’ve been infected with.”

Yeah, that’s pretty much the sum of it. We’re likely as well protected right now as we can be given our unacceptably low vaccination rate, but we’re sitting ducks if and when there’s a nastier version of COVID out there. Get your booster if you haven’t – it really matters. We can certainly act in ways that are better suited to risk level and the given situation, but let’s not forget that there’s still a risk out there, and it can and will change over time.

The Rodeo is back

Gonna be interesting to see how different it is, if it’s different at all.

And this year, after a one-year hiatus, the rodeo again will be focused on preventing the spread of COVID-19, the virus that abruptly brought the rodeo to a halt nearly two years ago. Masks will be required on public transit to the rodeo’s grounds, where an abundance of hand-washing and sanitizing stations will be positioned throughout. Many concession stands will only accept credit or debit cards instead of cash, and air-filtration systems have been updated to maximize the fresh air flowing inside NRG Stadium and NRG Center.

As the record-breaking omicron surge subsides, rodeo organizers encourage people to follow health and safety guidelines issued by the Centers for Disease Control and Prevention, which recommends that people stay up-to-date on vaccinations and take precaution such as wearing masks in areas of high transmission. People who are feeling ill are encouraged to stay home. More than 100 people a day continue to die of COVID-19 in Texas, with most of those fatalities among the unvaccinated, figures show.

Still, with the pandemic approaching the two-year mark and nearly 64 percent of Texans age 5 and older vaccinated, health experts agree that it’s time for people to return to large events such as the rodeo.

“We are going to have to live with COVID for a while, and I believe that people should be able to establish a new ‘normal’ and enjoy their lives,” said Dr. M. Kristen Peek, interim dean of the school of public and population health at the University of Texas Medical Branch in Galveston. “The Houston Livestock and Rodeo Show is an important part of Houston that people go and enjoy — just do it safely.”

After reviewing the rodeo’s eight-page document containing its COVID health protocols, Peek said the added precautions “look appropriate.” She said she is looking forward to attending the rodeo with her family.

“We will definitely be masked,” she said.

[…]

Now, 66 percent of Harris County is vaccinated with at least the primary series of Pfizer, Moderna and Johnson & Johnson, according to Harris County Public Health. The recent wave likely boosted natural immunity, and the community is equipped to handle the event without a major risk, said Dr. Paul Klotman, president and CEO of Baylor College of Medicine.

“The rodeo is in a big venue, so there’s a lot of ventilation and a big space,” he said. “Relative to other gatherings, this one ought to be safer than others. And if you look at some of the (recent) football games, there haven’t been a lot of big outbreaks.”

Klotman and other experts added a word of caution: the pandemic is not over. Vulnerable populations, such as immunocompromised people, still face a heightened risk of severe illness if infected.

“I wouldn’t be going if I lived with somebody who is going through cancer chemotherapy,” stressed Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor.

See here for some background. I’m mostly okay with this, especially for the outdoor parts of the rodeo. We don’t currently have any plans to go to the fairgrounds, but we’re all vaxxed and boosted, we don’t have any immunocompromised people in our daily lives, and the risk being outdoors is fairly low. Honestly, taking the train to and from the event, which is the only way to go for me, feels a lot more risky just because the trains are always super full during Rodeo times. I’d feel more apprehensive about attending indoor events and the concerts, but if we did we’d be wearing our KN-95s, so it’s no more risky than some other things we’ve been doing. I don’t expect this to become a vector for infection, but by all means exercise as much caution as you want. Don’t go if you don’t feel good about it.

HISD lifts its mask mandate

A bit earlier than expected.

The Houston Independent School District will lift its mask mandate Tuesday, no longer requiring the use of face coverings at all facilities and buildings, district officials said Monday.

The change in policy at Houston ISD arrived three days after the Centers for Disease Control and Prevention changed how it measures community spread to account for hospitalizations in addition to caseloads. Additionally, Harris County Judge Lina Hidalgo last week lowered the county’s COVID-19 threat level to “significant,” the second-highest possible threat level, while Mayor Sylvester Turner lifted a mandate that required city employees and visitors to municipal buildings to wear masks indoors.

“Masks within HISD schools, facilities, and school buses will become optional,” Superintendent Millard House II said in an e-mail to principals Monday morning. “Please encourage students, staff, and any other HISD stakeholders that may need an additional layer of protection or are exhibiting symptoms of a communicable disease to wear a mask regardless of vaccination status.”

See here for the official announcement. I was expecting this to come in a couple of weeks, but here we are. My kids have been pretty dedicated mask wearers, so we’ll see what they and their friends do. I hope that we have done what we can to improve air circulation in the schools, and I hope this spurs some people to get their kids vaccinated. And I really really hope we don’t have to change directions again this semester. The Press has more.

COVID madness

How many ways will unhinged lunatics find to kill us?

A federal appeals court has reversed a ruling, effectively halting United Airlines’ COVID-19 vaccine mandate for employees. The majority on the 5th U.S. Circuit panel ruled in favor of lifting the mandate. The majority explained its ruling was on very narrow ground, but in a seething dissent, one judge said he would rather “hide my head in a bag” than join the unpublished ruling he indicated would not be upheld on the merits.

The case was brought by a group of United employees challenging the airline’s policy that all employees receive the vaccination or remain on unpaid leave. Two workers received religious exemptions from getting the vaccine. The majority on the New Orleans based court held these exempt workers would suffer irreparable harm if the mandate remained in place, because “they are actively being coerced to violate their religious convictions.”

In an unsigned 22-page ruling from U.S. Judges Jennifer Walker Elrod and Andrew S. Oldham, the court reversed the ruling and remanded the case to the trial judge in the Northern District of Texas for re-consideration of the legality of the company’s vaccine mandate. The majority said the trial court must properly analyze the irreparable harm of making an employee choose between “the job or jab.”

The third judge on the panel, Jerry E. Smith, penned a 57-page signed dissent vehemently calling into question the wisdom of his colleagues’ conclusion, however narrow, that the lower court’s reasoning about the mandate was faulty.

Smith said his colleagues’ findings were “head scratching.” And then Smith offered a searing indictment, highlighted in a thread by attorney and prolific appellate law tweeter Raffi Melkonian.

The dissenting judge wrote, “If I ever wrote an opinion authorizing preliminary injunctive relief for plaintiffs without a cause of action, without a likelihood of success on the merits (for two reasons), and devoid of irreparable injury, despite the text, policy, and history of the relevant statute, despite the balance of equities and the public interest, and despite decades of contrary precedent from this circuit and the Supreme Court, all while inventing and distorting facts to suit my incoherent reasoning,” then “I would hide my head in a bag.” He went on to say, “Perhaps the majority agrees. Why else shrink behind an unsigned and unpublished opinion?”

You really should read that Twitter thread, and also Mark Joseph Stern’s analysis. I know some of y’all are tired of me calling the Fitch Circuit a lawless abomination, but here’s one of its senior jurists, and old school Reagan-appointed capital-C conservative calling it the same thing. Do you believe me now?

Of course, these nutballs need fuel for their fire, and there’s no shortage of that.

Texas Attorney General Ken Paxton and U.S. Rep. Beth Van Duyne, R-Irving, are suing the Biden administration to end mask mandates on planes.

The lawsuit, filed Wednesday, argues that the mandate imposes a “restriction on travelers’ liberty interests” and that the Centers for Disease Control and Prevention does not have the authority to introduce such a blanket preventive measure.

First issued in January 2021, the federal mask mandate requires travelers to wear masks while using public transportation services or facilities, including airports and subway stations. Those who violate the mask mandate could be subject to fines.

Travelers younger than 2 years old or with disabilities who cannot wear a mask are exempt from the requirement. The CDC also amended the order in June 2021 and said the mandate would not apply to outdoor settings.

The federal mandate is set to expire on March 18.

Airline companies — including Texas-based American Airlines and Southwest Airlines — have cited federal law as a reason for requiring face coverings and barring violators from travel.

The suit is the latest in a slew of state efforts to challenge COVID-19 safety measures in court. The state is locked in several legal battles with cities, counties and school districts over masks in public schools. Texas also has sued the Biden administration over federal vaccine mandates for health care workers, federal contractors and large businesses.

I’ll tell you what, when airlines impose a vaccination requirement for flying, which frankly the feds should have done months ago, then I’ll agree that the masks can go. Flying on a commercial aircraft is a privilege, not a right. That privilege can and should be revoked for reckless and dangerous behavior, despite what some Republican Senators would have you believe. Do you think Ted Cruz would actually want to be on the same plane as this guy? So-called “conservatives” have been yelling at us for years about the decline in civil society. Well, they were eventually right about the decline, but completely wrong about the cause. I think we all know the real reasons for it.

The CDC gets in on the “track COVID in the wastewater” project

Good to see.

U.S. public health officials are expanding their monitoring of Covid-19 in sewage, which has become a crucial early warning for surges of new cases.

The Centers for Disease Control and Prevention this week began sharing virus wastewater trends on its public-facing Covid data website. And the agency is in the midst of expanding the number of places from which raw sewage gets monitored for rising or falling waves of disease, adding hundreds of new sites in the coming months.

The U.S. struggle to track Covid in real-time has been one of the biggest frustrations of the pandemic. Early on, testing capabilities were only a fraction of what was needed. At-home tests, now more plentiful, mostly don’t get reported to health authorities. And even when local health departments and health care providers do get data, consolidating it for real-time analysis has been a challenge.

But with wastewater, the sewage – and the data it contains – keeps flowing.

Paying attention to that data can alert health officials to prepare medical surge teams, send out mobile testing units and to arrange for adequate supplies. It’s also a useful tool for health officials to help confirm what they’re seeing from other sources.

“The advantage wastewater surveillance has is that it’s not dependent on human behavior, beyond using the bathroom,” said Amy Kirby, program lead for CDC’s National Wastewater Surveillance System. “As the dynamics of the pandemic change, it remains an accurate measure.”

[…]

State and local health departments have been using, and publishing, the data since relatively early in the pandemic. The CDC has been monitoring it as well with Kirby’s program watching for SARS-CoV-2 signs in wastewater since 2020. Many cities track and publish the data on their own: Boston, Miami and dozens of others all make at least some data available.

To help get more places watching their wastewater, the CDC has convened working groups with state and local health officials who already use wastewater to track Covid levels. And they’re offering guidance and information sharing to help bring new sites online. As of Friday, the agency has begun posting wastewater data from 255 towns, cities, municipalities and other places.

The CDC has also contracted with a company called LuminUltra to collect wastewater data from 500 sites; about 200 are online so far. Kirby said the agency has identified hundreds more sites that it wants to enroll.

See here for another national tracking project. I also came across another dashboard, the Biobot Network of Wastewater Treatment Plants, which includes two Texas counties (Kaufman and Travis), though neither was up to date at the time. The CDC’s tracker is here. As the story notes, this is a macro view that can’t tell you how many people are sick, and it doesn’t cover all of the country, just places that are connected to sewer systems. But it’s a useful look at the data, which can tell you where the virus is going ahead of testing regimes, and we can use all the data we can get.

Biden employer vaccine mandate back on

For now, at least.

A federal appeals court panel on Friday allowed President Joe Biden’s COVID-19 vaccine mandate for larger private employers to move ahead, reversing a previous decision on a requirement that could affect some 84 million U.S workers.

The 2-1 decision by a panel of the 6th U.S. Circuit Court of Appeals in Cincinnati overrules a decision by a federal judge in a separate court that had paused the mandate nationwide.

The mandate from the U.S. Occupational Safety and Health Administration was to take effect Jan. 4. With Friday’s ruling, it’s not clear when the requirement might be put in place, but the White House said in a statement that it will protect workers: “Especially as the U.S. faces the highly transmissible Omicron variant, it’s critical we move forward with vaccination requirements and protections for workers with the urgency needed in this moment.”

[…]

“Given OSHA’s clear and exercised authority to regulate viruses, OSHA necessarily has the authority to regulate infectious diseases that are not unique to the workplace,” Judge Julia Smith Gibbons, who was nominated to the court by former President George W. Bush, a Republican, wrote in her majority opinion.

“Vaccination and medical examinations are both tools that OSHA historically employed to contain illness in the workplace,” she wrote.

Gibbons noted that the agency’s authority extends beyond just regulating “hard hats and safety goggles.” She said the vaccine requirement “is not a novel expansion of OSHA’s power; it is an existing application of authority to a novel and dangerous worldwide pandemic.”

She was joined in the majority decision by Judge Jane Branstetter Stranch, an appointee of former President Barrack Obama, a Democrat.

The case was consolidated in the 6th circuit, which is dominated by Republican-appointed judges. Earlier this week, the circuit’s active judges rejected a move to have the entire panel consider the case, on an 8-8 vote.

The dissent in Friday’s ruling came from Judge Joan Larsen, an appointee of former President Donald Trump, who said Congress did not authorize OSHA to make this sort of rule and that it did not qualify as a necessity to use the emergency procedures the agency followed to put it in place.

Larsen also argued that vaccinated workers “do not face ‘grave danger’ from working with those who are not vaccinated.”

Arkansas Attorney General Leslie Rutledge, a Republican, said she would ask the U.S. Supreme Court to block the order. At least two conservative advocacy groups said they had already appealed to the nation’s highest court.

“The Sixth Circuit’s decision is extremely disappointing for Arkansans because it will force them to get the shot or lose their jobs,” Rutledge said.

See here, here, and here for the background. Who even knew that it was possible to get a decent result from an appeals court? It appears the Sixth Circuit, or at least the two justices in the majority opinion, were perhaps not all that impressed by the ruling handed down by their Fifth Circuit colleagues.

Spicy. As noted, in the story, the death eaters among the Attorneys General, including our own, will be appealing to SCOTUS, so keep a firm grip on your expectations. For now at least, there’s a bit of sanity. Happy holidays and all that. Slate has more.

Here comes omicron

Ready or not.

Houston is seeing early signs of another wave of COVID-19 infections, fueled in part by a fast-spreading omicron variant, as public health officials warn of a nationwide spike in cases as early as next month.

The daily average of positive cases in the Texas Medical Center more than tripled last week, from 232 to 721, and Houston Methodist on Tuesday recorded nearly five times the number of positive cases in its system compared to the previous week. Harris County Public Health on Tuesday reported 483 new cases, the highest single-day total in more than two months.

The number of omicron cases in Houston detected through genome sequencing is small but rising, with Houston Methodist reporting 54 samples of the new strain Wednesday, compared to 31 four days earlier. The variant now makes up roughly 32 percent of cases in the hospital system, up from 13 percent on Saturday. Traces of omicron are also being detected at a growing number of city’s wastewater treatment plants.

With little data available in what is considered the early stages of the new variant’s spread, experts are uncertain about the degree to which it could overwhelm the healthcare system — a critical question in the months ahead. They are, however, growing more confident of an imminent swell of sickness.

“We’re going to have a wave. I don’t doubt it at all,” said Dr. Rodrigo Hasbun, professor of infectious diseases with McGovern Medical School at UTHealth Houston. “It’s just the magnitude of it and the duration that’s in question.”

[…]

Throughout the pandemic, Houston’s wastewater treatment plants have been a reliable indicator of future local spread, usually preceding new infections by about two weeks. During the week starting Nov. 29, the city found traces of omicron in seven treatment plants. By the following week — the most recently available data — that number jumped to 25.

“We can see how quickly this variant is going to spread,” said Hasbun.

Early findings from South Africa suggest that omicron causes less severe disease than earlier strains, though several factors, such as the country’s younger population, cloud the data.

Some experts offer cautious optimism despite the bleak outlook.

Dr. Annamaria Macaluso Davidson, associate vice president of medical operations for Memorial Hermann Medical Group, is hopeful that pockets of highly vaccinated areas in the city and new COVID treatments arriving on the market will stave off a dire situation at hospitals.

Two new pills to treat less severe COVID infections could receive emergency use authorization by early 2022.

“We’ve got more tools at our disposal that I think are really promising, even if we’re facing another surge,” she said.

The latest developments highlight the urgent need for vaccinations and booster shots ahead of the Christmas holiday.

Well, we know about the wastewater data. There’s been an uptick in demand for the booster, but the total number of people who have had a third shot is still pretty small. What we know so far suggests that omicron can evade the immunity response better than delta can, and so even fully vaxxed people, or people with two shots who have also had COVID, can still get the omicron variant. But if they do, it will very likely be mild. Even lesser-strength immunization seems to mitigate the severity of omicron, and that plus the Pfizer pill is the reason for guarded optimism. You should still take all reasonable precautions. Get that booster, avoid large indoor gatherings, that sort of thing. We’re in a much better place than we were last spring. Just don’t be dumb about it.

Omicron may be coming, but delta is still here

It’s still a big problem, in case we haven’t forgotten.

Omicron’s arrival in the U.S. came as no surprise to federal health officials and will be met with similar anticipation in Texas, where experts believe it could show up in state and local sequencing efforts as soon as this week.

“It’s almost certainly here,” said Dr. Benjamin Neuman, a Texas A&M University professor and chief virologist at its Global Health Research Complex, which does sequencing for COVID-19 variants.

On Monday, federal health officials concerned about omicron urged eligible vaccinated adults to get their booster shots to increase their protection from COVID-19, in whatever form it might take over the winter, and to keep masking, hand-washing and social distancing when possible.

In Texas, state health officials say they are ready to assist hospitals should another surge happen over the holidays and they are ramping up their own efforts to identify more variants in more parts of the state.

But their largest push, at least publicly, is for vaccination and booster shots. About 55% of Texans were fully vaccinated as of Dec. 1. Some 18.7% of fully vaccinated Texans have had boosters, according to state health numbers.

“Prevention is important, and vaccination remains our best prevention tool,” said Chris Van Deusen, spokesperson for the Texas Department of State Health Services.

[…]

Texas hospitals are still in the throes of a staffing shortage after almost two years of deadly surges and a summer wave of deaths and hospitalizations that saw record numbers of ICUs filled to capacity.

With more than 13 million Texans still not fully vaccinated, the fear of the medical community here is that another wave will further strain a health care system that is already exhausted and depleted.

At the moment, without more data about omicron, delta is still the variant likely to cause the most problems this winter, Neuman said.

“Today, it’s the delta wave that worries me. Not omicron yet,” Neuman said. “We’ve got to wait and see what omicron does, if anything. But with cases rising across the country — that’s entirely being driven by delta.”

There’s some interesting stuff in the article about how scientists in Texas are tracking different variants here – did you know there was such a thing as the Texas Variant Partnership? I didn’t – so read on. Everything I’ve read about omicron so far suggests it will be a couple of weeks before we have some real data on it, which will help us understand basic questions about how transmissible it is, how deadly it is, and so on. A huge question, especially in a still largely unvaccinated state like Texas is how much protection is natural immunity versus vaccination. I’m betting on the latter, but it’s certainly a possibility that another booster may need to be developed. Which, thanks to the nature of mRNA vaccines, can be done quickly, like three to four months. In the meantime, stay cautious and for crying out loud get your shots.

Biden tries again on the employer vaccine mandate

Different appeals court this time.

The Biden administration is asking the 6th US Circuit Court of Appeals to wipe away an order from another appeals court blocking its Occupational Safety and Health Administration vaccine mandate.

Several lawsuits were brought challenging the OSHA mandate, and last week the cases were consolidated in the 6th Circuit, an appeals court that leans right, as 10 of its 16 active judges are Republican appointees.

But, before the cases were consolidated, the 5th US Circuit Court of Appeals — perhaps the most conservative appeals court in the country — issued its order blocking the mandate.

In its filing overnight Tuesday, the Biden administration said the 5th Circuit erred in how its interpretation of the Occupational Safety and Health Act limited the law’s reach, while also arguing that the 5th Circuit had not taken into proper account the public health interest in letting the mandate go into effect.

“Simply put, delaying the Standard would likely cost many lives per day, in addition to large numbers of hospitalizations, other serious health effects, and tremendous expenses,” the administration said in the new filing. “That is a confluence of harms of the highest order.”

[…]

The administration told the 6th Circuit that if it does not lift the order blocking the mandate, it should at least modify the 5th Circuit order “so that the masking-and-testing requirement can remain in effect during the pendency of this litigation.”

See here for the previous update. The 6th Circuit is also pretty damn “conservative”, but it’s at least another shot. I have no idea what to expect, though I figure it’s best to not get one’s hopes up. I do hope they don’t take too long. Bloomberg Law has more.

Fifth Circuit extends hold on Biden employer vaccine mandate

The worst court in America keeps on keeping on.

A federal appeals court kept its block on the implementation on the Biden administration rule that requires large companies to mandate COVID-19 vaccines for employees or carry out weekly testing starting in January. The rule, which the court characterized as a “mandate,” goes “staggeringly overboard” and “grossly exceeds [the Occupational Safety and Health Administration’s] statutory authority,” Judge Kurt Engelhardt wrote in the 22-page ruling that was joined by Judges Edith H. Jones and Stuart Kyle Duncan.

The three-judge panel on the U.S. Court of Appeals for the Fifth Circuit, in New Orleans, issued the ruling saying that the challenges to the rule were likely to be successful so it further prevented the government form moving forward with its implementation. The Fifth Circuit is largely considered one of the country’s most conservative appeals courts and the panel is made up of one judge appointed by President Ronald Reagan and two others appointed by President Donald Trump.

Dozens of lawsuits have been filed in numerous appeals courts against the rule by businesses, religious organizations, and states. Engelhardt said those who opposed the measure, including Texas, Louisiana, Mississippi, and South Carolina, had standing to sue in the Fifth Circuit. “Rather than a delicately handled scalpel, the mandate is a one-size fits-all sledgehammer,” reads the ruling. The judges said the rule imposes a financial burden and could amount to a violation of the Constitution’s commerce clause. “The Mandate imposes a financial burden upon them by deputizing their participation in OSHA’s regulatory scheme, exposes them to severe financial risk if they refuse or fail to comply, and threatens to decimate their workforces (and business prospects) by forcing unwilling employees to take their shots, take their tests, or hit the road,” the judge wrote.

See here and here for the background. The Fifth Circuit never disappoints, do they? Completely predictable, regardless of the facts.

One small bit of potentially good news.

The ruling by the panel of the Fifth Circuit is unlikely to be the final word. Some challenges to the mandate are in other circuits, and the cases will be consolidated before a randomly chosen one of those jurisdictions. The Supreme Court is expected to eventually decide the matter.

Dena Iverson, a Justice Department spokeswoman, said the Biden administration would defend the mandate through that process.

Maybe we can hope for a better outcome from a less corrupted court. In the meantime, I’ll leave you with this:

Further developments soon, we hope. CNBC and Reuters have more.

We wait on the Fifth Circuit

They have received briefs and held a hearing about whether to keep or lift their hold on the Biden COVID vaccine mandate for employers.

A coalition of businesses argued in federal court Tuesday that they would suffer “irreparable harm” if the court fails to permanently halt the Biden administration’s Covid-19 vaccine-or-test mandate for large businesses as the legal challenges make their way through the courts.

Several staffing companies, religious employers and other businesses said in a court filing that the Fifth Circuit Court of Appeals should permanently block the standard “to protect Americans from being coerced to comply with the unconstitutional vaccine mandate during the pendency of this litigation,” after the court issued a temporary stay last weekend.

The Fifth Circuit challenge, led by Texas, is just one of at least a dozen lawsuits filed against the mandate by mostly Republican governors, conservative organizations and business groups, who say the mandate is an unconstitutional overreach of power by the federal Occupational Safety and Health Administration.

Comparing the vaccine-or-test mandate to the Biden administration’s eviction moratorium, business groups suing over the vaccine rule pointed to the Supreme Court’s decision in August to knock down the eviction ban. Then, the high court found in the case of the eviction moratorium, that “our system does not permit agencies to act unlawfully even in pursuit of desirable ends” and that Congress must specifically authorize such policies.

“Just a few months ago, the Supreme Court explained that the Centers for Disease Control and Prevention (CDC) could not unilaterally grant itself control of the nation’s housing market,” the business groups wrote in a Tuesday court filing. “Sweeping authority must come, if at all, from Congress.”

The emergency rules released by the Department of Labor last week require private businesses with more than 100 employees to ensure their workers are vaccinated or have them submit to weekly testing by Jan. 4.

The Biden administration said in a court filing Monday that the mandate was well within OSHA’s authority and that a permanent stay “would likely cost dozens or even hundreds of lives per day.”

Attorneys for OSHA and the Labor Department told a panel of judges for the New Orleans-based Fifth Circuit Monday that the legal argument lodged by states and businesses conflicts with earlier court rulings and federal law, and is unlikely to succeed.

They also said businesses and states challenging the rule don’t have the grounds for “emergency” relief because the effects of the mandate won’t be in place for another month.

See here for the background. I find it best for my sanity to always expect the worst from the Fifth Circuit, so I’m just going to take some deep breaths and try to think about other things. You night appreciate this Twitter thread from Raffi Melkonian about the arguments some of the companies that oppose the Biden mandate are making, and this Twitter thread from Karen Vladeck about the procedural aspects of this case. I’ll have more when the court says something.

More kids are getting their COVID shots

So good to see.

The possibility of the parties, vacations and family gatherings energized six families who attended the COVID-19 vaccination event on Wednesday inside Memorial Hermann, the morning after the Centers for Disease Control and Prevention officially expanded eligibility to kids from 5- to 11-years-old. Eager parents are clamoring for an opportunity to vaccinate their children after an especially challenging wave of infections, which hit a peak in late August just as kids returned to school.

Texas Children’s Hospital administered its first dose of the vaccine at 6:15 a.m., and is expected to administer thousands more throughout the week to children with an appointment, which are now only available as soon as Nov. 18. Memorial Hermann is making the vaccine available to walk-ins at its hospital campuses, beginning Thursday morning.

Parents, many of whom were affiliated with the Memorial Hermann system, shared their own harrowing experiences with the virus at Thursday’s vaccine event. Chris Lange, the father of 8-year-old and 5-year-old girls, said he is still dealing with brain fog after an aggressive bout with COVID during the February winter freeze.

The kids caught a less severe infection, but the experience raised the urgency of vaccination, he said.

“This whole (pandemic) is just such a drain on everyone,” he said. “Knowing that now maybe we don’t have to worry about schools closing. We don’t have to worry about kids staying home. I mean, that’s a big win.”

I’ve seen plenty of celebrating, on Facebook and Twitter, by friends who have kids in the 5-11 age range, much as I did when the shots were cleared for ages 12 and up. I figure we’ll see a big spike in vax rates in the first couple of weeks, then it will settle at a much lower level as the eager folks all get it done and what’s left are the more hesitant and resistant. Every little bit helps, that much is for sure.

Get your kids ready for their COVID shots

At long last.

The U.S. Food and Drug Administration on Friday authorized the emergency use of the Pfizer-BioNTech COVID-19 vaccine on children ages 5-11, marking a long-awaited milestone in the nearly two-year fight against the deadly virus that experts say has likely already infected nearly half the population in that age group.

In Texas, that makes up to 2.9 million children eligible for the vaccine.

The federal regulatory agency said the vaccine is safe and effective for children in that age group. The Pfizer test results shared with the FDA show that its vaccine prevents symptoms in most children and causes no side effects more serious than those already seen in older age groups. FDA panelists decided that the benefits of the vaccine for children ages 5-11 — many of whom have suffered isolation, depression and learning loss throughout the course of the pandemic — outweigh the risks associated with the Pfizer shot.

“As a mother and a physician, I know that parents, caregivers, school staff, and children have been waiting for today’s authorization. Vaccinating younger children against COVID-19 will bring us closer to returning to a sense of normalcy,” said Dr. Janet Woodcock, acting FDA commissioner. “Our comprehensive and rigorous evaluation of the data pertaining to the vaccine’s safety and effectiveness should help assure parents and guardians that this vaccine meets our high standards.”

Still uncertain, however, is whether the U.S. Centers for Disease Control and Prevention will limit the shots to only children with preconditions that put them at high risk of serious disease from COVID-19 — a decision expected next week.

The FDA’s announcement, which follows a recommendation by its vaccine advisory panel earlier this week, triggers an initial federal allocation of more than a million doses destined for children ages 5-11 to providers in nearly half of Texas counties. Those will start landing in Texas pharmacies, pediatrics offices, health clinics and hospitals within a few days, state health officials said.

After the first federal shipment, others will continue on a weekly basis. The amounts will vary based on providers’ requests, officials said.

Most of the parents I know nowadays have older kids who are already vaccinated, and yet I know plenty more who will be ready and eager to get their kids vaxxed. As with every other instance of this vaccine, I expect there will be a big surge up front as all of the willing people stampede to get it done, followed by a long fallow period in which the reluctant, the folks with access issues, and eventually some of the holdouts who meet up with mandates of one form or another get around to it. The boost to the overall vaccination rate in the state should help keep things under control, more or less, through the winter. It’s good news for many, and we have been waiting for it. The Chron has more.

Yes, mask mandates work

Not a surprise, but data is always nice.

The Centers for Disease Control and Prevention released new studies Friday that show enforcing masks in schools helps reduce the spread of COVID-19.

One study looked at data from schools in Arizona’s Maricopa and Pima Counties after they resumed in-person learning in late July for the 2021-22 academic year. The two counties account for roughly 75% of the state’s population.

The CDC found that the K-12 schools that did not have mask requirements at the beginning of the school year were 3.5 times more likely to have COVID outbreaks than schools that required all people, regardless of vaccination status, to wear a mask indoors from the first day of school.Of the 999 schools analyzed in the study, 21% had an early mask requirement, 30.9% enacted a mask requirement between nine and 17 days after the school year began, and 48% had no mask requirement. Of the 191 COVID outbreaks that occurred in those schools from July 15 to August 31, 113 were in schools that did not enforce masks at all. Schools with early mask requirements had the lowest number of outbreaks.

During that time frame, Arizona was experiencing an upward trend of weekly COVID cases, according to Johns Hopkins University.

Another study from the CDC looked at the impact of school mask mandates across the U.S.

Authors looked at data from 520 counties that started school between July 1 and September 4 this year and had at least a full week of case data from the school year. They only looked at counties where all the schools had the same mask policies. Of the 520 counties, 198 had a school mask requirement and 322 did not.

Researchers found that counties that had no mask requirements in their schools had a higher rate of pediatric COVID cases after the school year began than those schools that did have requirements. Schools that required masks, the study found, had 16.32 cases per 100,000 children in the first week of classes; schools without had 34.85 cases per 100,000 children.

Authors did note, however, that all children in the counties were included in the data and not just those who are school-age. They also noted that teacher vaccinate rates and school testing data were not controlled in the analyses, and that the sample size of counties is small.

Here’s the CDC press release for the studies. I’m sure you can guess why I posted about this. The data speaks for itself, so I’ll just leave it here.

We really need a mask mandate at every school district

Or we can just accept a lot more hospitalized kids. Easy choice if you ask me.

The number of Texas children hospitalized with COVID-19 hit an all-time high over the weekend, with 345 on Saturday and 307 on Sunday, the highest two-day stretch recorded during the pandemic, according to data from the Texas Department of State Health Services.

The data follows a national trend of rising pediatric COVID hospitalization rates. A study from the Centers for Disease Control and Prevention released Friday shows the highest rate of increase among teenagers and children 0-4 years old. The study also found unvaccinated adolescents were 10 times more likely to need hospitalization compared to their vaccinated peers.

Children under 12 are ineligible for any of the available COVID-19 vaccines.

School reopenings and “pandemic fatigue” are two primary reasons for the statewide increase, said Dr. Katelyn Jetelina, an epidemiologist at UTHealth School of Public Health in Dallas and author of the popular blog “Your Local Epidemiologist.”

“The more that kids interact with each other, the more this is going to transmit,” she said, adding, “We really need to step up our mask game. Parents really need to invest in good masks to wear for their school.”

She urged parents to buy N95 masks for their children and to “lead by example” with their own mask-wearing habits.

Multiple studies have shown masks help reduce COVID transmission indoors. The CDC study also recommends universal masking in schools, where cases are soaring in Texas. The state health department on Aug. 29 recorded 51,904 COVID cases among Texas students since the 2021-22 school year began.

I mean, we’re a year and a half into this pandemic. We do know all this stuff already. I get that some people are tired of doing pandemic things, but 1) if said person is not vaccinated then they can just STFU right now, as this is all their fault, and 2) as the kids say, we may be done with the pandemic but it’s not done with us.

Thankfully, HISD is doing it right.

While outbreaks have forced some districts to close schools already, Houston ISD has fared comparatively well two weeks into its school year.

By midday Friday, the state’s largest district of nearly 200,000 students had confirmed 1,085 active cases among students and staffers, according to its dashboard.

The most important mitigation strategy the district could implement is one it already has in place — ensuring people wear masks, Superintendent Millard House II said Thursday.

“As we look at the data in our schools, yes we have COVID cases,” House said during an agenda review meeting. “But if we look at the percentage of spread in our schools in comparison to the number of kids that we have, it looks — it does not look bad in comparison to some of the other schools that don’t have mandates in place.”

Health professionals agree the mask mandate may be helping HISD reduce the risk transmission inside its classrooms, even as kids younger than 12 remain ineligible to be inoculated and the delta variant continues to spread mostly unchecked in the Houston area.

“I attribute it to that,” said Dr. Quianta Moore, Huffington Fellow in child health policy at Rice University’s Baker Institute for Public Policy. “There are some schools that the parents and the community are wearing masks and they are also having low transmission.”

As I said before, I don’t want to get overconfident, but again, we know that masking helps. Given the risks, the current legal status, and the complete lack of consequences for defiance, I can’t think of any good reason for a school district to not have a mask mandate in place. We’re either trying or we’ve given up.

The nursing home vaccination mandate

This just seems obvious to me.

President Joe Biden announced on Wednesday that he is directing all nursing homes to require their staff be vaccinated against Covid-19 in order to continue receiving Medicare and Medicaid funding.

Biden said he is directing the Department of Health and Human Services to draw up new regulations making employee vaccination a condition for nursing homes to participate in Medicare and Medicaid. The decision on nursing home staff represents a significant escalation in Biden’s campaign to get Americans vaccinated and the tools he is willing to use, marking the first time he has threatened to withhold federal funds in order to get people vaccinated.

“Now, if you visit, live or work at a nursing home, you should not be at a high risk of contracting Covid from unvaccinated employees. While I’m mindful that my authority at the federal government is limited, I’m going to continue to look for ways to keep people safe and increase vaccination rates,” the President said during a speech at the White House.

[…]

The move comes as the more transmissible Delta variant now accounts for 99% of Covid-19 cases in the United States and as data shows a link between low vaccination rates in certain nursing homes and rising coronavirus cases among residents.

The Delta variant has spurred a jump in daily new cases from a low of 319 on June 27 to nearly 2,700 on August 8, according to Centers for Medicare & Medicaid Services. Many are in facilities in areas with the lowest staff vaccination rates.

In the seven states in which less than half of nursing home staff is vaccinated, weekly cases were 7.9 times higher in the week ending August 1 than they were in the week ending June 27. Meanwhile, in states that have vaccinated a larger share of staff than average (more than 60%), cases reported in the week ending August 1 were only three times higher than cases reported in the last week of June.

The new regulations could go into effect as early as next month, but Johnson said the CMS will work with nursing homes, employees and their unions to ramp up staff vaccinations before the regulations go into effect.

About 1.3 million people are employed by the more than 15,000 nursing homes that participate in Medicare and Medicaid. Some 62% of those workers are vaccinated nationwide, according to CMS data, but the figure ranges from 44% to 88% depending on the state.

“We have seen tremendous progress with low Covid rates within the nursing home population and I think we’re seeing signs that it is starting to tip the other direction. We don’t want to go backwards,” said Jonathan Blum, CMS’ principal deputy administrator.

Blum said CMS officials are “confident we have the legal authority” to implement the new regulation, noting that the law allows CMS to take action as it relates to the health and safety of nursing home residents.

As the story notes, this came a day after Biden directed the Education Department to get involved in the mask mandate fight. You would think, given how devastating the first wave of COVID was to the residents of nursing homes, that their staffers would be highly vaccinated as well, but you would be wrong.

Nationwide, most of the elderly and vulnerable in long-term care facilities have taken the coronavirus vaccine, but many of the staff caring for them have refused it. The federal program responsible for bringing vaccines to the vast majority of nursing homes and similar settings inoculated roughly half of long-term-care workers in the nation, and in some states a much slimmer percentage, as of March 15, according to new data from the Centers for Disease Control and Prevention provided to the Center for Public Integrity.

In seven states and the District of Columbia, the program vaccinated less than a third of staff members.

Now the federal program is winding down in the coming days, leaving states and facilities to figure out how to vaccinate the remainder of workers in settings where COVID-19 has already taken a heavy toll.

Though they represent a tiny fraction of the American population, long-term-care residents made up 34% of the nation’s COVID-19 deaths as of March 4, according to the Covid Tracking Project. Low vaccination rates among staff at these facilities mean that workers continue to have greater risk of contracting COVID-19 themselves or passing the virus to their patients, including residents who can’t be inoculated for medical reasons. Low staff uptake can also complicate nursing homes’ attempt to reopen their doors to visitors like Caldwell, who are striving for some sense of normalcy.

“Going into it, we knew it was going to be a problem,” said Ruth Link-Gelles, who led the team at CDC working on the federal initiative that’s now closing up shop, the Federal Pharmacy Partnership for Long-Term Care Program.

She cited past years’ low vaccination rates among long-term-care workers for diseases such as the flu. “We were disappointed, but I don’t think anyone was shocked to see the low uptake. … There is a stubbornly large portion of the population that really doesn’t want to get vaccinated, and we have a lot of work to do generally and in this community in particular.”

Federal agencies and states have poured resources into a #GetVaccinated educational campaign, hosting listening sessions, live chats and virtual town halls for long-term-care staff to get their questions answered.

In spite of all these efforts, many workers are reluctant to take the shots because they don’t trust information about the vaccines’ safety or they don’t wish to be among the first to take them, experts said.

“There are many reasons to blame nursing homes and the federal government,” said David Grabowski, a professor of health care policy at Harvard Medical School who studies long-term care. “We knew this coming in — that this was a group that was not very trusting of leadership and frankly not very trusting of the vaccine so it was going to take some work in terms of building that trust.”

That story was from late March, so things may be better by now. According to the map embedded in this story, as of that time about 54% of the long-term care workers in Texas who have been vaccinated got their shots through this federal program. But as usual, the overall story in Texas is not great.

The number of nursing homes across the state with at least one active COVID-19 case has shot up nearly 800% in the past month — while nearly half of nursing home employees in Texas remain unvaccinated.

Nursing home residents were among the hardest hit by COVID-19 last year as the virus tore through facilities at an alarming rate. More than 400 Texas nursing home residents died during a single week in August 2020; since the pandemic began, 9,095 have died after contracting COVID-19, according to the Texas Health and Human Services Commission. As of Aug. 11, that’s 17% of the state’s COVID-19 deaths.

To slow the virus’s spread, Gov. Greg Abbott shut down nursing home visitation in March 2020, then eased those restrictions five months later for facilities that didn’t have active cases in the previous two weeks. HHSC’s current visitation guidelines for nursing homes require visitors to wear a mask at all times and limits visitation to no more than two “essential caregivers” per resident.

But after seeing infections remain relatively low in recent months, the state’s more than 1,200 nursing homes are seeing a new wave of infections as COVID-19 cases explode around the state, driven by the highly contagious delta variant:

  • The number of Texas nursing homes with active COVID-19 cases has risen by 773% in the past month, from 56 in mid-July to 489 on Aug. 11. That’s still well below the peak in January, when more than 900 facilities had at least one active case.
  • Deaths are increasing as well. From July 21 to Aug. 11, 84 nursing home residents died from COVID-19, compared to seven deaths during the four-week period before.
  • Roughly 76% of nursing home residents in Texas have been fully vaccinated, putting the state 46th nationally. The national average is 82%.

But the current surge in nursing home cases hasn’t triggered renewed restrictions by the state.

“We continually assess what actions are necessary to keep people safe in the facilities we regulate,” HHSC spokesperson Helena Wright-Jones said in a written statement.

Meanwhile, just over half — 56% — of nursing home staff have been fully vaccinated, below the national average of 59%, which puts Texas 33rd nationally for nursing home staff vaccination rates.

In other words, the usual indifference from state government and general mediocrity, which puts a whole lot of people at risk. What do the nursing homes have to say for themselves?

Kevin Warren, the president and CEO of the Texas Health Care Association, whose members include both for-profit and nonprofit long-term health care facilities, said nursing homes are hesitant to require staff to be vaccinated because they are fearful of losing employees who might look for other jobs that don’t require vaccinations.

“Right now, we have a severely stretched workforce,” Warren said. “And when we see this surge occurring again, the stress and the emotional toll it places on staff and others that are in the building, the concern is: ‘If I put this vaccine mandate on, am I potentially going to lose staff?’”

The percentage of nursing home staffers who are unvaccinated is similar to the general population, Warren added, “so let’s not set them out to the side.”

Except they’re in close contact with the most vulnerable people in the state, and not enough of them are vaccinated, either. The DMN has a whole story on that, and while I can believe it to some extent, there’s a quote from a nursing home operator whose staff is 70% vaxxed, and I cannot see how this is any less urgent than getting hospital staff vaccinated. We’ve tried the carrot, now there needs to be a stick. There’s plenty of polling data to suggest that a non-trivial number of people who are vaccine hesitant will give in and get the shot if their workplace mandates it. Let’s put that to the test.

Back to Code Red

Pretty much inevitable at this point.

Harris County Judge Lina Hidalgo on Thursday returned the county to the highest COVID-19 threat level and urged unvaccinated residents to stay home and avoid unnecessary contact with others.

At a news conference, Hidalgo and Mayor Sylvester Turner pleaded with residents to get vaccinated, wear masks in public settings, and avoid hospitals except for life-threatening conditions.

“We find ourselves retracing our steps toward the edge of a cliff,” Hidalgo said. “It’s very conceivable that we can once again be heading toward a public health catastrophe.”

[…]

The county’s data report Wednesday evening showed how far and fast the situation has deteriorated: an explosion of new cases and a positivity rate of 16 percent. Hospitalizations in the Houston area have increased for 20 straight days and show no signs of slowing; they are on pace to set a pandemic record in about a week.

At its heart, the stay-home request of unvaccinated residents is toothless. Hidalgo lacks the authority to enforce it, let alone issue less restrictive edicts, such as mandatory mask wearing. As one of the most popular local elected officials, however, she hopes to shake residents from a sense of complacency that the pandemic is over.

“I know there’s a lot of conflicting messages, there’s a lot of confusion, so I don’t want to talk about what I don’t have the ability to do,” Hidalgo said of the state pre-emptions. “The truth of the matter is, the best we can do right now, the most we have the authority to do right now, is what we’re doing. So, we’re going to continue to make the most of that and really be direct about what we want the community to do.”

The mayor, who bucked the governor in requiring city workers to wear masks this week, said the numbers would dictate the city’s response to the virus. As of Thursday, 197 city employees had active cases of COVID-19.

“The numbers will dictate my response, and then we’ll deal with whatever happens after that. But I’m not going to be constrained by some order,” Turner said. “Wherever this virus goes, and whatever we need to do to check it and to save lives, is what I’m prepared to do.”

As the story notes, several other big counties have taken this step already, and more will surely follow. For those of you who like visuals, here you go:

Not a pretty picture at all. There’s nothing more Judge Hidalgo can do, since Greg Abbott has cut off any power that local officials had once had. I note that as of this writing, Mayor Turner’s employee mask mandate has not yet drawn a response from Abbott or Paxton. Makes me wonder if there’s more room to push the envelope a little, or if further provocation will draw their wrath.

While we can count on Judge Hidalgo to do everything she can to mitigate the spread of the virus, we can also count on her colleague to the north to do nothing.

COVID-19 cases and hospitalizations are continuing to increase dramatically in Montgomery County and around the region as the delta variant surges in unvaccinated residents.

While the Department of State Health Services recently started tracking cases in vaccinated people and specific data is not yet available, county health officials are reporting most new cases in unvaccinated residents.

“We can say that the vast majority of new cases, hospitalizations and deaths have not been vaccinated,” said Misti Willingham with the Montgomery County Hospital District. “Vaccines help reduce the risk of severe illness, hospitalization and death. Being vaccinated does a great job prepping your immune system should you encounter the virus.”

[…]

According to data from the health district since July 7, total hospitalizations in Montgomery County increased from 42 to 238 with 48 of those patients in critical care beds. MCPHD noted 157 of those 238 are Montgomery County residents.

The county’s active cases jumped 767 to 4,219. Since July 7, active cases in the county have surged by 3,624. The county’s total number of cases is now 60,941, increasing from 55,838 since July 7. Additionally, the county added three more reinfections bringing that number to 26.

However, health officials did not report any additional deaths from the virus. The total number of deaths remained at 354.

The county’s testing positive rate has climbed from 4 percent in early July to 19 percent. To date, 30,742 people have fully recovered.

Note there’s no comment from Montgomery County Judge Mark Keough in that story. Which is just as well, because when he does talk, this is the sort of thing he says. I have no words.

Since it’s all up to us to keep ourselves safe, we may as well remind ourselves of what we can do. Or at least, what we could do with just a little cooperation from our state government.

With COVID-19 cases and hospitalizations growing exponentially in Houston and Texas, responsibility for blunting the surge is still largely a matter of personal choices, leaving medical and public-health professionals pleading with Texans to be vaccinated, mask up and maintain social distancing.

On Wednesday, Texas reported 8,130 hospitalizations, a 44 percent increase since last Wednesday. At Texas Medical Center hospitals, 311 patients were hospitalized for COVID, up from 61 only a month before.

“When all the indicators head in the same direction, that gives you a good idea,” said epidemiologist Catherine Troisi, who teaches at UT School of Public Health. “Right now everything is looking bad.”

[…]

“Delta is so transmissible, it’s picking off anyone who’s unvaccinated,” said Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor. “That’s what’s been happening in Louisiana and Mississippi, and now it’s starting here.”

Of the three main strategies to blunt the effect of the coming surge — vaccinating, masking and social distancing — Hotez favors vaccinations, and says it’s crucial to administer as many as possible immediately.

“If we wait until mid-surge, a vaccine campaign will be much less effective,” he said. “If ever there were a time to vaccinate, it’s now.”

He continued: “The single best thing we could do is mandate vaccinations for schools, but in Texas we’re not even talking about that. We can’t even mandate masks.”

Troisi agreed that urging individuals to act responsibly isn’t enough.

“From a public health standpoint,” she said, “we need to get people vaccinated, and we need to increase testing. Maybe we don’t have to mandate vaccines. But you shouldn’t be able to go into Target or eat at McDonald’s if you’re not vaccinated. There have to be consequences for not getting the vaccine. You can’t just put other people at risk.”

The delta variant moves faster than previous coronavirus strains, notes Spencer Fox, associate director of the UT COVID-19 Modeling Consortium.

“With the traditional coronavirus, if someone is infected, on average they’re infectious starting two-and-a-half days after infection and show symptoms at five days,” he said. “But with delta, a key difference is that the time between exposure and being infectious is shorter by a day.”

A percentage of people infected today are almost certain to need hospitalization within one to two weeks. So preventive measures taken today, he said, “will help reduce hospitalizations a week from now, and will have major impacts two weeks from now.”

In other words, all of the same risk-minimization techniques we had before, back when we didn’t have an amazingly effective vaccine that was free and available to everyone over the age of 12 to really truly minimize the risk. I’m going to boil it all down to “get you and everyone in your family who is eligible vaccinated, and do everything you can to avoid any contact with unvaccinated people”.

For sure, stay the hell away from this.

Texans for Vaccine Choice will host a rally on the steps of the Texas Capitol later this month, protesting “the current state of medical mandates” as the state grapples with a surge in COVID-19 cases and stagnating vaccination rates.

The rally is scheduled for Aug. 21 at 11:30 a.m. A panel discussion will address the state’s current COVID protocols and vaccine requirements.

“I’m speechless,” Dr. Peter Hotez said Thursday morning. “To do that when there’s a public health crisis, with COVID rates going up — it’s terrible.”

As someone once said, terrible is as terrible does. If the COVID they will spread could be limited to just them it would be one thing. But it’s not, and so here we are.

On the reaction by some people to the new mask recommendations

I have one thing to say to this.

Texas Republicans in Congress are fuming over new mask requirements on Capitol Hill and recommendations from the CDC that even vaccinated Americans begin masking again as an extra precaution in parts of the country where the Delta variant is spreading, including Texas.

“Which is it, vaccines or masks?” said U.S. Rep. Chip Roy, a San Antonio Republican, in an impassioned speech on the House floor on Wednesday. “Do the vaccines work or they don’t work? Do the masks work or they don’t work? I’d like to know which it is.”

Health officials have been clear that the vaccines remain effective at preventing the worst outcomes of COVID, including hospitalization and death. The vast majority of breakthrough cases have been mild.

But COVID infections continue to climb throughout much of the U.S. — including Texas — and the Centers for Disease Control and Prevention this week revised its recommendations to urge even fully vaccinated Americans in those areas to wear masks indoors again.

That led to new mask mandates in the U.S. House and the White House, but Texas Gov. Greg Abbott has made clear he doesn’t not plan to require face coverings again in Texas.

Still, Republicans were outraged at the new guidance. U.S. Sen. Ted Cruz called mask-wearing “a virtue signal of submissiveness” as he referred to Democrats wearing face coverings again as “kabuki theater.”

If you are not fully vaccinated, have not made your vaccinated status known to others, and have not been a vocal advocate of vaccination, then you can take any and all complaints you may have about these new recommendations and go fuck yourself. Seriously.

I say again, with all the feeling I can muster: Go fuck yourself.

“Universal masking” for school children recommended

Seems like a sensible idea, especially given that children under the age of 12 can’t get the vaccine yet.

The American Academy of Pediatrics on Monday recommended that all children over the age of 2 wear masks when returning to school this year, regardless of vaccination status.

The AAP, which said its important for children to return to in-person learning this year, recommends that school staff also wear masks. The AAP is calling the new guidance a “layered approach.”

“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Sonja O’Leary, chair of the AAP Council on School Health. “Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”

The AAP said universal masking is necessary because much of the student population is not vaccinated, and it’s hard for schools to determine who is as new variants emerge that might spread more easily among children.

Children 12 and over are eligible for Covid-19 vaccinations in the U.S. And the FDA said last week that emergency authorization for vaccines for children under 12 could come in early to midwinter.

[…]

Universal masking will also protect students and staff from other respiratory illnesses that could keep kids out of school, the AAP said.

The Centers for Disease Control and Prevention recommended this month that vaccinated students do not have to wear masks in classrooms.

Dr. Francis Collins, director of the National Institutes of Health, said on MSNBC that the CDC may have been trying to be a little more lenient, allowing people to make judgment calls “depending on the circumstances in your school and your community.”

But he said he understands where the AAP is coming from.

“They will not be popular amongst parents and kids who are sick of masks, but you know what? The virus doesn’t care that we’re sick of masks,” Collins said. “The virus is having another version of its wonderful party for itself. And to the degree that we can squash that by doing something that maybe is a little uncomfortable, a little inconvenient … if it looks like it’s going to help, put the mask back on for a while.”

That was from last week. Yesterday, the CDC caught up.

To prevent further spread of the Delta variant, the US Centers for Disease Control and Prevention updated its mask guidance on Tuesday to recommend that fully vaccinated people wear masks indoors when in areas with “substantial” and “high” transmission of Covid-19, which includes nearly two-thirds of all US counties.

“In recent days I have seen new scientific data from recent outbreak investigations showing that the Delta variant behaves uniquely differently from past strains of the virus that cause Covid-19,” CDC Director Dr. Rochelle Walensky told a media briefing on Tuesday.

“This new science is worrisome and unfortunately warrants an update to our recommendations,” she said. “This is not a decision that we or CDC has made lightly.”

[…]

Earlier this month, the CDC’s Covid-19 school guidance noted that fully vaccinated people do not need to wear masks, and then about a week later the American Academy of Pediatrics issued stricter guidance recommending that everyone older than 2 wear a mask in schools, regardless of vaccination their status.

Now the updated CDC guidance recommends everyone in schools wear masks.

“CDC recommends that everyone in K through 12 schools wear a mask indoors, including teachers, staff, students and visitors, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with proper prevention strategies in place,” Walensky said. “Finally, CDC recommends community leaders encourage vaccination and universal masking to prevent further outbreaks in areas of substantial and high transmission. With the Delta variant, vaccinating more Americans now is more urgent than ever.”

The updated CDC guidance makes “excellent sense,” Dr. David Weber, professor at the University of North Carolina School of Medicine in Chapel Hill and board member of the Society of Healthcare Epidemiology, told CNN on Tuesday.

“Breakthrough disease clearly occurs, and for those cases, we know they’re much more mild in vaccinated people, but we don’t know how infectious vaccinated people are,” he said. “But clearly, if you want to protect your children under 12 or grandchildren, or protect immunocompromised people, as well as protect your own health — from even mild disease — then you should be wearing a mask, particularly in areas of high transmission when indoors.”

My kids have been vaccinated, but they’re still regular mask-wearers, especially the younger one. I fully expect them to continue to do so in school, at least for the fall. I’ve been wearing a mask again for indoor spaces as well. I will admit it’s kind of annoying, as we have been vaccinated for months now and have been pretty damn careful all along, but it is what it is. That said, I have a lot of sympathy for this position:

Some of that is happening in other states, but who knows, maybe we’ll get it for federal buildings and air travel, too. And who knows, maybe this will work.

As leaders in other parts of the country require government employees to get COVID-19 vaccinations, San Antonio and Bexar County are considering following suit, the Express-News reports.

Such a step would come as vaccination rates plateau and the highly contagious delta variant leads to a rise in infections, hospitalizations and deaths in Texas. California and New York City this week said they will make employees get the vaccine or submit to weekly coronavirus tests. Veterans Affairs became the first federal agency to mandate COVID vaccinations for frontline staff.

“We are supportive of the efforts of New York and California,” San Antonio Mayor Ron Nirenberg and County Judge Nelson Wolff said in a joint statement supplied to Express-News. “We will be reviewing the legalities and practicalities of requiring a COVID-19 vaccine and/or weekly testing in conformity with CDC guidelines in order to protect the health and well-being of city/county workforce.”

A city and county vaccine mandate would apply to roughly 18,000 workers, according to the daily, which reports that both Nirenberg and Wolff are unsure whether the requirement would be allowable under state law.

I think we can say with extreme confidence that the state would bring all its fight against such a move. That doesn’t mean it’s not worth the effort, but it’s not a move to be made lightly. Be prepared to hire a bunch of expensive lawyers, and have a solid communication strategy in place, that would be my advice.

As for masks in schools, well…

What did you expect? Greg Abbott has already said there won’t be any mask mandate in schools, and it’s impossible to imagine him changing his mind. It’s all up to the parents and school staff. I would not feel safe having my not-yet-vaccinated kids in school without a full-mask situation, which by the way is what we did in this past spring semester. I don’t even know what the argument against is. Doesn’t much matter when the power is on that side. The Trib and Daily Kos have more.

It’s not vaccinated people that are dying

Numbers don’t lie. It’s the unvaccinated that die.

Of the 8,787 people who have died in Texas due to COVID-19 since early February, at least 43 were fully vaccinated, the Texas Department of State Health Services said.

That means 99.5% of people who died due to COVID-19 in Texas from Feb. 8 to July 14 were unvaccinated, while 0.5% were the result of “breakthrough infections,” which DSHS defines as people who contracted the virus two weeks after being fully vaccinated.

The agency said nearly 75% of the 43 vaccinated people who died were fighting a serious underlying condition, such as diabetes, heart disease, high blood pressure, cancer or chronic lung disease.

Additionally, it said 95% of the 43 vaccinated people who died were 60 or older, and that a majority of them were white and a majority were men.

DSHS noted that these are preliminary numbers, which could change because each case must be confirmed through public health investigations. Statewide, more than 50,000 people have died of COVID-19 since March 2020, but the rate of deaths has slowed dramatically since vaccines became widely available in April.

Dr. David Lakey, the chief medical officer of the University of Texas System, said people succumbing to the coronavirus despite being vaccinated was “not unexpected.”

“No vaccine is 100%,” said Lakey, who is also a member of the Texas Medical Association’s COVID-19 task force. “And we’ve known for a long while that the vaccines aren’t 100%, but they’re really really good at preventing severe disease and hospitalizations. … There will always be some individuals that will succumb to the illness in the absence of full herd immunity.”

He added that 0.5% is “a very low number of individuals in a state of 30 million. … In the grand perspective of everything, that’s not a large number that would call into question at all the use of this vaccine.”

I should note that some of those 43 vaccinated people who died may have had other comorbidities, we don’t have enough data on that. But still, we’re talking a tiny fraction. One out of two hundred. Which group would you rather be in?

Need more? Go look at these charts from the CDC, one of new COVID cases and one of COVID deaths. The spike in new cases is much higher than the increase in deaths, because vaccinated people who still get COVID get a much milder version of it. They don’t go to hospitals, and they don’t die. If more people were vaccinated, that first chart wouldn’t have that big uptick in it, either.

And one more thing:

Just three states are now driving the pandemic in the United States, as the divide between vaccinated and unvaccinated regions of the country becomes ever more stark, as the more transmissible Delta variant of the coronavirus spreads.

Forty percent of all new cases this week have been recorded in Florida, Texas and Missouri, White House pandemic response coordinator Jeff Zients revealed at a press briefing Thursday.

Florida alone accounts for 20 percent of all new cases nationally, Zients pointed out, a trend that has stretched into its second week.

Zients added that “virtually all” hospitalizations and deaths — a full 97 percent — are among unvaccinated people. “The threat is now predominantly only to the unvaccinated,” he said. A few vaccinated people do experience so-called breakthrough infections, but they tend to experience only mild COVID-19 illness, or no illness at all.

Encouragingly, Zients said the five states that have experienced the most significant rise in infections — Arkansas, Louisiana, Florida, Nevada and Missouri — all also saw vaccination rates beat the national average for a second week in a row. But because immunity takes two weeks to develop, and the Delta variant spreads so rapidly, the benefits of the increased uptake of vaccinations may not be evident right away.

Singling out the three states where infections are now spiking could have the effect of putting pressure on elected officials there to do more to encourage vaccinations.

One of those elected officials is Greg Abbott, and we know how much he cares. But maybe some other people are less resistant. The numbers don’t lie.

The risk of being unvaccinated

The numbers don’t lie.

Nearly all COVID-19 deaths in the U.S. now are in people who weren’t vaccinated, a staggering demonstration of how effective the shots have been and an indication that deaths per day — now down to under 300 — could be practically zero if everyone eligible got the vaccine.

An Associated Press analysis of available government data from May shows that “breakthrough” infections in fully vaccinated people accounted for fewer than 1,200 of more than 853,000 COVID-19 hospitalizations. That’s about 0.1%.

And only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8%, or five deaths per day on average.

[…]

The preventable deaths will continue, experts predict, with unvaccinated pockets of the nation experiencing outbreaks in the fall and winter. Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle, said modeling suggests the nation will hit 1,000 deaths per day again next year.

In Arkansas, which has one of the lowest vaccination rates in the nation, with only about 33% of the population fully protected, cases, hospitalizations and deaths are rising.

“It is sad to see someone go to the hospital or die when it can be prevented,” Gov. Asa Hutchinson tweeted as he urged people to get their shots.

As the story notes, this is an AP analysis of the available data. The CDC has not done its own analysis yet because the data is not complete – only 45 of the 50 states report breakthrough infections, and they vary in how they define them. But the overall point is clear: Even though COVID deaths are down over ninety percent from January, when vaccinations started rolling out, they could be down a whole lot more, if more people were vaccinated. The extent to which COVID is under control is the extent to which the population is vaccinated. That can vary by quite a bit, by state and by region, and so we will continue to see some level of hospitalizations and deaths from COVID. And that level is higher than it needs to be. Link via Daily Kos.

Our Delta future

Don’t expect anything to change, except for the number of people getting sick and dying.

The new and highly contagious Delta variant of the coronavirus may have sparked the recent outbreak of 125-plus cases of COVID-19 linked to a Houston-area youth church camp, and a Texas virologist says the breakout should be a wake-up call for communities.

“Clearly, COVID is not over,” said Dr. Benjamin Neuman, a virologist and professor at Texas A&M University.

“COVID isn’t ever gone until it’s completely gone,” Neuman said. “And I think we’ve made the mistake of assuming that the virus would go away or assuming that the virus wouldn’t affect children … We keep stumbling into the same mistakes over and over, and that is not a way out of COVID-19.”

The Galveston County church camp took place in June with more than 450 adults and youth in attendance, according to the Houston Chronicle. More than 125 COVID-19 cases have been reported, of which three thus far have been confirmed to be the Delta variant.

The Delta variant is poised to become the leading strain in the United States in coming months according to Texas health experts, whose top concern is the risk it represents for those who are unvaccinated.

That strain, known by scientists as B.1.617.2, now accounts for about a quarter of virus infections in the nation, according to the Centers for Disease Control and Prevention. First discovered in India, it triggered a devastating outbreak there in April and May and has since spread to 85 other countries, attacking areas where vaccination rates are the lowest.

While dozens of strains have spawned from the original COVID-19 virus, the Delta variant is the most transmissible so far, said Dr. Rebecca Fischer, an infectious disease epidemiologist and assistant professor at Texas A&M University’s School of Public Health. It is also leading to higher rates of hospitalization for those infected, according to research.

[…]

DSHS said it recommends people protect themselves from the variant the same way they do for other strains of the virus.

“The best protection from all strains of COVID is getting fully vaccinated,” the statement said. “People who are not vaccinated should continue to follow COVID precautions, like wearing a mask and social distancing.”

Though the CDC says people who are fully vaccinated do not have to wear masks in public spaces, Neuman is pleading for everyone to continue wearing them, especially with the Delta variant spreading in Texas.

“The only confirmed cases that we know are cases that spread through the air,” he said, and those are “from somebody’s mouth to somebody else’s mouth.” Because of that, “blocking one or both of those mouths is really the ultimate way to stop the virus from spreading.”

Some more data, if you need it.

More than 40 percent of new COVID-19 hospitalizations at Houston Methodist are the Delta variant, researchers said Wednesday, a number expected to rise as travel returns but vaccination rates stagnate nationwide.

“The number of Delta variant COVID-19 cases at Houston Methodist has nearly doubled over the last week and is sixfold higher than in May,” said Houston Methodist spokesperson Lisa Merkl. Delta variant cases made up just 20 percent of hospitalizations at the hospital system the week prior.

COVID-19 vaccinations are critical to reducing infection rates, epidemiologists said, especially as the more contagious strain of the virus spreads worldwide. Positive case and hospitalization rates are also trending upward at Houston Methodist.

Experts expect that Delta, which is thought to be 60 percent more transmissible than the original SARS-CoV-2 strain, will soon become the dominant coronavirus variant in the U.S. Houston Methodist’s models estimate the Delta variant will make up 92 percent of all new infections within the coming weeks.

Not sure what more you need to know. The people who are vaccine hesitant, or who have obstacles in their way for getting vaccinated, will for the most part eventually get vaccinated. It will take too much time and I doubt there’s anything we can do now that we haven’t already tried to speed it up, but this group will steadily shrink. The anti-vaxxers are not going to get vaccinated, and there’s not a damn thing we can do about it. They’re also not going to wear face masks – they were the most whiny and resistant about it when that was the only mitigation available for when you had to be among other people. There’s also basically no chance Texas will impose any face mask requirements again, and local governments are prohibited from doing so. I wouldn’t even expect Greg Abbott to make a timid suggestion that maybe some people should think about wearing masks again.

If the Delta variant really takes off in Texas and we start looking like Missouri, I have no idea what happens. I have a hard time imagining Abbott even asking for federal help, though maybe the locals can do that. In many ways, we are where we were before, which is to say we’re on our own as far as Texas government is concerned. At least this time, some of us have more protection than others.

Kids still get COVID, too

And they need to get vaccinated if at all possible.

Since the Food and Drug Administration approved emergency use of the Pfizer vaccine for 12 to15 year olds on May 10, more than 300,000 Texas adolescents and teenagers have received at least one dose. Girls in this age range are receiving the vaccine at a higher rate (153,000) than boys (149,000), according to Texas Health and Human Services. Nationwide, more than 626,000 12 to 15 year olds have received two doses, according to the CDC.

Though young people can now receive shots, the number of children and adolescents being hospitalized is increasing. The Centers for Disease Control and Prevention released data from the first half of 2021 that shows nearly one-third of adolescents who are hospitalized with COVID-19 require intensive care. Five percent of those patients need to be put on ventilators with supplemental oxygen, as well.

The CDC reports that nearly 400 children and adolescents are currently in hospitals across the country with COVID or complications from the virus. More than 16,000 under the age of 18 have been hospitalized from COVID since the start of the pandemic, and more than 300 of them have died from it, said Dr. Jim Versalovic, interim pediatrician-in-chief at Texas Children’s Hospital.

“This is a huge setback for a child or adolescent with time spent out of school or activities,” Versalovic said. “There’s a long recovery time even if the infection is mild initially.”

He attributes the increase to fewer masks and stagnating vaccination rates.

More than half of all Texans are vaccinated with at least one dose, but that doesn’t mean Houston is free of several coronavirus variants that are more transmissible and deadlier than the original virus.

In the last month, fewer people are masking up in public outdoors and indoors after the CDC said it was safe for vaccinated people to go masklessThree-day holiday weekends and the onslaught of summer weather has turned Houston into the partying swamp city it was before the pandemic, too.

[…]

Versalovic said about 10 percent of children diagnosed with the virus at his hospital require hospitalization. This rate is nearly three times greater than the seasonal flu, which the CDC reported killed nearly 600 children between 2017 and 2018.

Child survivors sometimes have a whole new set of problems when the initial infection clears. Several weeks after other symptoms have gone away, children who had mild COVID develop other symptoms that typically require hospitalization. This is called Multisystem Inflammatory Syndrome in Children, or MIS-C.

MIS-C symptoms include fever, stomach pain, diarrhea, vomiting, neck pain, random rashes and bloodshot eyes. Extreme fatigue is also a symptom, but it’s usually blamed on other problems.

Texas Children’s has vaccinated more than 18,500 12 to 15 year olds since early May. Any person age 12 and older is eligible for a free Pfizer vaccine from the hospital, regardless of whether they are currently a patient. Vaccines are available at six Texas Children’s sites across Houston Monday through Saturday.

The hospital is partnering with Houston-area school districts now to immunize their students, so middle and high schools can open safely for the fall semester, he added.

“We are going to be very busy during the summer months as we seek to immunize as many children as possible,” Versalovic said. “It’s important to protect adolescents to stop the spread of COVID as they get ready for summer activities, camps, sports and the school year in August.”

Not much to say here that we haven’t said already, many times. Get your kids vaccinated. As long as there are unvaccinated and/or immunocompromised members of your household, you should continue with pre-vaccination safety protocols as much as possible, which I know is vastly more difficult now that masks are being removed all over the place. It is true that the health risks to kids from COVID are lower than they are with adults, but they are not zero and they can be serious. For all the progress we’ve made, we’re not out of danger yet.

Threat level down

Been waiting for this for some time.

Harris County finally will downgrade from its highest COVID-19 threat level, County Judge Lina Hidalgo said Monday evening, after 47 weeks of urging residents to stay home.

Hidalgo said the effectiveness of the COVID-19 vaccines and improving local metrics were among several factors that convinced her to revise the threat level system the county debuted last summer. The U.S. Centers From Disease Control also told fully vaccinated Americans last week they may resume their pre-pandemic lives.

“We’re very much at a turning point,” Hidalgo said. “We don’t want to claim victory because there certainly there’s a possibility that amongst the unvaccinated, the virus gets out of control. But we do have reason for celebration.

Hidalgo said she would make a formal announcement Tuesday. Remaining guidelines would only apply to unvaccinated residents.

The two Republican county commissioners had urged the Democratic leader for weeks to abandon Level Red, which states that virus outbreaks are uncontrolled and worsening; data show the opposite is true.

The pair, Jack Cagle and Tom Ramsey, have said that while COVID-19 still must be taken seriously, the Level Red designation obscures the progress the county has made in containing the virus.

[…]

Currently, Harris County meets four of five criteria to downgrade to the next-highest threat level, including 14-day averages of new cases below 400 and share of ICU beds occupied by virus patients below 15 percent.

The remaining barrier is a test positivity rate below 5 percent; currently that metric stands at 9.4 percent. That result differs greatly than the positivity rate recorded by the Texas Medical Center system, which currently is 3.7 percent.

The TMC rate comes from tests conducted on patients at member hospitals in the Houston region; the county rate comes from tests taken by the Houston and Harris County health departments, as well as local pharmacies.

Hidalgo said experts she consulted said since few residents were being tested, Harris County’s rate likely was artificially high. She said her team would revise the metrics so positivity rate and new cases are secondary criteria.

See here for the previous update, which was a month ago. We’re a lot farther along on vaccinations, and all of the numbers have moved in accordance with that. I like the fact that we’re being true to the metrics, and that we are making adjustments to them based on new facts on the ground. I commend Judge Hidalgo for consistently doing the right thing, which would have been a lot easier to do if we didn’t have Threat Level Super Duper Bright Red stupidity and malevolence from other parts of our government. The later story also notes that government buildings would reopen to 50 percent capacity, and the county is reviewing that dumb anti-mask mandate order. The Press and the Trib have more.

Abbott ends mask mandates

This guy, I swear.

Gov. Greg Abbott announced Tuesday that public schools can no longer require masks on their campuses starting June 5. The decision was part of a new executive order that bans governmental entities in Texas — like cities and counties — from mandating masks in the fight against the coronavirus pandemic.

Starting Friday, any government entity that tries to impose a mask mandate can face a fine of up to $1,000, according to the order. The order exempts state-supported living centers, government-owned or -operated hospitals, Texas Department of Criminal Justice facilities, Texas Juvenile Justice Department facilities, and county and municipal jails.

The order is arguably the most consequential for public schools. After Abbott ended the statewide mask requirement in early March, school systems were allowed to continue with their own mask-wearing policies unchanged. But after June 4, “no student, teacher, parent, or other staff member or visitor may be required to wear a face covering,” according to Abbott’s new order.

While 30% of Texans have been fully vaccinated against COVID-19, the vast majority of children are unvaccinated. The Pfizer vaccine was authorized last week for children as young as 12. The Moderna and Johnson & Johnson vaccines are still only authorized for those 18 and older. School-age children have seen lower infection rates than other age groups. COVID-19 cases among those 5-17 years old make up 10% of total cases in the country, according to the latest CDC data.

Last week, the Centers for Disease Control and Prevention said fully vaccinated people no longer have to wear masks outdoors in crowds and in most indoor places.

The Texas State Teachers Association called Abbott’s latest move premature. In a statement, the head of the association, Ovidia Molina, said Abbott should have waited until the CDC issued updated guidance on masks for the 2021-22 school year. Molina acknowledged that some Texas school districts have already ended their mask requirements but said the association believes “that also is ill-advised.”

“The health and safety of our students, educators and communities must remain our first priority as we attempt to emerge from this pandemic,” Molina said.

Abbott’s new rules will take effect as the school year is winding down for most students — or already over. The last day of classes for the state’s biggest school district, Houston ISD, is June 11, while May 27 is the last day for most students in the state’s second biggest district, Dallas ISD.

Why can’t you just wait another week? School is almost over here in Houston, and it will be over in some parts of the state before this kicks in. Vaccination levels still aren’t that great, though we can reasonably expect them to be significantly better by August, and we know that fully reopening schools when we did increased the COVID infection rate. Surely Abbott isn’t that afraid of little ol’ Don Huffines. One more week, that’s all that was needed. The Chron has more.

You can lose the mask if you’re fully vaxxed

Do your part, reap the reward.

Federal health officials reversed course Thursday and advised that people who are fully vaccinated can stop wearing masks and observing social distancing in most indoor and outdoor settings.

It’s welcome news for many who have grown weary of the safety precautions more than 14 months into the global public health crisis and is a significant milestone in returning to pre-pandemic life. But the announcement will likely give new life to the debate about requiring vaccinations that has been playing out in Texas and across the nation — and it comes as less than a third of Texans are fully vaccinated.

“We have all longed for this moment,” Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said from the White House on Thursday. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”

But Walensky cautioned that the CDC’s guidance comes with exceptions. Vaccinated people should continue to wear masks and distance themselves from others in medical settings and around high-risk populations, such as doctor’s offices, hospitals and long-term care facilities, and while traveling aboard airplanes, busses and trains. Incarcerated people and people in homeless shelters should also continue to observe safety precautions.

[…]

More than 11 million Texans had received at least one dose of the COVID-19 vaccine as of Tuesday, according to state data. Nearly 31% of the state’s residents are fully vaccinated. But the rate at which Texas is vaccinating its residents has slowed despite ample supply. An April poll by the University of Texas at Austin and The Texas Tribune found that 36% of Texans said they were either reluctant to receive the vaccine or would refuse to get it, including nearly half of the state’s Republicans.

Peter Hotez, a preeminent infectious disease expert and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, said on Twitter that he supported the announcement, but that it carries a risk in places like Texas.

“COVID19 immunization rates in my part of the country, TX + South, are still lagging the rest of the nation, so I worry about a 5th wave this summer in the South like last summer,” he said.

As noted in the story, this comes on the heels of the approval of the vaccine for 12 to 15 year olds. I’ve already seen pictures of a bunch of my friends’ kids getting their first shot; ours will do so later today. Our vaccination numbers in Texas can certainly be better, but that’s one part helping people overcome the obstacles in their path to getting a shot, and one part giving whatever answers or reassurances the hesitant folks have. Not much you can do about the flat-out resisters, but if we can limit the damage to just them we’ll be all right. I also suspect that over time we’ll see higher vax numbers in the urban areas than elsewhere, or at least we will if we do the job of making it as accessible as possible. In the meantime, those of us who have gotten our shots can show our faces again, and just in time for summer. That’s gonna feel good.

(To be sure, some number of unmasked people are the same chuckleheads who refuse to be vaccinated, and they’ve been walking around unmasked for a long time now. There is an argument that the CDC’s new guidance isn’t a good idea. And of course, individual retailers and restaurants and what have you may continue to require masks in their establishments for the time being, since there’s no way to tell who is and isn’t vaccinated. You can take your mask off where you can if you’re vaxxed, just as always be thoughtful and considerate about it.)

Pfizer shot approved for younger kids

Yes!

The Food and Drug Administration cleared the first coronavirus vaccine for emergency use in children as young as 12 on Monday, expanding access to the Pfizer-BioNTech shot to adolescents ahead of the next school year and marking another milestone in the nation’s battle with the virus.

The decision that the two-shot regimen is safe and effective for younger adolescents had been highly anticipated by many parents and pediatricians, particularly with the growing gap between what vaccinated and unvaccinated people may do safely. Evidence suggests that schools can function at low risk with prevention measures, such as masks and social distancing. But vaccines are poised to increase confidence in resuming in-person activities and are regarded as pivotal to returning to normalcy.

“Adolescents, especially, have suffered tremendously from the covid pandemic. Even though they’re less likely than adults to be hospitalized or have severe illness, their lives really have been curtailed in many parts of the country,” said Kawsar R. Talaat, an assistant professor of international health at the Johns Hopkins Bloomberg School of Public Health. “A vaccine gives them an extra layer of protection and allows them to go back to being kids.”

Expert advisers to the Centers for Disease Control and Prevention are scheduled to meet Wednesday to recommend how the vaccine should be used in that age group, and the vaccine can be administered as soon as the CDC director signs off on the recommendation.

In a news briefing Monday evening after the announcement, FDA officials said the Pfizer authorization for 12- to 15-year-olds was a straightforward decision because the data showed that the vaccine was safe and that the response to the vaccine was even better than among the 18- to 25-year-olds who got the shots.

Our almost-17-year-old has had her shots. We’ll be getting the 14-year-old signed up as soon as we can. “Herd immunity” may never be a thing we achieve with COVID, but having a greater share of the population vaxed is a good thing, and adding this group to the eligible list moves towards that goal. I’m ready for this.

Now it gets harder to vaccinate people

We reached this point pretty quickly. The hill gets steeper from here.

After months of not having enough COVID-19 vaccines to meet demand, Texas suddenly appears to have plenty of shots but not as many people lining up to receive them, even though more than three quarters of the state still isn’t fully vaccinated.

Almost 7 million Texans have been vaccinated against COVID-19 — more than 23% of the state’s population — and health officials say they are starting to see lower demand at public vaccination sites. Recent data show reported vaccine doses have decreased: The number of people who have gotten at least one shot in Texas grew by over 1 million during the week ending April 14; the following week the number dropped to about 660,000.

Across Texas, local leaders are trying to ramp up outreach efforts and fill more appointments. Houston’s FEMA hub at NRG Park is now offering walk-in slots, a shift from prior appointment-only requirements that kept some residents from getting early doses. The state will also be rolling out a TV campaign to boost vaccinations, Department of State Health Services spokesperson Chris Van Deusen told the Wall Street Journal.

Local health officials say efforts to vaccinate older Texans have been successful: As of April 21, nearly 60% of Texans age 65 and older have been fully vaccinated. Since the state opened vaccinations to all adults on March 29, around one-fifth of Texans between 16 to 49 years old — who make up the biggest proportion of eligible adults — have been fully vaccinated.

“It seems we’re getting to the point that most people eager to get vaccinated have gotten at least their first dose,” Imelda Garcia, associate commissioner of laboratory and infectious disease services for DSHS, said during a Thursday press conference. “The next phase will be about helping ensure that vaccine is more easily available to those folks who are not going to go as far out of their way.”

Nationally, vaccine supply may outpace demand within the next month, according to the Kaiser Family Foundation, a health nonprofit.

Vaccination rates vary across Texas: most large urban and suburban counties, except for Tarrant County, are above the overall state rate in terms of the percentage of people who have received at least one dose. Along the border, a region that has been particularly hard hit by the pandemic, more than 40% of the population in many counties, including El Paso, Starr and Cameron, have gotten a dose — compared with 36% statewide.

[…]

Texas’ vaccination efforts are still missing people who have faced obstacles for months, said Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health in Houston. Some lack internet access or the computer skills to make an online appointment, while others lack transportation to reach a vaccine provider.

And Black and Hispanic Texans continue to be vaccinated at lower rates than whites, even as appointments become more available across the state.

According to the embedded map in the story, Harris County has fully vaccinated 22.8% of its residents, which is a bit below the statewide average of 23.6%. However, more than twice as many people have had at least one shot, which by my calculation is 56.7% of the Harris population, and that’s pretty darn good. In theory, in a month’s time our baseline number should be close to sixty percent. The one-shot Johnson and Johnson vaccine has been resumed, and that should help with some of the harder-to-reach folks as well, since it only requires the one appointment.

There’s a lot of effort going on now to reach the people who have obstacles to getting vaccinated, and while that will take more time I believe they will get there. That leaves the anti-vax zealots, and I have no more idea how to reach them than you do. That said, there is one obvious strategy to maybe draw some of the more resistant folks out of the woodwork:

There are public policy “interventions” that can encourage further adoption: publicizing how safe the vaccine has been so far for people who’ve gotten it, stocking doctors’ offices and mobile clinics to make the shots more convenient, tying access to public spaces to being fully vaxxed, promising to eliminate mask mandates and other societywide restrictions once a certain percentage of the population has gotten its doses, and so forth.

Those are among the suggestions you’ll find being made by individuals arguing against the one really obvious way to get people to do something: paying them. Economist Robert Litan, former Democratic presidential long shot John Delaney, and an Oxford professor named Julian Savulescu are among those who’ve proposed such cash-for-vax payments; Litan would make them $1,000 and Delaney $1,500. In response, ethicists affiliated with the University of Washington and the Cornell and University of Pennsylvania medical schools have written, in the Journal of Medical Ethics and Journal of the American Medical Association, that it would be a bad idea.

The arguments against payment are reasonable ones: It’s crude and coercive to put proportionally huge pressure on lower-wealth citizens to do something that they might not want to; the idea that you get something like “hazard pay” for taking a vaccine might convince people it is risky; and setting a precedent of paying people to protect their health might make them less likely to take vaccines and follow guidelines in the future if there’s no money in it. Localized and incentive-driven initiatives like the ones described above, ethicists say, are more likely to build the long-term trust between officials and residents that will be crucial to ending this pandemic and preventing future ones.

The problem with this case is that it exists for the most part in an abstracted, theorized version of the United States that is populated by individuals making good-faith decisions based on credible public information and conversations with medical professionals. Our actual country, however, is one in which one of the two major parties sees an advantage in the weaponized misunderstanding of medical science, celebrity influencers build followings by pretending to uncover sinister threats everywhere, and media outlets spam every speciously correlated story about someone having a health problem after getting a shot into millions of pockets multiple times a day. Informational and incentive-based campaigns to reach people who have genuine, medically oriented hesitations about the vaccine are good ideas that should definitely be pursued. Does anyone honestly think they’re going to be enough? This is a fractured polity we’re dealing with here, folks!

Contemporary Americans self-evidently do not share a common trust in any government or media institution. On the other hand, almost all of us still appreciate and believe in the institution of the United States dollar, and the ways it can be earned and spent.

Maybe most of these people are die-hard Trumpers. As the author notes, those folks happily cashed their Biden stimulus checks. Money talks. It sticks in my craw to reward this kind of selfish and self-destructive behavior, too, but in the end the more vaccinated people the better off we all are, especially those who have legitimate medical reasons for not getting vaxxed. There is an inverse to this approach, which I’ll get to in another post. Put me down as being in favor of all reasonable strategies for getting as many shots in arms as we can.