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vaccinations

Are we about to get more COVID in Houston?

We could be.

New data from the Texas Medical Center shows COVID-19 cases have leveled off over the past week, but some trends suggest the Greater Houston area could be on the verge of seeing higher virus spread.

TMC hospitals reported an average of 351 new cases per day during the week of April 18, the same number it reported during the previous seven-day period. The number of new cases does not include anyone who used an at-home test and did not report a positive result.

Those numbers represent a significant decline from last month, when the hospitals were reporting an average of 2,592 new cases per day.

However, the effective reproduction rate – or the average number of people who will be infected by someone with COVID – increased to 1.0 last week, up from 0.82 one week earlier. The rate essentially measures how well collective behaviors like wearing masks and social distancing are slowing the spread of the virus, with any rate higher than 1.0 meaning that spread is increasing.

The amount of virus being detected at the city of Houston’s wastewater treatment plants has also increased to the highest rate since Feb. 7, according to data from the Houston Health Department. Twenty-one of the city’s 39 wastewater treatment plants saw an increase in viral load in samples that were collected and analyzed April 18. By comparison, 16 plants saw in increase in samples collected and analyzed one week earlier.

The TMC’s weekly update also shows new hospitalizations have increased to an average of 59 admissions per day during the week of April 18, up from 42 the week before. TMC hospitals admitted an average of 89 new patients per day last month.

The data isn’t strongly conclusive, but it’s also early in what could be a trend, and as we know with this virus once you really start to see an uptick, it’s already too late. On the other hand, lots of people have COVID antibodies now, and that plus the number of vaxxed people who haven’t had COVID is probably enough to mitigate any crazy spread, or at least to make it less harmful, at this time. But of course there are still plenty of high-risk people out there, and lots of kids haven’t been vaxxed, and no one wants to get even a mild case of COVID. So, you know, stay cautious. You can still wear a mask even if you don’t have to, and you can get that second booster if you’re eligible. It’s never a bad idea to minimize your exposure to this thing. Stace has more.

Paxton threatens HISD over its COVID sick leave policy

We live in such stupid times.

Best mugshot ever

Attorney General Ken Paxton and Republicans in the Legislature are taking aim at Houston ISD, arguing that the district’s COVID sick day policy violates state law.

This academic year, Houston ISD is offering 10 additional days of paid sick leave to employees who are vaccinated against the coronavirus but test positive during the school year. Unvaccinated staff, however, must use personal leave time if they are infected.

In a nonbinding opinion last week, Paxton said the policy likely constitutes a “vaccine passport,” the documentation certifying a person’s vaccination status shown in exchange for “entry or services.” The GOP-led Texas Legislature last year outlawed such requirements for both private businesses and public agencies, and Gov. Greg Abbott issued a similar executive order banning the practice last summer.

“A court would likely conclude that, by offering additional paid leave only to those employees showing proof of COVID-19 vaccination or a medical exemption, the Houston Independent School District’s COVID-19 paid leave policy violates” the executive order, Paxton wrote.

Tejal Patel, a spokesperson for Houston ISD, said Paxton’s opinion “does not change the implementation” of the district’s paid leave policy. The last day of classes is just about seven weeks away.

“No court has ruled that the district’s policy of awarding additional leave days to vaccinated employees violates” the executive order, Patel said. “The district continues to evaluate its COVID protocols in our efforts to maintain a safe learning and working environment.”

The point of this was that since HISD couldn’t mandate that employees get vaccinated, they took the approach of incentivizing it by offering a reward to those who did. And it worked pretty well, as the story notes – over 20,000 of the district’s 24,000 employees have been vaccinated. In practice, this is no different than a million corporate wellness programs out there. The one I’m most familiar with offered a discount on your health insurance premium if you jumped through certain hoops, which ranged from things like taking a dumb survey to getting a blood test. If you participated – it was completely voluntary – you got a couple hundred bucks off the cost of your insurance for the year. This made sense for the insurer as well, as it (supposedly, at least) led people towards healthier lifestyles, which meant they’d pay out fewer claims.

So I struggle to see how one differs from the other. Except of course that we’re dealing with the extremely whiny snowflakes who refuse to get a COVID shot and who therefore must be catered to at every turn by politicians like Ken Paxton and Paul Bettencourt, who requested the opinion. God knows, we cannot deprive these special delicate flowers of anything. I approve of HISD’s response. So far, the school districts have done pretty well for themselves ignoring Paxton and Abbott. No guarantees here, and of course the Lege can deal with this next year if the Republicans remain in control, but for now I’d say keep on keeping on and hope for the best.

New variants being detected

Got to keep an eye on that.

Two new omicron subvariants that health officials say are contributing to a COVID uptick in New York State have been identified in Houston, according to researchers at Houston Methodist.

Genome sequencing efforts within the hospital system have detected 83 cases of BA.2.12 and three cases of BA.2.12.1 — two sub-lineages of the dominant variant BA.2 — since the start of the year.

Local case numbers, however, are sitting at their lowest point in nearly a year, according to the Harris County Public Health COVID dashboard, which reports an average of 20 new cases per 100,000 people over the last seven days. That number was as high as 1,256 in mid-January, during the height of the omicron surge.

It’s a different story in New York, which has seen a 70 percent increase in new cases over the two weeks, from a daily average of 3,231 on March 13 to 5,467 on Thursday, according to the New York Times virus tracker.

[…]

Houston wastewater surveillance data show an increasing viral load at a growing number of the city’s treatment plants as of April 4, when samples were last collected.

The city’s wastewater dashboard shows 14 out of 39 total wastewater treatment plants experiencing an increase from the week before, compared to eight on March 28.

The wastewater data is here. As of April 4, the virus level was at 38% of where it was on July 6, 2020, which is the date when this collection project started and is used as the baseline. We’ll have to keep an eye on that of course, but we also have to consider infections versus hospitalizations and deaths. It makes sense to wear a mask in most indoor settings – I do, and plan to continue doing so for the foreseeable future – but it’s not clear yet that we need to do more than that. Other than get vaxxed and boosted, of course, which if you haven’t by now I don’t know what to say to you.

Grand jury indicts three Hidalgo aides

Not great.

Three Harris County staffers at the center of a mounting investigation into a since-canceled vaccine outreach contract have been indicted with misuse of official information and tampering, according to district clerk records.

Aaron Dunn, Wallis Nader and Alex Triantaphyllis face one felony count on each of the charges. Warrants for their arrest have been issued. Documents elaborating on the charges were not yet available on the district clerk’s website.

Lawyers for at least two of the defendants professed their innocence Monday as the charges were made public.

“Aaron Dunn is innocent — he has been an honest public servant,” attorney Dane Ball said.

A lawyer for Triantaphyllis said she believes upcoming court proceedings will “shine a light” on the lack of wrongdoing.

“These charges against my client are unsupported by a full and objective review of the facts and the voluminous evidence in this case,” lawyer Marla Poirot said in a statement. “In his service to Harris County, Alex has made the people the top priority and worked to ensure that taxpayer resources are utilized as effectively and efficiently as possible.”

Nader’s lawyer could not be reached for comment. The three defendants are expected Tuesday in the 351st District Court.

In the months leading up to the indictments — the Texas Rangers, at the request of the Harris County District Attorney’s Office, identified the three staffers in search warrants as having a role in potentially steering a vaccine outreach contract in 2021 to a vendor by giving them early access.

The three worked under County Judge Lina Hidalgo at the time of the $11 million contract, which she canceled in September amid accusations that her office manipulated the procurement process.

Dunn has since left the office, while Triantaphyllis is the judge’s chief of staff and Nader is her policy director. According to lawyers for Hidalgo and the aides, the three did not view Elevate Strategies, owned by Democratic political consultant Felicity Pererya, as a potential vendor while planning the contract, their lawyers have said. Pererya’s company ultimately won the bid.

The lawyers have argued that one of the documents outlining the outreach contract’s scope of work were sent by mistake. Another was sent as part of an unrelated project.

There are reasons to be dubious of the evidence, but once there’s a headline like this, it’s hard to shake no matter what happens next. I certainly have my doubts about these indictments. We’ll know more soon enough. That’s all I’ve got to say at this time.

COVID hospitalizations at a low in the state

Good news (say it with me) for now.

Texas hospitals are treating fewer than 1,000 patients with COVID-19 for the first time in two years. According to the Texas Department of State Health Services, hospitalizations totaled 993 on Sunday. The last time COVID-19 patients in Texas numbered less than a thousand was April 4, 2020, before the state’s initial surge in hospitalizations, which rose to nearly 11,000 by late July that year.

“Less than a thousand [hospitalizations] is a good place to be and this is what we’ve kind of been waiting for and watching really closely,” said Chief State Epidemiologist Dr. Jennifer Shuford.

Fewer people are getting severely ill and needing medical care, said Dr. Shuford, because nearly the entire Texas population has now developed at least some immune response to SARS-CoV-2, the virus that causes COVID-19.

“We expect, based on some antibody studies that we’ve done, that about 99% of our population has some antibodies to COVID-19, either from vaccination or from prior infection.”

Other infectious disease experts are also cautiously optimistic that vaccinations, combined with four waves of widespread infections – the most recent of which was driven by the omicron variant – will help minimize future surges in cases and hospitalizations.

“I do think that the antibody seroprevalence does have something to do with the declining severity of the illness that we’re seeing in terms of decreased hospitalizations,” said Dr. Robert Atmar, an infectious disease expert who teaches at Baylor College of Medicine.

Dr. Atmar said while he was not aware of how DSHS estimated Texas’ overall immune response, the high rate is possible, especially if infection rates for the virus have been under reported.

“It wouldn’t be surprising if a large percentage of the population had been infected and/or vaccinated. 99% just seems high, but it’s certainly not unreasonable that that might be the case,” he said.

I’m just some guy on the Internet, and I also think 99% is a little high. I do agree that between our mediocre vaccination rate and our undoubtedly high infection rate that a lot of people have at least some immunity at this point, and that is keeping the rate low for now. To some extent, as I understand it, this is how a pandemic becomes endemic – there’s enough residual immunity out there to keep infection rates modest and generally tamp down on larger outbreaks. But that surely comes with no guarantees, and the next bad mutation could happen at any time. If we’re lucky, that will either be relatively mild or be mostly stopped by vaccinations, but at this point who knows what could happen. I’ll be getting booster #2 in the near future, and you should be getting whichever booster you can if you haven’t already. It’s still your best bet.

Here comes BA.2 in Houston

But don’t panic, it’s just a change in the virus composition, not an increase in viral load.

Houston is seeing an uptick in the number of BA.2 cases, with genome sequencing and wastewater testing picking up higher levels this week compared to last week.

The more contagious omicron subvariant was identified in 24 percent of patients who were sequenced at Houston Methodist, a jump from the 1 to 3 percent previously reported. BA.2 was also detected at six wastewater treatment plants on March 21 — the most recent day for which data is available — after the Houston Health Department last week said it had not been detected at any plants.

“Previously, we saw some indications of mutations consistent with BA.2 but were not confident in the determination at the time,” health department spokesman Scott Packard said in an email. “Retrospective analysis indicates BA.2 was likely in the wastewater in low levels starting in mid-to-late January.”

The recent data is the first indication of a significant rise in BA.2 in the Houston-area. Eventually, the subvariant is expected to become the dominant strain here, lining up with the nationwide rate, according to the health department.

[…]

In Houston, the average positivity rate over the last two weeks is 1.8 percent, down from the high 30s in the early January. Wastewater testing shows an increasing viral load at nine wastewater plants, while the remaining 30 are plateaued or decreasing.

“Although BA.2 appears to be more contagious than BA.1, the good news is that countries experiencing a spike in cases are not seeing a proportionate spikes in hospitalizations,” Packard said. “That means being up to date on vaccines (initial shots plus boosters) remains highly effective against serious illness, even with BA.2.”

As a reminder, you can see the Houston wastewater dashboard here. I don’t know how long we will be in this trough, but at least in the short term our vax level plus the sheer number of people who contracted the BA.1 version of omicron should help.

In the longer term, as immunity wanes and new variants pop up, it will be time for more shots. A fourth shot has now been authorized by the FDA for us old folks.

A second round of booster shots was greenlighted for everyone over the age of 50 by public health officials on Tuesday, kicking off the regulatory process for shots to likely be available in pharmacies this week.

Everyone 12 and older is already eligible for a booster shot five months after their initial vaccine series if they received an mRNA vaccine like Pfizer or Moderna, or two months after getting the Johnson & Johnson vaccine.

But for those over 50, determined to be a vulnerable age group, officials at the Food and Drug Administration and Centers for Disease Control and Prevention have decided the data on waning immunity justifies making another shot available four months after the first boost. And while anyone who meets that criteria can now get another booster, CDC Director Rochelle Walensky said it was “especially important” for those 65 and older and those 50 and older with underlying medical conditions.

“This is especially important for those 65 and older and those 50 and older with underlying medical conditions that increase their risk for severe disease from COVID-19 as they are the most likely to benefit from receiving an additional booster dose at this time,” Walensky said in a statement on Tuesday.

My niece is getting married in June in Washington state. I expect all of us who will be there for it and who are eligible for that booster will have gotten it by then. I ain’t messing around.

COVID may be down but it’s definitely not out

Just a reminder, this pandemic hasn’t gone away. It’s less of a threat to us here right now, but it’s still very much a threat.

The evolution of the coronavirus is likely to produce dangerous new variants that escape built-up immunity and evade vaccines, according to a new study that may offer clues for the future of the pandemic.

In a searing condemnation of “misconceived and premature theories” about the demise of COVID-19, the authors — microbiologists at the European Commission and the University of Oxford — take aim at what they call the “persistent myth” that the virus will evolve to be benign.

That omicron caused relatively mild disease “has been enthusiastically interpreted to be a sign of the approaching end of the pandemic,” the authors write in the study, which was published Monday. “Yet the lower severity of omicron is nothing but a lucky coincidence.”

Instead, the microbiologists believe more severe strains could be on the way as the virus adapts to dodge natural immunity and vaccines. Analyzing the possibilities for how COVID may evolve in the coming months and years, they attempt to debunk the notion that omicron’s lessened severity represents a step towards normalcy.

“Omicron is not at all a good predictor for the future,” said Dr. Peter Markov, a scientist at the European Commission’s Joint Research Centre and lead author of the study.

Many viruses that plague human populations, including HIV and Hepatitis C, do not evolve to be less severe over time, Markov said.

You can find more details here. You know that BA2 omicron variant that’s already making case counts go up in Europe? We’re starting to see evidence of more infection in the US as well. In the wastewater, of course.

There’s a whole thread to read for that. The good news locally is that our wastewater virus levels are still trending down, as of March 7. That of course can change quickly. You know what the best protection from this is, of course.

That drum has been beaten to death, and yet the US as a whole and Texas and Harris County in particular are not great on getting shots in arms. Too many vaccinated people haven’t gotten boosters. Too many vax-eligible kids haven’t gotten theirs. The anti-vaxx crowd is as loud and obnoxious and dangerous as ever. And yet even with all that, we’re in a better position than some other places.

Another thread to read. An astonishingly small number of people over the age of 80 have been vaccinated in Hong Kong, which is absolutely getting slammed right now, and in China as well. That and a lack of immunity from prior exposures – this is their reward for suppressing the first waves of COVID so well – are the underlying factors. Our vax rate in Texas isn’t great, but so many people have been infected at least once that it helps make up the gap somewhat. But vax + booster is still by far the most effective protection against hospitalization and death. If the next variant is more effective at avoiding existing protections, or is more severe in addition to being more transmissible, we’re going to be in deep trouble. Hope for the best, make sure everyone in your circle is vaxxed and boosted, and stay vigilant. Stace has more.

How low can COVID go?

I feel like this is more a function of time and evolution than anything else, but we’ll see.

New coronavirus cases across the greater Houston area dropped to their lowest level in four months, new data showed Monday, just days after Harris County’s COVID threat level dropped to yellow, signaling the virus is not immediately threatening the capacity of the region’s healthcare system.

The demise of the omicron wave appeared all but complete in the latest numbers from the Texas Medical Center, which collectively admitted 77 new COVID-19 patients daily last week, down 63 percent since February.

Across the region, daily infection rates are now roughly equal to those recorded during the lull that followed the delta wave in late November, before the more contagious omicron variant swept the globe. The figures come as the remaining indoor mask mandates expire across the country and as Americans report feeling increasingly exhausted — or altogether fed up — with pandemic restrictions.

Around 430 people tested positive for COVID each day last week, down 80 percent from last month, Texas Medical Center reported Monday morning.

Houston-area deaths from COVID have plummeted in tandem with falling case counts in recent weeks. A total of 4,288 residents have died since the pandemic began.

The figures confirm Houston is in a period of low transmission. How long it will last is uncertain. Some experts, including Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health, consider omicron’s relatively milder disease a “lucky” happenstance that may not be repeated in future iterations of the virus.

Viral waves typically arrive about six months apart, meaning another surge could begin by summer.

Well, the next wave may already be underway in Europe, though at this point it remains to be seen if it will result in anything like what we have seen before. At some level, if we can get enough people vaxxed and boosted, then at least the next wave should not be as hard on the hospitals and the mortuaries. That’s the goal at this point, minimize the damage. You would hope that by now we’ve learned from our past experience.

MLB’s Canadian conundrum

Here’s an interesting wrinkle to the recently-resolved MLB lockout.

With the Major League Baseball season set to start, unvaccinated players will once again need to sit out series against the Toronto Blue Jays at Rogers Centre.

Players who haven’t been fully vaccinated against COVID-19 will not be able to play in Toronto.

In addition, unvaccinated players won’t be paid for games or service time for the entirety of a series played north of the border. Each day spent on a baseball club’s active roster or injured list represents one day of service time.

Current vaccination guidelines still doesn’t allow foreign unvaccinated travellers to cross the Canadian border. Athletes no longer have special status in order to travel without having taken the vaccine after the federal government revoked the exemption on Jan. 15.

Sportsnet’s Shi Davidi reports the subject was “a significant point” in players’ CBA discussions with “a few teams” taking issue before ultimately relenting.

According to the story, about 88% of “tier one individuals” are fully vaccinated, which includes players, coaches, and other staff that travel with the teams, so the extent of the problem should be relatively limited. Still, if we assume that is the value for active players as well, on a 26-man roster, that’s three players per team, and as anyone familiar with the Kyrie Irving situation knows, who the unvaxxed players are matters. It’s one thing to miss a reliever at the back of the bullpen or a starting pitcher whose turn in the rotation wouldn’t have happened anyway. It’s another thing to miss your starting catcher or an All Star outfielder. Some teams will be much more affected than others, and if a team in the same AL East division as the Jays has its own Kyrie on it, that could affect the playoff races.

The collective bargaining agreement that has settled the lockout is still preliminary and subject to some details being worked out, including those relating to this situation. It may be that Canada eventually relaxes this rule, and it may be that some holdout players give in so as not to be the reason why their teams are disadvantaged. Most likely, this will be an ongoing story and another reminder that however done we may be with COVID, COVID is not done with us.

And we’re back to yellow again

Let’s hope it lasts.

Harris County Judge Lina Hidalgo on Thursday lowered the county’s COVID threat level to yellow, signaling a controlled level of cases following the decline of the omicron wave.

The yellow level means COVID poses a “moderate threat” to the public and urges residents to continue to stay vigilant unless fully vaccinated.

Under the yellow or moderate level, unvaccinated residents are encouraged to continue masking and social distancing, while vaccinated residents are encouraged to do the same where required by law.

“My hope is that we are at a permanent turning point of this pandemic,” Hidalgo said in a statement. “But we’ve yet to have a wave where our hospitals don’t get overwhelmed, so we need to tread with caution before we declare victory over this virus.”

As noted, we dropped to the orange level two weeks ago. We were last in yellow in November, for less than a month before omicron moved in. I’m still wearing a mask for the grocery store and other indoor places with lots of people – I mean, I haven’t had a cold in over two years now, so why wouldn’t I? You do you, as long as that means getting vaxxed and/or boosted if you haven’t yet.

We’ve had a lot of COVID

Wow.

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

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

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

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

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

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

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

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

The Rodeo is back

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

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

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

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

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

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

“We will definitely be masked,” she said.

[…]

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

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

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

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

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

HISD lifts its mask mandate

A bit earlier than expected.

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

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

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

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

Orange is the new threat level

New again, anyway.

Harris County Judge Lina Hidalgo lowered Harris County’s COVID-19 threat level to “significant” Thursday, signaling the city is emerging from the worst of the omicron wave as infection rates plummet.

Harris County has met all four metrics needed to lower its threat level from red, its highest level indicating “severe risk,” to orange, the second-highest possible threat level. Under orange, officials still recommend that residents minimize all unnecessary contact and avoid large gatherings to stem the spread of the virus.

“The omicron wave hit Harris County very, very hard,” Hidalgo said in a statement. “In fact, only now have our hospitalization rates dropped to levels that don’t immediately threaten the capacity of our healthcare system.”

[…]

The two other metrics that were keeping the county in red — ICU capacity and new cases per 100,000 — have improved in recent days, leading to the downgrade Thursday. The overall percentage of COVID patients in the ICU fell to the county’s threshold of 15 percent, and the seven-day rate of new cases per 100,000 people declined to 83, well below the county’s goal of 100.

Hidalgo encouraged residents to get vaccinated to avoid another “dangerous” COVID spike.

“While we’re moving in the right direction, there are no guarantees we won’t see another wave in the future,” Hidalgo said.

We were last at orange in December, on the way to red a couple of weeks later. At this rate, we’ll likely be back to yellow soon, and after that who knows. The good news is that between our vaccination level and the sheer number of people who contracted omicron, our overall immunity level for the short term is as good as it’s ever been. The bad news is that our vax level is still way too low, far too few kids have been vaxxed, and the waning omicron wave is causing fewer people to get vaxxed now because the threat is receding. It really is just a matter of time before we’re back in a crisis situation again. If we’re lucky, and we make a strong effort to get a lot more people vaccinated in countries that have not had nearly enough vaccine supply, then maybe that next wave is farther off. If not, well, I probably don’t have to tell you what that means. Stace has more.

COVID madness

How many ways will unhinged lunatics find to kill us?

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

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

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

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

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

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

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

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

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

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

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

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

The federal mandate is set to expire on March 18.

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

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

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

Omicron on the decline in Houston

Some good news.

Omicron is receding in the Houston area, new data show, even as hospitals continue to feel the strain of January’s post-holiday bump in COVID-19 cases.

The region’s rate of transmission — a key metric used to gauge how likely an infected person is to spread the virus to others — fell for the third week in a row, health officials reported Monday, fueling hopes that omicron may be on its way out.

The COVID transmission rate across the Houston area was 0.74 last week, meaning the average person who had the virus gave it to one person or less, according to the Texas Medical Center. Spread has remained below 1.0 for two weeks, reflecting omicron’s loosening grip.

New hospital admissions also fell, an encouraging sign after an explosive surge that pushed Texas emergency rooms and intensive care units closer to capacity than at any time during the pandemic. About 2,300 people were hospitalized for COVID in the nine-county region around Houston on Sunday, down 20 percent from two weeks ago.

Houston averaged fewer positive COVID tests last week relative to the mid-January peak. Around 5,400 people tested positive for the virus each day in the greater Houston area, 60 percent as many as the previous week, when the region averaged 9,000 new cases daily, according to TMC data.

That’s good, and it’s consistent with other reporting. We could sure use a bit of a breather. That said, and as the story notes, hospital ICUs are near capacity, and there’s no reason to believe this wave will be the last wave. We still need to get a lot more people vaccinated and boosted. At least on that note, there’s a little more good news.

Earlier this month, Ipsos conducted surveys in Italy and France to gauge the support levels among the populations there for the tough new vaccination mandates that were just introduced. The polling firm shared the data exclusively with Fortune, and the findings surprised not only the pollsters, but also Fortune readers.

As a result, Fortune asked Ipsos to expand the survey to include four new countries: the United States, the United Kingdom, Germany, and Australia.

The findings were remarkably similar across all six countries. Among the general population, there’s wide support for compulsory vaccination rules. And even more startling, the ranks of unvaccinated see some merit in selective vaccination mandates. For example, there is overwhelming support for requiring teachers and health care workers to get vaccinated across all those polled. Requiring that private sector workers be vaccinated draws less support, but there’s still a majority in all but the U.K.

Even in the United States, where mandate battles have raged from state to state since the early days of the vaccination campaign, a majority of poll respondents are seemingly okay with rules requiring vaccination to enter workplaces, shops, and attend public events. This finding comes as courts across the country, and even the U.S. Supreme Court, strike down a variety of enforcement orders that would have required employees at large businesses get vaccinated, undergo weekly testing, or simply wear a mask.

But what continues to surprise pollsters the most is that the most strident blocs in each country—the unvaccinated—are showing signs that they, too, will go along with tougher measures in certain circumstances.

Call it a case of Omicron fatigue: This highly infectious variant is testing the resolve of even the most dogged anti-vaxxers, the pollsters find.

“They are definitely not a group of people that are hard-core sure they are right,” says Andrei Postoaca, CEO of Ipsos Digital. The data from these surveys tell him that there is probably one-quarter of the remaining unvaccinated who don’t fall into the strident “true believer” category. “More and more are willing to take a jab, are willing to accept a mandatory vaccination. So the question is: Step by step, will you get people to cross the line” and drop their opposition to vaccines and vaccine mandates?

“What I would say is clearly the vaccinated support a decision of mandatory vaccination. And a decent chunk of the unvaccinated in most countries also support it,” Postoaca adds.

The poll suggests that about 13% of unvaccinated Americans are planning to get their first COVID shot. That’s not a lot, but if it’s accurate it would raise the overall vaccination rate in the US by about four points, and that’s not nothing. Here’s hoping.

Two new polls of the Governor’s race

One is in the news.

Beto O’Rourke

Republican Gov. Greg Abbott is running 11 percentage points ahead of Democrat Beto O’Rourke in this year’s race for Texas governor, according to a Dallas Morning News-University of Texas at Tyler poll released Sunday.

Buoyed by 2-to-1 support among whites and a growing number of voters who identify as Republican, Abbott leads O’Rourke in a hypothetical matchup, 47%-36%. He even holds a narrow lead over O’Rourke among Hispanics, 40%-39%.

Registered voters are not in a great mood about Texas’ current direction: 50% say things are on the wrong track, compared with 49% who say the state is headed in the right direction.

Still, Abbott dodges much of the blame. His job rating has held at a respectable net approval, 50%-45%. While he’s still underwater with independent voters, with only 37% of them approving of how he’s performing, he draws unfavorable views from just 38% of all voters.

President Joe Biden is viewed unfavorably by 57% of Texans. That may be one factor weighing down O’Rourke, who in November was only six percentage points behind the incumbent. Abbott also has been linking the former El Paso congressman and presidential candidate to Biden, saying in ads that O’Rourke is too liberal and untrustworthy to lead Texas.

The poll, conducted Jan. 18-25, surveyed 1,082 adults who are registered voters and has a margin of error of plus or minus 3.5 percentage points.

Abbott increased his lead over O’Rourke, which in November stood at just 45%-39%, with modest, “single-digit shifts” among various constituencies, said UT-Tyler political scientist Mark Owens, the poll’s director.

You can see the poll data here and the previous DMN/UT-Tyler poll here. That result was from late November, and it was followed by terrible Quinnipiac result a couple of weeks later. This polling outfit has been eccentric at times, and definitely wasted a lot of energy on ridiculous McConaughey hypotheticals, but it’s a data point and we haven’t had one of those in awhile. They also polled the various primaries, and I would not pay much attention to any of it. Not because of them, but because polling primaries is extremely random, especially given how few people really pay attention to them. Look at the individual race numbers yourself, and you’ll see what I mean.

The results that are of greater interest, as others have noted, are on the issues that voters say are of interest to them:

As a public policy issue for this year, should it be a higher priority to strengthen of the electricity grid or secure the Texas-Mexico border?


Strengthen The Electricity Grid 50%
Secure the Texas-Mexico border  41%
I am not concerned about either  8%

Should it be a higher priority to enforce regulations to stop the spread of the coronavirus or secure the Texas-Mexico border?


Reduce coronavirus infections   52%
Secure the Texas-Mexico border  42%
I am not concerned about either  6% 

Are you more likely or less likely to support an elected official if they supported a mask mandate during the pandemic or do you not care?


More likely     45%
Less likely     22%
Absolutely not  10%

Some school districts have mandated masks be worn in school and others have not. Should masks be required in all K-12 classrooms, allow school districts to decide, or no mandates at all?


Required                41%
Allow schools to decide 28%
No Mandate              25%

Do you support or oppose local governments requiring people to wear masks or face coverings in most public places?


Support  57%
Oppose   35%

Do you support or oppose employers requiring vaccination or weekly testing from their employees?


Support 52%
Oppose  39%

In terms of the issues, this is not a bad place for Beto to be. We’ve talked a lot about how what people say they want in polls and what they actually vote for often diverges, and this may be another example of that. But the driving factor in the polls we’ve seen before is that the numbers are the result of Dems and Republicans being polar opposites, while independents modestly favor the Dem position. Here, while Republicans all fall more on the Abbott side of things, they are fairly evenly divided on the mask questions. Indies are less passionate about most of these than the Dems, and are just barely in favor of employer vaccine mandates, but they are strongly in favor of the other things, with majority support for most. Again, maybe this doesn’t do much to move votes, but these are things Beto is talking about, and it’s way more fun to be on the majority side of questions like these.

There is one other poll we can talk about:

I can’t find anything on the UH Hobby School page, but after looking all weekend I finally found a tweet that pointed me to their polling data. As noted, Beto does better with Latinos in this sample, and the partisan numbers (91-5 for Beto among Dems, 89-3 for Abbott among Rs) make more sense to me than what DMN/UT-Tyler has (72-14 among Dems for Beto, 74-10 for Abbott among Rs). But as always, it’s one result and we shouldn’t read too much into it. They have numbers for each primary race as well – it’s the main focus of the poll – which should be taken with the same large grain of salt. I suspect we’ll start seeing more general election polling going forward.

You don’t want to go to the ICU right now

And even if for some reason you did want to go to the intensive care unit, there probably wouldn’t be room for you.

The number of Texas intensive care unit beds available for adult patients is at an all-time low for the pandemic, with only 259 staffed beds open across the state as of Wednesday, as hospitals fight a historic staffing crisis and more unvaccinated people infected by the omicron variant pour into hospitals.

That’s 11 fewer beds than the previous record set in September during the deadly surge of the delta variant of COVID-19, according to the Texas Department of State Health Services. An average of 295 available beds has been reported in the last week, which is also lower than previous record averages.

The crunch on the state’s intensive care units comes as patient cases skyrocket and as hospitals themselves work to fill shifts left open by more workers home sick from COVID-19.

As of Wednesday, more than 13,300 hospitalized Texans have tested positive for the virus.

“Because of the high level of transmission and infectivity of the omicron variant, so many of our staff are getting positive,” said Bryan Alsip, chief medical officer for University Health in San Antonio. “We’ve been doing this a long time now — close to two years. We’re now experiencing our fourth large surge of those patients. It can get tiring.”

Alsip said University Health — the public hospital system for the San Antonio and the third largest of its kind in the state — is approaching numbers of hospitalized COVID-19 patients that the system has not seen since the last deadly surges in the early months of 2021 or the fall and summer of 2020.

[…]

But while omicron is putting fewer patients into the ICU than in previous surges, there are also fewer ICU beds that are able to be staffed due to a nursing shortage, officials say — and the sheer number of omicron cases is pushing patient counts higher.

The bottom line, they say, is that there are fewer beds for any Texas patient who may be suffering a serious medical event and need intensive care — whether they were put there by omicron or not.

So yeah, now when people tell you to drive safely, it’s more than just a bit of politeness. We might be reaching peak omicron, but as noted before hospitalization is a lagging indicator. There’s still a few weeks to go before we start seeing declines in those numbers.

While it would be nice to think that once this omicron wave recedes we’ll be in for a longer period of calm, but Dr. Peter Hotez says don’t count on it.

Q: There’s a lot of talk about omicron creating herd immunity and the transition from pandemic to endemic. Your thoughts?

A: The big picture, I’m still concerned about. There’s a lot of happy talk about omicron somehow acting as a weakened virus, herd immunity and the end of the pandemic. I do not think so yet. I think we’re in for another wave this summer across Texas and it could be just like 2020 and 2021. Here are the reasons why.

One: I’m not convinced the durability of the protection from omicron is going to be adequate. It may resemble the short-lived immunity you get from the upper respiratory virus. The population could still be vulnerable in the spring.

And vaccination rates are still not great in lower- and middle-income countries where these variants arose. I think we’re still very vulnerable to another variant arising in Africa or Asia.

Q: As you pointed out, that runs contrary to a lot of the hopeful buzz about omicron that I’m coming across.

A: Yeah, you hear that coming from the White House. And I’m hearing it from a lot of my talking head colleagues. But to me, right now, that rings hollow. I don’t think it’s wise. I think what we need most urgently right now is a national strategy for how we’re going to prevent another big variant in the summer from hitting Texas and the southern United States. Here’s what I think that strategy requires.

One: a strategy for global immunization against COVID-19, which just doesn’t exist now. The White House announced another 400 million doses, which is slightly more than what our Texas Children’s vaccine has done. We need 9 billion doses.

Second: We need a greater understanding about the durability and protection from the mRNA boosters. We’re getting conflicting results about the durability. That needs to be clarified. We need to understand that for a strategy for moving forward. Whether we keep the singular focus on the mRNA vaccine or broaden our COVID stockpiles to include additional technology.

And let me say, third: What’s our plan for global surveillance? So far we’ve been surprised by every major variant of concern. We need predictable surveillance models, but we don’t have them. That’s a need. What I’d like to see coming out of the White House is a national strategic task force to really dive into those three components. We need a realistic plan for the country. And I just don’t get the sense we have that right now. Nationally, we’re still in reactive mode every time.

As noted, Dr. Hotez and his colleague Dr. Maria Elena Bottazzi have done what they can to help with global vaccine supply. But we still need to get more shots in arms here – ESPECIALLY KIDS – and I don’t know what we can do to make that happen. Rewards and gimmicks might help a little around the margins, but not enough to really make a difference. The various federal mandates would have made a real difference, but well, you know. Your safety is officially in your hands. Don’t screw around with it.

The Rodeo will (probably) happen

Assuming it all doesn’t go south from here.

Harris County Judge Lina Hidalgo said Tuesday the Houston Livestock Show & Rodeo should proceed as planned, citing a decline in COVID-19 cases and hospitalizations.

“It’s difficult to predict what things are going to look like in a month, but I’m very hopeful,” Hidalgo said. “I hesitate to say A-OK, because I know what our hospitals are facing.”

She did not rule out, however, shuttering the event for the third straight year if trends reverse.

Hidalgo returned the county to its highest virus threat level on Jan. 10, which urges the more than 1 million unvaccinated residents here to stay home and avoid unnecessary contact with others.

There is growing evidence that the omicron wave is waning in the Houston region. Virus hospitalizations have declined 8 percent since peaking on Jan. 18. Unlike previous surges, the Texas Medical Center has never exceeded its base ICU capacity while dealing with omicron.

Last year’s Rodeo was cancelled, and the 2020 Rodeo, which began just before COVID became a known threat here, ended early, though some argued at the time that decision took too long. Our current numbers are headed in the right direction and should be better in a couple more weeks. I doubt I’d be ready to attend actual Rodeo events or one of the concerts, as those are all indoors, but I expect that going to the fairgrounds for a day of outdoor activity ought to be fine. Especially, you know, if you’re vaxxed and boostered. Wearing a mask, at least when you’re in line and definitely when you’re getting food, would also be a good idea. Do what you think makes sense for your risk profile.

I repeat: We need to get more kids vaccinated

Come on, Houston.

In spite of the spread of the omicron variant, national COVID-19 vaccination rates for children ages 5-11 remain low. The same is true for children in Harris County, according to a Kaiser Health News analysis of CDC data.

Of Harris County’s children aged 5-11, only 18.2% of them are fully vaccinated; 22.2% have received one dose. Pharmaceutical company Pfizer announced the FDA authorization of their COVID-19 vaccine on October 29, 2021.

In Texas, most counties have low vaccination rates. Only 34 of Texas’ 254 counties have child vaccination rates above 10%.

When compared to other counties in the U.S. with child populations over 100,000 Harris County comes near the bottom of the list when ranked by vaccination rate.

At 13% fully vaccinated, Harris County’s child vaccination rate is barely higher than Dallas County’s (11%), lower than Bexar County’s (14%) and is about half of Travis County’s (26%).

That 18.2% cited appears to be a typo – according to both the embedded image in the story and the Kaiser Health News story, the actual figure is 12.8% for Harris. Half of what Travis County has done to this point, in other words. We have to do better than that.

And as a reminder why, there’s this.

Vaccines continued to provide strong protection against death from COVID-19 in December, even against the new omicron variant, according to state data released Friday.

Unvaccinated Texans were 16 times as likely to die from the virus in December, and were two times as likely to test positive for it. That gap has shrunk from the fall, likely due to omicron’s increased transmissibility.

The divide was most evident for Texans between 65 and 75 years old, who were 19 times more likely to die from COVID if they were unvaccinated. Nearly 80,000 COVID deaths have been reported in Texas since the pandemic began, the majority of them in 2021, when vaccines became available. Just under 1,600 deaths were reported to the state in December.

Yes, not being vaccinated is not the same risk for a 5-year-old as it is for a 75-year-old. But still, there are a lot more kids in the hospitals these days, and the little ones can certainly spread COVID to their elders. Get them their shots already.

Spare a thought for the nurses

And do everything you can to avoid getting COVID.

[Kristen McLaury, a nurse and unit manager at Methodist Hospital The Woodlands] treated one of the hospital’s first COVID patients and hasn’t stopped since. She now runs the respiratory unit, where she and her nurses have watched otherwise healthy young people gasping for breath. They’ve put countless people on oxygen, or taken them off life-support. They’ve had to comfort grieving families, and facilitate video calls so no one had to die alone.

She’s risked her own life on the frontlines for nearly two years, and now, watching these hospital beds fill up again, she just feels defeated. In Montgomery County, a conservative, wealthy suburban county northwest of Houston, only 53 percent of its more than 600,000 residents are vaccinated, which is among the lowest rates for Texas counties with populations exceeding 500,000. Less than 16 percent of residents have received a booster shot.

“I work 60 hours a week and I don’t see my child, I don’t see my husband, so that I can come and care for you while you yell at me because you’re upset that you have a disease that I told you how to prevent in the first place,” McLaury said.

As the unit manager, it’s McLaury’s job to keep morale up among the other nurses, a herculean task right now. Like every hospital across the country, they’re facing a nursing shortage, an increase in employee infections and a potentially terminal case of staff burnout.

As the omicron variant surges, Texas is on track to soon surpass its previous COVID hospitalization record, set in January 2021. Then, at least, there was the hope of vaccines on the horizon. Now, nurses like McLaury don’t see much hope at all.

From behind her Houston Astros mask and face shield, she begins to cry.

“It’s real, and maybe it might not be you [in the hospital], but it might be somebody else,” she said. “That compassion, I think, is just gone. The world has become so selfish.”

[…]

“Patients stay in the lobby for my entire shift,” said Meredith Moore, an emergency room nurse. “12 hours. It’s frustrating. It’s hard for them…and they get angry. It’s justified. But who receives that anger? Me.”

Moore has been a nurse for nine years and joined the emergency department here since soon after the hospital opened in 2017. She’s young and energetic, with expressive eyes that communicate exactly what she’s thinking — even behind a mask.

Before the pandemic, Moore loved the fast-paced environment and the feeling of helping people who really needed it. She was especially good at controlling her emotions, a requisite for this job.

“In the ER, you have a patient die on you and you have to go into your next room, and you have to act like nothing is wrong,” she said. “That has gotten more difficult as this has gone on.”

Last week, for the first time, she broke down and cried in the emergency room.

“I had five ambulances that had to have a bed…I had a patient that was circling the drain…I don’t have a nurse to take care of that patient,” she said. “That was the first time in two years I really felt helpless, because if one thing falls, if one person starts coding, it’s all over. It all goes up in flames.”

“I don’t think that people [know] unless you’re on this side,” she said. “I tell my family all the time. I’m glad you don’t know. But that’s a heavy burden to carry.”

The article started with a focus on one of the patients at Methodist Hospital The Woodlands, some unvaccinated dude who didn’t believe in the science of vaccines but was more than happy to trust the science of hospitals. I think we’ve heard enough from people like that. The rest is about the nurses and their experiences, and we need to be more aware of what they’re going through. Go read it.

Have I mentioned that we need to get more kids vaccinated?

Seriously, y’all.

Since November, 693,345 Texas elementary-age children have received at least one dose of the vaccine, accounting for about 24% of the state’s 2.9 million children ages 5-11 — and a figure in line with the national rate. Nearly 390,000 of the 5-11 group are fully vaccinated, while more than half of Texans ages 12-15 are fully vaccinated.

Texas’ child vaccination rate is higher than in many other Southern states, where rates as low as 10% are being recorded. In the first two weeks after the shot was approved for emergency use in the younger age group, some 100,000 children showed up to Texas school clinics, pharmacies and pediatricians’ offices to get inoculated.

[…]

At Texas Children’s Hospital in Houston, positive cases among patients went from zero in early December to some 70 patients with COVID-19 a month later, mostly among unvaccinated children, said Dr. Jim Versalovic, pathologist-in-chief for the hospital. Their hospitalizations of children with COVID-19 broke all previous pandemic records, and at breakneck speed, he said. Just weeks after omicron was first detected in Texas, it was causing more than 90% of new cases showing up at his hospital — less than a month after the vaccine was approved for young kids.

“We have staggering numbers here during this omicron surge,” Versalovic said in a news conference in early January.

That same day, the state broke its own record of children hospitalized with COVID-19, reporting 350 — five more than the previous peak a few months before.

On Friday, the state health department released data on 3.8 million confirmed cases of COVID-19 in Texas in the first two years of the pandemic. Almost 19% of them — 722,393 — were diagnosed in residents under age 20. The demographics do not include cases reported in 2022.

During the first week of January, the Texas Department of State Health Services and the Texas Education Agency reported that about 26,500 students and 11,800 staff members had been infected with COVID, according to data released Friday.

While the numbers of student cases are nearing levels not seen since the start of school last fall, there are more cases of COVID-19 among staffers than at any other time in the pandemic. The numbers are likely to increase as more districts report their numbers to the state. The current numbers include only about half of all of the state’s 1,200 districts, and the number of districts reporting any numbers is inconsistent from week to week.

Meanwhile, on Wednesday, the state reported 471 children in Texas hospitals with COVID-19. Most of them are unvaccinated, hospital officials have said. But there is no state data detailing how many COVID-19 child patients are in Texas pediatric intensive care units.

Yes, I’ve said this before. The numbers have climbed a bit since then, but there’s so much farther to go. As was the case with previous iterations of the vaccine, there was a large initial burst of activity, as the folks who had been eagerly awaiting the day that it became available for that group rushed out to get it, then it leveled off. The difference is that this time that initial burst was much smaller. Gotta say, I have no idea why. Get your kids vaccinated. What are you waiting for?

You (probably) still have to get vaxxed if you work in Houston

I’m glad to see this, but there’s a huge question that this story doesn’t address, much less answer.

Local companies say they will maintain their vaccination policies despite last week’s Supreme Court ruling that struck down the Biden administration’s vaccination mandate for firms with more than 100 employees.

The Houston software company Hewlett Packard Enterprises, for example, said vaccinations are still required for employees to enter offices, work at clients’ sites, travel for business, or required for team members to enter work sites, work at third-party sites, and to travel or attend events on business. Those who decline to be vaccinated are required to work from home.

More than 90 percent of the company’s workforce is vaccinated, a company spokesperson said. The company has not yet decided whether to require booster shots.

[…]

The Houston chemical company LyondellBasell and CenterPoint, the Houston utility company, have not adopted vaccine mandates. They said they have COVID protocols in place and will continue to monitor them.

Corporate vaccine requirement increased the rate of vaccination among employees by 20 percent, according to a recent survey by the National Safety Council. The survey found 95 percent of workers at businesses with vaccine mandates were inoculated, compared to 75 percent among those at businesses without requirements.

At BakerRipley, employees are required to get vaccinated or tested weekly, the Houston charity said. Nearly 90 percent of its 1,200 employees are fully vaccinated.

Camden Property Trust, a national real estate company headquartered in Houston, put in vaccine requirements over the summer before Biden announced the mandate. Of its 746 Texas employees, 718, or about 96 percent, are vaccinated, said Ric Campo, CEO of Camden Property Trust said.

“We just had this discussion about safety and it’s about keeping teammates safe. We’ve done all the analysis and that’s what we think,” Campo said, “And once people had a rational discussion, and it wasn’t political, and it wasn’t ‘You do this or else’ people chose to vaccinate.”

The few who aren’t vaccinated must wear masks at work, Campo said.

Whether to require vaccinations is now in the hands of companies, said Seth J. Chandler, a professor at the University of Houston Law Center. It’s unlikely that Congress would pass new laws to give OSHA the authority that the Supreme Court says it now lacks to impose workplace vaccination requirements.

The story is about the effect of the SCOTUS ruling that blocked the Biden employer vaccination mandate. I’m happy that employers are mostly moving forward with whatever vaccine policies they already had in the works, but I have to ask: What about the state ban on such mandates? The original story line was that employers would be caught between conflicting orders, but that’s no longer the case. The thought that these employers are ignoring Abbott or have found a way around him is delightful, but how is it possible? What are their legal risks here? Is there a lawsuit against the Abbott’s order?

So I did some googling. While Harris County Attorney Christian Menefee urged businesses to sue Abbott over this order, as far as I can tell none have done so yet. Maybe they were waiting to see what happened with the federal mandate first. On the question of what Abbott’s order actually means, I found some interesting writing. For example:

The Order provides enforcement via fines. Specifically, non-compliant entities may be fined up to $1,000 per offense, while jail time is specifically excluded as a penalty. The Order’s language makes no exception for health-care providers such as hospitals and other related entities.

The Order also contemplates its own sunset upon the passage of overlapping legislation. Specifically, in the Order, Governor Abbot states that he is “adding this issue to the agenda” for an upcoming session of the Texas legislature, and that he “will rescind this [Order] upon the effective date of such legislation[.]”

Notably, the Order contradicts both the Governor’s own statements on the rights of private businesses within the state, and legal consensus regarding the ability of employers to mandate vaccinations in most cases. For example, in August, Governor Abbot issued an executive order banning public and governmental entities from enacting vaccine mandates, but explicitly left private entities to make their own decisions regarding the matter. At that time, a spokesman for the Governor’s office also commented that private businesses would be left to make their own decisions regarding the matter. The Order essentially closes that loophole.

The Order also contravenes existing legal precedent within the state regarding employer vaccine mandates. For example, in June 2021, the Federal District Court for the Southern District of Texas dismissed a lawsuit by 117 employees of Houston Methodist Hospital; who claimed Methodist’s policy requiring employees to be vaccinated against COVID-19 amounted to wrongful termination under the law, because the vaccine(s) are “experimental and dangerous.” Bridges v. Houston Methodist Hosp., CV H-21-1774, 2021 WL 2399994, at *1 (S.D. Tex. June 12, 2021). In no uncertain terms, the Order squarely contradicts the holding in Bridges.

[…]

The immediate impact of the Order on businesses who implemented vaccine mandates is unclear—especially in light of conflicting Federal mandates. For example, Texas-based Southwest Airlines and American Airlines have stated publicly that—regardless of the Order—they will continue to implement plans requiring employees be vaccinated, citing federal mandates for contractors and the forthcoming OSHA rule for private business with 100 or more employees. While nothing is certain, it is somewhat likely that OSHA rules and regulations would preempt the Order. But Texas businesses with fewer than 100 employees would still be subject to the Order, or future, related State legislation.

Regardless, in light of the Order’s language, any Texas business entity that previously required employees or customers be vaccinated should seek counsel and reexamine its accompanying policies or risk non-compliance with the Order. At a minimum, Texas businesses should—for now—consider adding exemption language to vaccine policies that mimic the Order’s “personal conscience” and “prior recovery from COVID-19” carve outs.

The fact that the order only calls for what appears to be a modest fine (though that may depend on how an “offense” is counted; if it’s per employee, that would quickly add up) and conflicts with an existing federal court ruling may be the reason for the lack of action on it. Here’s more:

Additional questions loom, such as whether the governor’s Order exceeds his authority – his prior Executive Orders regarding vaccinations and so-called vaccine passports governed only public employers and private companies who were receiving state funds. Additional uncertainties include likely legal challenges to the Order; possible conflicts with federal law; and how and to what extent EO-40 will be enforced. It is also unclear to what extent, if any, the State will actually enforce EO-40, which provides for fines of up to $1,000 per violation.

Companies with employees in Texas who have already begun requiring vaccinations can take a relatively low risk approach to dealing with the governor’s Order by modifying their policies to provide accommodations to employees who object to being vaccinated on the basis of “personal conscience” (which is not defined in EO-40) and for “prior recovery from COVID-19.” These practices can be modified as new federal rules are issued and/or legal challenges play out. Other options for responding the Order are discussed in more detail below.

[…]

EO-40 departs from the governor’s prior orders in other ways. The Vaccine Passport Ban prohibits state agencies from adopting policies or requiring proof of vaccination as a condition of receiving services. In a notable contrast, EO-40 does not expressly forbid proof of vaccination as a condition of employment. Instead, it specifically forbids an entity from “compelling receipt of a COVID-19 vaccine.” By aiming squarely on the act of receiving a vaccination as opposed to policies requiring proof of vaccination, the Order gives rise to more ambiguity. In other words, employers may argue that they are not “compelling receipt” of a vaccine so long as that they do not intend to strap an employee down to a chair and force a vaccine needle into a worker’s arm, which they do not. Instead, that worker always has a choice: they can refuse to get vaccinated, but the consequence is that they will lose their job. Thus, another question is whether employer policies requiring vaccination as a condition of employment would be considered coercive enough to be deemed a violation of EO-40’s bar on compelling receipt of a COVID-19 vaccination.

In a larger context, considering the Texas’ at-will employment environment and the narrow availability of a “wrongful termination” cause of action in Texas, it is not clear that an employer “compels” an individual to be vaccinated by making it a condition of employment.

That last bit was a key component of that Methodist vaccine lawsuit. My interpretation of all this – and you lawyers out there, feel free to tell me why I’m wrong – is that businesses that want to get their employees vaccinated see a way forward, and so far the state hasn’t tried to make an example out of anyone. Abbott’s order was primarily about politics and his need to appear maximally troglodytic for the primary. If he scares a few businesses into abandoning any pro-vaccination plans, so much the better, but the point was to make the order. Optics come first, and on that score Abbott got what he wanted. The details don’t matter. Very much on brand for him, in other words.

On the campaign trail again

It’s good to be back.

In the 2020 election cycle, many campaigns in Texas went fully virtual as the coronavirus pandemic, then a new and uncertain threat, bore down on the state. They held virtual rallies, phone banks and fundraisers, trading in clipboards and walking shoes for webcams and microphones.

As the weeks went on, though, Republicans resumed in-person campaigning and managed to stave off a massive Democratic offensive in November. Democrats later admitted that their decision to suspend door-knocking and other in-person activities hurt them.

Now, nearly two years later and with a new COVID-19 variant surging across the state, Democrats appear set on avoiding the same mistake. Few, if any, Democratic campaigns have gone fully virtual, and many are pressing forward with in-person campaigning while taking some precautions.

“Like everyone else across the globe, we are keeping a close eye on the Covid-19 Omicron Variant and assessing the risks associated with this surge,” Texas Democratic Party spokesperson Angelica Luna Kaufman said in a statement. “However, there is a lot at stake this midterm election and in-person campaigning will be a critical component to engaging voters and winning these races.”

She emphasized the country is “not in the same situation as we were in 2020.” Vaccines are widely available, and people are well-practiced in how to stay safe in public.

Still, the omicron variant looms large, and the campaign trail has not been immune to it. Some forums are still being held virtually, and candidates, staffers and volunteers are having to deal with the logistical challenges that come when one of them tests positive amid the fast-spreading variant.

[…]

Democrats’ most celebrated candidate this cycle, gubernatorial contender Beto O’Rourke, has been regularly campaigning in person since launching his bid in November. He has been holding larger events outside, and his campaign asks attendees to wear masks and encourages them to be vaccinated. The campaign has made rapid testing available to attendees at some events.

“Speaking with Texans one-on-one is at the heart of our campaign,” O’Rourke’s campaign manager, Nick Rathod, said in a statement. “After holding 70 events in 30 cities during the first weeks of our campaign, we remain committed to meeting Texans where they are and will continue to closely follow” public health guidelines.

O’Rourke’s first campaign event since omicron began surging in Texas was Saturday in El Paso. Attendees were told “masks are strongly encouraged regardless of vaccination status” and that they would be provided for those who need them. On event sign-up pages, attendees were also told that by attending, “you understand and accept the risks associated with COVID-19.”

O’Rourke’s campaign is already block walking, though those who volunteer to do so have to sign a “COVID-19 Block Walk Safety Agreement Form.” Among other things, the form requires volunteers to wear masks when not eating or drinking and maintain their distance from voters “at all times possible.”

O’Rourke was among the Democrats who lamented the party’s refusal to campaign in person ahead of the 2020 election. He had been deeply involved in the fight for the Texas House majority through his Powered by People group, which shifted virtually all its activities online because of the pandemic. Writing to supporters days after Republicans swept Texas in the election, O’Rourke said one of the lessons was “nothing beats” talking to voters “eyeball to eyeball” and that “there is a safe way to do this, even in a pandemic.”

Not much to add here. To whatever extent the virtual campaigning of 2020 led to lesser outcomes than we might have had otherwise, no one wants to do that again. Most in-person events right now are being done virtually, but that is temporary. I’m certainly ready to see a bunch of my political friends in person again, in our natural environment. To that, here’s a little song you might know:

Happy trails, y’all.

Back to Code Red

Hopefully not for too long.

Harris County Judge Lina Hidalgo on Monday moved the county again to its highest COVID-19 threat level, her office said.

The announcement should be old hat for Hidalgo, who has moved to Level Red each of the past three calendar years.

“Unfortunately, today we find ourselves crossing a threshold we don’t want to cross,” Hidalgo said at Booker Elementary School in Spring ISD. “We are in the midst of another COVID-10 tsunami.”

She cited an explosion of new COVID-19 cases. She expounded on the dangers of the new Omicron variant. She pointed out that virus hospitalizations are increasing at a higher rate than ever.

Twenty-one months into the pandemic, a question looms: How many people are still listening?

Schools are back in session. Restaurants, bars, theatres and sports arenas are open to capacity. There are no county- or state-wide mask rules. Moving to Level Red does not change any of that; instead, it urges unvaccinated residents to stay home and avoid unnecessary contact with others. The decree is not enforceable.

[…]

Hidalgo has made warning the public about COVID-19 central to her messaging since the pandemic reached Texas in March 2020. For more than a year, she and county public health officials have cajoled, implored, exhorted, implored, advised, recommended, begged and even bribed residents to get vaccinated.

Hidalgo tried to remain optimistic, reasoning that getting more residents inoculated is the way to retreat from Level Red and never return.

“We can break that habit,” Hidalgo said. “I don’t want this always to be bad news.”

Growth of the county’s rate of vaccinated residents has slowed significantly. It now stands at 59.8 percent, up just 3.3 percent since before Thanksgiving. At this rate, 70 percent county of county residents would not be vaccinated until July.

See here for the previous time the threat level was raised. It’s a fair question whether anyone is still listening. I never really stopped wearing masks for indoor things like grocery shopping and ordering at restaurants – I eat outside if at all possible – but now I’m wearing KN95s instead of cloth masks. In my observation, we’re nowhere close to the levels of mask wearing we had a year ago, and few places are doing much about it. I guess we’re going to got for a low-rent version of herd immunity, at least for the short term. Better hope that the “milder” part of this strain holds up. More here from the Chron.

The hospitals are getting slammed again

Take precautions, y’all.

Pandemic forecasters in Texas say the state’s current surge of omicron infections and hospitalizations is likely to get much worse before it gets better, with hospitalizations expected to continue climbing for at least three weeks if social behaviors don’t change and slow the trend.

Across the nation, hospitalizations are already on the verge of breaking new pandemic records. In Texas on Thursday, according to state data, about 9,200 people were hospitalized with COVID-19 — far short of the record 14,218 hospitalizations from Jan. 11, 2021.

But with current numbers climbing exponentially each week, hospitalizations of Texans with COVID are likely to follow national trends and surpass previous levels in the state before they start to decline, said Anass Bouchnita, a researcher at the University of Texas COVID-19 Modeling Consortium, which uses data and research to project the path of the pandemic nationally.

The number of Texans testing positive for the virus every day is already at an all-time high, reaching a seven-day average of almost 44,000 confirmed cases on Friday. The seven-day average of new confirmed cases during the peak of the delta surge back in September was over 15,000.

That trend is likely to continue for at least another week, Bouchnita said.

“The situation in Texas is that it probably won’t reach the peak [for cases] until the second half of January,” he said.

Experts say the extremely high case count is why so many people are showing up in the hospital even as medical evidence suggests that the omicron variant — responsible for most new and active cases in Texas — is less severe than the previously dominant delta variant.

Bouchnita talked to The Texas Tribune on Friday, the same day the UT consortium released a report with the research team’s latest calculations about omicron’s projected path nationally. The report, which looked at eight scenarios in which omicron had varying degrees of severity, infectiousness and resistance to immunity, suggests the nation could see its new cases of this more contagious but less severe strain peak by mid-January before decreasing by half in early February.

The report called the current surge the largest COVID-19 wave in the United States to date.

[…]

Intensive care units at more than 50 hospitals are at 100% capacity, according to state reports, and some regions of the state, including El Paso, are reporting no ICU beds available in the area.

Already, the state’s children’s hospitals have more patients with COVID-19 in their beds than at any other time in the pandemic — 351 statewide on Thursday, which is higher than the last peak during the delta variant surge of 345 in early September.

“It’s pretty crazy,” said Frisco pediatrician Dr. Seth Kaplan, immediate past president of the Texas Pediatrics Society. “Our volume is way up.”

It’s mostly omicron now, very little delta in Texas, though there’s still a fair amount of delta in other parts of the US. It is true that omicron is less severe than delta, but it’s also true that it’s far more transmissible, and it’s affecting far more vaccinated people. Even with less severity, the sheer number of people being infected is driving the higher number of hospitalizations.

And while more vaccinated people are being infected by COVID, there’s still a big difference in outcomes between the vaxxed and the unvaxxed.

Omicron is sending a larger share of vaccinated people to the hospital that any previous COVID-19 variant, but unvaccinated people are still more likely to need critical care, according to Houston-area hospital officials.

Twenty-two of the 27 COVID patients in Harris Health System’s intensive care units are unvaccinated. At Houston Methodist, roughly 60 percent of the 80 COVID patients in the ICU are unvaccinated, and a high percentage of the remaining patients have underlying health conditions, said Dr. Faisal Masud, the hospital’s medical director of critical care.

It’s a similar story at St. Luke’s Health and Memorial Hermann Health System, both of which say 70 percent of ICU patients are unvaccinated.

“The vast majority of the people who are critically ill are either unvaccinated or have significant comorbidities,” said Dr. James McCarthy, chief physician executive at Memorial Hermann. “We are not seeing middle-aged, healthy, vaccinated individuals in the ICU like we did in the previous wave.”

[…]

Statewide, the number of patients in the ICU has been steadily rising since Christmas Eve, from 1,030 to 1,711 on Wednesday, according to the Texas Department of State Health Services. That’s about half of the patients in the ICU at the peak of the delta wave, but some Houston hospitals are already seeing ICU rates double over the last week.

The number of incoming ICU patients could exceed all previous peaks, said Dr. Esmaeil Porsa, president and CEO of Harris Health System. While the vaccines may not be as effective as they were initially, the current ICU population indicates that “they are still extremely effective against severe disease,” he said.

“More and more breakthrough infections are going to happen,” Porsa said. “We’re going to get a higher percentage of people who are vaccinated, but that number is never going to be a big number. It’s always going to be minority of people.”

Overall, doctors say omicron is not damaging the lungs as much as earlier strains. Fewer COVID patients in the Harris Health ICU require mechanical ventilation compared to delta, said Porsa, but other health issues like kidney and heart failure are becoming more common.

At Methodist, Masud has observed a similar pattern. A large portion of ICU patients Masud has treated ended up in the unit because the virus exacerbated an existing disease. The risk of facing such complications is higher for unvaccinated people, he said.

“This is eliciting an immune response, which is not only limited to lungs but which makes the patients sicker, with existing disease becoming much worse,” he said.

Masud said that now is a critical time to wear a well-fitted mask in public, especially for people who are not vaccinated.

It’s the same as before, in that the things you can do to mitigate your risk haven’t changed. Get vaxxed, and get your booster. Wear an N95 or KN95 mask when out with people. Avoid large indoor events and gatherings. Stay home if you’re not feeling well. This will pass, but how bad it gets before it passes is still up in the air. For more on the national picture, see TPM, Mother Jones, and Daily Kos.

Three comments about three vaccine mandate news stories

Item one:

A U.S. district judge in North Texas has blocked a mask mandate and vaccine requirement for staff and students in the Head Start program that was issued by President Joe Biden.

Head Start is a federal school readiness program for young kids in low-income families that is administered nationally by the federal Health and Human Services department, but run locally by nonprofits or schools. Biden previously ordered that staff running Head Start programs must be vaccinated and all students over the age of 2 had to wear masks. Texas Attorney General Ken Paxton and Lubbock ISD sued the Biden administration to stop enforcement of that order.

U.S. District Judge James Wesley Hendrix, a 2019 appointee of Republican President Donald Trump, ruled Friday that the Biden administration could not enforce its mask and vaccine mandates for the Head Start program in Texas, although the mandates would continue in other states.

Hendrix wrote that the process by which the Biden administration implemented the mask and vaccine rules was in violation of federal law because such rules could only be put in place through a detailed process or with the authorization of Congress. The order applies until the judge holds a trial and issues a final decision on the full merits of the case, or if it is lifted by a higher court.

Item two:

In the state’s latest push against federal vaccine mandates, Gov. Greg Abbott on Tuesday announced plans to sue the Biden administration for requiring Texas National Guard members to get vaccinated against COVID-19.

The suit would be the latest in what has been a slew of litigation against federal vaccine mandates that Texas has either brought forth or taken part in during the pandemic.

In a letter issued Tuesday to Maj. Gen. Tracy R. Norris, the adjutant general of the Texas National Guard, Abbott claimed authority to exempt Texas guard members from receiving the vaccine.

Item three:

A federal judge in Fort Worth granted an injunction Monday against the Department of Defense and the Biden Administration that temporarily halted the U.S. Navy’s COVID-19 vaccine mandate.

The mandate is challenged by a group of U.S. Navy SEALs and other Naval special warfare personnel who say the mandate violates their religious freedom and they have been denied religious exemptions from receiving the vaccine.

U.S. District Judge Reed O’Connor of the Northern District of Texas signed the injunction order after hearing testimony from several Navy SEALs in December as part of the group’s lawsuit. The suit is against President Joe Biden, the Department of Defense, the Secretary of Defense and the Secretary of the Navy Carlos Del Toro.

My comments:

1. It is impossible to overstate how much Greg Abbott and Ken Paxton are on the side of the COVID virus. They themselves are vaccinated, because they are not stupid and want to stay alive, but they absolutely do not care how many people die as a result of COVID. They see only political advantage in making the pandemic worse.

2. They will always be able to find Trumpy judges to plead their cases to, and will generally get favorable rulings from them as a result.

3. The only way to stop the state of Texas from filing these lawsuits is to elect a Democrat as Attorney General. Electing Beto O’Rourke as Governor would also help, as he would be less likely to impose pro-COVID executive orders.

Any questions?

Corbevax gets its approval

Kudos.

The Peoples Vaccine
Image courtesy of Texas Children’s Hospital

Texas Children’s Hospital and Baylor College of Medicine today announced Corbevax — a protein sub-unit COVID-19 vaccine — has received approval from the Drugs Controller General of India to launch in that nation.

The vaccine has been developed in Houston by Dr. Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Center for Vaccine Development at Texas Children’s Hospital and Dr. Maria Elena Bottazzi.

Hotez called the approval “an important first step in vaccinating the world and halting the pandemic.”

[…]

Bottazzi and Hotez led efforts at Texas Children’s Hospital to develop the “initial construct and production process of the vaccine antigen.” After the vaccine was found to be “safe, well tolerated and immunogenic,” the Drugs Controller General of India granted emergency use authorization.

Corbevax completed two Phase III clinical trials with more than 3,000 subjects. The trials suggested a better immune response to the Ancestral-Wuhan strain of the virus as well as the delta variant compared to Covishield, which was developed by Oxford-AstraZeneca. None of the subjects showed severe adverse reactions to the vaccine; and adverse effects in the study were half of those from Covishield.

See here for the background. Vaccine supply isn’t a problem in the US and Europe but it is a problem in many parts of the world. We know very well that the more opportunities this virus gets to spread and mutate, the more chances it has to turn into something worse and more dangerous. Hopefully Corbevax can help close that gap. Kudos to all involved. Here’s the Texas Children’s Hospital page about Corbevax and its development, and CultureMap has more.

Back to school, kids

It’ll probably be fine. And honestly, there’s no appetite for anything else.

Most of Texas’ roughly 1,200 school districts will welcome students and staff back within the next week, even as other states debate whether to mandate vaccines for teachers and staff or even return to remote learning. Almost 1 in 4 COVID tests in Texan are coming back positive for the virus, and hospitalizations have increased by 1,613 patients compared with a week ago. As of Dec. 28, 4,917 Texans were hospitalized for the coronavirus.

As of Wednesday, there were 220 Texans under the age of 18 hospitalized for COVID-19, according to data from the Texas Department of State Health Services. That number has been increasing since Christmas. Texas saw the highest number of people under the age of 18 hospitalized for COVID-19 in early September, when it was at 345.

The omicron variant has been surging across the United States. So far, it has generally been less severe and deadly than the earlier delta variant. However, the federal government recommends that all children 5 or older get the vaccine.

At Cook Children’s Health Care System in Tarrant County, positive cases among children have climbed sharply since Dec. 21 — going from a 5.7% positivity rate to 22.1%. “We are seeing upwards of 400 positive COVID-19 cases among children per day,” Dr. Mary Suzanne Whitworth said in a statement. “This is similar to where we were in early September when delta was spreading rapidly in our area.”

Despite those numbers, education leaders have largely urged a return to regular in-person instruction, with precautions in place.

Superintendent Millard House II of the Houston Independent School District, the state’s largest, announced Wednesday that it will maintain its mask mandate and will start to offer free COVID-19 testing for students and staff.

“We are looking forward to adding this layer of protection to our COVID-19 mitigation strategies,” House said in a statement. “We remain committed to keeping our students and staff safe and working toward implementing strategies that can help us continue offering safe and sustainable in-person instruction.”

In Austin, the school district will continue to require masks on campus and will offer testing to students and staff and vaccination clinics for anyone 5 and older.

In an email sent to Austin parents, district administrators said they were keeping schools open because they were confident that mitigation strategies were working and because vaccines are now widely available.

“Our layered protocols work! We have been here before. We can do this. Our kids need the schools to stay open,” Superintendent Stephanie Elizalde wrote in the email.

She added that the Austin ISD would continue social distancing, serving lunches outdoors and using its advanced air filtration system to slow the spread.

HISD’s mask mandate has been a big success, though it hasn’t really been tested by omicron yet. If people are properly wearing appropriate masks, they can protect themselves pretty well. Better ventilation and doing whatever possible outside is helpful. I’d feel a lot better if a whole lot more kids were getting vaccinated, but maybe getting them back into schools will nudge a few more in that direction. Some universities have pushed back the start of in person classes for their spring semester in favor of online learning, but I just don’t see that as viable for the independent school districts, at least not at this time. Mask, ventilate, vax, test, and isolate as needed, and we can get through this. I’m hoping for the best.

Got to keep an eye on the hospitalizations

They’re up, but for now we’re still in reasonably decent shape.

More than 1,200 people were hospitalized for COVID-19 in the Houston area on Monday, according to data released by the state Tuesday afternoon. The Department of State Health Services reported that 1,224 people were hospitalized for COVID-19 in the nine-county region around Houston.

The figure comes one day after the state reported topping 1,000 hospitalizations for the first time since October as the delta wave tapered off.

The hospitalization rate represents a 93 percent increase over last Monday, when DSHS recorded 636 COVID hospitalizations in the Houston area. The surge corresponds with the rapid spread of the highly-transmissible omicron variant, which first appeared in South Africa in late November, and has swelled to account for more than 90 percent of local cases in recent weeks.

Houston’s hospitalizations are still well below their delta peak, which reached 3,500 on Aug. 24. But less than a week after Houston  logged its 300,000th case of COVID, data from the Texas Medical Center shows that local transmission is increasing at a steady rate.

The current transmission rate is high – basically, on average everyone who gets the omicron variant will pass it on to another two people – and our vaccination rates remain pathetically mediocre. Harris County is better than the state overall, but not by much. There’s still a lot of room for this thing to find vulnerable people. Use rapid tests, isolate if you get a positive result, and wear good quality masks. We really can get through this if we’re not too dumb about it.

HISD will not lift its mask mandate

Seems like an easy call at this point.

The Houston Independent School District will maintain its mask mandate and offer free COVID testing at campuses for students and staff in 2022, Superintendent Millard House II announced last week.

House previously said the district would review the mandate after the holidays. The largest public school district in the state, HISD remains one of the few school systems regionally with a mask requirement.

“In light of the surge of COVID-19 cases in Houston and the surrounding areas, HISD continues to prioritize safety, including providing additional vaccination and COVID testing opportunities,” House said in an email to parents.

The ongoing spread of the omicron variant, which has proven capable of evading some immunity from vaccines, has triggered a steep surge in cases nationwide. The average number of daily cases has more than doubled since Nov. 29, from 80,680 to 201,330, according to the New York Times COVID data tracker. The numbers are also climbing in Texas, which reported 10,600 confirmed new cases last Thursday, the highest total since Oct. 6.

HISD data only shows confirmed cases up to Dec. 17. The district reported 143 positive cases on that day, up from 22 on Dec. 10.

Starting in January 2022, the district will offer free COVID-19 PCR tests on campuses to HISD students and staff. A one-time consent is required for testing and can be filled out at the following link https://bit.ly/HISDC19Test.

See here and here for some background, and here for a copy of Superintendent House’s email. It was reasonable, back in November when things were looking good and Harris County was lowering its threat level to consider whether the mask mandate was still needed after the holidays. For obvious reasons, things have changed since then, and it would be more than a little unwise to take other action. If omicron burns itself out quickly, if the kid vaccination rate skyrockets, the district can consider the question again later. For now, there was no other call to make.

And by the way, isn’t it nice how HISD called Greg Abbott and Ken Paxton’s bluff on their mask mandate ban and threats to sue over HISD’s totally correct action? That has paid off in spades, and brings with it the extra zest of knowing we beat them fair and square. A whole lot more districts should have followed this path.

We need to get more kids vaccinated

C’mon, y’all. Now is very much not the time to be hesitant.

Most Houston parents have not rushed out to inoculate their children against COVID-19, new data show, the latest indication that achieving widespread immunity among the young may be a faraway prospect, even as case counts explode across the region.

Overall, about 85 percent of 5- to 11-year-olds in the nine-county Houston area have not yet received a COVID vaccine, according to tallies compiled by Texas Children’s Hospital. The remaining 15 percent have had at least one dose, the lowest rate among any eligible age range.

The figures are far below what health officials hoped to see nearly two months ago when the shots became available. In promoting the shots, public officials — including First Lady Jill Biden, who visited Texas Children’s Hospital in November to plug the pediatric vaccine — have struggled to reach the broad swath of parents who remain reluctant to vaccinate their children.

Dr. James Versalovic, the hospital’s pathologist-in-chief, said he hopes the arrival of the highly contagious omicron variant gives hesitant parents a renewed sense of urgency.

The doses are tailored for children and have a “tremendous safety record,” he said.

[…]

It is unclear whether the low rate of childhood vaccinations means the region has reached a saturation point, or whether harried parents simply have not had time to vaccinate their little ones.

“There’s not one specific reason why some parents haven’t vaccinated their kids,” said Jermaine Monroe, co-chair of Texas Children’s COVID Task Force. “We are trying to meet people where they are to help parents overcome their concerns.”

I’m sure the holiday season is a contributing factor, though you’d think it would also be an incentive, and there would be more opportunities with people off work. I hope this picks up in January, we really need to do everything we can to resist omicron. In my particular bubble, it seemed like most of the folks I know with kids in that age range got them vaxxed as soon as they could, but those I know who haven’t done that yet aren’t posting about it on social media, so I don’t have a full picture. Just, please, let’s get this going.

Simply having a COVIDful Christmastime

Sorry not sorry.

Houston has surpassed 300,000 COVID-19 cases, just days after the highly contagious omicron variant leapfrogged delta to become the dominant viral strain circulating in the region and around the United States.

The staggering milestone reached Thursday, when the Houston Health Department reported 2,397 new cases for a cumulative total of 302,460, underscores the virus’s ability to evade all attempts at containment nearly two years into a global pandemic few predicted would be this persistent or deadly.

“Twenty-one months ago I never imagined our cases would get anywhere close to this big,” Houston’s Chief Medical Officer Dr. David Persse said. “If you had told me 300,000 I would have politely told you, ‘I think you’re crazy.”

Yet the easily transmitted omicron variant, first detected last month in South Africa, appears poised to sweep the Houston area and is already fueling outbreaks and scuttling holiday plans across the region.

The milestone is almost certainly an undercount, Persse said. Prevalence studies have found between 20 and 25 percent of Houston residents carry the antibodies that indicated a previous COVID infection. Accounting for those who contracted the virus but were never tested could put the city’s true COVID case count closer to half a million people.

“It’s a lot of suffering,” Persse said.

Extrapolating out to Harris County, that’s something like 1.2 million people who have had COVID, maybe a bit more. Obviously, for a lot of those people the consequences have been fairly small so far, but who knows what the longer term effect may be. And of course, we’re in the early stages of the omicron surge. So check back again later to see where these numbers go.

This says a lot, too.

As the omicron variant of COVID-19 threatens to fuel another surge of infections this winter, the state’s vaccination data shows demand for booster shots has outpaced the demand for first doses of the vaccine in the last few months — even as millions of Texans remain unvaccinated.

The average number of people getting boosters in Texas every day has surpassed those getting their first shots since late September, according to the state’s data. As of Dec. 21, the daily average of Texans who received their booster shots over the last week was about 52,000 — compared with the approximately 20,000 who received their first doses.

So far this month, at least 1.2 million Texans have gotten booster shots — nearly triple the number of people who received their first doses of the vaccine during the same time.

Meanwhile, the number of people getting their first shot of the vaccine over the last few months has remained far below people getting boosters, though the rate of first shots slightly increased in November and December.

[…]

Booster rates have gone up as the Food and Drug Administration has gradually authorized their use among different age groups. Adults 18 and older are allowed to get booster shots, and this month, the FDA authorized emergency use for 16- and 17-year-olds who had the Pfizer vaccine as their initial two-dose treatment, making them eligible to receive the same vaccine as a booster.

Meanwhile, the amount of people getting their first vaccine doses has waned in the last few months as vaccines have become more widely available and more people take the next steps in their vaccination regime. The state’s data shows a slight bump in first doses in November as Thanksgiving approached.

Even so, 10 million Texans remain unvaccinated.

And while there isn’t one specific reason why first-dose rates lag behind booster shots, Dr. Emily Briggs, who specializes in family medicine and has seen the split in the demand for the vaccine from a private practice in New Braunfels, largely credits ideology.

“We are at that point of anybody who believes in science acknowledges that we have had benefit from this vaccine. Those who are politically motivated or have been given fear and are focused on that fear are not vaccinated,” she said.

The people who have taken this pandemic seriously and have done what they can to minimize their risk and protect their communities are continuing to do so. The people who have not done so are still not doing so. Same as it ever was.

Same as it ever was.

As other states are mobilizing to respond to the rapidly spreading omicron variant, Gov. Greg Abbott is not budging on his hands-off approach to the coronavirus pandemic that was cemented months ago.

In March, Abbott ended the statewide mask mandate, marking the beginning of a sharp shift toward preaching “personal responsibility” and an outright rejection of any government mandate — whether state or local — to curb the pandemic. That philosophy carried the state through the delta variant this fall, even as hospitals were overrun and deaths climbed. Now as the state stares down the latest variant, Abbott remains unmoved, continuing to rule out any mask or vaccine mandates and business shutdowns.

“We’re moving forward with life as we know it,” Abbott said Tuesday in a radio interview when asked about omicron.

[…]

Asked Tuesday what the state is doing to address omicron, Abbott’s spokesperson Renae Eze said in a statement that the governor recently got a briefing on the state response to the variant by John Hellerstedt, the commissioner of the Department of State Health Services, and Nim Kidd, chief of the Texas Division of Emergency Management. Eze otherwise gave no indication the state was doing anything differently, saying it was continuing to respond to the pandemic by “setting up therapeutic infusion centers, ramping up COVID vaccination efforts, and providing surge staffing and medical equipment to hospitals and nursing homes.”

Eze ended by calling vaccination the “best defense” against COVID-19 and encouraging Texans to get immunized.

Even as Abbott’s office says it’s prioritizing vaccines as the best defense against COVID-19, the state’s vaccination rate lags nationally. As of Monday, 56% of Texans were fully vaccinated, placing Texas in the back half of the 50 states when ranked by vaccination rates.

Abbott got vaccinated on camera late last year and has encouraged Texans to get the shot. But he does not go out of his way to promote vaccinations and he has expended much more energy in recent months fighting vaccine requirements by local and federal officials.

Abbott has been virtually silent on the booster, which the U.S. Centers for Disease Control and Prevention said last month every qualifying adult should receive. The word “booster” has never appeared on Abbott’s personal Twitter account, and a spokesperson did not respond when asked whether the governor has received a booster.

I’m sure he has been boosted. Abbott is not an idiot. He’s a coward, but he’s not going to risk his own health and well-being. Same as it ever was.

Our year in COVID

It was bad. How it is next year is at least partially up to us.

Speaks for itself (Source: DSHS)

Texas recorded a 35 percent increase in COVID-19 deaths in 2021, compared to the first year of the pandemic, even though vaccines have been available for all adults since March.

The climbing toll, public health experts said, is almost entirely driven by people who are unvaccinated. From mid-January through October, just 8 percent of Texas virus deaths were among inoculated residents.

Memorial Hermann Chief Physician Dr. James McCarthy said it makes sense there would be more virus deaths in 2021, the first full year of the pandemic, though the highly transmissible delta variant coupled with a low vaccination rate and the decline of safe practices made fatalities worse than they otherwise would have been. And as the ultra-contagious omicron variant spreads rapidly in Houston, the pattern could continue.

“The real reason it’s worse this year is we stopped all the mask-wearing protection activities we had with a large portion of the population still unvaccinated and vulnerable to infection, hospitalization and death,” McCarthy said.

Texas this year had recorded 42,100 virus deaths through Dec. 13, according to data from the state health department, compared to 31,309 in 2020. The pandemic was declared in March 2020.

The share of fully vaccinated Texans is 56 percent, the 29th-highest rate in the country. Its large population means Texas has more unvaccinated residents — 12.8 million — than any state except California.

Four of the six deadliest months of the pandemic in Texas were in 2021. The most populous cities and counties have had the most virus deaths.

[…]

At this pace, Texas would not reach 70 percent until late May of 2022, the Centers For Disease Control and Prevention projects.

Harris County is outperforming the state average vaccine rate. Through Dec. 16, 59 percent of county residents were fully inoculated.

In other words, there’s still a lot of room for the next surge to rip through and infect, hospitalize, and kill unvaccinated people. Vaccinated people will also get sick, but they will be far less likely to get sick enough to be in danger.

We’re not going to get any help from the state government. The federal government is making more tests available and has ordered vaccine mandates, which really will do a lot to improve things, but of course our state leaders are fighting them as if they had stock in COVID itself. I don’t have anything original to say, but do go read the Department of State Health Services report that provided a lot of these numbers. And do what you need to do to protect yourself and your family.