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Texas Department of State Health Services

By the way, medical abortion is now more tightly restricted in Texas, too

Another piece of crap from the special session.

Misoprostol

A new law limiting the use of abortion-inducing medication in Texas goes into effect Thursday.

The law makes it a felony to provide the medication after seven weeks of pregnancy, putting Texas at odds with federal regulations. It also makes it a crime to send the medication through the mail.

Medical abortion is the most common way women in Texas terminate their pregnancies, according to state data.

These new restrictions reflect a growing concern among abortion opponents about the rise of “self-managed” abortions, in which pregnant people obtain the medications from out-of-state or international providers, with or without a prescription.

There’s evidence that more women turn to self-managed abortions when legal abortion is restricted. Texans have been unable to access abortions after about six weeks of pregnancy since Sept. 1, when a controversial new ban went into effect.

“Texas is looking at the ways that people are navigating around restrictions and trying to essentially make that as unsafe and as frightening for people as possible in order to deter them,” said Farah Diaz-Tello, senior legal counsel for If/When/How, a reproductive justice legal group.

Diaz-Tello and other advocates worry that the new criminal penalties may make pregnant Texans fearful of seeking medical care after a self-managed abortion.

[…]

Texas’ new law also specifies that no one may provide abortion medication “by courier, delivery or mail service.”

Texas already required the medication to be provided by a physician in person. But this specific clause addresses a growing concern among abortion opponents that patients are trying to circumvent the required doctor visit by getting the drugs by mail, especially with the state’s new restrictions that bans abortions after around six weeks.

Called a “self-managed abortion,” this usually entails ordering abortion-inducing drugs online, with or without a prescription, from doctors, pharmacies and other providers out of state or overseas.

The FDA has attempted to crack down on some providers, including AidAccess, a group founded in 2018 by Dr. Rebecca Gomperts, a European doctor. AidAccess provides abortion-inducing medications to women in areas that have restricted access to the procedure.

Gomperts has said she will continue prescribing to patients in Texas. She told CBS News in September that she believes she is on solid legal ground since it is legal to prescribe this medication where she is based.

See here for the backgroun; I didn’t blog it at the time for whatever the reason. A bit more than half of all abortions in Texas are medical abortions, which the FDA says are safe up to ten weeks. I suspect Dr. Gomperts and others like her if they exist will get more business now, despite the prohibition on sending the medication via mail. It’s really a matter of enforcement, and it’s not clear to me how Texas will be able to do that. That FDA action against her was from 2019, by the way. It would be nice for the current FDA to maybe revisit that now. I don’t have anything positive to end with. This is where we are right now.

COVID hospitalizations are (generally) down in (most of) Texas

For now. I think you always have to add “for now” to this sort of thing.

As Texans head into the holiday season, there is much to celebrate when it comes to addressing the pandemic. But health experts say the state is not out of the woods just yet.

First, the good news. The number of residents here hospitalized with COVID-19 is at one of its lowest points since the beginning of the pandemic, while average daily deaths from the virus are also dropping and vaccines are finally — after a year of parents anxiously waiting for approval — flowing into the arms of the state’s elementary age children.

After a miserable summer when the delta variant caused a surge that rivaled the worst moments of the coronavirus pandemic, state health officials and experts say they are grateful for signs of relief. But they’re wary of being too optimistic about a pandemic that has, more than once, had this state in a stranglehold.

“People are just kind of happy or relieved that the most recent surge is done with, but I don’t think anybody’s celebrating anything yet,” said Dr. James Castillo, public health authority in Cameron County. In that county, the share of hospital beds occupied by COVID-19 patients has dropped to 3% percent, down from over 25% during the summer surge.

Still, health officials are now watching a recent increase in the number of new confirmed COVID-19 cases and a small uptick in the rate of COVID-19 tests coming back positive as potential warning signs.

They’re also keeping an eye on a troubling new surge in the nation’s Western states that has hit El Paso, a region that was spared the deadly delta surge that rocked the rest of the state in August and September.

“We’re certainly in a better place right now than we have been in quite a while,” said Chris Van Deusen, spokesperson for the Texas Department of State Health Services. “But we are sort of starting to see things change again. And you know, if there’s one thing we know about this pandemic, it’s that it’s going to keep changing.”

[…]

Every day of good news, it seems, carries with it a note of caution.

At highest risk, officials say, are the millions of Texans who have not been vaccinated. During the month of September, at the height of the surge when about half of Texans had been fully vaccinated, unvaccinated people were 20 times more likely to die from the virus than those who had been vaccinated.

What that means, scientists say, is that a surge among the unvaccinated could still happen.

“Overall, our projections right now are fairly optimistic for the state of Texas,” said Spencer Fox, associate director of the University of Texas COVID-19 Modeling Consortium. “But when we look at the winter, we’re still fairly concerned about what might happen in the future. … Our models suggest that there’s still enough susceptibility in our population to see another pandemic surge if we remove all precautions. I think Thanksgiving will be a lead indicator of what’s to come.”

As one of the graphics in this story shows, only 54.3% of the state’s population is fully vaccinated. So yeah, there’s a huge reservoir of vulnerable targets for the virus. And all of this is before we consider the possibility of new variants reaching our shores. If you’re fully vaxxed, you’re as safe as you’re going to be, but the old standbys of wearing masks and avoiding crowded indoor spaces are still in vogue. Don’t let your guard down.

Just a reminder, the COVID vaccine really will save your life

Numbers don’t lie.

New data from the Texas health department released Monday proves what health officials have been trying to tell vaccine-hesitant Texans for months: The COVID-19 vaccine dramatically prevents death and is the best tool to prevent transmission of the deadly virus.

Out of nearly 29,000 Texans who have died from COVID-related illnesses since mid-January, only 8% of them were fully vaccinated against the virus, according to a report detailing the Texas Department of State Health Services’ findings.

And more than half of those deaths among vaccinated people were among Texans older than 75, the age group that is most vulnerable to the virus, the study shows.

“We’ve known for a while that vaccines were going to have a protective effect on a large segment of our population,” said Dr. Jennifer A. Shuford, state epidemiologist. “By looking at our own population and seeing what the impact of the vaccines have been on that population, we’re hoping just to be able to reach people here in Texas and show them the difference that being fully vaccinated can make in their lives and for their communities.”

The state health department study covers most of the positive cases and COVID-19 deaths reported in Texas among residents from Jan. 15 to Oct. 1. It’s the first time state officials have been able to statistically measure the true impact of the vaccine on the pandemic in Texas — which has one of the highest death tolls in the nation. The majority of Texans ages 16 and up didn’t become eligible for the vaccine until late March.

State health officials also found the vaccine greatly reduced the risk of virus transmission, including the highly contagious delta variant that ravaged the state over the summer.

Only 3% of 1.5 million positive COVID-19 tests examined since mid-January occurred in people who were already vaccinated.

Let’s be clear, these are the stakes when Greg Abbott and Ken Paxton do all the things they’ve been doing and are still doing to impede vaccination efforts. People have died, are dying, and will die because of them. We wouldn’t have needed the mandates if people like them hadn’t been feeding a steady diet of lies and grievances to the mostly gullible population that listens to them. I will never understand any of that.

The new report is particularly well-timed, officials say, because gatherings throughout the holiday season could touch off another surge as families get together — many of them for the first time since last year — and around 9 million Texans remain unvaccinated.

Texas saw its deadliest surge of the pandemic in January, when more than 400 deaths were reported daily at its peak, a trend health officials said was likely a direct result of the holidays.

The recent Texas Coronavirus Antibody Response Survey, commissioned by the state health department in partnership with the University of Texas System, estimated that about 75% of Texans — roughly 22 million people — likely have some level of protection against the virus, either by natural immunity from being infected or through vaccination.

But that doesn’t mean infected people are immune indefinitely or that they shouldn’t get the vaccine, health experts say.

In fact, doctors, scientists and health officials urge those who have been infected to get vaccinated anyway, saying the vaccine provides a strong boost in immunity even to those who have some level of natural protection.

The Texas CARES study found that fully vaccinated participants showed significantly higher antibody levels than those who were unvaccinated but had been infected.

A week ago, the CDC found that while both vaccination and natural infection provide about six months of protection from infection by the virus, the vaccine provides a “higher, more robust, and more consistent level of immunity” than natural infection does.

And while the fact that a solid majority of Texans are estimated to have some protection from the virus bodes well for the state in its fight against the pandemic, Shuford said, it still means that millions of Texans are vulnerable to severe illness or death from the highly contagious virus, without any vaccine or natural immunity.

The next frontier in COVID data reporting needs to focus on repeat infections, which I’m going to bet will also be overwhelmingly from the unvaccinated population. You get some immunity from having had the virus, but it’s not nearly as much as you might think. I don’t actually expect data to move a whole lot of opinion, but maybe it’ll help a little. And maybe those mandates plus vaxxes for kids will finally get us ahead of the curve. Here’s hoping, because winter is coming.

The Delta surge is killing younger people

So many avoidable deaths.

About two weeks later, sometime in August, the [woman in the San Antonio intensive care bed] died. She was in her mid-40s.

She is among more than 9,000 Texans who have died from COVID-19 in August and September, nearly 40% of them under the age of 60, part of an alarming upswing in reported daily deaths that threatens to overtake last summer’s deadly surge in average weekly numbers.

The dramatic and sudden increase in deaths — which jumped nearly tenfold over two months this summer — comes in spite of tens of thousands of vaccine doses being administered to Texans every day.

[…]

Of the nearly 19,000 Texas deaths attributed to COVID-19 since early February, 119 were fully vaccinated according to preliminary data from the state health department.

Scientists are still researching whether the delta variant is more deadly than earlier versions of the virus, but it is known to be much more contagious, and some data suggest that it makes people much sicker, much faster than the previous versions. The COVID-19 vaccines are extremely effective in preventing serious illness or death, scientists say.

“We shouldn’t be surprised,” Dr. David Lakey, vice chancellor for health affairs, chief medical officer at the University of Texas System and a member of the Texas Medical Association’s COVID-19 task force, said of the death numbers. “The main reason the fatality rates are as high as they are is there’s a lot of COVID in a lot of people that have underlying conditions and are not immunized.”

[…]

The deadliest month of the pandemic so far was January — before vaccines were widely available — when 9,914 people died from COVID-19, according to state data. That month only 15% of the COVID-19 deaths were among Texans under age 60. Last month during the height of the delta surge, they accounted for 38% of deaths.

More Texans younger than 60 died in August than at any other point in the pandemic. Deaths of Texans in their 40s, for example, jumped to 679 — nearly double the previous peak for that age group in January 2021. For Texans in their 30s, deaths in August were 33% higher than the winter peak, while deaths of those younger than 30 — 124 in August — were 77% higher than the previous peak for that age group, which was 70 in July 2020.

Older people are still dying in the largest numbers, even as their vaccination rate has reached 98% in some areas and 79% of Texans ages 65 and older are fully vaccinated statewide. That’s because they are still more vulnerable to the illness and much more likely to die from an infection than their younger counterparts, said Spencer Fox, associate director of the University of Texas COVID-19 Modeling Consortium.

While deaths in that age group also increased in August, they were far below their peaks over the winter and last summer.

Hospitalizations peaked in August statewide — nearly reaching the record numbers from the January surge — and more hospitals reported ICUs at or over capacity than at any other time in the pandemic. Those numbers are starting to level off or decline, along with the positivity rate, which measures the percentage of COVID tests that are positive.

It’s an encouraging sign that the delta surge may finally be cresting, although that’s not a certainty, Fox said.

National models are saying the same thing, though everyone remains worried about the winter. That’s actually less of a concern here, at least for much of the state, because our winters tend to be mild, the occasional deadly freeze aside, and that means people can continue to be outdoors. Given how high our overall death rate has been, we can use all the help we can get. We’re sure not getting any from our state government.

El Paso is doing all right with Delta

Good for them, let’s hope it lasts.

While some other metro areas like Austin reported record high numbers of COVID-19 patients in their area hospitals just last month, and while statewide hospitalizations came close to eclipsing the January peak of 14,218, El Paso-area hospitals, which serve nearly a million West Texas residents, haven’t come close to their previous highs.

El Paso’s peak for COVID-19 hospitalizations was just over 1,100 in mid-November, said Wanda Helgesen, director of BorderRAC, the state’s regional advisory council for local hospitals.

On Thursday, the number of people hospitalized for COVID-19 in El Paso was 127.

In fact, the city’s daily hospitalization numbers haven’t broken 200 since March, according to the Texas Department of State Health Services. Hospitals are seeing an increase in patients, have occasionally seen their ICUs fill up and are having the same staffing problems as the rest of the state, she said, but have so far been able to handle the uptick.

Most of the pressure is related to non-COVID patients, many of whom had been waiting to get treatment for other problems, she said.

“We do have a surge of patients but not to the extent that other parts of Texas are having,” she said.

Helgesen and others say much of the credit can be attributed to the area’s high vaccination rate, widespread compliance with masking and social distancing, and a strong partnership among local community and health care leaders.

“It is amazing,” Helgesen said. “It is absolutely a credit to our community. I really think it was an all-out effort.”

The share of COVID-19 tests in El Paso that come back positive is hovering around 6%, while the statewide positivity rate is three times that at 18%.

And while COVID-19 patients, most of whom are unvaccinated, took up more than 30% of hospital capacity in some areas and more than 20% statewide last week, in El Paso they accounted for only 7% of patients in local hospitals.

For a city with one of the state’s highest per-capita COVID-19 death counts, the numbers present a rare glimmer of good news for the traumatized residents of this West Texas border city.

“Compared to the rest of Texas, we’re in heaven,” said Gabriel Ibarra-Mejia, assistant professor of public health at the University of Texas-El Paso. “That doesn’t mean we are free from COVID, but we’re doing much, much better than most of the rest of the state. The numbers don’t lie.”

Civic and health leaders say they aren’t ignoring one important fact: El Paso’s surges have been weeks behind the rest of the state throughout the pandemic, so it’s possible that the region’s own delta-fueled spike could still be ahead.

“We aren’t letting our guard down,” Helgesen said.

El Paso Mayor Oscar Leeser, who lost his mother and brother to COVID during the winter surge, said the reason the city and county have enacted recent mask mandates, in defiance of Gov. Greg Abbott’s ban on them and in spite of lower numbers, is because the potential for another surge is still real.

“We do worry and we want to make sure that we don’t have any spikes,” he said. “You always want to be proactive and you always want to be prepared.”

The story goes on to recount the huge spike in COVID cases that El Paso experienced last November, which put it in the national news. If you look at the included chart of COVID cases, which tracks El Paso and the state as a whole, the two were mostly in sync except for that giant surge in November, which came between the two big statewide surges, and now, when the statewide rate began to take off in May but El Paso’s stayed more or less where it had been. I’m sure the mask mandate and above-norm vaccination rates have helped with that, but it may also be that enough unvaccinated El Pasoans have had COVID that the overall rate of immunity is high enough to be something like herd immunity. Or maybe they’re just lucky right now, and the curve will begin to turn upward for them eventually. I very much hope that’s not the case, but I think we all know that this pandemic has been persistent and somewhat random about who gets it the worst at a given time. In the meantime, though, keep on keeping on, El Paso.

COVID rate slows a bit, but ICUs still full

The good news.

So far, the delta variant has fueled a month of Houston-area COVID hospitalizations over 3,000, according to the Texas Department of State Health Services.

But Texas Medical Center records show positive case rates may be slowly declining. According to TMC’s daily report, 1,939 people tested positive Tuesday in the Greater Houston area, a decline that may be related to COVID testing site closures as a precaution before Hurricane Nicholas.

Also Tuesday, the medical center admitted 310 new COVID-19 patients compared to the average 328 per day last week. Hospitals in the TMC remain at 90 percent capacity.

Dr. Wesley Long, a microbiologist and medical director of diagnostic microbiology at Houston Methodist, has been tracking and analyzing the virus and its variants through the hospital’s COVID-19 genome sequencing operation.

While Long sees the increase slowing, he hesitates to say Houston is passed the peak of the surge.

“It’s like cresting the top of the wave, you don’t know what the backside of the wave is going to look like,” Long said. “In the beginning of this fourth wave, there were some people hopeful it would go up quickly and come down quickly. That’s not the case.”

The fourth wave’s peak has been broader than previous waves, which spiked and declined within about 25-30 days, Long explained. The big question with the delta wave is whether it will plateau at a high rate of hospitalizations or have a slow decline.

“It’s hard to know how other things like holidays and school will affect the case count,” he said. “It’s really important to keep masking, social distancing and staying home if you’re sick because it’s important to bring the fourth wave under control.”

Another way to look at it:

The not so good news.

COVID-19 hospitalizations have been declining across Texas and the Houston region, but the virus is still keeping a high number of people in ICUs, prolonging the strain on patients waiting for critical care beds.

Last week, the number of available adult ICU beds in Texas sunk below 300 for the first time in the pandemic, with 270 beds available on Sept. 8 and 279 available on Sept. 9, according to the Texas Department of State Health Services. There were 326 beds available this Wednesday, including 65 in the nine-county region surrounding Houston, the data show.

Texas Medical Center ICUs for weeks have been hovering around 90 percent full with “Phase 2” surge plans — which add 373 ICU beds to the 1,330 available in Phase 1 — activated.

[…]

ICU data is a lagging indicator of the virus’s impact, [Dr. Syed Raza, vice president of medical operations at CHI St. Luke’s Health-The Woodlands Hospital] said, because the sickest patients need care for a longer period of time. He said it is the “natural course of the pandemic” for ICUs to remain high after hospitalizations decline.

Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine, said the hospital strain appears to be easing overall. The number of COVID patients in ICU beds likely peaked at the end of August, when they took up 49 percent of all critical care beds, he said. As of Wednesday, that number dropped to 45 percent.

He said he is cautiously optimistic that “we’ll continue to see this trend move in right direction.” He compared the current ICU situation to flooding during hurricane.

“We are no longer stuffing towels under the door” to stop the water, he said. “But the water is still over our threshold.”

I mean, it could be worse. It’s still not good, and it’s going to continue to not be good for awhile, but it could be worse. Keep up with the precautions, they’re our best hope in the short term as more people get vaccinated.

We really need a mask mandate at every school district

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

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

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

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

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

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

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

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

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

Thankfully, HISD is doing it right.

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

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

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

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

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

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

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

The contract health worker surge

Don’t know how sustainable this is.

Dr. Esmaeil Porsa, president and CEO of Harris Health System, said the hospitals in the system were at a breaking point when he learned that 100 temporary medical workers were being sent to help.

As cases surged, the hospitals were admitting more children and pregnant women with complications from COVID-19, and patients who needed intensive care waited in emergency rooms for ICU beds to become available.

The nurses, respiratory therapists and other contract staff “definitely arrived here at a pivotal moment,” Porsa said. “They did exactly what I had hoped that they would do, which is allowing us the opportunity of a couple of things: to provide a little bit of relief for front-line staff who have been running around ragged, but also created an opportunity for us to expand our capacity.”

[…]

Gov. Greg Abbott announced the Texas Department of State Health Services would deploy state-funded relief workers to hospitals, and 8,100 have either arrived from other states or are expected soon.

It’s the second time the state has taken such action. At the height of the state’s winter surge, almost 14,000 medical workers were deployed across the state, according to DSHS. From July 2020 to early August of this year, the state spent more than $5 billion in federal disaster funds and coronavirus relief funds on medical personnel.

Abbott’s move came after hospitals and local health officials complained that they were having to outbid each other to hire contract nurses amid a statewide shortage of hospital staff.

W. Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council, said that competition among hospitals meant “they’re going to take from Peter to give to Paul, so to speak. That’s why using the state with their purchasing power [is important].”

The new push to bring more health workers to Texas comes as many have reached their limits, said Carrie Williams, spokesperson for the Texas Hospital Association.

“This surge has come faster and stronger than previous surges, and it comes at a time when the frontline [worker] is burned out,” Williams said in a statement. “We were already starting from behind when this surge hit.”

According to DSHS, the state’s hospitals requested more than 15,000 temporary staffers between Aug. 12 and Aug. 25. As of Aug. 25, almost 4,000 have been deployed, with most going to regions with the state’s most populous counties and metro areas.

[…]

Health officials continue to stress that the main way to reduce the need for additional staff is clear: more vaccinations. As of Aug. 25, about 47% of Texans were fully vaccinated.

Since Jan. 1, Porsa said, everyone who has died at LBJ Hospital and Ben Taub Hospital from COVID-19 has been unvaccinated.

“Space is not unlimited, resources are not unlimited,” Porsa said. “At some point it doesn’t matter how many nurses you throw at the problem, we are going to arrive at a situation where we’re not going to have enough clinicians, we’re not going to have enough doctors, we’re not going to have enough something else.

“We will run out of options at some point, and this is really really important for people to realize that this cannot go on forever, and they know what the solution is.”

It’s still not clear to me how there could even be that many not currently working medical staff out there to be brought in, but they do exist in some number, for which we are grateful and lucky. It’s also not clear at what point demand will outstrip supply, and as noted above, we may run into other limits even sooner than that.

How long can we last? There’s actually a tiny bit of cause for optimism in the most recent data.

The average number of daily COVID hospitalizations in the Texas Medical Center dropped for the first time since early July from a record 390 patients to 388, the medical center reported Monday.

The metric reflects the daily average of hospitalized patients over the previous week. The drop comes amid declining COVID hospitalizations both nationally and statewide.
A three-day decline in total COVID hospitalizations in Texas brought the number to 13,557 on Saturday, the most recent day for which data is available. The Centers for Disease Control and Prevention also reported a drop in the average number of new daily hospitalizations nationwide, from 12,354 on Thursday to 12,051 on Friday. More recent national data is not yet available.

Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine, said the decline is part of the natural course of the pandemic.

“When you see an outbreak like this, the virus kind of runs through the population until it gets to the point where it starts running out of people to infect,” he said, adding, “That does not mean herd immunity.”

He warned that the virus still has room to spread, especially as schools reopen. In an interview last week, McDeavitt said hospitals will continue to feel the strain of the current surge as cases decline.

Burnout among nurses, lingering staffing shortages and the record number of hospitalizations all factor into a longer recovery period.

“From the peak, we’re probably still a month-and-a-half to getting to something that feels like business as usual,” he said last week. “So best case, we’re into October now before we start to get some relief.”

So don’t get too cocky. It’s good that maybe we’ve peaked and will start to see a decline, but we’re still a long way out from where we were in May and June, and we could easily reverse course again. We need to keep getting people vaccinated, because the alternative is more of what we’re going through now.

Readin’ and writin’ and gettin’ COVID

Welcome back to school, kids.

Positive COVID-19 cases among Texas public school students rose by more than 9,000 last week, the highest number ever recorded in a seven-day period, state data shows.

As of Aug. 22, there were 14,033 reports of positive COVID cases in students across the state, according to data released by Texas Health and Human Services on Friday. The number represents a 182 percent increase from the 4,976 student cases reported through Aug. 15.

There were another 3,425 positive cases reported in school staff across the state, an increase of 712 from the previous week.

In some districts, more than half the new infections are among elementary school students, who are not eligible for any of the available vaccines.

“This school year is gonna look a whole lot different than last year,” said Dr. Katelyn Jetelina, an assistant professor of epidemiology at UTHealth School of Public Health in Dallas. “We have a whole lot more transmission now in the community and we have the delta variant.”

The cumulative number of cases in students since the 2021-2022 school year began is 20,256. The total staff cases so far this school year is 7,488.

In case you were wondering why so many parents are pissed about the fight against mask mandates. Now that all schools are open I would hope we won’t see any more big jumps like that, but we are going to see the case levels rise for now. I hope that at some point, when there’s enough data to be reasonably confident in the results, we can get a comparison of COVID rates in districts that have mandated masks versus those that have not.

On a related note:

People under 50 are being admitted to hospitals with COVID-19 in larger numbers than at any point during the pandemic as the latest surge of the coronavirus continues to tighten its grip on Texas.

According to data released by the Texas Department of State Health Services, as of Aug. 22, adults 30 to 49 now account for roughly 29% of all COVID-19 hospital admissions in Texas, up from 15% on Jan. 11 during the height of the winter surge.

The data shows that people in the 18-29 age group increased their share of admissions during that period from 5% to 7%, while the percentage of children under 18 admitted to hospitals with COVID-19 increased by 1 percentage point — an average of 46 children each day were hospitalized during the week ending Aug 22.

Meanwhile, fewer people over 70 are landing in hospitals with COVID-19. During the winter peak, about 41% of hospitalized COVID patients were over 70. As of Aug. 22, that dropped by almost half, to 23%.

The data confirmed what many doctors have been saying in recent weeks about the delta variant sending younger people into hospitals at a higher rate than earlier in the pandemic.

“We are seeing certainly younger patients hospitalized and younger patients on ventilators where we haven’t seen that before,” said Dr. Ron Cook, chief health officer at the Texas Tech University Health Sciences Center.

This variant has spread faster among unvaccinated Texans of all ages. As of last week, between 93% and 98% of hospitalizations have been unvaccinated people, depending on the area of Texas, officials said.

More than 70% of Texans over the age of 50 are fully vaccinated, compared to only about half of Texans between the ages of 16 and 49 and one-third of those ages 12-15. Children under age 12 are not eligible for vaccination.

And as the hospitals fill up with COVID patients, people who have other serious but treatable conditions are put in jeopardy. No amount of horse de-wormer is gonna fix that.

Other things the Lege has been up to

A brief roundup, to clear some tabs…

Bad Bail Bill 2.0 moves forward.

A sweeping revision of the process for releasing accused criminals on bail won initial approval from the Texas House on Friday night, nearly three months after the GOP-priority legislation stalled in the regular legislative session.

Senate Bill 6, which would require people accused of violent crimes to put up cash to get out of jail, tentatively passed the House on an 82-37 party line vote. The Senate passed the legislation earlier this month on a 27-2 vote.

A House committee advanced the bill Monday after taking out a controversial provision that would have restricted charitable groups from posting bail for defendants, a practice that gained popularity last summer when groups posted bail to release people arrested while protesting the death of George Floyd, a Black man murdered by a white Minneapolis police officer.

On Friday, House members added a related provision back into the bill that does not limit the ability of such groups to post bail. Instead, the amendment would require charitable bail funds to be certified by county officials as nonprofit organizations and file reports on who they bond out of jail.

“The original bill that came over [from the Senate] was essentially going to outlaw … the charitable bail process,” said state Rep. Travis Clardy, R-Nacogdoches, on his amendment. “We made it very clear to the other side of the building that this would not stand.”

The bill still needs to pass the House a final time before it is sent back to the Senate, which can either accept the House changes or enter into closed-door negotiations. State Sen. Joan Huffman, the Houston Republican who authored the bill, did not respond to questions about House changes this week.

See here and here for some background. This is bad, and there’s a decent chance parts if not all of it will eventually be found unconstitutional, but in the short term it will do some damage. Go read Grits for Breakfast or follow him on Twitter for a deeper dive.

Some virtual learning gets funded.

After months in limbo, Texas lawmakers took a step toward expanding and funding virtual learning as the pandemic still proves a threat to families not yet comfortable sending their children back to classrooms.

The Texas House approved Senate Bill 15 on Friday night in a 115-3 vote. The bill will go to a final reading and vote in the House before making its way to Gov. Greg Abbott’s desk.

The House’s initial approval of the bill will give some parents a measure of relief that there could be more virtual learning options as the pandemic once again strains the state’s resources. Hospitalizations and cases are surging due to the more transmissible delta variant of the coronavirus.

Necessary, albeit regrettable. We wouldn’t be revisiting this topic if we had a better handle on COVID, but given that we are not we need to acknowledge reality where we can. This is one reasonable place to do so.

More border boondoggling.

The Texas House approved nearly $2 billion in additional funding for border security operations, giving Gov. Greg Abbott more state dollars to implement his plans to build a border wall and incarcerate migrants for state criminal offenses in an effort to deter migrants from coming to the state.

Lawmakers gave initial approval Friday to a funding bill by a vote of 81-38 that would triple what the state allocated for border security during the last biennium. The $1.88 billion appropriated by House Bill 9 is in addition to the $1.05 billion lawmakers approved for border security this spring.

“There’s a crisis on our southern border with serious consequences extending throughout our state,” said Rep. Greg Bonnen, R-Friendswood, who authored the bill. “Texas must respond to the crisis that has been brought to our doorstep.”

In June, Abbott announced Texas would build a state-funded border wall to decrease the number of migrants entering through its border with Mexico. Earlier this year, the two-term Republican governor launched Operation Lone Star, an effort that directed state military and police resources to the border to aid local and federal authorities fighting the smuggling of people and drugs across the border.

Abbott, who is seeking reelection next year, had previously said he expects the state to build hundreds of miles of wall along the state’s 1,254-mile border with Mexico, but had not specified where the wall would be or how much it would cost.

This message has been paid for by the Greg Abbott campaign.

More money for “temporary” hospital workers.

Gov. Greg Abbott announced Thursday that for the second time amid a recent surge in COVID-19 hospitalizations that Texas will increase the number of state-funded relief workers it will be sending to Texas hospitals, bringing the total to 8,100.

The Texas Department of State Health Services had previously authorized contracting 5,600 medical personnel, and Thursday’s announcement adds 2,500 more.

During the state’s winter COVID-19 surge, more than 13,500 temporary medical workers were deployed across the state, according to DSHS. Those numbers began to dwindle once cases started to decrease and vaccinations became more widely available.

Now, the highly-contagious delta variant has pushed the state to reverse course and again take the lead in alleviating staffing shortages as hospitals are inundated with COVID-19 patients and intensive care unit beds are becoming scarce. On Aug. 9, Abbott directed DSHS to use staffing agencies to secure out-of-state medical personnel for Texas hospitals and asked hospitals to voluntarily halt elective medical procedures.

The state will fully fund the temporary health workers through Sept. 30.

Not technically a Lege thing, but Lege-adjacent. See my previous point about things we wouldn’t need to be doing if we had handled COVID better. I have no idea where we will find all these relief workers, but that’s yet another mess Greg Abbott will have to clean up for himself.

And finally, one thing the Lege hasn’t been doing:

And yet here we are. Still not too late, I suppose, but with every passing day this becomes more and more true.

Abbott flails about on the COVID surge

He remains committed to the bit.

Gov. Greg Abbott announced new moves Monday to fight the coronavirus pandemic as it rages again in Texas, including asking hospitals to again put off certain elective procedures to free up space for COVID-19 patients.

Still, the governor did not back down on his refusal to institute any new statewide restrictions on businesses or to let local governments and schools mandate masks or vaccines.

Instead, Abbott announced he had written to the Texas Hospital Association asking hospitals to “voluntarily postpone medical procedures for which delay will not result in loss of life or a deterioration in the patient’s condition.” As coronavirus was consuming the state last summer, Abbott took a more restrictive approach and banned elective surgeries in over 100 counties before ending the prohibition in September.

Abbott also announced Monday he was asking state agencies to open additional COVID-19 antibody infusion centers that aim to treat COVID-19 patients with therapeutic drugs and keep them from requiring hospitalization. And he said the Department of State Health Services “will be utilizing staffing agencies to provide medical personnel from out-of-state to Texas health care facilities to assist in COVID-19 operations.”

That is a reversal for the state. In July, the state told cities and counties it would not send additional health care workers to aid hospitals with the latest surge of COVID-19 patients, like it had earlier in the pandemic. Instead, state officials said, city and county leaders should dip into $10.5 billion worth of federal stimulus dollars to pay for those workers should hospitals need them.

[…]

As part of Monday’s announcement, Abbott’s office said he was directing state agencies to “increase vaccination availability across the state” but did not provide further details.

“Texans can help bolster our efforts by getting vaccinated against COVID-19,” Abbott said in the news release. “The COVID-19 vaccine is safe and effective, and it is our best defense against this virus.”

Well, some hospitals had already taken the step of halting elective procedures, so way to be out in front on that, bro. Part of this “plan” includes recruiting more nurses from out of state to help us with the shortage we are now experiencing. I presume this means he’ll be trying to lure them from states that have COVID under a greater degree of control, probably places where the Governors in question made an actual effort to get people vaccinated and didn’t kneecap local leaders’ attempts to keep their people safe. I have no idea why any of them would want to come here now, but God bless ’em if they do. I guess we should be thankful that Abbott is doing something other than literally fiddling while the state burns, but color me a little too grumpy to care about such crumbs.

Overflow COVID tents

This is fine.

Harris Health System’s intensive care units are nearly full as the delta variant sends more COVID-19 patients into hospitals, prompting the safety-net health system for the county’s indigent communities to construct tents for triaging patients.

As of Monday afternoon, Lyndon B. Johnson Hospital’s ICU was 100 percent full, and 63 percent of patients were being treated for COVID-19 complications. Ben Taub Hospital’s ICU was 95 percent full, with 27 percent of patients sickened by the virus.

“The trend line is vertical,” said Bryan McLeod, a spokesperson for Harris Health.

The tents apparent outside the hospital in northeast Houston could be used for COVID-19 overflow patients, but officials may also choose to use it for patients who come in with other illnesses. Last summer, they were used to diagnose coronavirus cases, McLeod said.

This year, they may just be used to treat non-COVID patients, or those with less severe infections. Staff are still installing operational and diagnostic equipment in the overflow area, which will take patients from the emergency room.

While LBJ is the only hospital currently using such tents, Memorial Hermann is creating additional space for overflow patients by converting beds in their pre- and post-anesthesia units into ICU beds.

[…]

Statewide, hospitalizations have been increasing rapidly; on Saturday 9,462 people were hospitalized, an increase of 30 percent over the previous Saturday, according to the Texas Department of State Health Services. This weekend’s hospitalization figures were the highest Texas has seen since Feb. 6.

Not just in Houston.

Dozens of Texas hospitals have run out of intensive care unit beds as COVID-19 surges faster than any other time during the pandemic, propelled by the new delta variant.

The state is divided into 22 trauma service areas, and half of them reported 10 or fewer available ICU beds on Sunday. As more than 9,400 COVID-19 patients fill the state’s ICUs, which are reserved for the patients who are the sickest or most injured, the trauma service area that includes Laredo reported no available ICU beds, while the area that includes Abilene reported having one.

At least 53 Texas hospitals have no available ICU capacity, according to numbers reported to the federal government during the week ending Aug. 5. In Austin, five hospitals were at or above 90% of their ICU capacity during the same period, with two reporting no available ICU beds.

“This surge is by far the fastest and most aggressive that we’ve seen. Almost all of our hospitalizations are due to unvaccinated patients developing severe illness,” Dr. Desmar Walkes, Austin-Travis County’s health authority, told reporters last week. “ICU staff are seeing a younger population in our hospitals. Patients in the ICU are sicker and stay in the hospital longer than with prior surges, putting more strain on hospital resources.”

Around 87.1% of all hospital beds in Texas are in use — the highest level since the start of the pandemic — with 14.1% of those beds occupied by COVID-19 patients. When Gov. Greg Abbott began to relax some COVID-19 restrictions on businesses in October, his order maintained reduced restaurant capacity and kept bars closed in regions in which 15% or more of hospital beds were filled with COVID-19 patients.

This week, COVID-19 hospitalizations reached higher levels across the state than when Abbott imposed a statewide mask mandate in July 2020. Abbott has maintained that he will not be reviving the mask mandate and has barred local authorities from issuing their own.

No, really, NBD.

More than 10,000 Texans are hospitalized for COVID-19, according to data released by the Texas Department of State Health Services Tuesday afternoon.

According to Tuesday’s report, 10,041 people were hospitalized with COVID-19 across the state of Texas on Monday, the highest rate since Feb. 4, as the delta variant continues to dominate new COVID-19 infections.

[…]

Monday’s figure represents a 37 percent increase over the number of hospitalizations one week prior.

But don’t worry, Abbott has asked for more nurses to move to Texas, so we’re going to be fine. Really, what more do you need him to do?

Back to Code Red

Pretty much inevitable at this point.

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

For sure, stay the hell away from this.

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

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

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

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

The data for the “fourth wave” looks so, so bad

Yikes.

Fueled by the delta variant, a surge in Houston COVID-19 hospitalizations is growing as fast as at any time during the pandemic so far, and is projected to pass previous records by mid-August — even though roughly half of all eligible Houstonians are fully vaccinated.

“We’re heading into dark times,” said Texas Medical Center CEO Bill McKeon. Already, he said, “our ICUs are filled with unvaccinated people.”

On Tuesday, Texas Medical Center hospitals listed 1,372 people in intensive care — more than the number of regular ICU beds. The hospitals are now in Phase II of the medical center’s surge plan, opening unused wards to accommodate the gravely ill patients expected to need them.

The Texas Department of State Health Services reported 7,305 people were hospitalized statewide for COVID-19 as of Tuesday — more than four times as many as on July 1, and a 38 percent increase over last Tuesday’s figure.

Estimates by the UT-Austin COVID-19 Modeling Consortium suggest that all regions across Texas will face surges larger than anything seen so far.

In the Houston area, the previous record for COVID hospitalizations was 2,927 people on Jan. 8. The consortium’s latest model predicts that record will be broken Aug. 8. The previous record for ICU patients — 947, set July 18, 2020 — is predicted to be broken Aug. 15.

Even more alarmingly, the surge isn’t predicted to level off there, but to keep climbing sharply. By the end of August, the consortium forecasts that roughly 2,000 people will be in Houston ICUs — double the previous high.

“It’s really scary,” said Spencer Fox, associate director of the modeling project. “I’m worried about the next few weeks. It’s so clear in the data: We’re in the midst of a very severe surge.”

Houston Methodist CEO Marc Boom described “a perfect storm”: the combination of Texas’ large number of unvaccinated people, the rampaging delta variant, and the recent relaxation of preventive measures such as masking and social distancing.

I’m at a loss for words and have wrung out just about all of my outrage. So I’m just going to leave this here:

If only Greg Abbott would listen to his own Department of State Health Services. I wonder what it’s like to live in a state that has a Governor that isn’t actively trying to harm its residents.

One more thing:

White Linen Night is back — well, sort of.

In lieu of official festivities, a group of Heights business owners have gotten together to host “Late Night on 19th Street” this Saturday. The good news is there will still be plenty of live music, pop-up vendors, artisans and white linen. The bad news is there will not be street closures, so plan accordingly.

Celebrations — geared toward supporting small, local businesses — are slated to run Aug. 7 from 5-7 p.m. between the 200-300 on Heights’ historic 19th Street.

Manready Mercantile owner Travis Weaver suggests bringing water, sunscreen, a bandana, portable cooler and potentially an umbrella.

“It never hurts to be prepared,” he said via statement. “If you don’t have any white linen, anything white will do. Don’t forget comfy shoes!”

How about “And don’t forget a mask! And for Christ’s sake don’t bother to show up if you and your entire party aren’t fully vaccinated!” I’m just saying.

More on the Memorial Hermann and Baylor vaccination mandates

Memorial Hermann: Get your shots or get out.

Memorial Hermann on Monday said it will require all employees to be vaccinated by Oct. 9, becoming the third Houston healthcare institution to do so.

The hospital system follows Baylor College of Medicine, which announced its employee vaccine requirement last week, nearly two months after Houston Methodist reached its vaccination deadline.

Managers and other leaders across the organizations must be compliant by Sept. 11. The deadline is Oct. 9 for all other employees, including the system’s affiliated providers and volunteers.

About 83 percent of Memorial Hermann’s workforce is fully vaccinated, including 87 percent of bedside staff, 95 percent of managers and above and all executive leaders, according to the hospital system. Memorial Hermann employs more than 29,000 people.

Exemptions will be made for those who are unable to be vaccinated due to medical or religious reasons. Employees who are not exempt and refuse the vaccine “will be deemed to have voluntarily resigned their position,” said Dr. David L. Callender, Memorial Hermann President and CEO.

He said spiking hospitalizations and COVID cases prompted the move.

“We’ve been waiting a little bit just to make sure the circumstances fully warrant moving forward, and we think they do now, “ Callender said Monday. “We’re seeing the impact of the very aggressive delta variant, a significant spike in new cases and hospitalizations, and about 50 percent of Houston’s population remains unvaccinated, which means the community continues to be at risk.”

See here for the background. I don’t think that justification needs any further explaining. By the way, the Memorial Hermann CEO wrote an op-ed in March, just as we were starting to hear about some scary variants out there, begging Greg Abbott to leave mask mandates in place. We know how that went.

Here’s Baylor, from about a week ago, with a somewhat less punitive approach.

Baylor employees have until Sept. 15 to become fully vaccinated or they may be subjected to discipline, said Dr. James McDeavitt, senior vice president and dean of clinical affairs at the medical school. However, he believes termination will be a “rare event.”

“We thought it was important to make a statement,” McDeavitt said. “As an organization, we are committed to vaccination, and we have been involved in all stages of the pandemic, from the development of vaccines, testing, clinical trials of medications and critical care of patients. (Requiring vaccines) was a necessary step for us to close that loop.”

Baylor’s vaccine policy had been in the works for some time, McDeavitt said, but the spike in cases was a catalyst for releasing the policy this week. “The spreading of the delta variant had a role in the timing of the release of this,” he said.

The policy, which was sent to employees Wednesday, details requirements for annual influenza and COVID-19 shots, except for people who have religious beliefs or a medical condition that would preclude them from becoming immunized.

So far, employee feedback has been positive, he said.

“I haven’t gotten any negative pushback to date,” McDeavitt said.

Baylor looked to Houston Methodist’s example when developing its policy, McDeavitt said. Methodist was the first health system nationwide to require vaccinations for employees in early June. More than 150 hospital employees resigned or were fired over the new policy — fewer than 1 percent of Methodist’s 25,000 employees.

“We will roll this out differently than Houston Methodist did. If someone flat-out refuses to become vaccinated, we don’t intend to jump to termination,” McDeavitt said.

For employees who are vaccine-hesitant, there will be a human resources process to further encourage them to take the shots. McDeavitt hopes no one is terminated over the new vaccination policy.

We’ll see how that works for them. I don’t care either way, as long as it gets the desired result. There’s no indication in that story of how many BCM employees are already vaccinated. MH’s 83% is not bad, but obviously it can – and will – be better. I wish they had done this sooner, but at least they are doing it. Texas Children’s, where are you on this?

More hospital systems to require vaccines

About time.

Memorial Hermann officials are finalizing details on its mandatory vaccine policy for employees.

During a radio interview Wednesday, Dr. David L. Callender, president and CEO, said the system will soon announce the timeline for its employees to become fully vaccinated.

The new measure comes as a fourth wave of the virus spreads across the state, due in large part to the ultra-transmissible delta variant. On Friday, the Department of State Health Services reported 13,871 new confirmed COVID cases, the largest single-day count since last winter’s surge and more than 12 times the number of cases confirmed on July 1.

“We think it’s very important for health care workers across the country to be vaccinated as vaccination is really the only way to stop this pandemic,” Callender said on the Houston Public Media radio show. “We’re working on (the policy), and will be making an announcement early next week.”

As of Friday morning, no details were made available on a vaccination deadline for employees or what type of discipline they may face if they do not comply with the new policy.

[…]

Memorial Hermann follows Baylor College of Medicine, which this week became the second Houston-area health care facility to require vaccines for employees, nearly two months after Houston Methodist reached its vaccination deadline.

Baylor employees have until Sept. 15 to become fully vaccinated or they may be subjected to discipline, said Dr. James McDeavitt, senior vice president and dean of clinical affairs at the medical school. McDeavitt expects most of the system’s employees will comply, and he believes firings connected to the policy will be rare.

I mean, Houston Methodist was doing this back in April, before any of us had ever heard of the Delta variant. They prevailed in a lawsuit, which is now under appeal, so the legal precedent is there for Memorial and Baylor. I honestly don’t know what has taken them so long, but better late than never. Now I’m wondering about other hospital systems – when I went to the Memorial Hermann Twitter page to get their logo for the embedded image, they suggested Texas Children’s Hospital, and now I’m wondering what their policy is. A Google search did not answer that question for me, which suggests the answer is No. Get it together, Texas Children’s!

Greg Abbott will blame you if you get sick

He will take no responsibility at all.

With COVID-19 hospitalizations soaring past 5,000 statewide for the first time in nearly five months, state officials are stepping up vaccination outreach programs and promotional campaigns but Gov. Greg Abbott insists that the state won’t impose any new mandates on Texans.

State officials announced Wednesday that Texas has 5,292 people hospitalized with lab-confirmed COVID-19 — the highest number since March 2, the day Abbott announced he was ending all state mask mandates and restrictions on businesses.

At that time, Abbott called for “personal diligence” and said statewide mandates are no longer needed.

Though 10,000 new COVID infections were reported statewide on Wednesday, the most since February, he has not changed his messaging.

“The time for government mask mandates is over — now is the time for personal responsibility,” Abbott wrote on Twitter on Tuesday. “Every Texan has the right to choose whether they will wear a mask or have their children wear masks.”

His latest comments came as the president of the Texas State Teachers Association publicly called on Abbott to allow schools to require masks, particularly since vaccines have not been approved for children under 12.

“If Gov. Abbott really cares about the health and safety of Texas students, educators and their communities, he will give local school officials and health experts the option of requiring masks in their schools,” Texas State Teachers Association President Ovidia Molina said on Tuesday.

I mean, I think we know the answer to that hypothetical.

Meanwhile, statewide hospitalizations from the virus have doubled in the last two weeks and more than tripled since the start of July, when Abbott re-issued a disaster declaration to deal with COVID-19.

“COVID-19 hospitalizations are rising and new variants of the virus are spreading quickly in our communities,” said Dr. John Hellerstedt, commissioner of the Texas Department of State Health Services in a statement Wednesday.

While Texas still appears to have more 9,100 available hospital beds statewide, there are areas around Beaumont, College Station and Killeen reporting that few intensive care beds are available for additional chronic patients.

The College Station region reported no more available ICU beds on Wednesday and Laredo officials were down to just 1 available ICU bed.

Killeen is a city in Bell County, which has one of the worst vaccination rates in the state, according to state data. Just 33.5 percent of that county’s population over 12 years of age have been fully vaccinated compared to over 54 percent in Harris County and 56 percent in Bexar.

“It is clear that increasing vaccinations is still our best strategy to navigate through this pandemic and get to closure,” Bell County Judge David Blackburn said in a recent news release.

Statewide, just 52 percent of Texans 12 and older have been vaccinated.

Here’s the Thursday update.

Across Texas, 5,662 people were hospitalized for the virus as of Thursday, the highest number recorded by DSHS since Feb. 28 and a massive increase since its low point of 1,428 on June 27.

It’s bad, y’all. And it’s getting worse. There’s a bit of a vaccination push now, but as you know it takes time to get fully protected, and we don’t have any. Abbott’s lifting of the mask mandate when he did was premature, and his mulish resistance to any possible leeway for local officials is harmful in the extreme, but let’s be clear that his biggest sin is not doing everything he could to get more Texans vaccinated. Masks at least would do something now, and even if it is too late for this surge to ramp up vaccinations, that’s still by far the best thing to do. So what is Abbott doing?

Vaccinations > masks, but thanks to Abbott’s utter lack of leadership, we have neither. And so thousands more people are getting sick, and some number of them – more than it should be – will end up in the hospital or a grave. And all of that is on Greg Abbott.

Still surging

Hospitalizations.

The number of lab-confirmed COVID hospitalizations in Texas broke 4,000 on Friday for the first time since March, a worrying sign of the pandemic’s quick resurgence since the Delta variant was discovered in the state.

[…]

As of Saturday, Texas Department of State Health Services data reported 4,320 lab-confirmed COVID hospitalizations in the state, more than three times the cases it had at its low of 1,428 less than a month ago. In the span of one week, COVID hospitalizations had spiked nearly 50 percent.

The increases in COVID hospitalizations have been dramatic. In the week ending July 24, Texas averaged 3,710 people hospitalized with COVID, up from 2,537 in the week before and 1,838 in the week before that.

Texas Medical Center hospitals are seeing an influx of COVID patients in ICU beds, and medical leaders may soon consider postponing elective procedures, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.

“Everywhere is experiencing that same sort of explosive growth right now, so that’s obviously very concerning,” said McDeavitt, who has been closely tracking local COVID data since the start of the pandemic.

Positive tests.

More than 1,000 people are testing positive per day for COVID-19 in the greater Houston region, more than seven times last month’s daily average, according to the Texas Medical Center.

As the delta variant dominates new COVID-19 infections across the country, the Texas Medical Center is returning to daily coronavirus updates.

The takeaways, sent every morning from William McKeon, president and CEO of the Texas Medical Center, provide a glimpse into one of the world’s largest medical complexes as its clinicians treat infected patients. Previously released weekly, the switch back to daily missives illustrate how rapidly delta is spreading across the region.

Last week, an average of 1,069 people tested positive per day for COVID-19 in the greater Houston region, more than double the prior week’s daily average.

“The COVID-19 Delta variant is spreading rapidly throughout Texas as only 43 percent of our population is fully vaccinated,” McKeon wrote in a Monday email.

If you don’t know what to do by now, I can’t help you.

It’s not vaccinated people that are dying

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

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

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

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

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

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

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

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

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

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

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

And one more thing:

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

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

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

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

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

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

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

The fourth wave

We’re not ready.

One local hospital is reinstating visitor limits and Harris County Judge Lina Hidalgo is mulling a change to the county’s threat level amid a wave of COVID-19 variant cases that medical leaders warned Tuesday could overwhelm area hospitals and wreak further havoc as schools reopen next month.

The warning came amid massive spikes in hospitalizations across the Houston region, which Hidalgo’s office is closely monitoring to decide if the county needs to raise its emergency threat level from yellow to orange — or moderate to significant.

“We’re watching this very, very closely,” Hidalgo spokesperson Rafael Lemaitre wrote in an email. “The trends are moving in the wrong direction again and we are in a high-stakes race against the delta variant of this virus. Our message to the community is simple and clear: If you haven’t been vaccinated, take action now.”

In May, Hidalgo lowered the threat level from red — where it had been for nearly a year — to orange, then yellow a few weeks later, as COVID cases waned statewide.

But this month, hospitalizations across the state have more than doubled, ballooning from 1,591 on July 1 to 3,319 as of Tuesday, according to the Texas Department of State Health Services. The state’s hospitalization count peaked in January at 14,000.

Texas Medical Center CEO William McKeon said he fears the closing of many testing centers will make it more difficult to gauge the extent of COVID’s spread in the coming weeks.

“As this fourth wave begins in force, our radar is down,” Texas Medical Center CEO William McKeon said in a Tuesday conference call with reporters. “We have only a fraction of the testing…. We’re going to be running much more blind to the spread of delta variant in our community.”

[…]

Memorial-Hermann Health System plans to readopt visitor restrictions this week, and will test all patients for COVID, regardless of their vaccination status, said Dr. Annamaria Macaluso Davidson, vice president of employee health medical operations.

The hospital system had about 100 confirmed COVID cases on July 4; by Tuesday, there were more than 250.

We’ve been discussing this, and you know how I feel. The hospitalization numbers are still relatively low, but that’s a sharp increase, and there’s no reason to think there won’t be more. And I hadn’t even thought about the drastic reduction in testing facilities – I don’t know how big an effect that may have, but it’s not going to help.

I drafted this a couple of days ago, and before I knew it, Judge Hidalgo had already taken action.

Harris County’s emergency threat level was raised to orange — or “significant” — on Thursday and County Judge Lina Hidalgo called for resumed mask wearing amid a fourth wave of COVID-19 that has already caused hospitalizations to spike across the region.

“It’s not too late,” Hidalgo said. “But if we don’t act now, it will be too late for many people…. We are at the beginning of a potentially very dangerous fourth wave of this pandemic.”

The guidelines for the orange threat level are voluntary, and urge residents — namely those who are not vaccinated — to avoid large gatherings and businesses with poor safety procedures.

Hidalgo also said “everyone” should resume wearing masks to protect the County’s population who are not fully vaccinated. Currently, about 2.1 million county residents are fully vaccinated — 44 percent of Harris County’s total population.

She noted the county’s positivity rate is now doubling about every 17 days, quicker than any other point in the pandemic.

Get your masks back on, and hope for the best. I trust Judge Hidalgo to do everything she can to ameliorate this situation, but as we know, there’s not a lot she can do. Greg Abbott has seen to that.

One thing that could help is if more places of business begin putting in their own vaccination requirements, mostly for employees but also possibly for customers or business partners, depending on the situation. Putting some limits on what one can do as an unvaccinated person is one of the few effective ways to compel people to get their shots. That will have to come from the private sector, because it sure won’t come from the state. The FDA giving final approval to the Pfizer and Moderna shots will help, too. I just don’t know how long we can wait.

Are any state leaders going to talk about the rising COVID rate?

Just curious.

With less than half of Texans vaccinated and the highly contagious delta variant of the coronavirus spreading, the percentage of COVID-19 tests coming back positive in the state has climbed to a rate unseen since winter.

As of this weekend, Texas’ positivity rate is over 10% — a level that Gov. Greg Abbott and the Trump administration had identified as a red flag earlier in the pandemic. Meanwhile, daily confirmed new case totals and hospitalizations are climbing fast, but are far below their winter peaks.

On Saturday, the seven-day average for new confirmed cases in the state was 2,119. That’s nearly triple the average on the first day of the month, when it was 757. Meanwhile, the number of people hospitalized for the coronavirus in the state climbed from 1,591 on July 1 to 2,834 on Friday.

More than 14,200 people with COVID-19 were hospitalized on Jan. 11 — the highest number of pandemic hospitalizations in Texas so far.

But the positivity rate stands out among the rising numbers because experts view it as a leading indicator.

“The early signs are similar. They are all right there,” said Benjamin Neuman, a virologist and professor at Texas A&M University. “Epidemiologists read test positivity stats like the low tide, and it looks as though we are in for a big wave.”

In the last seven days, about 144,000 molecular tests, such as nasal or throat swab tests, were administered in Texas, and 10.2% of those came back positive, according to the Texas Department of State Health Services. The last time the state’s positivity rate was above 10% was in February, and the rate hit an all-time low of 2.8% in mid-June.

The positivity rate does not clearly measure how prevalent the virus is spreading across the state since it depends on the number of administered tests, Neuman said, but “what it indicates is that we are missing a lot of cases.”

“Ten percent of the state is not infected right now,” he continued. “But 10% of the people with the sniffles have COVID, which means we are at the start of something like another wave. We have seen the numbers in the rest of the U.S. go up and Texas has been a little bit behind, but it looks as though we may be catching up fast.”

[…]

Public health experts have been raising alarm about the delta variant in recent weeks, especially in places like Texas where the vaccination rate is low. Around 43% of Texans are currently fully vaccinated.

The vaccines have been shown to be highly effective at preventing new coronavirus cases, though there have been some rare occurrences of breakthrough infections — which Dr. John Carlo, the CEO of Prism Health North Texas and president of AIDS Arms Physicians, explained is when someone who is completely vaccinated contracts the virus anyways.

“The reason that is happening more and more is because if we still have people that are unvaccinated circulating with those who are vaccinated, it still presents a risk for breakthrough infections, even though the risk is minimized,” Carlo said.

Evidence also suggests that the small numbers of people who are vaccinated but do get infected tend to face less severe versions of the illness.

“The good news is that though we are seeing breakthrough infections, these are only mild cases,” Carlo said. “The vaccines show great protections but we knew it was never going to be perfect, it’s not 100%. And the big thing to know is that the vaccine removes the high chance of severe symptoms if you do get the virus.”

In a statement, DSHS said the delta variant is “having a significant effect on unvaccinated people leading to increases in new cases and hospitalizations.” Texas officials have not said how many of the new cases are among vaccinated and unvaccinated people, but national and local health leaders say the most severe impacts appear to be happening overwhelmingly among the unvaccinated.

I mean, I know there are walls to be built, and voters to suppress, and trans kids to kick around. Greg Abbott has a busy schedule, you know? I’m sure he’ll get around to talking about the rising COVID rate and the need to get vaccinated and maybe the return to mask wearing any day now.

Our Delta future

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

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

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

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

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

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

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

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

[…]

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

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

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

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

Some more data, if you need it.

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

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

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

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

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

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

The COVID death spike

Another way to visualize the data. It’s bad no matter how you look at it.

More than 51,000 Texans have died of COVID-19, according to the state’s latest tally.

That is larger than the capacity of Minute Maid Park, though it represents less than two-thousandths of Texas’ 29 million residents.

So, was the virus, which killed less than 2 percent of the Texans with documented cases, responsible for anything more than a blip in historical death trends?

An examination of Texas the past 50 years reveals the answer: Unequivocally yes.

Deaths in Texas historically are cyclical, explained Mark Hayward, a sociology professor at the University of Texas at Austin who studies mortality trends. They peak in winter with the annual flu season and ebb in summer, and steadily increase overall as the state’s population grows.

During the pandemic, however, that pattern was disrupted by a surge in mortality with no precedent in modern history. Hayward said that will lead to a decreased life expectancy for Texans; a British study published this week found the average lifetime of Americans decreased by almost two years in 2020.

“You don’t lose two or three years of life expectancy without actual catastrophe happening,” Hayward said. “Modern populations don’t go through that. In any kind of normal year, there’s never that kind of impact on a population’s mortality such as we’ve seen from COVID.”

Instead of falling in the summer, Texas deaths surged beginning in June 2020. They peaked in the third week of July at 6,211, up 71 percent over the same week the previous year. A second wave of the virus during the holiday season peaked the third week in January at 7,154, a 69 percent year-over-year jump.

The Chronicle examined weekly deaths in Texas back to 1964, the earliest year the state health department has reliable data. From that year through 2019, deaths in Texas increased an average of 2 percent annually. Deaths jumped 23 percent in 2020.

Considering that the pandemic reached Texas in March, deaths over the next 12 months jumped 32 percent over the previous year. Of the 285,108 Texas deaths between March 2020 and March 2021, 17 percent were from COVID-19, according to state health records.

You’ll need to click over to see the chart. It’s not just the number of deaths that increased – you would expect that based on overall population trends – but the rate as well. As the story notes, this is further evidence that the “official” COVID death count is well below the true number, with many factors contributing to the undercount. There’s nothing to be done about what has happened, but we might want to give some thought to why it happened this way and what we might do differently (and hopefully better) next time.

Another upward revision of the freeze death count

Buzzfeed News takes a deep dive.

The true number of people killed by the disastrous winter storm and power outages that devastated Texas in February is likely four or five times what the state has acknowledged so far. A BuzzFeed News data analysis reveals the hidden scale of a catastrophe that trapped millions of people in freezing darkness, cut off access to running water, and overwhelmed emergency services for days.

The state’s tally currently stands at 151 deaths. But by looking at how many more people died during and immediately after the storm than would have been expected — an established method that has been used to count the full toll of other disasters — we estimate that 700 people were killed by the storm during the week with the worst power outages. This astonishing toll exposes the full consequence of officials’ neglect in preventing the power grid’s collapse despite repeated warnings of its vulnerability to cold weather, as well as the state’s failure to reckon with the magnitude of the crisis that followed.

Many of the uncounted victims of the storm and power outages were already medically vulnerable — with chronic conditions including cardiovascular disease, diabetes, and kidney problems. But without the intense cold and stress they experienced during the crisis, many of these people could still be alive today.

[…]

The BuzzFeed News analysis of deaths during the storm is based on mortality data from the CDC. It relies on a method called “excess deaths” analysis, recently used to estimate the full toll of the COVID-19 pandemic.

Our analysis, reviewed by three independent experts, suggests that between 426 and 978 more people than expected died in Texas in the week ending February 20 alone. Our best estimate is that 702 people were killed by the storm that week. Even the lowest end of the range is almost three times the number officials have acknowledged. Neighboring states that were hit hard by the winter storm but did not experience the widespread power outages seen in Texas did not show a spike in deaths.

BuzzFeed News reached out to relatives of people who died during the power outages, identified from dozens of wrongful death lawsuits as well as death reports obtained from public records requests to medical examiners in eight of the biggest counties in Texas. Interviews revealed stories of anguish and confusion, as families struggled to find out exactly how their relatives died.

This confusion also poses real economic challenges for survivors. For Mary Gonzales, the delay in obtaining a cause of death for her husband meant she was unable to claim an income from his pension for almost three months. And without an official acknowledgment tying their loved ones’ deaths to the storm, families will be unable to claim federal assistance for funeral costs.

The high death toll adds pressure on state legislators, energy regulators, and Texas Gov. Greg Abbott to harden the state’s infrastructure to avert another deadly disaster.

Abbott’s press secretary, Renae Eze, did not respond to questions about the significantly higher death toll or whether the state would investigate further, but said Abbott was “working collaboratively with the House and Senate to find meaningful and lasting solutions to ensure these tragic events are never repeated.”

“The Governor joins all Texans in mourning every single life lost during the winter storm, and we pray for the families who are suffering from the loss of a loved one,” she said.

But with the state’s legislative session ending on May 31, lawmakers only have a week left to finalize a proposal to address some of the vulnerabilities that made the February storm so horrific.

“As it stands, nothing has happened,” said Michael Webber, a professor of mechanical engineering focused on energy infrastructure at the University of Texas at Austin.

As of the end of March, the official death count was at 111, and a Houston Chronicle analysis in early April estimated it at 194. As this story among others notes, there are only so many medical examiners in the state, and only so many deaths result in an autopsy. As was the case with COVID, some deaths are attributed to chronic conditions like heart disease despite the obvious external cause. Similar statistical methods that estimate “excess deaths” have been used for COVID as well, and you can read how they arrived at these figures in the story. We’ll never know an exact number, but we do know that the official number will always be too low. Daily Kos has more.

Hospitalizations are down

Very good news.

The number of Texans hospitalized for COVID-19 this week hit its lowest mark in nearly a year, the latest sign that the state is turning a corner.

According to the state Department of State Health Services figures released Wednesday, fewer than 2,000 people were hospitalized for COVID-19 for the first time since June, 2020. Wednesday’s data showed 1,962 people were in the hospital due to the virus; by Thursday, the number had dropped again — to 1,899.

It’s the first time the hospitalization rate has dipped below 2,000 since June 2020, and a massive drop from its January peak of more than 14,000.

The news was welcomed by public health officials and experts, though they also warned against complacency until more people are vaccinated.

“We are at this point where the virus is basically in an arm-wrestling match with vaccines, and vaccines are winning,” said Dr. David Persse, Houston’s chief medical officer. “Things are absolutely getting better, but I don’t want us to completely take our foot off the brake.”

He said the drop in hospitalizations is likely due to the elderly — who are more at-risk of serious symptoms — being initially prioritized for inoculations. Nearly 70 percent of all Texans older than 65 have been fully vaccinated as of Thursday, according to DSHS.

Persse remains worried about the number of people who have not been vaccinated.

“There’s still a risk,” he said.

As of Thursday, about 52 percent of all eligible Texans — those aged 12 and older — have received at least one vaccine dose, a number that puts the state near the bottom of all states for vaccines per capita.

Like I said, this is all very good, but there’s no question it could be better. We could have more people vaccinated, and we could be vaccinating the rest at a faster clip. We could have more unvaccinated people wearing masks and exercising caution about being around other people. We could have fewer people who don’t intend to get vaccinated. Our numbers are better than they’ve been in a year – basically, since the start of last year’s summer surge – and they’re going in the right direction, but we’re still vulnerable to an uptick. If we make it through without that happening, at least some of that will be pure dumb luck.

The kids are getting vaxxed

Good news.

In the first week that Texas adolescents were eligible to be vaccinated for COVID-19, after a year of pandemic-induced isolation from their families, peers and classrooms, more than 100,000 kids ages 12-15 poured into pediatricians’ offices, vaccine hubs and school gyms across Texas to get their shots.

One of them was Austin Ford, a 14-year-old in Houston whose mother is a pediatric nurse, whose father has a disability that makes him vulnerable to COVID, and who lost a family member to the virus last month.

“It was a no-brainer for us,” said his mother, Sherryl Ford, 46, who took Austin to Texas Children’s Hospital for his shot last Friday, less than 24 hours after the Pfizer vaccine was approved for emergency use for his age group. “I have friends who took their kids the night before. In the days since the federal approval on May 13, about 6% of Texas children ages 12-15 have gotten a dose of the Pfizer vaccine. It took more than a month to reach that percentage for eligible adults last winter when the vaccination effort began.

It marks a promising start, health officials and others say, to the state’s first attempt to inoculate Texas’ estimated 1.7 million adolescents, who have endured isolation and virtual-learning challenges for more than a year.

“It’s amazing,” said Dr. Seth Kaplan, a Frisco pediatrician and president of the Texas Pediatric Society, which represents about 4,600 pediatricians and other child medicine professionals.”

[…]

In Texas, where the issue of vaccinating children for any kind of illness has sparked intense political debate, parents are permitted to opt out of vaccines required to attend public schools, as well as opt in to a statewide immunization registry that tracks childhood vaccinations.

But while Texas health officials have expressed concern about what they describe as a growing anti-vaccine movement, between 97% and 99% of Texas schoolchildren are fully vaccinated, according to the Texas Department of State Health Services.

State health officials don’t expect that high of a number with the COVID vaccine, at least not right away, but say that number signals a high rate of general vaccine acceptance among Texas parents, said Chris Van Deusen, spokesperson for DSHS.

The state is doing research to determine the best messages and outreach for parents, who will be targeted in a public awareness campaign over the summer, Van Deusen said.

Texas pediatricians have also been talking with parents for months about vaccinating their kids, in preparation for its availability to that age group, Kaplan said.

See here for the background. My younger daughter is in that six percent, and in less than two weeks we’ll be a fully vaccinated family. That’s not only good for the kids, it’s good for our overall vaccination numbers, which can use all the help they can get. Given the universal return of in-person school and the removal of mask mandates, this makes a lot of sense. The schools themselves will be used to help get kids vaccinated, which is a big deal considering how many obstacles some folks face in getting the shots.

Statewide, more than three dozen school districts from Laredo to McKinney and from East Texas to El Paso have become official providers and have received vaccines, either for students or staff or, in McKinney’s case, for both.

“We want to be part of the solution for our staff and our students, and we want education and our school experience to get back to what it was pre-pandemic,” Pratt said.

Although the vaccines require parental consent, a key part of the enthusiasm appears to be coming from teenagers themselves.

“Most of the kids that I’ve spoken to are really ready to get it because they understand that even though we kind of opened everything up and they are getting back to normal, there’s still a risk for them,” Kaplan said. “If they can get vaccinated, then their participation in activities that they want to be participating in is that much safer for them.”

I don’t know what we need to do to get HISD involved as well, but we should do that. The Dallas Observer has more.

Please get your second shot

I hope this is mostly a function of incomplete data.

Millions of Americans — including tens of thousands of Houstonians — either have delayed or are forgoing their second dose of a COVID-19 vaccination.

As of late last month, roughly 51,000 people who received their first inoculation through the Houston Health Department were “overdue” for their second dose. The department’s number is preliminary but includes any person who has gone at least 42 days since their first round without returning for a second shot.

Statewide, more than 630,000 of the roughly 11 million people who’ve received one dose are more than six weeks overdue, the Texas Department of State Health Services told the Houston Chronicle.

“We need a lot of those folks from February to come back in and get their second dose now,” Dr. David Lakey, a DSHS commissioner who sits on Texas’ COVID-19 Expert Vaccine Allocation Panel, said last week.

Part of the gap, however, is likely due to people who opted to receive their second dose through other health care providers as vaccine availability expanded.

It’s not cause for alarm just yet, said Rice University health economist Vivian Ho, though she said the trend does not bode well for the overall goal of herd immunity.

[…]

Ho said people shouldn’t be dissuaded from rescheduling appointments that they missed, as they’ve been shown to give additional antibodies even if they come late.

“The first dose really does boost your antibodies, but it’s the second that really gives you the second umph,” she said.

Houston Methodist radiologist Dirk Stotsman worried that some people are forgoing their second round of inoculations because the first doses of Moderna and Pfizer have been proven highly efficacious against the virus.

While the first dose offers a good level of protection, he said, the extra antibodies provided by the second dose will be integral to prevent the spread of more infectious and dangerous strains of the virus.

Getting just the one Pfizer or Moderna shot is better than nothing, but it’s not as good as it should be. If you’ve gotten one shot and for whatever the reason not gotten the second one, it’s not too late. Go ahead and make an appointment or do a walk-in where available.

In related news:

With the rescission of the mask mandate and full reopening of businesses, medical experts worried spring would bring a debilitating fourth wave of COVID-19 infections to Texas.

But as vaccination rates slowly leveled off in recent weeks, the rate of infections and hospitalizations did as well. More than a year after businesses closed, offices sent workers home and traffic vanished from Houston’s concrete jungle of freeways, public health officials are cautiously optimistic efforts to quell the spread of the virus and vaccinate as many people as possible are working.

Yet despite claims from officials like Gov. Greg Abbott that this downturn is linked to “herd immunity” — the mysterious target ranging between 60 and 80 percent fully vaccinated against COVID-19 — experts say Texas cannot rely on vaccinations alone to achieve what some think may mean the end of the pandemic.

“Nobody knows for sure what’s going to happen,” said Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health in Houston. “But my educated guess would be as more of the population becomes either vaccinated or immune through natural infection, we won’t see as many cases.”

Fewer than 3,000 patients have been hospitalized across the state for the past five weeks, according to a Chronicle data analysis. It’s the longest streak with that few patients since June 2020.

Dr. Carl Vartian, chief medical officer at HCA Houston Healthcare’s Clear Lake and Mainland hospitals, worries the public conflates “herd immunity” with “ending COVID-19.” But COVID-19 may not truly end. Rather, experts suspect it will become “endemic,” never fully leaving the population — like influenza, which still infects hundreds of thousands of people a year in the U.S.

Again, what we have now is better than what we had before, but not as good as it could be. Even at “herd immunity levels”, there’s still a lot of unvaxxed people. The difference is that it becomes harder for the virus to really take off as it has done before. But people can and will still get sick and die if they’re not vaccinated. It’s up to us what the level of those illnesses and deaths are.

Now it gets harder to vaccinate people

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

Our COVID numbers are staying down

Let’s keep this going.

While the East Coast struggles with a fourth wave of rising COVID-19 infections, Texas experts say the state is doing “reasonably well” as case rates stabilize across the state.

Case rates and hospitalizations have plateaued in the region in recent weeks, averaging roughly 3,500 new daily reported cases, the lowest it’s been since early-to-mid September. The decline in hospitalizations has been an even more welcome trend, with fewer than 3,000 patients hospitalized for COVID, the lowest it’s been since June.

Medical experts such as Dr. Carl Vartian, an infectious disease specialist and chief medical officer at HCA Houston Healthcare Clear Lake and Mainland hospitals, suspect the winter freeze, increasing vaccination rates and the prevalence of antibodies in Texas’ population have kept case rates low over the last month.

[…]

“Texas is doing better than most states, which are seeing a pretty sharp rise in the number of daily new cases,” said Ben Neuman, a virologist at Texas A&M University.

The lower rate of infections doesn’t mean that Texans can let their guard down, though. Fewer than 37 percent of state residents have received at least one dose of the COVID-19 vaccine, and just over 20 percent have been fully vaccinated.

“You have to plateau before you rise, and I think that’s where we’re headed,” Neuman said.

The flat line of case rates starts with a sharp drop-off in testing. According to data from the Department of State Health Services, results from PCR testing dropped sharply during the winter freeze in February, and have not rebounded. As of April, Texas is testing at just half the rate it was before the state iced over.

While the number of daily tests has declined heavily, so too has the positive test rate. It’s now under 5 percent, and the second-lowest it’s been since the start of the pandemic, according to state data. Even with the reduced number of tests being conducted, fewer people are testing positive for COVID.

The low number of tests mean there could be a lag before a potential surge, Neuman said.

In Houston, medical experts are cautiously optimistic there won’t be a rise.

Usually, case rates spike first, followed by hospitalizations the week after and ventilator demand and deaths after that. So far, all three have stayed low in Houston, Vartian said.

The freeze was basically a one-week lockdown in the middle of February, and that no doubt helped keep infections down. I don’t know what it’s like anywhere else, but at least in my little part of the world people are still masking up, despite the Governor’s order. I won’t extrapolate from such a limited data point, but I feel hopeful that at least in the big cities people are still inclined to be cautious.

And I take heart at the progress in getting shots into arms. The Astros are getting their shots. The Rockets are getting their shots. Judge Hidalgo has gotten her first shot. People are celebrating the ways that their lives have been improved by getting vaccinated. (Can confirm, by the way.) I’m hopeful. We still have to be careful, but I can see the road ahead, and it’s going someplace good.

Chron analysis puts freeze death total at 194

Sobering, to say the least.

The deaths of nearly 200 people are linked to February’s cold snap and blackouts, a Houston Chronicle analysis reveals, making the natural disaster one of the worst in Texas this past century.

The tally, which is nearly double the state’s official count, comes from an investigation of reports from medical examiners, justices of the peace and Department of State Health Services, as well as lawsuits and news stories.

The state count, which is preliminary, has yet to incorporate some deaths already flagged by medical examiners as storm-related.

The 194 deaths identified by the Chronicle so far include at least 100 cases of hypothermia that killed people in their homes or while exposed to the elements, at least 16 carbon monoxide poisonings of residents who used dangerous methods for heat and at least 22 Texans who died when medical devices failed without power or who were unable to seek live-saving care because of the weather.

Sixteen deaths were from other causes, such as fires or vehicle wrecks, while the remaining 40 were attributed by authorities to the storm without listing a specific cause.

“This is almost double the death toll from Hurricane Harvey,” said State Rep. Rafael Anchia, D-Dallas. “There was no live footage of flooded homes, or roofs being blown off, or tidal surges, but this was more deadly and devastating than anything we’ve experienced in modern state history.”

The toll is almost certain to grow in coming weeks as death investigators in the state’s most populous counties clear a backlog in cases from the cold snap. The Travis County medical examiner alone is investigating more than 80 deaths between Feb. 13 and Feb. 20.

The deaths come from 57 counties in all regions of the state but are disproportionately centered on the Houston area, which at times during the crisis accounted for nearly half of all power outages. Of the known ages, races and ethnicities of the victims, 74 percent were people of color. Half were at least 65. Six were children.

The previous count released by the state was 111, but as noted then and in this story that is sure to go up. There’s no central database for this kind of thing, only 14 counties have a medical examiner’s office, and not all county data is currently available. As with COVID deaths, there are likely some cases where one could argue whether the freeze was the actual cause of death or whether it was just proximate. The main point here is that the freeze was responsible for a lot of misery around the state and by any count more deaths than there were from Hurricane Harvey. It remains to be seen if the Legislature and the Public Utility Commission (which currently has no members) are taking adequate action to prevent this from ever happening again.

Winter storm death count now at 111

A revision of the numbers. Expect this to happen at least once more.

At least 111 Texans died as a result of last month’s winter storm, according to updated numbers released Thursday by the state Department of State Health Services.

The newly revised number is nearly twice what the department had estimated last week, and will likely continue to grow. Some of Texas’ larger counties, such as Tarrant County, have yet to report any storm-related deaths.

The majority of people died from hypothermia, but health officials also attributed deaths to “motor vehicle accidents, carbon monoxide poisoning, medical equipment failure, exacerbation of chronic illness, lack of home oxygen, falls and fire.”

[…]

Harris County reported 31 storm-related deaths, the largest share in the state. Travis County followed with nine deaths.

Health officials will continue to update their preliminary findings weekly.

According to DSHS, the data is compiled from forms that certify deaths are related to a disaster, notification from death certifiers and analyses of death certificates from state epidemiologists.

See here for the background. As a reminder, there were 103 deaths attributed to Hurricane Harvey, so the February freeze event (I’m sorry, I’ve not adopted the new paradigm of naming winter storms, so I have not and probably will not again refer to this as “Winter Storm Uri”) has now surpassed that total. And will likely put some more distance between them when the next month’s data is available.

There has been a bit of legislative action on this front.

A bill that would overhaul Texas’ energy industry — including mandating weatherization for natural gas and power generators — was approved by a Texas Senate committee on Thursday.

The sweeping Senate Bill 3, sponsored by Republican state Sen. Charles Schwertner of Georgetown, includes a number of reforms that have been floating around the state Capitol since last month’s deadly winter storm left millions without electricity during freezing temperatures. While the Texas House earlier this month approved a package of similar, standalone bills, Thursday’s vote represents the first substantive action on the issue by the upper chamber.

“This is an important issue to get right for the people of Texas, for the future of Texas, for the economy of Texas,” Schwertner said.

Chief among the bill’s provisions is a requirement that all power generators, transmission lines, natural gas facilities and pipelines make upgrades for extreme weather conditions — a process known as weatherization. Many power generators and gas companies were ill-suited for the freezing temperatures in February, which led gas pipelines to freeze and power transmission to falter.

The measure would delegate rulemaking authority to the Texas Railroad Commission, which regulates the oil and gas industries, and the Texas Public Utility Commission, which regulates the electric and telecommunication industries. If a gas or energy company fails to comply with the weatherization rules, it would face a fine up to $1 million for each offense. The bill does not address funding to pay for the required upgrades.

A Texas House committee earlier this month passed a similar weatherization bill. But the requirements only apply to electric companies, not natural gas companies. In public testimony before the Legislature, Railroad Commission Chair Christi Craddick largely dodged talks of winterizing the natural gas supply chain.

There’s more, so read the rest. I don’t know enough to offer a general critique of these bills, but I would certainly argue that natural gas companies should have the same weatherization requirements. All of these bills are sure to change as they move from one chamber to the other, so we’ll need to see where they wind up.

The vaccination eligibility list is about to be wide open

Go ahead and get on it, though be prepared to wait as the supply issues work themselves out.

Everyone age 16 and older, regardless of occupation or health status, will be eligible for the COVID-19 vaccine in Texas starting March 29, state health officials said Tuesday.

The Texas Department of State Health Services is still asking providers to prioritize appointments for people who are 80 and older, and to prioritize walk-ins from anyone in that age group who shows up without an appointment. The vaccines are not limited to Texas residents, and citizenship is not a requirement for the vaccine.

“We are closing in on 10 million doses administered in Texas, and we want to keep up the momentum as the vaccine supply increases,” said Imelda Garcia, DSHS associate commissioner for laboratory and infectious disease services and the chair of the state’s Expert Vaccine Allocation Panel.

Until now, eligibility for the vaccine was mainly restricted to a few groups: health care workers, people ages 50 and older, those with certain underlying health conditions who are 16 or older, and employees of schools and day care centers. Texas began receiving vaccines in mid-December.

The vaccine is still in short supply as the announcement makes about 22 million people eligible on Monday. The state has been allocated more than 14 million doses since distribution began in December — far short of the supply needed to fully vaccinate everyone right away.

[…]

The state is also launching a website next week for people to sign up for vaccines at public health centers and state-run clinics. The Texas Public Health Vaccine Scheduler will alert participants to upcoming events and available appointments. For those who do not have access to the internet, the state will also be creating a hotline for appointments by phone, officials said.

The DSHS has more on Twitter. Great news for those who have not yet been eligible, though as we have previously discussed it’s not necessarily great for the distribution effort or for vaccine equity. All states were mandated by President Biden to make the vaccine generally available by May 1, so this is just getting a one-month head start on that.

County Judge Lina Hidalgo calls this a milestone moment.

“Opening vaccine eligibility vaccines to every adult is a key milestone in our fight against COVID-19,” Hidalgo said. “The onus is now on each adult to do their part. This vaccine is safe and effective, and the faster we all get a vaccine the sooner we’ll be able to pull through this crisis, get our economy running at full speed, and get life back to normal.”

Many experts have continued to raise concerns about unequal access to vaccines, particularly among low-income communities.

Rice University health economist Vivian Ho said the opened eligibility could help on that front because public health agencies will be able to, for example, vaccinate all workers at a grocery store.

“Now you can say we are going to go to workplaces, because there’s no age limit,” she said.

Conversely, Ho said, the announcement will do little to convince people who have already decided not to get vaccines, namely in communities outside of major cities.

Opening eligibility criteria will clear confusion for many communities who have hesitated to get a COVID-19 vaccine because of constantly changing age and medical condition restrictions, said Luis Torres-Hostos, dean of the University of Texas – Rio Grande Valley School of Social Work.

Torres-Hostos, who has worked with his university to get the message out to Latino communities, is hopeful public health officials will have more luck with immunization with these changes.

“Where are the vaccine deserts? Where are the places where it’s really hard for members of the community to get their vaccine?” he said. “We’ve got to do something to make sure that the vaccine is being given there.”

However, even his optimism comes with a caveat. Expanded criteria will only fix inequities if it comes with increased vaccine supply.

Communities of color and low-income communities are not hesitant to get the vaccine; a recent poll by the Kaiser Family Foundation finds 7 in 10 Hispanic people surveyed have received or want to book an appointment for a COVID-19 vaccine.

“If we build it, they will come,” Torres-Hostos said.

I sure hope this will help with the inequity issue, and I agree it will clear up any lingering confusion. We’ll look for that DSHS website when it’s up (and hopefully doesn’t crash). Y’all get yourself – and anyone you know who might need some assistance – in line for the vaccine.

Winter storm death count at 57

This is likely to rise as we get better data.

At least 57 people died in Texas as a result of last month’s winter storm, according to preliminary data the state health department released Monday.

The largest number of deaths — at least 25 — occured in Harris County, the Texas Department of State Health Services reported.

The deaths occurred in at least 25 counties between Feb. 11 and March 5, the state agency said. The majority of verified deaths were associated with hypothermia, but health officials said some were also caused by motor vehicle wrecks, “carbon monoxide poisoning, medical equipment failure, falls, and fire.”

The preliminary data is “subject to change” as state disaster epidemiologists gather additional information and additional deaths are verified, the agency said. The information will be updated weekly, it said.

For purposes of comparison, there were 103 deaths in Texas attributed to Hurricane Harvey, 68 to direct effects of the storm and 35 more in the aftereffects. The financial costs of the freeze were higher. Just keep all that in mind when you see Greg Abbott and Dan Patrick and others play the blame game.

Vaccine progress

Good news.

Texas will surpass more than 7 million COVID-19 vaccination doses administered today, top public health officials told the Texas Senate as Gov. Greg Abbott lifted all capacity limits for businesses and ended government-imposed mask mandates in the state.

At the same time, the health officials also offered a strong defense of the previous mask mandates, saying they reduced the chance of asymptomatic people spreading the virus and resulted in a record low year for influenza in Texas.

The speed with which vaccinations are being distributed is one of the keys to Abbott’s new order removing all mask mandates and allowing all businesses to re-open to 100 percent of their occupancy. Still, Texas has one of the lowest vaccination rates in the country, with 15.8 percent of residents having received at least one shot.

“We have come a long way in a very short period of time,” said Imelda Garcia, a top official with the Department of State Health Services, as she testified before a committee in the Texas Senate on Wednesday morning.

Garcia reminded lawmakers that Texas didn’t get its first vaccine shipments until Dec. 14. She lauded vaccine providers around the state for stepping up to administer so many shots in such a small window.

“They have been busting their butts in order to get shots in arms as fast as they physically and possibly can,” Garcia said.

Harris County alone topped 1 million doses on Tuesday.

Because the majority of vaccines in Texas require two doses, the number of people fully vaccinated is just over 2 million statewide.

Yes, there has been a lot of great work done, and everyone involved should be praised and thanked for it. There have been plenty of obstacles to overcome, that’s for sure. Because I’m a numbers nerd, I feel like I have to say something about the totals and percentages cited in this story, because as is they’re making me twitch. Seven million people would represent about 23% of the total state population. Given that the vaccines are only being given to those 16 and up, that makes the denominator in that fraction smaller, and thus would make the percentage higher. The only way this works if that total of “seven million doses administered” counts all shots given, both first and second. That would put the number of people that have had at least one shot at almost five million, which is closer to that 15.8% (it’s now higher on that NYT page, as it updates in real time). I’m just a little annoyed that I had to think it through like this to make sense of it all.

Not so good news.

The Texas Medical Center, in partnership with the city, is now administering 232,000 COVID-19 vaccine doses per week, and experts expect that number to ramp up as more vaccines are shipped to the state.

While vaccination rates are increasing and COVID-19 cases are trending downward again, medical officials said the public shouldn’t get too comfortable. Texas Medical Center leaders said there is currently no strong correlation between vaccination and hospitalization rates.

Experts are anxious that there could be another surge as students go on spring break this month. There’s more virus in Houston, and it’s spreading faster as more infectious variants circulate in the area.

“We’re not seeing the rapid decline we want to see,” Bill McKeon, president of the Texas Medical Center, said at a Wednesday webinar on the state of COVID-19 in Houston.

Part of the reason for this is that it takes time for the vaccine to take full effect – this is true of both the one-shot J&J vaccine and the two-dose Pfizer and Moderna vaccines – and it is eminently possible to continue to carry the disease after getting your shots. You will be much less likely to get sick, but you can pass it on to others, who may not be so lucky. This is why everyone who cares about keeping people alive and healthy are continuing to urge everyone to wear masks and maintain social distancing. We are approaching a point where those things will not be vital, but we are not there yet.

Good news for some, just news for others.

Texans ages 50 and older will be eligible for the COVID-19 vaccine starting March 15, state health officials announced Wednesday.

“We’ve seen a remarkable decrease in the number of hospitalizations and deaths since people 65 and older started becoming fully vaccinated in January,” said Imelda Garcia, the chair of the state’s Expert Vaccine Allocation Panel. “Expanding to ages 50 to 64 will continue the state’s priorities of protecting those at the greatest risk of severe outcomes and preserving the state’s health care system.”

Currently, the state is vaccinating members of priority groups 1A and 1B, which include health care workers, Texans 65 and older, and anyone over age 15 who has a pre-existing condition. Last week, state officials also made educators and child care employees eligible for a dose.

Those 50 and older will be included in priority group 1C. More than 93 percent of Texans who have died from the virus have been at least 50 years old, health officials said in a press release.

One can certainly argue that some other folks should have been next in line, but this is where we are. On the plus side, thanks to President Biden, everyone will be eligible for the shot in a few weeks. Until then, get yourself signed up at your first opportunity. And keep that mask on until someone other than Greg Abbott tells you to take it off. The Trib has more.