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Beware of RSV

Worrying.

Two common respiratory viruses continue to keep Houston pediatric hospitals unusually busy this time of year, with both the flu and RSV seeing a second surge following a rise in cases over the spring and summer, respectively.

Before the COVID-19 pandemic, children sickened with either illness flocked to hospitals later in the winter months, from November to January. But intense isolation, social distancing and masking appears to have changed when those viruses spread, experts say, with a swath of young children being exposed for the first time.

It’s also unusual to see both viruses surging twice in the same year, puzzling top pediatric doctors in Houston.

“I was not necessarily expecting a surge right now,” said Dr. Michael Chang, a pediatric infectious disease specialist at UTHealth and Children’s Memorial Hermann Hospital. “Having had a summer (RSV) surge, I was expecting that was it. It’s very unusual to have two surges in a single season. It happens, rarely, but it’s very uncommon.”

Both RSV, or respiratory syncytial virus, and the flu have similar symptoms with slight differences. Both illnesses produce cold-like symptoms. The flu is more associated with a higher fever, while a key indicator of RSV is wheezing, according to the Cleveland Clinic. Nearly all children catch RSV before age 2. Both illnesses often do not require hospitalization, but young infants and older adults with compromised immune systems are at higher risk of severe illness from RSV.

RSV saw a massive spike last summer, and Chang and other pediatric doctors had warned of another summer surge this year. But when cases initially started to rise in June, the numbers never dropped back to baseline levels. The statewide positivity rate for antigen tests hovered around 10 percent until September and early October, when the positivity rate jumped again to more than 25 percent, according to the Texas Department of State Health Services.  Last summer, the statewide positivity rate for antigen tests surpassed 30 percent.

[…]

Influenza A, one strain of the flu, also is on the rise after an increase in March and April. Houston Methodist’s respiratory pathogen data shows the hospital system is seeing year-long high in weekly cases with 656.

Despite the unusual pattern, parents of young children in the Houston area should not panic, doctors say. While national reports indicate record high patient volumes in some parts of the country, Houston is better equipped than other large cities to handle the surge, with two large pediatric hospitals in Texas Children’s and Children’s Memorial Hermann. The dual virus threat also is nothing new for pediatricians, as the flu and RSV season often overlapped before the pandemic.

“This is how every December and January used to be in children’s hospitals across the country,” Chang said.

COVID cases remain low in the Houston area. While some hospitals may hit capacity on busier days, and patients may encounter long wait times, the small percentage of RSV and flu patients who need hospitalization should be able to find beds, doctors say. Dr. James Versalovic, chief pathologist at Texas Children’s Hospital, said parents should consult with pediatricians if their children have persistent symptoms, including coughing, fever, poor feeding or rapid breathing. Virtual appointments are also available if area hospitals are strained.

It’s not just happening in Harris County, either. It’s having some negative effects.

With respiratory illnesses spreading among children more widely and earlier than in previous years, hospital leaders and medical experts say pediatric hospital beds across the state are in short supply.

After two years of mild flu seasons — a result of mitigation strategies to limit the spread of COVID-19 — medical experts say the number of children developing respiratory illnesses is already much higher this year, leading to more visits to health care centers and increasingly strained resources to treat those children.

Experts say the strain stems from overburdened hospital systems still reeling from the impact of the COVID-19 pandemic and a shortage of medical providers.

Dr. Gerald Stagg, a pediatrician working in Mount Pleasant, said cases of respiratory syncytial virus, known as RSV, and an earlier flu season have added pressure to hospital systems on top of other respiratory illnesses caused by COVID-19 and other viruses.

“I’ve been doing this for 42 years and I’ve never seen anything quite like it,” Stagg said of the number of children needing treatment for respiratory illnesses this year.

With the higher rates of respiratory illnesses, Stagg said not only are hospitals filling up, but clinics like his are having trouble keeping up with the huge uptick in visits from children with the flu.

Stagg said it’s become more difficult over the last two months to find beds in larger medical systems for sick children who require higher levels of care than what rural hospitals are able to provide.

“We’ve had to even send kids to Arkansas or Louisiana from our Texas facility because we couldn’t find a bed,” Stagg said.

He added that the shortage of hospital beds is a risk to children with serious illnesses that are not respiratory because there isn’t sufficient space in intensive care units for them.

Carrie Kroll, the vice president of advocacy, public policy and political strategy at the Texas Hospital Association, said the shortage of pediatric beds is a workforce issue. Hospital systems are still dealing with staffing shortages after droves of nurses and other hospital workers, suffering from pandemic-related burnout, retired or left the field.

“A bed is a bed. If it doesn’t have anyone to staff it, you can’t put a kid in it,” Kroll said.

[…]

Dr. Iván Meléndez, the Hidalgo County health authority, said his region has enough beds and resources to meet the needs of the community at the moment.

Meléndez did warn that this year could have significantly more cases of the flu than previous ones. Federal health data released Friday reported 880,000 cases of influenza and 360 flu-related deaths nationally. The last time the country saw similar rates of the flu was in 2009. And flu season has just started; it generally spans from October to May.

Earlier this month, Hidalgo County reported one of the first deaths of a child due to the flu this season.

“We’re thinking this may be the third since the turn of the century of being a ‘high-flu’ year,” Meléndez said.

He said the prevalence of the flu this year is an unintended consequence of masking and isolating during the COVID-19 pandemic.

“As a community, worldwide, we didn’t develop those antibodies that are usually present in the community at some level to protect people,” he said.

To address the surge of respiratory illnesses, Meléndez and other medical experts strongly recommended vaccinations against the flu and COVID-19.

Sure would be nice if we had a governor that was capable of delivering that message. There’s no vaccine for RSV, but the flu shot and the bivalent booster are easily available, so do what you can to protect yourself. Your Local Epidemiologist has more.

Math test scores took a hit during the pandemic

The decline started before the pandemic, but kept on going from there.

Students in Houston and across the nation showed “appalling and unacceptable” declines on the 2022 Nation’s Report Card, adding to mounting evidence that the pandemic impacted young people already facing academic and mental health challenges.

U.S. Secretary of Education Miguel Cardona said low-performing students’ scores on the National Assessment of Educational Progress were faltering even before the pandemic and now all performance levels are showing sharp declines. The nation must take swift action and invest more in education to reverse these troubling trends, he said.

“It’s heartbreaking, and it’s horrible,” Cardona said. “It’s an urgent call of action. We must raise the bar in education.”

The U.S. Department of Education administers the NAEP every other year to fourth- and eighth-graders across the country. Comparisons can be made among states, as well as among 27 of the country’s largest school districts. Desegregated results from Houston, Austin, Dallas, and Fort Worth ISDs are available, as are state totals. Score range from 0 to 500.

Results for Houston ISD show:

  • In math, the number of fourth-grade students performing “below basic” on the math NAEP increased 14 percentage points to 37 percent since 2019. On average, Houston ISD fourth-graders scored a 226, compared to 235 in 2019. The national average this year fell to 227.
  • The average score of a white fourth-grader in HISD on the math test was a 260, compared to a 212 for Black students and a 223 for Hispanic students. Additionally, 22 percent of white fourth-graders reached the “advanced” benchmarks of the math test, compared to 2 percent of Black and Hispanic students.
  • About 44 percent of eighth-graders in Houston ISD performed “below basic” on the reading NAEP, an increase from 41 percent in 2019. Their average score was 247, falling 2 points lower than 2019 scores and 8 points lower than the national average. White students averaged a 275, while Black students averaged 236 and Hispanics 244.
  • Additionally, only 4 percent of white eighth-graders in Houston ISD reached the “advanced” benchmark on the reading test.

Houston ISD Superintendent Millard House II said support services will be key to improving scores.

“While these challenges are not unique to HISD, providing students and families with the necessary academic and non-academic supports as detailed in our community driven five-year strategic plan, will address many of these needs,” House said in a statement. “We are confident that these investments in our students such as requiring a librarian, counselor or social worker, and supporting our schools with the highest need through our RISE program, will ensure a more equitable, targeted approach increasing positive academic outcomes.”

The first STAAR results post-pandemic weren’t so bad, but there was definitely an impact on poorer students. I feel reasonably confident that we can make up the lost ground, but what we can’t ever get back is those years of those kids’ lives. At a certain point, the effect of the learning loss has real long-term negative effects. That’s a problem that won’t go away.

One more thing:

There’s more to the thread, but you get the idea. Don’t let people go jumping to conclusions around you. The Trib and Texas Public Radio have more.

Is this just the calm before the next COVID wave?

Things look good now, at least in the Houston area, but COVID never sleeps.

As the U.S. heads into a third pandemic winter, the first hints are emerging that another possible surge of COVID-19 infections could be on its way.

So far, no national surge has started yet. The number of people getting infected, hospitalized and dying from COVID in the U.S. has been gently declining from a fairly high plateau.

But as the weather cools and people start spending more time inside, where the virus spreads more easily, the risks of a resurgence increase.

The first hint of what could be in store is what’s happening in Europe. Infections have been rising in many European countries, including the U.K., France, and Italy.

“In the past, what’s happened in Europe often has been a harbinger for what’s about to happen in the United States,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “So I think the bottom line message for us in this country is: We have to be prepared for what they are beginning to see in Europe.”

Several computer models are projecting that COVID infections will continue to recede at least through the end of the year. But researchers stress there are many uncertainties that could change that, such as whether more infectious variants start to spread fast in the U.S.

In fact, scientists are watching a menagerie of new omicron subvariants that have emerged recently that appear to be even better at dodging immunity.

“We look around the world and see countries such as Germany and France are seeing increases as we speak,” says Lauren Ancel Meyers, director of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. “That gives me pause. It adds uncertainty about what we can expect in the coming weeks and the coming months.”

However, it’s not certain the U.S. experience will echo Europe’s, says Justin Lessler, an epidemiologist at the University of North Carolina who helps run the COVID-19 Scenario Modeling Hub.

That’s because it’s not clear whether Europe’s rising cases are related to people’s greater susceptibility to new subvariants they’ve not yet been exposed to. In addition, different countries have different levels of immunity.

“If it is mostly just behavioral changes and climate, we might be able to avoid similar upticks if there is broad uptake of the bivalent vaccine,” Lessler says. “If it is immune escape across several variants with convergent evolution, the outlook for the U.S. may be more concerning.”

In fact, some researchers say the U.S. is already starting to see early signs of that. For example, the levels of virus being detected in wastewater are up in some parts of the country, such in Pennsylvania, Connecticut, Vermont and other parts of the Northeast. That could an early-warning sign of what’s coming, though overall the virus is declining nationally.

“It’s really too early to say something big is happening, but it’s something that we’re keeping an eye on,” says Amy Kirby, national wastewater surveillance program lead at the Centers for Disease Control and Prevention.

But infections and even hospitalizations have started rising in some of the same parts of New England, as well as some other northern areas, such as the Pacific Northwest, according to Dr. David Rubin, the director of the PolicyLab at Children’s Hospital of Philadelphia, which tracks the pandemic.

“We’re seeing the northern rim of the country beginning to show some evidence of increasing transmission,” Rubin says. “The winter resurgence is beginning.”

As the story notes, we’re overall in a much better place because there’s a lot more immunity thanks to vaccinations and our previous high rate of infections. The COVID levels in wastewater here is low now, and while we’re hardly a leader in vaccinations, we at least have warmer winters so there are still plenty of opportunities to be outside, and fewer times where you have to be congregated inside. But also, not nearly enough people have had their bivalent boosters yet, and there are concerns about the flu season. So, you know, remain appropriately cautious – masking in places where you used to have to mask is still an excellent idea – and get those shots.

Microbreweries are getting back on track

A bit of good news.

Texas craft breweries rebounded in 2021, a promising sign after the pandemic staggered the industry.

The state of beer: Of the state’s 10 largest breweries, seven increased production in 2021 compared with 2020, according to an Axios analysis of data from the Brewers Association.

Just one Texas brewery — Spoetzl Brewery — saw a year-over-year decline in production, but the Shiner-based brewery continues to see the highest sales in the state, with more than 500,000 barrels sold last year.

  • The state also saw 12 breweries close and 45 open, the data shows.

The big picture: The craft beer industry grew by 8% in 2021, while the overall market moved up 1%. Texas placed two breweries — Saint Arnold and the brewer of Shiner — among the nation’s 50 largest.

  • Yes, but: The rebound could be hampered by supply chain problems and a carbon dioxide shortage caused by contamination at an extinct volcano in Mississippi.

Yes, the CO2 shortage. Hopefully that will get worked out soon. You’d think of all the things on this planet we would not be short on that would be it, but here we are. I’d like to see this same reporting done on a more local level, say a Houston story about how all of the microbreweries in our area are doing now. There could be a lot of variance, based on size or location or business capability or just dumb luck. The growth of small breweries in Texas has been a huge success story, we should know more about how it’s going now this far into the COVID era. But at least at a high level, things are looking up.

Treasury Department investigating DeSantis

Noted for the record.

The Treasury Department is now investigating whether the taxpayer money Florida Gov. Ron DeSantis (R) spent to fly Venezuelan migrants to Martha’s Vineyard for political theater last month came from federal COVID-19 relief.

Richard Delmar, the department’s deputy inspector general, sent a letter to a congressional delegation of Massachusetts lawmakers on Friday saying that his office was reviewing Florida’s use of the Coronavirus State and Local Fiscal Recovery Fund (SLFRF) that was established by the American Rescue Plan.

“We will review the allowability of use of SLFRF funds related to immigration generally, and will specifically confirm whether interest earned on SLFRF was utilized by Florida related to immigration activities, and if so, what conditions and limitations apply to such use,” Delmar wrote.

The Treasury official said the department planned to “get this work underway as quickly as possible.”

Delmar’s letter, which was released by Sen. Ed Markey (D-MA) on Wednesday, came in response to the request Markey and five other Massachusetts lawmakers had sent on Sept. 16 asking for a probe into DeSantis’ potential abuse of the aid.

“States should not be permitted to use COVID-19 relief funds for any parochial interest unrelated to the pandemic, particularly for naked political conduct that imposes severe and unjust harms on disadvantaged groups of individuals,” the lawmakers wrote.

While the $12 million DeSantis poured into the gambit didn’t come directly from Congress’ COVID-19 relief funds, it did come from the interest his state had earned off the aid, per the Washington Post.

See here and here for some background. Daily Kos adds some details.

The civil rights organization Southern Poverty Law Center (SPLC) had this past June urged the Treasury Department to open a probe into the Florida governor. DeSantis had not yet launched his cruel stunt dumping migrants across the country, but he had been seeking to use $12 million in federal coronavirus funding to aid his anti-immigrant platform. SPLC had warned in its letter that the “proposed misuse of these funds reinforces anti-immigrant policies,” as well as “sets a dangerous precedent.”

Damn, was that on money. DeSantis had already signaled last fall that he was going to make a scandal out of entirely routine flights that the federal government carries out, including under the insurrectionist president. When that didn’t stick long enough to his liking, he went to Texas to just carry out his own flights.

Markey’s office said it has been in contact with federal, state, and local officials regarding DeSantis’ cruel transportation of dozens of migrants to Martha’s Vineyard, with support from nonprofits like the Massachusetts Immigrant and Refugee Advocacy Coalition and the Venezuelan Association of Massachusetts. Markey’s office noted efforts to ensure that vulnerable children and adults transported by DeSantis from Texas to Massachusetts have been met with “continued care.”

DeSantis is not the only anti-immigrant governor under investigation by the Treasury watchdog, as a matter of fact. This past spring, Delmar said the department would be launching a probe into whether Texas Gov. Greg Abbott misused federal pandemic funds to keep his illegal Operation Lone Star border stunt operational. The Washington Post reported possible misuse of as much as $1 billion.

Congressional lawmakers led by Texas’ Joaquin Castro and Veronica Escobar had urged the watchdog to investigate Abbott using federal funds like his personal ATM for racist hate, writing that he was diverting money from critical public sector resources. “It is negligent and irresponsible for Governor Abbot to direct additional funding to Operation Lone Star, especially if the funding in question was intended to help Texans rebuild from the pandemic,” they wrote.

This story has just a tangential Texas connection, but I’m following it anyway out of sheer curiosity. Mostly, I want to see if it’s even possible for there to be consequences for would-be authoritarians like DeSantis, who will otherwise keep pushing boundaries since there’s apparently nothing to stop them. Along those lines, we also have this.

Bexar County Sheriff Javier Salazar on Thursday certified that 49 migrants who were flown to Martha’s Vineyard by Florida Gov. Ron DeSantis last month were victims of a crime. The move clears a pathway for those migrants to get a special visa to stay in the country that they otherwise would not have received.

Rachel Self, a Massachusetts attorney working with the migrants, told radio station WGBH that the move by Salazar is a key part of the migrants’ applications for a “U visa,” which is reserved for victims of crime or people who witnessed a crime. In a statement, Salazar said his office had submitted documents with the federal system “to ensure the migrants’ availability as witnesses during the investigation.”

Attorneys like Self are seeking the visas for the migrants on the grounds that they were taken to Martha’s Vineyard under false pretenses.

“Based upon the claims of migrants being transported from Bexar County under false pretenses, we are investigating this case as possible Unlawful Restraint,” Salazar said in a statement.

Salazar said his office has identified witnesses in the case but could not release their names because the investigation is ongoing.

DeSantis’ office did not immediately respond to a request for comment. Salazar’s statement hinted that no action would be taken against the Republican governor, saying that “only those who were physically in our jurisdiction at the time of the offense are considered suspects.”

While it is no surprise that there were laws broken in this process, the idea that DeSantis himself could have been targeted by law enforcement was always a big stretch. He’d have plenty of cover even if there were a good circumstantial case to be made. Maybe if Perla does some singing if and when she’s ever hauled in, that could change, but again I would not bet on it. Perhaps just the idea that his own actions led to these migrants getting a long-term stay in the country will serve as a deterrent to future stunts like this by DeSantis. I’ll take what I can get. The Current has more.

UPDATE: Things get even more complex.

District of Columbia Attorney General Karl Racine has opened an investigation into whether southern border state governors misled immigrants as part of what he called a “political stunt” to transport them to Washington.

Racine told ProPublica and The Texas Tribune his office is examining whether immigrants were deceived by trip organizers before boarding buses for Washington, including several hundred who were bused from Texas under instructions from Gov. Greg Abbott and dropped near the official residence of Vice President Kamala Harris. Racine’s office has the authority to bring misdemeanor criminal charges or to file civil fraud cases.

Racine said that in interviews with his investigators, arriving immigrants “have talked persuasively about being misled, with talk about promised services.” He offered no specifics about the inquiry, including whether it is being handled by his office’s criminal or civil divisions. The attorney general’s office declined to answer further questions.

Various state and federal laws could apply to transporting immigrants across state lines. Racine’s office could look into whether anyone committed fraud by falsely promising jobs or services, whether there were civil rights violations or whether officials misused taxpayers’ money.

[…]

Racine’s involvement ratchets up the pressure on the governors over their actions.

Elected as a Democrat, Racine criticized the Republican governors for using “people as props. That’s what they’ve done with the immigrants.”

Racine’s office can prosecute certain misdemeanors, and felonies are handled by the U.S. Attorney’s Office. But its highest profile work has been bringing civil fraud lawsuits against nonprofits and businesses. In May, it reached a $750,000 settlement in a lawsuit against former President Donald Trump’s inaugural committee, alleging that it had abused donors’ funds by overpaying for rentals at the Trump International Hotel.

The governors have said they have done nothing wrong in transporting immigrants to “sanctuary cities” that may be better equipped to care for them. They say they want the rest of the nation to share the burden of what they call the Biden administration’s open border policies.

[…]

Domingo Garcia, president of the League of United Latin American Citizens, an advocacy group, said that some immigrants who were sent from Texas to Harris’ residence in Washington have told his team they were misled about their final destination. The immigrants believed they were bound for Union Station, the city’s central transportation hub, where many hoped to connect with family or trains and buses to other locations. Instead, he said, they were dropped off at about 6 a.m. in an unfamiliar spot, where a church group quickly organized to pick them up.

“I think they are being tricked and being used,” Garcia said.

Since the spring, buses have arrived almost daily at Union Station, where immigrants can now seek support from a new city Office of Migrant Services. So far, Texas taxpayers have spent about $14 million on migrant transportation, according to state records. Buses into Washington have continued in recent days, with several additional arrivals at the vice president’s residence.

As I said above, I don’t know how much actual accountability this can force, but it’s something.

School enrollment in Texas declined in 2020-2021

Blame it on COVID.

Tens of thousands more students either dropped out or otherwise left Texas public schools during the 2020-21 school year, compared to previous years, according to the most recently available records from the Texas Education Agency.

The number of students who dropped out jumped roughly 34 percent from 46,319 students in the 2020-21 school year, which was disrupted by the COVID-19 pandemic, compared to 34,477 two years prior. The number of students who left Texas public schools for other reasons, including death, pregnancy or to enroll in other education programs or schools, was 79,071 in 2020-21, up more than 12,000 from the 2019-20 school year.

The dropout rate for students in grades 7 through 12 increased from 1.4 percent in the 2018-19 school year to 1.8 percent in the 2020-21 school year. The rate decreased during the 2019-20 school year to 1.2 percent.

High schools saw the highest increase in its dropout rate. The rate increased to 2.4 percent in the 2020-21 school year, from 1.9 percent in the 2018-19 school year.

The number of students who left to be home schooled increased about 30 percent to 29,846 in the 2020-21 school year from 22,967 in 2018-19. The increase is likely due in part to the impacts of COVID-19. In October 2020, only about 54 percent of Texas public school students were learning in-person.

Enrollment in 2020-2021 was at 5.3 million, down from 5.4 million the year before. I expect this number to bounce back, if only because the overall state population keeps growing and continues to be young, but this is a big blip and it needs urgent attention. That’s going to have to come from the locals, because the current crop of state leaders will do nothing to help. Yes, this is another reason to vote for Democrats this November.

The wastewater is looking good now

In terms of COVID levels, anyway.

The COVID-19 viral load in Houston’s wastewater has sunk to its lowest point in seven months as the city puts the latest wave, driven by the highly contagious omicron subvariant BA.5, in the rear view.

The wastewater levels are 71 percent of what the Houston Health Department detected during the July 2020 wave, which the city uses as a benchmark, according to Texas Medical Center data published Tuesday. The COVID hospitalization rate and positivity rate also continue to decline steadily.

Harris County last week dropped its COVID community level from “medium” to “low,” which recommends staying up to date on vaccinations and testing if you have symptoms. Scientists are looking to other countries for signs of what comes next.

“Our history has typically been a winter surge,” said Dr. Luis Ostrosky, chief of infectious diseases with McGovern Medical School at UTHealth Houston. “So let’s enjoy it while we can.”

Several new omicron off-shoots have been detected in the United Kingdom, India, Singapore, Denmark and Australia, according to the journal Nature. BA.5 continues to dominate cases in the United States, though one subvariant, BA.4.6, has gained some traction and now makes up roughly 12 percent of cases, according to the Centers for Disease Control and Prevention. Ostrosky urged people to get their updated booster shots, which better target omicron variants.

The dashboard is here, and you can see it as a graph here. COVID from the omicron wave peaked in the wastewater in July, but it was at almost ten times the level as it had been in July of 2020. It is now at 71% of the July 2020 levels, which is much better in so many respects. Get up to date on your boosters – I got my bivalent booster the other day – and get a flu shot (got one of those as well, at the same time), because there’s concern this could be a bad flu season. And even with these levels going down, hopefully for the foreseeable future, it’s still a good idea to wear a mask in crowded indoor spaces. Might help you avoid catching a winter cold, too.

The new county COVID risk assessment system

We’ll see how it works.

Harris County has revamped its method for assessing the public’s risk for contracting COVID-19, replacing the threat level system that has been in place since early in the pandemic with a community level system that places a greater emphasis on new cases.

The change was made due to a “decoupling” of the relationship between new cases and new hospitalizations during the most recent wave of COVID-19 fueled by the BA.5 subvariant of omicron, Judge Lina Hildalgo said during a news conference Thursday. Harris County did not see a spike in hospitalizations as COVID-19 cases surged this summer, she said.

The new system will allow the public to make their own decisions about the level of risk they are comfortable with taking, knowing that the chance of being hospitalized with a severe illness is relatively low if they have been vaccinated and boosted, Hidalgo said.

“We’re turning a page on a phase of this virus, and I’m very hopeful that we won’t have to go back to a time when surge hampered the entirety of the community,” Hidalgo said.

Hidalgo said the threat level system had been an important tool for gauging risk throughout the pandemic. It had been updated before, but this week’s changes represent a “wholesale redesign,” she said.

The new system uses a trio of color-coded community levels that indicate the risk for contracting COVID-19. Low is green, medium is yellow and high is orange. Harris County is currently yellow, but Hidalgo anticipated the community level could rise to orange with the risk for transmission increasing with children back in school.

[…]

The Harris County Public Health website offers guidance for each of the three threat levels, including recommendations for wearing a mask, traveling and social gatherings when the county is green, yellow or orange. The site will continue to offer other pertinent information, such as wastewater monitoring data and the percentage of county residents who have been vaccinated and boosted.

I had to find the appropriate webpage for this on my own – click the embedded image to get there. The old threat level webpage now gives a 404 error. This new system seems fine and reasonable. The main concern is about what might come next.

Q: So how are we doing these days? The numbers certainly look better than they did.

A: They are falling, no doubt about it. But we have to keep in mind that we don’t have a lot of details about the real number of cases. Most of us are getting diagnosed at home using home testing kits. The numbers were always underestimating by a factor of four or five. Now it’s probably seven to 10. So you have to have to look trends.

Numbers are going down. But here are numbers I keep reminding people of: We’re still losing 400 or 500 Americans a day to COVID, which makes it the third or fourth leading cause of death on a daily basis in the United States. There’s still a lot of terrible messaging. People say we don’t have as many hospitalizations. Or that everybody has been infected or vaccinated or vaccinated with breakthrough. All of that is true. On a population level, it has had mitigating effects. But that doesn’t help you make an individual health decision.

People conflate that with individual health decisions. If you’re unvaccinated, there’s still a possibility you could lose your life to COVID. Even if you’re vaccinated and not boosted, there’s that possibility. And we’re seeing the boosters aren’t holding up as well as we’d hoped. That’s one of the reasons I’m strongly encouraging people to get this new booster, which has the mRNA for the original lineage and an added one against BA.5. After four or five months, there’s risk again for being hospitalized. The coverage declines from 80 percent to 50 percent protection against hospitalization.

Then this BA.5, even though it’s going down, it’s a long, slow tail. It’ll be around well into the fall. And the toughest thing to get people to understand is what’s going to happen in the winter. Obviously there’s no way to predict. But I think it’s still quite likely that we’re going to see a new variant just like we have the last two winters. Last winter it was omicron, BA.1. The winter before that we saw alpha. And new variants are arising because we’ve done such a poor job vaccinating low and middle-income countries.

We don’t know what a next variant could look like. More like the original lineage? Or something more like BA.5? The advantage of the new combined booster is that it gives you two shots on goal. It’s more likely to cross-protect against what’s coming down the pike. That’s no guarantee. But we’ve never done this before in terms of what the FDA does. We’ve never vaccinated against something that might be lurking out there. It’s a paradigm shift. What’s happening, and I don’t think the FDA will phrase it this way, but we’re creeping toward a universal coronavirus vaccine.

That’s from a Q&A with Dr. Peter Hotez, who knows better than I do. But I do know enough to say that you should get the omicron booster. And I also know enough to say that political stunts that endanger public health are bad. I think that about covers it.

Ken Paxton keeps trying to kill the SAISD vaccine mandate

On brand, always on brand.

Texas Attorney General Ken Paxton has filed another petition seeking to reverse a Bexar County judge’s decision that rejected the state’s bid for a temporary injunction to block the San Antonio Independent School District’s staff vaccine mandate.

Even though SAISD’S vaccine mandate remains on pause despite the court’s ruling in its favor, Paxton said he will “continue fighting for medical freedom.”

“Nobody should be bullied, coerced, and certainly not fired because of their COVID-19 vaccination status,” said Paxon in his announcement, adding the decision is not only an affront to individual liberty, but “illegal under Texas law.”

“The governor’s executive order specifically protects workers from the type of mass firings that San Antonio ISD is seeking, and I will continue to fight in court to defend GA-39 and Texans’ medical freedom,” he said.

The petition was filed Sept. 7 with the Texas Supreme Court.

An SAISD spokeswoman said in a statement that the vaccine mandate remains suspended and that no employee was ever disciplined for refusing to get the vaccine.

See here and here for the previous updates. There’s a recitation of the long history of this legal saga in the story if you want that. I remind you that this mandate was never enforced and remains on pause, not that these things matter to Ken Paxton. The appellate court ruling that Greg Abbott doesn’t have the power he claimed to have when he forbade these mandates seems pretty clear to me, but you never know what SCOTx will do. Now we wait to see if they’ll take this up.

Our overall vax level is down

Not great!

The coverage rate for routine childhood vaccines – or the percentage of kids getting them – dropped during the COVID-19 pandemic and have yet to recover, according to statistics from the Texas Department of State Health Services.

Health care providers said many families skipped doctor’s visits during the pandemic to avoid exposure to the virus. But the drop is also due to a rise in “conscientious exemptions,” or parents and guardians who refuse to get their children vaccinated for religious, moral or philosophical reasons.

While anti-vaccine movements have existed since the smallpox vaccine debuted in the early 1800s, some worry the pushback against the COVID-19 vaccine may have a detrimental effect on the uptake for routine childhood immunizations, too.

“I think that, certainly, [the pandemic] is a good explanation for this,” said Terri Burke, the executive director of the Houston nonprofit The Immunization Partnership. “But there is no question that the vaccine hesitancy, skepticism, misinformation [and] disinformation that circulates around the COVID vaccine has bled over into childhood vaccines.”

A study published in the journal Vaccine found that from 2019 to 2020, immunization rates fell 47 percent among 5-month-olds and 58 percent among 16-month-olds.

Texas did see a slight increase in vaccination rates earlier this year, but they still remain below pre-pandemic levels, said Tasmiah Nuzhath, a Texas A&M School of Public Health doctoral candidate who led the study. That’s a concern because regardless of the reason, a lower percentage of vaccinated children means heightened for outbreaks of a disease like the measles, she said.

“Even a few-percentage dip in vaccination rates will put children at risk of getting sick, and could affect community protections against serious diseases,” Nuzhath said.

[…]

In the Houston area, there are some signs that coverage rates may be slowly recovering from the pandemic. The HOPE Clinic, for example, had a large demand for the shots before students returned to school this fall, Clinical Director Kara Green said.

The Immunization Clinic in Stafford has also seen more children coming in for their vaccines this year, but coverage rates are “still not where [they] should be,” Nursing Director Yvette Cheeks said.

During the 2011-12 school year, coverage rates were at least 97.4 percent for each of the routine vaccines required for kindergarten students, and at least 96.6 percent for each required for seventh grade.  By 2021-22, rates fell to a range of 93.5 percent to 95.9 percent for kindergarten, and 91.9 percent to 98 percent for seventh grade.

Some of the decline can be attributed to children who haven’t gotten their shots yet, but may do so later. Those “delinquency” rates topped 3 percent for the chickenpox, polio and DTaP (diphtheria, tetanus and acellular pertussis) vaccines for kindergarten and around 6 percent for the meningitis and DTaP vaccines for seventh grade.

It’s also due to a rise in conscientious exemptions. Ten years ago, the chickenpox vaccine for kindergarten had the highest rate of conscientious objections at 0.8 percent. By last year, rates hit at least 2.1 percent for each kindergarten vaccine and at least 1 percent for each seventh grade vaccine.

Those percentages may not seem like a lot, but they represent an increase from 28,432 conscientious objections across Texas in 2011-12 to 85,726 last year, according to TDSHS statistics.

Green and Cheeks believe coverage rates could increase through better access to the vaccines. Both the HOPE Clinic and the Immunization Clinic offer vaccines to lower-income and uninsured patients.

However, Green noted that the HOPE Clinic sees families cancel their child’s vaccine appointment due to issues such as a lack of transportation, or not having child care for their other children. Pop-up vaccination clinics at Houston schools or other community sites could help increase uptake, she said.

“I think if we make it easier for families to get these things done, then we really open up a lot of opportunities,” she said.

We need to do everything we can to make sure that all needed vaccines are easily available to all that want them. That’s a bigger problem that can be solved locally, but we have to try. Anyone can claim to be “pro-life”, but unless you’re pro-getting-lifesaving-shots-into-kids-arms, you’re just full of hot air.

Coulda Been Worse

Are you ready for some attack ads?

A shadowy new group has purchased at least $6 million in TV ads ahead of the November election and is airing an ad that targets Gov. Greg Abbott as he runs for reelection.

The minute-long ad from Coulda Been Worse LLC, which started airing Friday, rattles off a list of major calamitous events that have happened on Abbott’s watch, like the Uvalde school shooting and 2021 power-grid collapse. As the narrator speaks, a picture slowly zooms out to show Abbott’s face.

“Any one of these — a terrible shame for Texas,” the narrator says at the end. “All of these — a horrific sign something big is terribly, terribly wrong.”

The spot ends with a clip of Abbott saying after the Uvalde massacre that it “could have been worse,” increasingly a rallying cry of Abbott’s critics. Abbott made the comment while praising the law enforcement response to the shooting, which has since been been widely criticized for taking well over an hour to confront the shooter. Abbott later said he was “misled” when he made the comment.

The advertising represents a significant escalation as Abbott fights for a third term against Democratic challenger Beto O’Rourke. Abbott has led O’Rourke by mid-single digits in polls throughout the summer.

Here’s the ad, which I can’t find right now on YouTube in part because there’s a song called “Coulda Been Worse” and in part because there’s a ton of video clips of Abbott’s original “could have been worse” quote.

60-second ads always feel interminable to me, but I’m not sure how you cut this one down. I mostly encounter ads like this when I watch sports – the college and NFL football seasons are just rife with this stuff, especially in even-numbered years – so I’ll be interested to see how often I encounter it. What’s your reaction?

Your omicron booster will be ready this week

I’ll be getting mine.

Most Texans will be eligible in the coming days for a second round of Covid-19 booster shots after updated vaccines got final federal approval this week.

The new doses, from Pfizer-BioNTech and Moderna, are designed to fight off severe infection from the latest versions of the omicron variant, which have proven especially easy to spread. Federal health officials hope the new round of boosters can add a layer of immune protection heading into a potential uptick of infections this fall as people head back indoors.

The new boosters will be available to anyone 18 and older for Moderna’s, and anyone over the age of 12 for Pfizer-BioNTech’s. Older adults have been eligible for several months.

“If you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it,” the Centers for Disease Control Director Rochelle Walensky said Thursday after endorsing an advisory committee’s recommendation to make the shots widely available.

The updated vaccines add spike protein components from the omicron subvariants BA.4 and BA.5, which helps restore protection that has waned since previous vaccine rounds. The CDC recommends waiting two months after your most recent COVID shot before getting the booster.

A spokesperson for the Texas Department of State Health Services said the doses are expected to ship out in the next few days, so Texans should be able to make appointments next week. Like previous boosters, these will be available at pharmacies, standalone health clinics and through local health departments, the agency said.

Both CVS and Walgreens were allowing patients to schedule the updated boosters as of Friday.

As the story notes, while COVID deaths in Texas are way down – about 100 a month statewide at this time – people are still getting infected. Plenty of people I know have been sidelined for a week or two in recent months. Long COVID and other risks remain as well. I’m still pretty vigilant about masking in indoor spaces, which usually puts me in a distinct minority, but it’s just a numbers game, and sooner or later that catches up to you. I’ll add on another layer of defense for that, thanks very much.

First school ratings since 2019 released

All in all, not too bad. But for poorer schools and school districts, it remains a very hard go.

The Texas Education Agency on Monday released its first public school ratings in three years and despite pandemic interruptions, the number of schools that received the highest rating increased.

This year, 27.9% of 8,451 schools evaluated received an A rating. Another 46.1% received a B, 19.4% received a rating of C and 6.7% received “Not Rated” labels. Not all schools and districts are rated because some are alternative education programs and treatment facilities.

The state agency’s ratings — tied in large part to results of the State of Texas Assessments of Academic Readiness, or STAAR test — are the latest metrics used to grade how well Texas public schools are performing as students emerge from the worst of the global coronavirus pandemic. Even though students returned to classroom instruction last year, surges in COVID-19 infections both last fall and winter forced some schools to close and revert back to remote instruction.

TEA Commissioner Mike Morath credited local educators with the increases seen, despite those interruptions, in each of the A and B categories and a reduction in the number of schools that received below-average grades, those in the “Not Rated” category.

“These results show our state’s significant investment in the post-pandemic academic recovery of Texas public school students is bearing fruit,” Morath said. “I’m grateful for the driving force behind this year’s success: our teachers and local school leaders.”

The TEA’s ratings are determined by scores in three categories: how students perform on the STAAR test, which is given each spring; improvement in those scores; and how well schools are educating disadvantaged students. Students are tested on different subjects: reading, math, science and social students.

Districts also get an overall rating. There are a total of 1,207 school districts in Texas, and 1,195 were evaluated. Out of the districts evaluated, 33.1% got an A, 54% got a B, 9.4% got a C and 3.5% got a “Not Rated” label.

[…]

In 2019, the last time that TEA put out these ratings, 8,302 schools were rated, and 21.1% received an A, 39.5% received a B, 26.1% received a C and 13.3% received failing grades. In 2019, 1,189 districts were rated. Of those, 25.3% received an A, 56.9% received a B, 13% received a C and 4.8% received failing grades.

Texas continues to show some struggle with getting “high-poverty” schools an A grade. Data shows that only 18% of those campuses in Texas were rated an A. The TEA labels schools as “high-poverty” if their number of economically disadvantaged students surpasses 80%. Of the schools that received a “Not Rated” label, over half of them were “high-poverty” schools.

Texas has about 5.4 million students in its public schools, and 60% of them are economically disadvantaged, meaning they qualify for free or reduced lunch. Out of the 8,451 schools rated this year, 564 campuses received the “Not Rated” label. Most of these “Not Rated” campuses — 499 — serve students who live in some of the state’s poorest communities.

While there is work to be done with Texas’ poorer schools, Morath said, the increase among the A-rated schools — a rise seen after the pandemic interrupted classroom instruction — means the state is on the right track to catch students up to pre-pandemic levels.

This spring’s STAAR results showed big gains in reading. While math scores did increase from the dips seen in 2021, they revealed that Texas students still have work to do to catch up to their pre-pandemic test score levels.

You can see all the results here. The Chron complied results for area schools; HISD overall got a B, but some schools such as Kashmere and Yates high schools were Not Rated, which is the grade given in place of a D or F this year. Those grades will return next year. As I said, all things considered this isn’t bad, but there remains a lot of work to do. We need the Lege to not do anything to screw it all up next spring. Reform Austin has more.

At least you’re (probably) not giving birth in West Texas

This is a long story about the lack of prenatal and obstetric care in West Texas. It’s mostly set in Alpine, Presidio, and Big Bend, which are the “big cities” in the area that actually have doctors and medical facilities in them. The one hospital in the area is in Big Bend, and its labor and delivery unit is now closed much of the time, for a variety of reasons. This is a small taste of what it’s like to be pregnant in this part of the state.

Big Bend is the only hospital in a 12,000-square-mile area that delivers babies. If Billings’s patient goes into labor when the maternity ward is closed, she’ll have to make a difficult choice. She can drive to the next nearest hospital, in Fort Stockton, yet another hour away. Or, if her labor is too far along and she’s unlikely to make it, she can deliver in Big Bend’s emergency room. But the ER doesn’t have a fetal heart monitor or nurses who know how to use one. It also doesn’t keep patients overnight. When a woman gives birth there, she’s either transferred to Fort Stockton—enduring the long drive after having just had a baby—or discharged and sent home.

This situation is stressful and dangerous for pregnant women. Uterine hemorrhages, postpartum preeclampsia (a potentially deadly spike in blood pressure), and other life-threatening complications are most likely to occur in the first few days after childbirth. This is why hospitals usually keep new mothers under observation for 24 hours to 48 hours. “This is not the ‘standard of care’ that women should receive,” Billings says. “You’re not supposed to discharge patients and leave it up to chance.”

Big Bend doesn’t really have a choice. In the past two years, almost all its labor and delivery nurses quit. The hospital has tried to replace them, but the national nursing shortage caused by the pandemic has made that impossible. When Big Bend is too short-staffed to deliver a baby safely, its labor and delivery unit has to close.

[…]

Medicaid pays for 42 percent of all hospital births, but it doesn’t reimburse hospitals for the full cost of care. (In most states it pays between 50 cents and 70 cents on the dollar, which means a hospital loses money when it cares for someone on the program.) To offset its losses, a hospital often charges its privately insured patients significantly higher fees. But if it’s in a poor neighborhood and doesn’t have enough privately insured patients, it can’t recoup the money. So most pre-pandemic maternity ward closures were in low-income areas and disproportionately affected pregnant women of color. Pandemic-related nursing shortages have only made the situation worse. Nowhere is this problem more evident than in Texas.

The state is the national leader in maternity ward closures. In the past decade, more than twenty rural hospitals have stopped delivering babies. More than half the state’s rural counties don’t even have a gynecologist. Texas has some of the lowest income eligibility limits for Medicaid and has declined to expand them, as allowed by the Affordable Care Act. (Childless adults don’t qualify for the program unless they’re disabled.) As a result, more than 18 percent of Texans don’t have health insurance, the highest percentage of uninsured residents in the U.S. Income eligibility limits jump for pregnant women—$36,200 for single mothers, $45,600 for married ones—but the application process takes at least a month. According to the March of Dimes, a fifth of all pregnant women in Texas don’t get prenatal care until they’re five months along. In other words, when a poor woman gets pregnant in Texas, it’s hard for her to find a doctor or even a hospital.

“What we’re seeing in terms of health outcomes, it’s not good,” says John Henderson, chief executive officer and president of the Texas Organization of Rural & Community Hospitals. “We have lower birth weights, more preterm births. When it comes to caring for pregnant women and their babies, Texas does not compare favorably to other states.”

Like I said, this is a long story and it’s worth your time to read. I’m old enough to remember when tort “reform”, in particular putting a cap on damage awards that can be given in medical malpractice lawsuits, was supposed to usher in a new era of doctor abundance in Texas. I don’t think that has worked out in the way we were promised. Towards the end, one of the doctors the author spoke to for the story notes that since abortion was already impossible to get in their region, the new state ban on abortion likely won’t result in more babies being born there. These docs will still deal with miscarriages and ectopic pregnancies and other life-threatening situations – they tell some amazing stories – despite the threat to their own safety. Click over and read on for more.

It’s not a teacher shortage yet

But you can see one on the horizon.

School districts across the Houston region are trying to fill thousands of teacher vacancies before most will be welcoming students back to classrooms in the coming weeks.

A review of about 18 area school districts’ job listings, including Alvin, Deer Park, Fort Bend, Galena Park, Goose Creek, Katy, Magnolia, Pasadena, Galveston, Humble, Spring Branch and Spring ISDs, as well as Lamar CISD, showed a need for more than 3,400 educators to fill a variety of vacancies as of Monday.

The Houston Independent School District, the state’s largest system scheduled to kick off its year Aug. 22, had about 870 openings for certified teachers listed on its career portal Monday.

Aldine ISD, which serves nearly 67,000 students and employs more than 4,000 educators, currently has 370 teacher vacancies. That number is “way up” from previous years, according to administrators, despite recruiting efforts that include signing bonuses, increased salaries and looking for applicants internationally. Klein ISD is searching for 120 teachers, according to its website. Cypress-Fairbanks ISD, the state’s third-largest system, is trying to fill 472 teaching vacancies.

It is a nationwide problem as low pay, long hours and the politicization of education have taken their toll on the beleaguered profession.

“You look across the state and across the country, there are districts even smaller than us with even more vacancies,” HISD chief talent officer Jeremy Grant-Skinner said. “We’re all feeling the challenge together of staffing during this very unique time. We’re feeling like we’re going to get as close as we can.”

HISD, with roughly 195,000 students and 27,000 full- and part-time employees, had about the same number of vacancies at this time a year ago, Grant-Skinner said, before reducing it to about 400 by the time schools opened. To fill those openings until certified educators could be hired, the district sent central administration staffers who held teacher certifications into classrooms. Grant-Skinner said there have been no conversations about doing that again this year.

The 870 openings represent about 8 percent of the 11,000 teachers included in the upcoming year’s budget.

Since then, the district has raised teacher pay, hoping it will help recruit and retain educators. Several other districts, including Katy and Cypress-Fair ISDs, also have boosted teacher salaries.

Emphasis mine. I highlighted that to note that this problem, at least for HISD, is not unprecedented. The gap was more than cut in half least year, HISD was able to fill in other vacancies from within, and they have raised their pay as a way to attract new job seekers. There are obviously a lot of major challenges facing teachers now, most of which are the result of actions taken by Republicans, but it’s too soon to say for this year that the problem is getting worse. That may end up being the case, and it’s good to draw attention to this now, I just want to be a little cautious about getting ahead of ourselves.

That said, there are other danger signs out there that should be taken seriously.

More Texas teachers are considering leaving the profession than at any point in the last 40 years, according to new polling from the Texas State Teachers Assocation.

The survey found that 70 percent of teachers were seriously considering quitting this year, a substantial jump from the 53 percent who said so in 2018, the last time the typically biennial survey was conducted. Teachers attributed their grim outlook to pandemic-related stress, political pressure from state lawmakers, less support from parents and stretched finances.

The survey represented all grade levels and regions of the states. It was skipped in 2020 amid of the pandemic.

[…]

In the survey, which was completed by 688 Texas teachers, 94 percent said the pandemic increased their professional stress, and 82 percent said financial stress was exacerbated. Experts have pointed to better pay as a key way to recruit and retain teachers. Respondents taught for about 16 years on average, and their average salary was around $59,000. That’s about $7,000 below the national trend, according to the teachers association.

Besides salary, Texas teachers on average also receive some of the worst retirement benefits of those in any state, a separate study from June found. Teachers who have retired since 2004 have not received a cost-of-living adjustment, although the Legislature has routinely passed “13th check” bills that send extra annuity payments.

In addition to pay, 85 percent said they felt state lawmakers held a negative view of teachers, 65 percent said the public held a negative view and 70 percent said support from parents had decreased over the last several years.

If your job is more stressful than before, if you don’t feel respected by the powers that be or your stakeholders, and if on top of that you could make more money doing something else, well, that’s a pretty powerful combination. We can take this feedback seriously and try to do something about it, or we can ignore it and risk having to deal with a crisis situation later. Seems like a straightforward choice to me.

Houston will monitor for monkeypox in the wastewater

Seems like a good idea.

Houston will begin monitoring its wastewater for monkeypox in late August as cases of the blister-causing contagion continue to climb, health officials said.

Scientists will begin testing for the monkeypox virus in city sewage samples “starting in about three weeks,” Houston Health Department spokesperson Porfirio Villarreal said Thursday morning.

There are 152 cases in Harris County, 131 of those in Houston, the county’s Public Health Department reports. More than 6,300 Americans had tested positive for monkeypox as of Wednesday, nearly 500 of them in Texas. Many cases have been among gay and bisexual men, but the disease can be spread among anyone via close contact.

To collect the data, Houston scientists will take weekly samples from flushed wastewater at sewage treatment plants across the city. Once tested, the samples will give scientists a snapshot of which neighborhoods have the most monkeypox virus.

Health officials have used wastewater tracking to monitor COVID-19 levels in the city’s sewage since the beginning of the pandemic to understand how quickly the virus is spreading among the city’s two million inhabitants. The tracking project, a joint effort by Rice University and the Houston Health Department, offers clues to the severity of the pandemic that may be invisible in testing data.

We are familiar with the track-COVID-in-the-wastewater project, which has been a resounding success (and which is currently showing a decrease in the levels, praise be). Not clear yet if this data will show up on the same dashboard or if there will be a new one, but we’ll know soon enough. I’ll be on the lookout.

William-Paul Thomas

This is bad. The question is how much worse might it be.

William-Paul Thomas, the mayor’s council liaison, was offered more than $13,000 by a local bar owner to help him pass a building inspection and fast-track a new permit to reopen a bar as a restaurant, newly unsealed court documents show.

Thomas contacted the “relevant” fire official to ensure the unnamed business owner passed the inspection in May 2020, prosecutors wrote, and then he used his position in the mayor’s office to “pressure other officials” to approve the permit in July, as well. He was paid an undisclosed amount of money for his efforts.

Thomas pleaded guilty on July 25 to one federal count of conspiracy to accept a bribe. He will appear for sentencing before U.S. District Judge Andrew S. Hanen on Nov. 28. His lawyer, Monique Chantelle Sparks, did not respond to a request for comment Wednesday.

The documents were sealed until Wednesday morning at the request of the U.S. Attorney’s office. The Chronicle published an article about the allegations Tuesday night. Thomas’ plea deal, however, remains sealed.

It is unclear whether federal investigators are looking into the unnamed city officials Thomas allegedly worked with to get the certificate and permit approved, or if they are conducting a broader inquiry into City Hall affairs.

Sean Buckley, a legal expert on federal judicial procedures, said Thomas’ quick guilty plea and his willingness to forgo a probable cause hearing before a grand jury means he likely agreed they had strong information against him. It also suggests Thomas may be part of a wider investigation by the Justice Department.

Thomas abruptly resigned from his City Hall position last Wednesday, one day after pleading guilty. He told the mayor in an 11:30 p.m. email he was retiring due to health reasons.

[…]

City Attorney Arturo Michel said later Wednesday the office of the inspector general is opening its own investigation, based on the document’s charges that Thomas worked with officials in the fire department and permitting office to approve the requests.

Prosecutors say the bar owner — whom they did not name — needed to pass a city fire inspection to get a temporary certificate of occupancy in May 2020. He turned to Thomas for help.

“Thomas, in his official capacity, placed calls to the relevant Houston Fire Department official to ensure that COMPANY 1 would pass its fire inspection and be issued its TCO,” the charging document says. The owner then paid Thomas an undisclosed amount of money after he got the certificate.

It is not clear which fire department official Thomas contacted. Fire Chief Samuel Peña said it difficult to identify the person without the name of the business.

The business owner reached out again in June 2020, after his bar — a separate business — was shut down by the Texas Alcohol and Beverage Commission. COVID-19 restrictions around that time ordered bars to close but allowed restaurants to continue operating with limited capacity.

“On July 6, 2020, BUSINESSMAN 1 offered THOMAS up to $13,0000 to have the necessary permit issued quickly so that COMPANY 2 could reopen,” the document says. “THOMAS agreed to use his official position to pressure other officials to issue the permit quickly, all in exchange for money.”

Thomas then used his position to “pressure other officials” to grant the necessary permit, and the owner was allowed to open as a restaurant. It is not clear which specific permit the owner was seeking from the city; the Texas Alcohol and Beverage Commission was responsible for classifying bars and restaurants based on the percentage of sales that came from alcohol.

Buckley, a federal defense lawyer who represented former U.S. Congressman Steve Stockman and authored a book on federal criminal rules and codes used by trial attorneys across the country, reviewed the court documents at the request of the Houston Chronicle. He is not involved in the case.

“He’s obviously cooperating because no one who is a target in a federal investigation would ever agree to plea to a criminal information unless there have been extensive discussions between the target, his lawyer and the government leading up to that decision,” Buckley said.

“Either the government lawyers showed him what they had or he knew what they had. He knew he had everything to gain by cooperating and agreeing to plead guilty without forcing the government to get an indictment from the grand jury, and much to lose by not cooperating.”

Buckley said it also clear the investigation, by prosecutors from the public corruption unit, has been going on for months and there likely is a wider-ranging investigation underway involving multiple defendants.

“My read on this is that this person has something of value to the government,” Buckley said.

He said the documents also indicate “there is an environment in the city of Houston that allows this type of thing to take place.”

I will say up front that I am acquainted with William-Paul. As is the case in this kind of situation, I’m shocked to see the story. I don’t know him well enough to say more than that, but as I have met him and talked to him, I wanted to say so.

I Am Not A Lawyer, and I have no experience in these matters, but it seems to me unlikely that there would be only one such transgression like this. If nothing else, I would think the FBI wouldn’t prioritize a case with one crime of this nature. I’d expect that the bribe payer and whoever was involved with the Fire Department and permitting office will be implicated next. The big question is then whether it goes beyond that, and if so how far. There is certainly the potential for this to be big, but we won’t know until the FBI tells us, and as we know from other experiences that may take a long time. In the meantime, I wouldn’t want to be BUSINESSMAN 1 or anyone else who might be implicated. Don’t take or give bribes, y’all.

The latest COVID wave may be peaking in Houston

Hopefully

Texas Medical Center data released Tuesday suggests the latest wave of COVID-19 might have reached its peak in the Houston area, though several key metrics used to track the virus remain high.

The medical center’s weekly data report shows that COVID-19 hospitalizations, the positivity rate of coronaviruus tests and the amount of virus detected at the city of Houston’s wastewater treatment plants all trended downward for the second straight week. Those trends indicate the Houston area has likely crested the peak of a recent surge caused by the extremely contagious BA.5 subvariant, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.

“All the numbers are pointing to the fact that we’ve peaked maybe a week, a week and a half ago,” McDeavitt said. “I fully expect we will continue to trend down over the next several weeks.”

The line graphs from the TMC show a mountain range of peaks from prior waves of COVID-19, such as those caused by the delta and omicron variants. The latest BA.5 wave shows that after several weeks of steady climbing, the line is finally on the descent.

During previous waves, the virus did not pick up steam again after the numbers started to trend downward, McDeavitt said. He expects the same trajectory from BA.5.

It appears the current wave has at least reached a plateau, said Dr. Ashley Drews, an infectious disease specialist at Houston Methodist. The fact that the key metrics have stabilized is an encouraging sign, she said.

“We’re cautiously optimistic that things are turning in the right direction, and we’re going down,” Drews said.

[…]

During the week of July 25, TMC hospitals admitted an average of 219 patients with COVID-19 per day. That’s down from an average of 226 during the week of July 18, and 240 during the week of July 11.

However, the numbers remain much higher than they were before the emergence of BA.5. Three months ago, TMC hospitals admitted an average of 80 patients per day.

The good news is that the percentage of patients who need to be treated in an ICU remains lower than prior surges of COVID-19.

Last week, less than 14 percent of the 912 patients admitted with COVID-19 were treated in an ICU, according to TMC data. That’s lower than the percentage of patients treated in an ICU at the peaks of the omicron wave (17 percent) and the delta wave (22 percent).

[…]

The amount of virus detected at the city of Houston’s wastewater treatment plants, which has been a reliable indicator of community spread, also fell for the second straight week.

Wastewater loads reached an all-time high during the week of July 11, at 927 percent higher than a baseline established in June 2020. That fell to 774 percent during the week of July 18, and to 725 percent over the past week.

The amount of virus in the wastewater is still much higher than before the recent surge. Three months ago, it was less than 100 percent higher than the June 2020 baseline.

So, the data is starting to go in the right direction, which is good. But there’s still a lot of COVID out there, and all of the levels are still a lot higher than they were before the wave began, even if they never approached the heights of the previous peaks, and that’s bad. You should still be exercising caution, which is to say wearing your mask and avoiding indoor crowds if you can. And of course, get vaxxed and boosted as needed. We may be back on the downswing, but there’s no reason to believe we won’t trend up again at some point, and we’ve still got a ways to go to get to the lower levels we want.

Fifth Circuit tosses mask mandate lawsuit filed by disability rights activists

Par for the course.

A federal appeals court on Monday tossed out a lower-court injunction, issued in November, that would have allowed public schools in Texas to ignore Gov. Greg Abbott’s ban on mask mandates.

U.S. District Judge Lee Yeakel of Austin had blocked Abbott’s order as it pertained to schools, ruling that a ban on mandatory face masks improperly endangered students with disabilities and violated the Americans with Disabilities Act by denying them the opportunity to participate equally in school.

Texas appealed, and a month later the 5th U.S. Circuit Court of Appeals blocked enforcement of Yeakel’s injunction while it considered the state’s case.

On Monday, in a 2-1 ruling, the appeals court sided with state officials, tossing out Yeakel’s injunction and dismissing the lawsuit by the students. The court said the students did not prove that the ban on mask mandates put them at imminent and concrete risk of contracting COVID-19.

“In light of widely available vaccines and the schools’ other mitigation efforts, the odds of any particular plaintiff contracting COVID-19 and subsequently suffering complications are speculative,” Judge Andrew Oldham wrote in an opinion joined by Judge Don Willett. Both were appointed by former President Donald Trump.

In addition, Oldham wrote, the Americans with Disabilities Act only ensures that students have access to school, not that they have access to their desired accommodation of universal masking.

“Schools, in turn, have numerous alternatives for mitigating the risks of COVID-19 so plaintiffs have such access. The schools can adopt policies regarding vaccines, plexiglass, hand sanitizer, social distancing, and more,” Oldham wrote. “Plaintiffs have not even attempted to show that one or any combination of these accommodations is insufficient to mitigate the risks of COVID-19 to a level low enough that plaintiffs can attend school.”

In a dissenting opinion, Judge Eugene Davis complained that Oldham mischaracterized the students’ argument by saying they merely feared an increased risk of contracting COVID-19. Instead, the students argued that state Attorney General Ken Paxton’s dogged defense of Abbott’s ban on mask mandates, including lawsuits against school districts and threats of additional litigation, amounted to disability discrimination.

The students also proved that they had been, or will be, harmed by a ban on all mask mandates, even at schools that determine that limited mask orders were a reasonable accommodation for student health, he wrote.

“While all students bear some health risks by attending school in person during the ongoing pandemic, the district court found, and it is undisputed, that these plaintiffs face a much higher risk to their health because of their disabilities,” said Davis, appointed by former President Ronald Reagan.

See here for the previous update, and here for a copy of the opinion. There are still a lot of state lawsuits over the Abbott executive order that banned mask mandates in school, which largely turn on the question of what the Governor’s authority under the 1975 Texas Disaster Act is; the San Antonio ISD vaccine mandate lawsuit is in that same bucket. This was a federal lawsuit that claimed discrimination under the Americans with Disabilities Act. I still think they had a pretty good argument, but it’s the Fifth Circuit, what are you gonna do? I suppose an appeal to SCOTUS is possible, but perhaps not advisable, as it’s probably not a good idea to give them a chance to mess with that law. Texas Public Radio and the ABA Journal have more.

SAISD vaccine mandate upheld again

Also still on hold, but the state loses again at the appellate level.

A state appellate court upheld San Antonio Independent School District’s authority Wednesday to mandate its workers get vaccinated against COVID-19, almost a year after the district instituted the requirement for all staff to help stem the spread of the virus.

The 4th Court of Appeals on Wednesday denied Texas Attorney General Ken Paxton’s request to overturn a Bexar County judge’s decision not to grant the state a temporary injunction to block the staff vaccine mandate. Judge Mary Lou Alvarez of the 45th District Court issued that ruling in October, allowing SAISD to continue enforcing the mandate.

The court also ordered that the costs of the appeal be assessed against the state.

Paxton filed a lawsuit against SAISD in September, after first suing the district over the mandate in August because the vaccine had not been approved by the federal Food and Drug Administration. The August lawsuit was dropped after the FDA approved the Pfizer COVID-19 vaccine.

The lawsuit has wound its way through the state court system over the past year. Paxton’s office appealed Alvarez’s ruling to the 4th Court of Appeals and also requested the appellate court temporarily block the mandate while it considered Paxton’s appeal. The attorney general then requested the state Supreme Court step in and halt the mandate, which it did in mid-October.

The Texas Supreme Court’s ruling forced SAISD to stop enforcing the mandate while the 4th Court of Appeals considered the state’s appeal of the temporary injunction that Alvarez denied.

[…]

Paxton’s lawsuit argued that SAISD’s vaccine mandate violated Gov. Greg Abbott’s executive order prohibiting governmental entities from implementing COVID-19 vaccine mandates, which the governor claimed he had the authority to do under the Texas Disaster Act. Attorneys for SAISD challenged that reasoning, contending the Act does not give the governor the power to suspend all state laws.

Wednesday’s ruling by the 4th Court of Appeals determined that the Texas Disaster Act does not give Abbott the authority to suspend parts of the Education Code that allow school districts to issue vaccine mandates.

“The Texas Disaster Act expressly limits the Governor’s commander-in-chief authority to state agencies, state boards, and state commissions having emergency responsibilities,” the ruling states. “The District is not a state agency, a state board, or a state commission. Rather, the Texas Disaster Act defines the District as a ‘local government entity.’”

See here for the previous update. This sounds like a solid ruling, one that SCOTx ought to uphold, though who knows what they’ll actually do. It would also be written on sand to some extent, in that if the Republicans retain full control of government next year they’ll just amend the Texas Disaster Act to make it cover school districts and/or explicitly exclude anything having to do with vaccinations. In the meantime, even though the policy remains on hold during the litigation, it’s surely the case that the mandate got some holdouts vaccinated during the period while it was in effect. That will always be a win, no matter what happens from here.

The current state of the hospitals

Worse than before, but not nearly as bad as before that.

A small but growing share of Houston healthcare workers are calling in sick with COVID, exacerbating long-running staffing issues at some hospitals amid the virus’s resurgence.

But despite spreading infections, medical leaders say the Houston-area healthcare system is managing this wave better than previous bouts with the virus, pointing to better therapeutics and fewer COVID patients requiring critical care.

Anecdotally, doctors say at least half of all COVID patients were admitted for reasons unrelated to the virus. While wastewater data reflects a soaring infection rate, daily new hospitalizations are climbing at a slower pace compared to the record-breaking omicron wave in January and February, according to Texas Medical Center data.

“I don’t anticipate we’re going to have major operational problems” among medical center hospitals, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.

The latest Texas Medical Center data, published Tuesday, show hospitalizations have nearly doubled over the last five weeks, from 121 in early June to 240 last week. In January, it took only five weeks for omicron to spark a nearly 600 percent increase in daily COVID hospitalizations, as admissions jumped from 74 to a record 515, according to TMC data.

Meanwhile, the increasing viral load detected in the city’s wastewater — 927 percent higher last week than July 2020 — appears to be as high as ever. Two weeks ago, the viral load was 843 percent of the July 2020 baseline. The citywide positivity rate also saw a slight increase from 29 percent two weeks ago to 31 percent last week, while the positivity rate in the medical center dropped slightly from 16.1 percent to 15.9 percent.

[…]

The number of sick hospital staff members reflects a small portion of the overall workforce at Houston hospitals. On Monday, Houston Methodist reported 402 staff members — 1.4 percent of all employees — had tested positive for COVID. Harris Health System said 245 staff members, or 2.4 percent of its workforce, had tested positive for COVID so far this July, compared to roughly 90 staff members throughout most of June.

Additionally, spokespeople for Memorial Hermann Health System, Texas Children’s Hospital and HCA Houston Healthcare say they are not experiencing major staffing issues or operational interruptions amid the current surge.

“Because of our vaccination and booster requirements, our staffing across hospitals is robust and fully intact,” said Dr. James Versalovic, chief pathologist at Texas Children’s Hospital. “I’m happy to say, we have prepared ourselves for this moment.”

More than two years into the pandemic, medical leaders now greet surges with more nuanced messaging, showing concern over rising infections and staffing struggles while assuring the public that hospitals are now better equipped to withstand rising infections.

Versalovic noted that Texas Children’s has seen its COVID population double over the last month. The 7-day rolling average of pediatric COVID patients is now more than 50 in the hospital system. He urged parents to seek out vaccinations as the start of school closes in.

On the one hand, this is basically good news. The hospitals are able to function without being overburdened, our overall vaccination level (and the good luck that this variant, however more contagious it is, isn’t particularly devastating) is helping keep levels in check, and while we’re worse off than we were a couple of months ago we’re much better off than we were in previous waves. One could argue that this is more or less what “endemic” looks like.

On the other hand, Stace is right. We’ve basically given up on trying to keep a lid on this thing – to be sure, there’s far less that governments can do now, thanks to a bunch of wingnut court rulings and Greg Abbott executive orders, but there are plenty of things we could be doing that we aren’t. A lot of leaders who should know better aren’t setting good examples. Even a milder form of COVID is potentially deadly to people with various comorbidities and risk factors, or who are immunocompromised in some way. Just having people mask up again as a matter of course would make all of their lives better, but we’re not doing that.

I’m definitely masking in indoor spaces again, but I’m also willing to be in indoor spaces, and to be among groups of people. I’ve mitigated some of my risk, but I’m engaging in riskier behavior than I had been before. It’s one part denial, one part pandemic fatigue, one part the perhaps naive hope that there will be another booster coming soon, and one part hoping that I’m being cautious enough. I don’t know what happens next if things do get worse from here. I very much hope I don’t have to find out.

There’s no cheap housing in Houston any more

What are we going to do about that?

In the sprawling Houston region, those who could not afford homeownership in the city’s urban core always had options. They could trade proximity for affordability.

But as rising home prices and mortgage rates push homeownership further out of reach for the average renter, the suburbs within Harris County are losing their reputation as an affordable haven, said Rice University’s Kinder Institute for Urban Research — just one example of how access to homeownership and quality housing has grown more difficult over the past decade, with challenges accelerating during the pandemic.

The Kinder Institute and Harvard University’s Joint Center for Housing Studies released Tuesday morning their annual reports on the state of housing in the Houston area and the nation. Together, they painted a picture of a deepening divide between the prospects of current homeowners, whose equity has been buoyed by record-breaking home price appreciation, and renters, who have seen the monthly costs of buying a home rise far more quickly than wages.

The median-priced home in the suburbs of Clear Lake and Jersey Village, for example, were priced between $162,000 and $175,000 in 2011, according to the Houston Association of Realtors. They now go for $300,000 to $317,000.

“You have to go farther and farther out until you find a home that’s affordable,” explained Stephen Sherman, a researcher at the Kinder Institute. “The whole saying is drive until you qualify. We’re finding that people will have to drive even more” — a development which will have rippling implications on traffic and the way floodwaters drain.

And no matter how far out you look, it’s difficult to find a home priced below $200,000 in Harris County these days, where the median home price is on track to soon surpass that in Houston, according to the Kinder report.

Nationwide, four million renters in the past year have been priced out from buying homes, the Joint Center for Housing Studies report found. That’s a concern, said Daniel T. McCue, senior research associate at the center, because “if the door is closing on homeownership, it would lock in some significant inequities in housing.”

[…]

Home prices have outpaced incomes because of a confluence of issues including the chronic underbuilding of homes (the building of which has failed to keep up with population growth for years), the increased demand for homes as millennials enter the homebuying market, surging construction costs as the pandemic interrupted supply chains around the country and the fact that most new construction is focused on the high end of the market.

“Suburban Houston — and new homes in suburban Houston — used to be extremely affordable,” said Lawrence Dean, the Houston regional director for Zonda, which does market research related to new home construction. Since then, the costs of land, materials and labor have all shot up. These days, it’s near impossible to build a home for less than $200,000, he explained.

Wood, fiber-cement siding and even land that’s ready for new homes became harder to come by and labor became scarce during the pandemic. According to the federal government’s producer price index, which measures the average change in selling prices, residential construction materials saw costs rise more than 30 percent in January 2022 from March 2020, when the pandemic began to disrupt businesses in the United States.

The Kinder report is here. This is a regional problem, but it’s also a national problem. It’s partly pandemic-induced, and so may ease up a bit over time, but it’s also driven by other factors, including some lasting effects of the pandemic such as working from home. The point about housing within the city of Houston now being generally less expensive than in the non-Houston parts of Harris County is interesting, as a lot of the population growth in the unincorporated areas has been driven by affordable housing. We’re still cheaper than many other parts of the country (though not by as much now) so some of that will continue, but some of it will be pushed into other counties, and perhaps some of it will come back within the city of Houston. I’d like to see what the demographers think about that.

In the meantime, this is a real problem for a lot of people, and it’s going to take some big ideas to fix. Which, I’m sorry to say, doesn’t exactly fill me with hope. The abundance of available land, the lack of restrictions on building, and the general attractiveness of Texas as a place to live has been a huge driver of growth in the area. What do we do when the first two aren’t making a difference and the third is no longer true?

COVID hospitalizations up in Houston

Welp.

COVID-19 hospitalizations have nearly doubled in the Houston area over the last month, according to re-published Texas Medical Center data, which paints a clearer picture of the risk associated with newer, increasingly transmissible versions of the virus.

The medical center discontinued its weekly reports in May, when the omicron wave had officially receded, and COVID drifted out of the public’s mind. But a new COVID surge prompted the medical center to post a revamped dashboard Tuesday, showing that the virus remains a persistent part of life.

Among the more urgent revelations: The average number of daily new hospitalizations rose from 121 in early June to 224 last week. That number is nearly half of the record-breaking hospitalization peak in early January, when an average of 515 COVID patients were admitted per day, according to the updated TMC data.

“Hopefully it’s peaking,” Dr. Paul Klotman, president and CEO of Baylor College of Medicine, said during a Tuesday news briefing. “It’s still a dangerous virus.”

[…]

The increase coincides with the rise of BA.5, a latest subvariant in the omicron lineage, which in a matter of weeks took over as the dominant strain in the U.S. First detected in South Africa, the subvariant made its way to the U.S. in early May and now makes up 65 percent of cases nationwide. In the Houston Methodist system, BA.5 comprises 57 percent of cases, while BA.4, another highly transmissible strain, makes up 19 percent.

BA.5 is concerning, experts say, because it appears to be more capable of re-infecting people and more resistant to vaccine-induced immunity. Even those who battled a COVID infection a few weeks ago could be susceptible to BA.5, said Dr. Wesley Long, a clinical pathologist and medical director of diagnostic microbiology at Houston Methodist.

“In previous waves, there was a thought that if you were infected, you had natural immunity for a couple of months,” he said. “With this shift from BA.2 to BA.5, that rule isn’t holding true.”

A recent study published in Nature found that BA.4 and 5 — which share similar mutations — are more likely to cause vaccine breakthrough infections compared to BA.2.12, the previously dominant strain. Waning vaccine immunity also compounds the risk.

Even so, vaccines are still effective at preventing severe disease, hospitalization and death, Long said.

“People shouldn’t get the wrong idea and think ‘I don’t need to get my vaccine’ or ‘I don’t need to get my booster,’” he said.

It’s still too early to say whether BA.5 is causing more severe illness than its predecessors. Early research shows it contains mutations found in the delta variant, which was linked to more acute sickness. But the rise in hospitalizations could simply be attributed to the volume of infections in the community, said Klotman.

Yeah, it could be worse. We’ve definitely seen worse. You know what you need to do to keep it from getting worse. All together now: You may be done with COVID, but COVID isn’t done with you. Stace and the Texas Signal have more.

Get your kids vaccinated (I’m saying it again)

We have a long way to go.

In the two weeks since the federal government allowed emergency use of COVID-19 vaccines for children younger than 5, nearly 32,000 Texas kids in that age group have been vaccinated.

That accounts for just over 1% of the state’s youngest residents, a lower rate than doctors had hoped, but faster than the national rate for kids that age — even as Texas deals with a lower-than-average vaccination rate across the state.

[…]

Vaccine acceptance by parents of Texas babies and toddlers is slower than the medical community had hoped it would be after COVID-19 vaccines were approved for use in children ages 6 months to 4 years old in late June.

On June 17, the U.S. Food and Drug Administration granted emergency use authorization, after frequent delays over several months, to Pfizer’s COVID-19 vaccine for children ages 6 months to 5 years, as well as to Moderna’s vaccine for kids ages 6 months to 6 years. The Centers for Disease Control and Prevention recommended their use the following day.

So far, just over 1% of the estimated 1.8 million Texans under 5 have gotten at least one dose. Nationwide, the number is slightly lower, with less than 1% of the country’s 29 million kids under 5 having their first doses.

Hesitancy with the vaccine rises among parents of younger kids because they tend to be more skeptical about the need for them, said Dr. Jaime E. Fergie, director of pediatric infectious diseases and hospital epidemiologist at Driscoll Children’s Hospital in Corpus Christi.

When the vaccine was made available to Texas kids ages 5 to 11 in November, nearly 6% of the population was vaccinated in the first two weeks. For children ages 12-15, when they were approved for the vaccine a year ago, more than 11% were vaccinated in the same time frame, according to the Texas Department of State Health Services.

During that time, the delta variant was making an alarming and devastating impact on the nation’s children, killing twice as many Texas kids in August through October 2021 than COVID-19 did the entire first year of the pandemic. That likely fueled early interest in the vaccine for children ages 5 and up, while recent months with lower community spread have likely bred what Fergie called “complacency” among the parents of the state’s tiniest residents.

“The uptake [for younger children] has been low; it’s been pathetic,” Fergie said. “I think the misconception is that COVID-19 in children is not important. But even though the impact on children is much less than on adults, there is still death for children, and hospitalizations are rising. There are still very powerful reasons to vaccinate children.”

Children accounted for nearly 20% of all COVID-19 cases reported in the U.S. throughout the pandemic. But they are less likely to develop serious illness or die than are patients who are decades older, and the mortality rate has been relatively low compared with adults.

Still, at least 155 Texans age 19 or younger have died from COVID-19 since the beginning of the pandemic, according to state health data. One-third of them were younger than 10.

Some 61% of Texans are fully vaccinated, compared with 67% nationwide.

See here for some background, and go read the rest, it’s a long story. I do think that the earlier authorizations came during the delta period made for a faster initial rollout, though the overall vax rate for kids remains bafflingly low. The fact that with current variants, the shots now are about preventing bad outcomes rather than preventing infection has probably changed the risk calculus for some folks. Add in the lack of any coordinated push for people to get the shots, the continued resistance by numerous Republican factions, and the general weariness with the pandemic, and this is what you get. I don’t know what else to say.

Sniffing out COVID

Very interesting.

Dogs are as reliable as laboratory tests for detecting COVID-19 cases, and may be even better than PCR tests for identifying infected people who don’t have symptoms. A bonus: The canines are cuter and less invasive than a swab up the nose.

In a study involving sweat samples from 335 people, trained dogs sniffed out 97 percent of the coronavirus cases that had been identified by PCR tests, researchers report June 1 in PLOS One. And the dogs found all 31 COVID-19 cases among 192 people who didn’t have symptoms.

These findings are evidence that dogs could be effective for mass screening efforts at places such as airports or concerts and may provide friendly alternatives for testing people who balk at nasal swabs, says Dominique Grandjean, a veterinarian at the National School of Veterinary Medicine of Alfort in Maisons-Alfort, France.

“The dog doesn’t lie,” but there are many ways PCR tests can go wrong, Grandjean says. The canines’ noses also identified more COVID-19 cases than did antigen tests (SN: 12/17/21), similar to many at-home tests, but sometimes mistook another respiratory virus for the coronavirus, Grandjean and colleagues found. What’s more, anecdotal evidence suggests the dogs can pick up asymptomatic cases as much as 48 hours before people test positive by PCR, he says.

I can totally believe that dogs are capable of doing this, though as the study notes it’s not clear what exactly they’re picking up on. I’m just not sure what the practical use of this knowledge is. What are the circumstances under which dogs would be deployed to sniff for COVID, and how could it be done in a way that was non-invasive and respectful of people’s privacy? I’m a big believer in requiring negative COVID tests for a variety of things, but those should be allowed to be done at home and in private. I can’t imagine turning someone away from an event or whatever for failing a sniff test. But maybe there’s a good way to do this now that we know that it’s possible.

Get your kids vaccinated

A good start, but we can do a lot more.

Texas Children’s Hospital has administered COVID-19 vaccines to nearly 6,000 children ages 6 months through 4 years old since the youngest age group became eligible to receive the shots last week, the hospital said Thursday.

“We’ve been waiting for a long time to be able to protect our youngest children,” said Dr. Stan Spinner, the chief medical officer and vice president of Texas Children’s Pediatrics. “We’ve had families asking for a long time ‘When is this vaccine going to be available for our kids?’ And now it is.”

Still, the overall share of children younger than 5 who have received the shot is incredibly low — hovering around 1 percent statewide.

Another 3,000 children are scheduled for vaccine appointments at Texas Children’s Hospital or more than 60 Texas Children’s Pediatrics locations in the Houston, Austin and College Station areas, hospital spokeswoman Natasha Barrett said during a news conference.

Vaccines are also available to kids under 5 at other hospitals, including Children’s Memorial Hermann, as well as pediatrician’s offices, pharmacies and other locations.

Across Texas,the overall interest in vaccines for children has been lagging. Just 26 percent of Texas residents aged 5 to 11 and 59 percent of residents aged 12 to 17 are fully v accinated, according to data from The New York Times. Just 4 percent of Texas residents under 18 years old have received a booster.

However, Texas Children’s doctors said they have also been encouraged by that fact that families with children 5 to 11 years old have been signing up for booster shots of the Pfizer-BioNTech vaccine. The U.S. Food and Drug Administration approved booster shots for that age group last month.

My kids are older and got vaxxed and boosted at their first opportunities. If there’s an omicron-specific booster this fall, they’ll get that, too. I’ve definitely been disappointed by the low vaccination rate among younger kids, but maybe that will turn around now. Even with the lower hospitalization and mortality rates, so many people have gotten an infection lately that perhaps the ongoing threat of this pandemic is sinking in again. We all still need to do our part to try to keep this under some control.

Still no new Election Administrator

C’mon, y’all.

Harris County officials canceled an election commission meeting for the second time this week, again citing a lack of quorum because only two members were able to attend in person. The rescheduled meeting now is set for Tuesday.

Harris County Judge Lina Hidalgo, one of five members of the commission, announced Sunday evening that she had tested positive for COVID-19.

When they meet, members of the county’s election commission are expected to pick a new official to run elections, as outgoing Harris County Elections Administrator Isabel Longoria’s resignation went into effect Friday.

At their most recent meeting on June 15, members of the commission narrowed their search to two finalists. Both candidates live outside Texas and have previous election experience, according to Hidalgo.

See here and here for the background. Again, I would like to know who (besides the presumably still-testing-positive Judge Hidalgo) was unable to attend and why, and I would like to know when we might reasonably expect the next meeting to occur. We may be at risk of losing out on one or both of these candidates if we don’t move forward, and that would be a catastrophe. I want to see this done by the end of next week. Please!

Bexar County raises its COVID threat level

Hopefully not a sign of things to come.

Local health officials raised San Antonio’s COVID-19 risk level to high this week after warning of a “silent surge” just two weeks ago.

That surge continues, according to data from the city’s Metropolitan Health District, which is documenting an increase in new cases and hospitalizations.

As the July Fourth holiday approaches, San Antonio Metropolitan Health District chief Claude Jacob urged folks who will be getting together with friends and family to follow COVID-19 prevention strategies: “mask up in crowded indoor places, get tested if you have been exposed or have symptoms and stay up to date with COVID-19 vaccine and boosters.”

Dr. Bryan Alsip, chief medical officer at University Health, said the curve is starting to rise again, “but it’s not as steep an increase. It doesn’t look like the previous waves, not yet, so I think we have to wait and see how that turns out.”

The actual number of COVID-19 cases are suspected to be much higher than what is officially reported, as most people aren’t reporting positive home tests to any health authority.

Metro Health does not collect at-home test data, a spokeswoman said. Some rapid test kits include a way to report results through a mobile app, she noted, and urged everyone who uses a self-test to report positive results to their healthcare provider.

Alsip echoed Metro Health’s prevention strategies, noting that most people have stopped wearing masks. “Now that we know that the data support this high level [of transmission], while we’re in that higher risk timeframe, it would be a good additional layer of protection.”

He also warned that COVID-19 can now include a constellation of symptoms beyond the fever, cough and shortness of breath that characterized the disease at the beginning of the pandemic.

For the record, Harris County is still at Moderate threat level. Given the viral load in Houston’s wastewater these days, it’s not hard to imagine it going up. They key metric is hospitalizations, and that at least has remained at a sufficiently moderate level. It’s still the case that everyone needs to be vaxxed and boosted – kids under the age of five can now get vaccinated, and it looks like we’re getting an Omicron-specific booster later this year – and masking in indoor public places as well as anytime you may feel ill are still necessary. City and county governments can’t do much beyond exhort you to do the civic-minded thing, and for that matter the feds are pretty limited thanks to a bunch of sociopathic court rulings, so this is where we are. Do your part, if only for yourself, and we can make this be less bad than it otherwise would be.

No new election admin yet

Hope this delay is brief.

Harris County’s top election position remains unfilled, after a Monday meeting of the county’s election commission to select a candidate was canceled due to a lack of quorum. Their final pick will face a narrowing time frame to prepare for his or her first test: Early voting for the November election begins Oct. 24, less than three months after the new administrator’s likely start date.

The tight schedule adds to an already daunting job in a sprawling county with more than 2.5 million voters, an adversarial political climate with frequent election lawsuits, and a startlingly high rejection rate of nearly one out of five mail ballots in this year’s March primaries under the state’s new voting laws.

Only two of the five members of the commission were able to attend the Monday meeting in person, a day after County Judge Lina Hidalgo announced she had tested positive for COVID-19. The commission has not yet rescheduled the meeting.

With outgoing Harris County Elections Administrator Isabel Longoria’s resignation going into effect Friday, Beth Stevens, chief director of voting for the county, will become the interim administrator until the new hire begins, which Harris County Judge Lina Hidalgo said is likely to be Aug. 1. The new administrator’s appointment will be voted on at a later meeting after the selected candidate meets a residency requirement to become a voter under the Texas Election Code.

The commission was slated to hold a closed-door executive session to interview two finalists for the position and take “possible action” to name the administrator at Monday’s meeting. Both finalists have prior experience running elections and are located out of state, according to Hidalgo.

See here for some background. I agree with Campos, it would have been nice to know who besides Judge Hidalgo (who had a perfectly good excuse) didn’t show up and why. May have been valid reasons, but the clock is ticking and we deserve to know. I get the impression that there’s no real dissension on the committee, they just need to finish the job.

The target date to have the new admin in place is still August 1. That’s a brief time to get up and running, but if they are hiring an experienced person and the operational staff is in place – and hopefully we have a way forward on the ballot collection question for Election Day – then I think we’ll be fine. So with that in mind, let me comment on this:

At the commission’s most recent meeting on June 15, Rob Icsezen, deputy chair of the Harris County Democratic Party’s primary committee, presented a letter to the commission signed by around 100 members of the public, many of them current or former Democratic election workers, asking that Longoria be reinstated as elections administrator. One of the reasons they cited was the time frame left until the November election.

“Any new elections administrator would have the same challenges as Ms. Longoria, without the benefit of a year and a half of hands-on experience,” the letter stated. “In short, they would be starting from scratch. November is rapidly approaching. The voters of Harris County do not have time for this.”

This will not be the first time an administrator has overseen a major Harris County election on relatively short notice. In June 2020, Chris Hollins took over as county clerk shortly before the November election, after outgoing clerk Diane Trautman resigned her position, citing health concerns during the pandemic.

“On my first day as County Clerk in 2020, we had just four months to figure out how to administer an election in pandemic conditions for the first time in Texas history,” Hollins said in a statement. “That included acquiring the necessary protective equipment, recruiting the election workers we needed, and creating and training our team on new safety procedures.”

Hollins benefited from an unprecedented budget to administer the 2020 election, after Commissioners Court approved $27 million — much of that coming from federal CARES Act dollars — to fund his plan, which included additional polling locations, up to 12,000 election workers and an extra week of early voting.

“Many core planning items (e.g., number and location of voting centers) should be well under way by August, but the new EA will need to ensure that solutions are in place for issues that have arisen in recent elections, as well as problems created by the recent voter suppression law,” Hollins said. “These include record rejection rates for mail ballots, which we saw in March, and intentional disruption by partisan poll watchers, which will be something we face for the first time in November.”

I was contacted by Icsezen and a couple of other folks, all people I respect, with this pitch. I did not join them. I like Isabel Longoria and I totally get where Icsezen and the others are coming from, but I just think that ship has sailed. It didn’t work out. That’s unfortunate, but it is what it is. Let’s get the new person in there, give that person all of the support and financing they will need to run a successful election, and do everything we can to help. At least COVID ought to be a much smaller issue this time around. We can do this.

COVID vaccines for kids under 5 are now available

It’s been a long wait.

On Saturday, the Centers for Disease Control and Prevention Director Dr. Rochelle Walensky signed off on Covid vaccines for the youngest Americans. Her endorsement means shots can begin immediately, finally ending the two-and-a-half year wait on the part of parents of children under 5.

Walenksy accepted the recommendation within hours after the CDC advisory committee voted unanimously in favor of the Pfizer-BioNTech and Moderna vaccines for children as young as 6 months. A Centers for Disease Control and Prevention advisory committee on Saturday endorsed Pfizer-BioNTech and Moderna’s Covid-19 vaccines for the youngest children, the last step before CDC Director Dr. Rochelle Walensky could issue her final sign-off.

The unanimous recommendations from the CDC’s Advisory Committee on Immunization Practices followed the Food and Drug Administration’s authorization of the shots on Friday.

President Biden responded to the announcement Saturday hailing it as a “monumental step forward.”

“For parents all over the country, this is a day of relief and celebration,” Biden said. “As the first country to protect our youngest children with COVID-19 vaccines, my Administration has been planning and preparing for this moment for months, effectively securing doses and offering safe and highly effective mRNA vaccines for all children as young as six months old.”

Shortly before Saturday’s votes — one for Moderna and a separate one for Pfizer — many panel members celebrated the milestone, noting that parents will soon have two effective tools to protect their youngest children from Covid after more than two years of living with the virus.

“We want to say today that if you’re not going to immunize your children, we think that’s a misplaced concern and that you should immunize your children to save their lives,” said committee member Dr. Sarah Long, a pediatrician at St. Christopher’s Hospital for Children in Philadelphia.

While young children are generally less likely than adults to experience the most serious outcomes of the virus, some do. Among children 6 months old through age 4, there have been more than 2 million confirmed cases of Covid, more than 20,000 hospitalizations and more than 200 deaths, according to CDC data. Covid is the fifth most common cause of death in children younger than 5.

“This is an opportunity, which one doesn’t get very often, to participate in preventing the death of young children,” said committee member Dr. Beth Bell, a clinical professor in the department of global health at the University of Washington. “A death of a young child is an incredible tragedy, and we know that this disease is killing children.”

It’s a function of where we are now in this pandemic that this isn’t bigger and more exciting news than it is. The vaccination rate for kids in the 5 to 11 year old range remains disappointingly low, and the estimates I’ve seen suggest that maybe 20% of the under-five crowd will get their shots. We could of course mandate COVID vaccines for enrollment in schools, but, well, I think you know what would happen then. The best way forward, as even a modest number of kids getting their shots will help save lives, is for those of us who have kids in that age range to get them vaccinated, and for the rest of us to help persuade our family and friends who do to do the same. Your Local Epidemiologist, who has two young kids of her own, has some ideas on that front. COVID is still out there killing people, y’all. We should try to remember that.

Fifth Circuit upholds dismissal of Methodist vaccine mandate lawsuit

Good.

A federal appeals court on Monday upheld the dismissal of a lawsuit challenging Houston Methodist’s COVID-19 vaccine mandate, which last year thrust the hospital into the national spotlight as the first healthcare system in the U.S. to require the shots for its employees.

The lawsuit, filed on behalf of 117 Houston Methodist employees who refused to abide by the policy, was dismissed in June 2021 by U.S. District Judge Lynn Hughes, who at the time decried arguments comparing the requirement to those made under Nazi Germany.

In its opinion, the U.S. Fifth Circuit Court of Appeals said it affirmed the original ruling “because plaintiffs do not demonstrate any error in the district court’s judgment on the arguments made in that court but instead make an entirely new argument on appeal.”

The plaintiffs’ attorney, Jared Woodfill, said “this battle is far from over.”

“We believe employment should not be conditioned on your willingness to take an experimental shot,” he said in an email to the Chronicle. “During oral argument, the court indicated that one way to potentially address this case of first impression is to take it back to state court. We will pursue every legal avenue available to our clients, including taking this case to the United States Supreme Court.”

Woodfill added that a “companion case” has been filed in Harris County, though records of that lawsuit could not be found by press time.

[…]

The lawsuit brought three separate claims of wrongful termination, alleging violations of state and federal law. In their appeal, the plaintiffs “pivoted” from focusing on the federal law violations to state law, the appeals court notes in its opinion.

The plaintiffs “now even equivocate on whether federal law supports their claim,” according to the opinion. “Federal law does not, and the district court did not err in dismissing plaintiffs’ claim.”

See here for the previous update. As noted at the time, Texas state law isn’t exactly employee-friendly, so the odds of a better result for the vaccine refuseniks seems quite low. But hey, they have Jared Woodfill, Super Genius, on their side. What could possibly go wrong?

Calling all lifeguards

The city needs you.

Lifeguard shortages are keeping most Houston community pools closed as summer arrives with scorching heat and near record-breaking temperatures.

Just 12 of 37 aquatic centers operated by the Parks and Recreation Department are scheduled to open for the season, and even fewer were welcoming swimmers Tuesday. The pools will each operate three days a week on a rotating basis as parks department officials seek lifeguards to fill vacancies.

That ratio marks a slight improvement on last year, when 10 aquatic centers opened amid widespread staffing shortages. City officials blamed the paucity of lifeguards on its inability to recruit high school and college students, who make up the majority of its summertime employees.

“Local high schools and colleges stayed closed to off-campus visitors” due to COVID-19 safety protocols, said Leroy Maura, the director of Houston Parks and Recreation Aquatics. “We were not able to get in and recruit and that put us in this bind.”

The 37 aquatics centers require about 180 lifeguards to operate at full capacity. For decades, Maura said, the department could expect up to 150 of those lifeguards to return for subsequent summers. That changed with the pandemic. In 2021, 40 lifeguards came back. This year, only 24 returned.

[…]

Maura, the aquatics director, asked Houstonians to remain patient as his department recruits more lifeguards. He said he hopes to gradually open more pools as the summer scorches on.

I sure hope so. As the story notes, it’s going to be a hot, hot summer – hell, it already is. The schedule for the city’s polls is here, and you can find information on how to apply for a lifeguard job there as well. If you know someone 16 or older who can meet the requirements, the pay starts at $13.66 an hour. I worked way worse jobs than that back in the day.

HISD approves its budget

First one for the new Superintendent.

Houston ISD trustees on Thursday unanimously approved a $2.2 billion budget that will give teacher raises some have called long overdue and fund the upcoming school year when the district is expected to begin implementing a strategic plan aimed at making the state’s largest school system more equitable.

All nine trustees voted in favor of the proposed budget following a presentation from Superintendent Millard House II about how parts of the budget will meet board goals, which a few trustees had asked about. A roughly $100 million deficit will end up being reduced to some $30 million at year’s end through unspent funds, mostly from job vacancies, administrators have said they anticipate.

“We cannot hope to serve the needs of our children by being close-fisted on the most important determinant of their success: high-quality professional educators,” Trustee Elizabeth Santos, who frequently advocates for educators from the dais, said in a statement posted on Twitter after the vote. “This budget honors our kids by honoring our teachers, support staff and principals. It is past time for HISD to be the district that sets the standard in our region. I’m proud to be part of the team that gets us there.”

The compensation package, backed with the help of federal COVID-19 relief money the district received, will boost the salary of a starting teacher to $61,500 from the current annual pay of $56,869. Employees at the higher end of salary ranges will see about $3,000 more each year, those salaries reaching the mid- and high-$80,000s.

Other employees are also expected to receive raises as the district will update its master pay table.

The spending plan also set the financial framework for the first full year of House’s five-year strategic plan. Campuses will be required to staff librarians or media specialists, nurse or nurse assistants, and counselors.

In addition to the $2.2 billion operating budget, the district expects to pay another $374 million in debt service. Central administrators this spring cut $60 million in what House has called the first step toward financial sustainability. The cuts did not affect the police force, financial or legal services, House said.

See here and here for some background. HISD was known to pay its teachers less than other area districts, and it has seen some teachers leave as a result, so the pay raise was needed. We’ll see how those first pieces of the strategic plan go. I’m generally optimistic, but there are always some bumps in the road. Now that this has been settled and HISD appears to be in fairly stable shape for the near term, it’s probably time to start talking about the next capital bond issuance. The last one was in 2012, and there are surely numerous buildings that need work, and that’s without mentioning the urgency of better ventilation as a COVID mitigation. I don’t know if there’s time to get a bond item on the ballot this year, but if they wait until next year at least it’s a city election year and we’ll have an open Mayor’s race, so they won’t have to sweat as much to get their voters to the polls. Hope you’re working on a plan for this, HISD.

When we had more deaths than births in Texas

Seems like that would be a bad thing.

In the midst of the nation’s deadliest pandemic, Texas recorded more births than deaths every month since 2016 — with one exception.

Provisional data from the Texas Department of State Health Services shows that January 2021 was the only month when, statewide, the number of deaths was greater than the number of births.

Nine months before in April 2020, the world was one month into the COVID-19 pandemic. In January 2021, the seven-day average number of deaths from COVID-19 peaked in Texas, according to The New York Times, and vaccines had just become available to select groups of individuals.

Twenty counties — including Bexar County — recorded more births than deaths every month until the pandemic, when they began having months with more deaths than births.

The number of births for a county is determined by the mother’s residence.

Thirty one counties — including more populous ones like Harris, Dallas and Travis — always recorded more births than deaths, even during the pandemic.

Five counties — Bowie, Kerr, Potter, Smith, and Wichita — reported more deaths than births for all 22 months of pandemic data available.

There are charts and maps in the story, and they calculate the birth and death rates on a per 100K people basis to make everything more easily comparable. One thing the story doesn’t go into, which is a thing that has been widely reported on elsewhere, is differences in voting patterns across the counties. I’m not going to dive into all of the data here, but I will note this much about those five counties that had a net loss (not counting migrations) for each month:

Bowie – Trump 70.9%
Kerr – Trump 75.3%
Potter – Trump 68.5%
Smith – Trump 69.0%
Wichita – Trump 69.7%

You get the picture.