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Our COVID failures and our economy

Remember when the goal was to get the economy going again?

The recent surge in COVID-19 cases is not only hitting the state in terms of lives lost, but it’s taking its toll on the Texas economy. That’s according to a new report from the Perryman Group, an economic research and analysis firm in Waco.

They estimate the state’s failure to contain the disease has led to nearly 72,000 job losses. The analysis also found on average, the state loses roughly $187,000 for every employee unable to return to work because of the pandemic. That amounts to total potential losses of about $13 billion per year, the firm found.

But they argue many of these potential losses are preventable.

“What we need to do right now is do everything we can to make it safer for people to return to work. That includes masks where appropriate. That includes safety in schools so people that have issues with their children in childcare and things like that that prevent people from returning to work,” said Ray Perryman, president and CEO of the Perryman Group. “These are what we call preventable [economic] losses.”

Perryman said certain industries are being hit harder than others.

“In terms of dollar impacts, obviously a worker in a tech industry per worker has a much bigger impact than say a worker in a restaurant. But from an industry perspective, the ones being hit the hardest are the ones you’ve been hearing about since the beginning of the pandemic that deal in interpersonal relationships – retail, particularly restaurants, salons, airlines,” he said.

He says getting more people vaccinated is also key to avoid future economic losses.

The full report is here if you want to read it, and there’s video of an interview with Perryman about this at the first link. Honestly, in the context of Texas’ economy, $13 billion is pretty small, as is 72,000 jobs. Not nothing, especially if you’re in one of the more affected sectors, but not so much that you’d notice it on a graph. The point that all of this was preventable, with more aggressive vaccination promotion and distribution, and a continued reliance on masks while allowing local governments to have the discretion they need to respond as they see fit, is still true. There’s no good reason why we have to be going through what we are going through now. It was all the result of Greg Abbott’s actions.

COVID and college football

We sure these sellout crowds are a good idea?

At Virginia Tech last Friday, the packed crowd bounced to “Enter Sandman.” At the University of Wisconsin the next day, fans jumped around to “Jump Around.”

College football and its crowd traditions are back to their full glory like they were in 2019, before Covid-19 restrictions sharply limited fan attendance in 2020.

Some of the country’s biggest powerhouses — including Georgia, Alabama, Ohio State and Oklahoma, to name a few — are hosting games to full capacity on Saturday. And fans who attend these games won’t have to prove their vaccination status, won’t be required to social distance and won’t have to wear masks in their seats.

The return of college football and its unique cultures, which began in earnest last week, are a source of communal bonding for sports fans, yet they also represent a source of anxiety for others.

[…]

Both the SEC and NCAA deferred to schools to make their own decisions — based on local and state requirements — when asked what each was doing to mitigate the spread of Covid-19 at football games. Both do have Covid-19 protocols for student-athletes.

“My ask of our fans is to try to take advantage of what science has done,” Greg Sankey, SEC commissioner, said last month.

Georgia’s plan to host such a large crowd comes as the state has fully vaccinated about half of its residents 12 and older, one of the 10 lowest vaccination rates among all states, according to the Centers for Disease Control and Prevention. Athens-Clarke County, where the Bulldogs play, has a “high” rate of Covid-19 community transmission, the CDC says.

Last week marked the full opening of the college football season, and stadiums across the country were packed with fans eager to rejoin the communal sports experience.

In Georgia, the Mercedes-Benz Stadium in Atlanta hosted nearly 72,000 fans for an Alabama-Miami game on Saturday and hosted about 31,000 fans for the Louisville-Ole Miss game on Monday. At both games, the stadium roof was open and masks were required in enclosed spaces but not in open-air areas, and there were no vaccine requirements.

A number of the universities that have packed fans into seats this season require students to be vaccinated, including at large Big Ten schools Michigan (109,000 in attendance), Maryland (44,000) and Illinois (41,000).

These schools are hardly breaking new ground by holding packed games. The National Basketball Association and Major League Baseball have similarly held full capacity events this summer, and the National Football League will do so when the season begins later this week.

This story was published Saturday morning, before this week’s games were played. Those other sports aren’t a great comparison because they have smaller crowds and their gamedays aren’t all-day party affairs. The SEC and some other conferences put an emphasis on getting players and coaches vaccinated, but getting fans vaccinated is not on their agenda. I can hardly blame them, because I can imagine the pushback they’d get if they tried. There’s evidence to suggest that limited-seating football games did not help spread COVID, but we are not doing limited seating any more – these are full stadia, with 80K to 100K people in attendance. Don’t be surprised if that has a negative effect.

Hospital systems have no excuse for not mandating COVID vaccines now

So get on with it already.

Local hospitals reacted Friday to President Joseph Biden’s sweeping vaccine mandates directed at the health care workers, who make up much of the Houston workforce.

In a move that overrides Gov. Greg Abbott’s executive order barring public institutions from issuing their own COVID-19 restrictions, the administration said it would require vaccinations for employees at health care facilities that accept Medicare and Medicaid reimbursement.

Baylor College of Medicine’s dean of clinical affairs, Dr. James McDeavitt, said Thursday he supported the new measures.

“It is the right thing to do,” he said.

Still, he wished the plan had come sooner. “It is not going to help us with the current delta surge,” he added.

[…]

Five Houston hospital systems already require a vaccine. In June, Houston Methodist became the first hospital in the nation to announce it would require its staff to be fully vaccinated, a move that met months of resistance, including a lawsuit by some employees. Memorial Hermann and Baylor College of Medicine enacted their own vaccine mandates in July; St. Luke’s Health and Texas Children’s Hospital announced similar plans in August.

Thursday’s executive order will bring similar mandates to the city’s remaining health systems.

Until now, Harris Health System and UTHealth had encouraged worker vaccinations but were unable to require it under the governor’s order.

But on Friday, Harris Health System said it “fully intends to embrace the vaccine mandate” for workers at its two hospitals, 18 community health centers and 10 clinics serving the greater Houston area. The system has not yet set a date.

UT Health said it would wait for guidance from the Centers for Medicare & Medicaid Service, expected in October. It had not instituted a mandate as of Friday afternoon.

St. Joseph Medical Center and UTMB Galveston said they are still evaluating Biden’s plan.

While Kelsey-Seybold Clinic said in August it was waiting for full vaccine approval from the U.S. Food and Drug Administration before asking employees to provide proof of immunization, the clinic has not announced a mandate since the Pfizer-BioNTech vaccine gained full U.S. Food and Drug Administration approval late last month.

See here for the background. I agree that the mandate coming out now will have little to no effect on the current surge, given that it takes a few weeks to get both shots and the full effect of them, and that it will take time for these hospital systems to get their programs going. It would still be nice if some of them had more of a sense of urgency about it. This is still by far the best thing we can do for the medium to longer term, and at the very least these hospital systems should be setting a better example. Get it done already, y’all. The Trib has more.

Now that’s a vaccine mandate

Good.

President Joe Biden on Thursday imposed stringent new vaccine rules on federal workers, large employers and health care staff in a sweeping attempt to contain the latest surge of Covid-19.

The new requirements could apply to as many as 100 million Americans — close to two-thirds of the American workforce — and amount to Biden’s strongest push yet to require vaccines for much of the country.

“We’ve been patient, but our patience is wearing thin, and your refusal has cost all of us,” Biden said, his tone hardening toward Americans who still refuse to receive a vaccine despite ample evidence of their safety and full approval of one — the Pfizer-BioNTech Covid-19 vaccine — from the US Food and Drug Administration.

He said vaccinated America was growing “frustrated” with the 80 million people who have not received shots and are fueling the spread of the virus. And he acknowledged the new steps would not provide a quick fix.

“While America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact: We’re in a tough stretch and it could last for awhile,” Biden said in an early evening speech from the White House.

At the center of Biden’s new plan is directing the Labor Department to require all businesses with 100 or more employees ensure their workers are either vaccinated or tested once a week, an expansive step the President took after consultation with administration health officials and lawyers. Companies could face thousands of dollars in fines per employee if they don’t comply.

Biden also signed an executive order requiring all government employees be vaccinated against Covid-19, with no option of being regularly tested to opt out. The President signed an accompanying order directing the same standard be applied to employees of contractors who do business with the federal government.

He also said 300,000 educators in federal Head Start programs must be vaccinated and called on governors to require vaccinations for schoolteachers and staff.

And Biden announced he would require the 17 million health care workers at facilities receiving funds from Medicare and Medicaid to be fully vaccinated, expanding the mandate to hospitals, home care facilities and dialysis centers around the country.

“We have the tools to combat the virus if we come together to use those tools,” Biden said at the outset of what was billed as a major speech to tackle the latest phase of the Covid-19 pandemic.

I mean, I’d have ordered the FAA to issue a vaccine mandate for getting on an airplane as well while I was at it, but maybe that’s still to come. To the extent that this is allowed, and based on a lot of public polling, this will move the needle significantly in the vaccination rates. Still won’t get us to 100%, but it will get us a lot closer. There will be wailing and gnashing of teeth and lawsuits – you can already hear Greg Abbott caterwauling – but it is going to have an effect. (And by the way, none of this would have been necessary if it hadn’t been for the likes of Greg Abbott.)

I have no idea what the legal status is of any of this. I’ve seen a few people I trust on Twitter suggest that the President has the authority to impose this kind of rule on large businesses in the name of public safety, especially via his emergency powers, but for sure there will be a broad array of opinion on that. Most of the rest of us are at most barely aware than it’s the Occupational Safety and Health Administration (OSHA) that will be doing the work on this, or that it will take some time for the rule to be developed. But as you can see, it has already had an effect:

The more you know…The Trib and the Chron have more.

Mayor Turner orders unvaxxed city employees to get tested twice a week

So maybe get vaccinated, and avoid all the hassle.

Mayor Sylvester Turner

Unvaccinated city workers must get tested for COVID-19 twice a month and report their results to the human resources department, Mayor Sylvester Turner announced Wednesday.

Turner signed an executive order implementing the policy,which takes effect Oct 8. It will allow some exemptions for religious and medical reasons.

The plans come as the city regularly has had more than 300 active cases of the virus among its workforce, Turner said. The latest numbers showed 342 workers with the virus, including 129 police, 161 municipal and 52 fire department employees.

Those cases hamper city operations, the mayor said.

“When you have 129 police officers with COVID, they’re not able to perform their jobs. Same thing with municipal workers, and, for example, permitting, that slows things down,” Turner said. “Simply don’t want them to get sick and don’t want anybody, anybody to die.”

[…]

The policy will apply to all police, fire and municipal staff who have not been fully vaccinated. It will not apply to elected officials or appointed members to the city’s boards and commissions.

The fire, police and municipal workers unions did not respond to requests for comment on Turner’s plan.

Turner said staff will face disciplinary action if they do not comply.

“It could even cost you your job,” the mayor said.

The mayor in recent weeks had teased a policy to encourage vaccinations, saying many city workers have not gotten their shots.

Mayor Turner implemented a mask mandate for city employees in early August. As far as I know, that executive order has not been involved in any of the lawsuits over mandates and Greg Abbott’s ban on them. This is a step up from that – it’s not a vaccine mandate per se, but it’s pretty close and I doubt Greg Abbott or Ken Paxton will split hairs. (They already have a reason to be whipped into a frenzy about this.) Whether or not cities can issue vaccine mandates is on the agenda for the next special session. What I’m saying is, I don’t know how long I expect this policy to last. And that’s before we hear of the inevitable resistance from the police and firefighter unions – police unions around the country have been staunch resisters of vaccine mandates, and we know how well the Mayor and the HPFFA get along. I support what the Mayor is doing here – if anything, I’d want to see the testing be more frequent – I just doubt he’ll be able to fully implement it. I’ll be happy to be proven wrong.

We really need a mask mandate at every school district

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

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

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

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

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

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

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

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

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

Thankfully, HISD is doing it right.

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

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

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

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

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

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

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

Special session 3.0

Yeah, we knew it was coming. Still too soon.

Gov. Greg Abbott on Tuesday announced a third special legislative session that will begin on Sept. 20 and tackle redistrictingrestrictions on transgender student athletes and the ongoing COVID-19 pandemic.

“The Texas Legislature now has the opportunity to redraw legislative and congressional districts in accordance with the new census numbers,” Abbott said in a statement. “In addition to redistricting, there are still issues remaining that are critical to building a stronger and brighter future for all Texans.”

Lawmakers, who will meet in Austin for the fourth time this year, will also be tasked with allocating $16 billion in federal COVID-19 relief funds and with deciding whether state or local governments can mandate COVID-19 vaccines. Abbott also included on his five-item agenda a bill that would ban the tethering of dogs outside with heavy chains, which he had vetoed earlier this year. Abbott asked lawmakers to address concerns he had about the specificity of the bill and “over-criminalization.”

The Legislature just wrapped its second overtime round on Thursday, delivering on major conservative priorities like an elections law that restricts how and when voters cast ballots, a ban on how teachers can talk about race and history in classroomsbillions of dollars in additional border security funding and further restricting abortion access.

But lawmakers failed to deliver on two issues pushed by the GOP base: requiring transgender student athletes to play on teams based on the gender assigned to them at or near birth, and banning COVID-19 mandates.

Abbott had asked lawmakers to ban mask mandates in schools during the second special session but lawmakers could not get that proposal over the hump. Now, Abbott is asking the Legislature to decide whether state or local governments can mandate COVID-19 vaccines.

The bills about transgender student athletes and COVID-19 mandates will likely turn up the heat on an already contentious 30-day session. Lawmakers will take up their decennial redrawing of the state’s political maps, meaning some legislators will be fighting for their political lives. (Redistricting usually takes place during the first legislative session after the census, but it was delayed this year because of setbacks spurred by the coronavirus and the Trump administration’s handling of the census data.)

Like I said, we knew it was coming. I don’t know if the lawsuit that was filed by two State Senators to stop legislative redistricting will be successful, but I have to assume there will be a ruling of some kind before this session gets underway. The continued assault on trans kids is sadly unsurprising; the lack of a fraudit item is at least temporarily hopeful. I mean look, none of us want another special session. I’m sure that wearing us all down is part of the plan. But here we are anyway. Oh, and Abbott et al will try to do a bit of cleanup on the so-called “heartbeat bill” since none of them know how to talk about the lack of a rape or incest exemption. So we have that to look forward to as well.

The contract health worker surge

Don’t know how sustainable this is.

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

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

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

[…]

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Readin’ and writin’ and gettin’ COVID

Welcome back to school, kids.

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

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

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

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

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

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

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

On a related note:

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

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

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

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

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

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

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

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

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

The financial incentive

At this point, whatever works.

A week after public health officials in Texas’ most populous county started handing out $100 cash cards to locals getting their first COVID-19 shot, the number of daily vaccinations has shot up to six times its previous rate, Harris County Judge Lina Hidalgo said Tuesday.

“We had an inkling that something was going right when I started my announcement [about the incentive] at noon, and by the time I was done, 30 minutes later, there was a line of cars waiting to receive the vaccine,” Hidalgo said. “We haven’t seen those lines for months.”

To accommodate and encourage the increased demand, the county will be opening an additional mass vaccination site and expanding its mobile vaccine program, Hidalgo said.

“You have to be creative, and we’re seeing the results and we’re doubling down on it,” Hidalgo said.

Harris County officials began the incentive program last Tuesday in a bid to jumpstart stalled vaccinations in Houston and surrounding areas, and to provide relief to the region’s stressed hospitals during what health officials say is the worst surge of infections the area has seen since the pandemic began last year.

For the three weeks before the program started, Hidalgo said, Harris County Public Health was administering an average of 431 first doses per day. The day the announcement was made, the number jumped to 914. The next day, 1,596 people sought the first doses from public health providers.

On Saturday, four days into the program, some 2,700 people got their first injection, Hidalgo said.

“This is an incredible achievement,” she said.

As the story notes, more vaccination sites are being opened to accommodate what I hope will be a sharp uptick in demand. The FDA approval of the Pfizer shot, and more companies telling their employees to get vaxxed may help push the numbers up as well. I honestly don’t care what the cause is, as long as it happens. And it needs to happen at a higher rate than this – even with the uptick statewide, we’re at less than 30% of the shots-per-day peak in April. Let’s get closer to that, and then we’ll really have something.

Greg Abbott remains COVID’s best friend

It’s hard to even know what to say.

Gov. Greg Abbott on Wednesday announced an executive order banning COVID-19 vaccine mandates regardless of a vaccine’s approval status with the U.S. Food and Drug Administration.

He also said he was adding the issue to the agenda for the current special session of the Texas Legislature.

The order comes two days after the FDA granted full approval to the Pfizer vaccine. That raised questions about the fate of a previous Abbott order that prohibited vaccine mandates, but only for those under emergency authorization.

Abbott’s latest order is simple, saying “no governmental entity can compel any individual to receive a COVID-19 vaccine.” The order preserves exceptions for places like nursing homes and state-supported living centers.

At the same time, Abbott asked lawmakers to consider legislation addressing whether state or local governments could issue vaccine mandates and, if so, which exemptions should apply.

“Vaccine requirements and exemptions have historically been determined by the legislature, and their involvement is particularly important to avoid a patchwork of vaccine mandates across Texas,” Abbott said in a statement.

[…]

There specifically appeared to be the fresh potential for cities, counties and school districts to require their employees to get vaccinated against COVID-19. San Antonio Independent School District had already announced mandatory employee vaccinations, prompting a lawsuit from Attorney General Ken Paxton.

District officials said Wednesday they will move forward with the mandate — despite Abbott’s latest order.

“We strongly believe that the safest path forward as a school district is for all staff to become vaccinated against COVID-19,” the district said in a statement.

See here for some background, and here for a copy of the order. As the story notes, this would prevent government entities from ordering their employees from getting COVID shots, though as you can see that’s already being challenged. Private employers are not affected by this, so if you work for one of the increasing number of them that are imposing COVID vax mandates, you’re out of luck. A bill passed during the regular session forbids businesses from requiring proof of vaccination from their customers, though that doesn’t take effect until September 1 so Harry Styles can still do what he wants.

I don’t think this is anywhere near the end of it. The same arguments being made about mask mandate bans – successfully, so far – by multiple counties and school districts is that the Disaster Act of 1975 doesn’t actually give Abbott this power. That would be equally true for vaccine mandate bans, I would think. That doesn’t mean the courts, by which I mostly mean the Supreme Court, will eventually accept that argument, just that these same entities will give it a try. The federal government will have a say as well, and let’s not forget the federal lawsuit, too. We’re also going to have an election next year, and we have the option of electing a Governor who wants to fight against the COVID virus instead of fighting for it. There’s a lot more of this story to be written. The Current and the Chron have more.

More teenagers are getting vaccinated

Good, but not enough in itself.

As a third COVID wave coincides with the back-to-school season, more Texas teenagers are getting the vaccine — but health experts say they need to see shots increase in even larger numbers to protect children from the delta variant.

Vaccinations have gone up recently among all Texas age groups, especially for those under 50, and they’ve more than doubled over the past six weeks for 12- to 17-year-olds.

In the last week of June, about 36,000 Texans under 18 got a shot — the lowest point to date — but that number shot up to 86,000 two weeks ago and remained there last week, according to new data from the state health department.

The jump is promising for public health experts, who stress that vaccines are the best way to avoid severe illness and slow the spread of the coronavirus. Still, youth vaccination rates are the lowest of all age groups in Texas, with just 49 percent of those under 18 getting at least one shot, compared to much higher rates for their elders.

“The percent of adolescents that are eligible for vaccination and have been vaccinated, certainly in Houston and in Texas, is still quite low,” said Dr. Stan Spinner, the vice president and chief medical officer for Texas Children’s Pediatrics and Texas Children’s Urgent Care in Houston. “Yes, the numbers are going up. That’s encouraging. But they’re not going up fast enough.”

About 46 percent of 12- to 15-year-olds, who have been eligible for the Pfizer vaccine since May, have received a shot. Roughly 55 percent of 16- and 17-year-olds have gotten the shot, according to the health department data.

Meanwhile, the number of pediatric COVID cases and hospitalizations has exploded — more than 500 children are currently hospitalized with the virus in Texas. Children account for about 20 percent of all positive COVID tests at Texas Medical Center, Spinner said.

“They are the major component of the population that’s vulnerable,” he said. “They have not been able to get vaccinated, and we know kids get it. We’re seeing it. It’s not a myth. We’re seeing it in larger numbers than ever.”

The increase in vaccinations is unequivocally good, I want to be clear about that. But there are still two concerns. One is that the rate of increase is not enough. About one-fourth of all Texans are under 18, which means in absolute terms between seven and eight million people. Not all of them are currently eligible for the vaccine, but at a rough guess it’s probably two to three million. Even at 100K shots a week, it’ll take us months and months to get to a sufficient level of immunization. We need to increase that 86K figure by a factor of at least five, maybe even ten.

And two, as we well know, while even the first shot conveys some extra level of protection from COVID from the get-go, it takes a month from the first shot to be really protected. We need to be doing more in the here and now to help mitigate the spread of this plague. We all know the drill – masking, avoiding indoor gatherings, social distancing – but as long as our malicious Governor and malignant Attorney General are doing everything in their power to prevent those things, we’re going to continue putting everyone in a maximal amount of jeopardy. We’ve already seen high infection rates in school districts that have been open, and several districts forced to close down in person instruction in the short term. We know what needs to be done. It’s Greg Abbott and Ken Paxton and Dan Patrick who want to stop us from doing them. We can’t let them put our kids, and ourselves, in such danger.

HISD starts its year

Good luck, kids. You too, parents.

For the second straight year, Houston ISD is set to welcome back nearly 200,000 students in the midst of a pandemic.

The similarities between last year and Monday’s reopening end there, however.

HISD entered the 2020-21 school year with COVID-19 infections and hospitalizations in Harris County on a downward slope. Nonetheless, the district began the year online and did not open its campuses until October. Nearly half its students finished the school year learning remotely even as case numbers had waned toward the end. Those who returned to campus remained masked up, socially distanced, and in some cases, behind plexiglass.

This year, the district is plunging right in, offering limited remote learning to vulnerable kids, requiring face masks but relaxing social distancing requirements while the number of COVID cases and hospitalizations are rising higher than ever, driven by the highly contagious delta variant and a lagging vaccination rate in Harris County.

Many of those cases involve young people, including some under 12 unable to be vaccinated. Eighteen percent of all the new cases in the Texas Medical Center this month have been children, President and CEO Bill McKeon said.

A look at COVID numbers in the surrounding districts, most of which have been open for less than two weeks, provides a glimpse into what the largest school district in the state could face when it opens its doors Monday.

A week and a half into the school year, Conroe ISD reported 1,487 students and 143 employees were isolated with symptomatic or test-positive COVID-19. Fort Bend ISD disclosed 536 total cases among students and staff. At Spring ISD, officials had 139 active student cases on the seventh day back.

On Friday, HISD had 157 active cases. The district finished last year with 2,037 total cases among students and another 1,600 among staff, according to state figures.

“We are really shoveling water out of the boat as we go because the cases are going up. The cases are jumping into the boat while we are shoveling them out of the boat,” HISD Superintendent Millard House II said of the region’s surge. “We are doing the best job we can, being as strategic as we can — keeping students and staff first in every decision that we make.”

It is what it is at this point. I forget where I saw it, but I came across the observation that HISD and other school districts were planning over the summer to emphasize making up for lost ground this year, and instead they’re having to deal with another form of the pandemic. The school year starts as the case rate is as high as it’s been since February, young kids still can’t be vaccinated, and the district is fighting to be able to enforce its mask mandate. I’m happy with the way Superintendent House has handled this so far, and I’m cautiously hopeful that we can get through the worst of this and be in a good place when we do. If you have schoolkids like I do, good luck and stay safe.

The approval and the mandates

As I’m sure you’ve heard by now, the FDA has given its final approval to the Pfizer vaccine for COVID-19. That should mean a lot of good things, but among them it should mean broader vaccine mandates are now in play.

The U.S. Food and Drug Administration’s full approval of the Pfizer vaccine Monday is cracking open the door for Texas cities, counties and school districts to compel their employees to get vaccinated against COVID-19 — moves previously blocked by Gov. Greg Abbott.

Abbott had banned public schools and local governments from enacting their own vaccine mandates. But the governor’s executive order specifies that the ban on mandates applies to COVID-19 vaccines that are under emergency authorization — a designation that no longer applies to the Pfizer two-dose vaccination.

Already, one major school district is pressing forward with its plan to require vaccinations for teachers and staff.

Pedro Martinez, superintendent for San Antonio Independent School District, called for mandatory employee vaccinations last week — drawing a lawsuit from Attorney General Ken Paxton, who accused the district and Martinez of breaching Abbott’s ban on vaccine mandates.

But with the FDA’s approval, San Antonio school officials are moving forward with their vaccine requirement for district employees.

In a statement, Martinez called the FDA approval “a positive step forward in the fight against COVID-19 nationwide and a step forward in helping keep schools safe for learning here at home.”

Here’s Superintendent Martinez on CNN discussing his fight against Greg Abbott over this. Most of the fights so far have been about mask mandates, but as we noted recently, San Antonio ISD has notified its employees that they must get vaccinated, which has drawn a lawsuit from Ken Paxton. Which, apparently, has been withdrawn now, as the executive order against vaccine mandates only covered “vaccines administered under an emergency use authorization”.

Here’s more from the Chron.

The Pfizer vaccine’s change in status appears to give cities, school districts and universities a way around the governor’s ban.

“Receiving a COVID-19 vaccine under an emergency use authorization is always voluntary in Texas and will never be mandated by the government, but it is strongly encouraged for those eligible to receive one,” Abbott’s most recent executive order reads.

A spokeswoman for Abbott did not immediately respond to a request for comment on Monday.

The update means San Antonio Independent School District, which was sued by the state after requiring its employees to get the shots by Oct. 15, is still moving forward with its mandate. The district had clarified late last week that it would not compel workers to get a vaccine that wasn’t fully approved by the FDA.

Attorney General Ken Paxton touted that as a win in a news release Monday, distributed less than an hour after the FDA granted full approval.

“State law could not be clearer: ‘No governmental entity can compel any individual to receive a COVID-19 vaccine administered under an emergency use authorization,’” Paxton said in the release. “But San Antonio ISD tried to play by its own set of rules. Thankfully, we stopped them.”

San Antonio school officials say the full authorization now allows the district to go ahead with its requirement that all employees get the shots by mid-October, they say. In his clarification statement last week, Superintendent Pedro Martinez had stipulated that the timeline would only change if the FDA hadn’t fully authorized the vaccine by Sept. 10.

Hey, if you want to declare victory while you’re surrendering and retreating, it’s fine by me. Just keep on surrendering and retreating, that’s all I ask.

The remaining questions are 1) What about Moderna and J&J; 2) What will other government entities do about this new ability; and 3) What about the mask mandates? In short,

1) “In May, Pfizer and BioNTech submitted their license application. Moderna began its application in June, and Johnson & Johnson said it will begin the process later this year.” As such, I’d assume the Moderna approval will come sometime in September or October, and J&J will be later than that. But most people have Pfizer or Moderna shots, so that’s the main thing.

2) My guess is they will move more slowly, but once the first domino falls I’d expect others to follow quickly. Note that this will be about mandates for local government employees, not residents. It’ll help, but it won’t apply to everyone.

3) Not the same thing, so we’re still waiting for the lawsuits to play out.

In the meantime, go tell all your vax-hesitant family, friends, neighbors, co-workers, acquaintances, and whoever else that now is the time for them to get their shots. It’s all officially approved, there’s no need to wait any longer.

The nursing home vaccination mandate

This just seems obvious to me.

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The mask rebellion

Sweet, sweet music to the ears.

The local mask rebellion, coupled with the fresh threat of legal action from President Joe Biden’s administration, poses the most serious challenge yet to [Gov. Greg] Abbott’s emergency powers, which he has wielded in unprecedented ways that have drawn intense criticism both from Democrats and from some conservatives.

[…]

Many school boards and superintendents are stuck between conflicting requirements from the governor and their local health departments, while others feel that masks are essential and that they have the authority to control their own schools, regardless of the governor’s wishes.

“I don’t think the governor has an MD next to his name,” said Conrado Garcia, superintendent of West Oso Independent School District in Corpus Christi. “We’re just trying to help our kids, and maybe what’s missing is some of that kind of thinking.”

West Oso is one of 58 school districts deemed “noncompliant” with Abbott’s order by Attorney General Ken Paxton, who is publishing a list of the rogue government entities.

At last count, the list also included three charter school groups, one city and eight counties — Bexar, Cameron, Dallas, Harris, Hays, Hidalgo, Nueces and Travis — for a total of 70 entities. Paxton, who is also suing to overturn some of the local mandates, encouraged the public to notify his office of any “violator” that was not included on the list.

Garcia said he hopes Abbott will come around on the local mask mandates.

“Our intention is not to fight the governor, our intentions are that he will realize that there’s so many parents, and the list is growing of the number of school districts that are passing more and more resolutions,” Garcia said. “So I think eventually, somewhere, somehow, common sense dictates to me that if you’re hearing from that many people, I hope that he will compromise and let us continue with our work.”

The cases pose a new legal test for Abbott, whose emergency orders withstood early challenges from the right, filed by conservative groups that argued against business closures and the governor’s own mask mandate.

The Texas Supreme Court decided last year that it didn’t have standing to take up those cases, though Justice John Devine nonetheless issued an opinion in which he critiqued a portion of state law that allows the governor to suspend certain laws and rules during emergencies.

“I find it difficult to square this statute, and the orders made under it, with the Texas Constitution,” Devine wrote, noting that only the Legislature — not the judiciary or executive branches — has constitutional power to suspend laws.

In the latest mask challenges, local officials are citing the same portion of state law, but with the opposite intent: to stop Abbott from blocking local action aimed at blunting the spread of COVID. In cases involving San Antonio’s and Dallas’ mask mandates, local officials have argued that Abbott may suspend only local orders that would “in any way prevent, hinder or delay necessary action in coping with a disaster.”

Ron Beal, an attorney and former administrative law professor at Baylor University, sided with the local officials in an amicus brief submitted to the state Supreme Court on Monday.

“It is wholly inconsistent with the legislative intent for the governor to consciously and knowingly not meet or prevent the dangers, but to enhance them,” Beal said. “There is simply no language in the statute that empowers the governor to give citizens permission to prolong the disaster. It is thereby void.”

[Dale Carpenter, a constitutional law professor at Southern Methodist University], said the case raises difficult constitutional questions for the conservative jurists on the court.

“That cuts a number of ways in this case, both for and against the governor, because he’s acting in a way that many conservatives believe is reinforcing individual rights to choice, choice about wearing masks specifically,” Carpenter said. “But I think the court certainly doesn’t want to issue an opinion that says the governor’s the commander-in-chief and he can do what he wants, and not qualify that opinion a lot.”

[…]

Paris ISD, in Northeast Texas, has taken a novel approach to its own mask mandate. While other districts have argued that health data or conflicting local requirements required them to ignore Abbott’s order, Paris ISD’s board simply amended its dress code to include a mask.

The lawyer for the district, Dennis Eichelbaum, argues that so long as the state’s education law remains in place, school districts have the exclusive right to govern themselves. Unless Abbott decides to use his emergency powers to suspend that law, Eichelbaum argues, school districts can institute mask mandates.

“We’ve always had dress codes. It’s very common in Texas. And this is no different, really, than saying we’re requiring our students to wear shoes,” he said. “I can’t explain why other law firms weren’t as creative, but it seems pretty simple to me.”

Eichelbaum argued that Abbott’s executive order is vague and inconsistently enforced, pointing to requirements that students wear face masks during welding class or that baseball catchers and football players wear face protection. Amending a dress code to include masks to protect against COVID is no different, Eichelbaum said.

Obviously, I am delighted by the resistance to Abbott’s shameful demagoguery on this issue. Abbott, who has made a career out of defying federal laws and directives he doesn’t like, deserves no sympathy for any of this. I don’t know what the Supreme Court will do, though their refusal to just call an end to all the litigation is moderately heartening, and I appreciate the legal analysis in this story. There’s at least a chance that common sense can prevail, and that’s more than we’ve had around here in awhile.

I will say, it’s been this kind of resistance to Abbott’s anti-mask mandate, which as noted has come from some red areas as well as the cities, that makes me give some credence to that Spectrum/Ipsos poll. Abbott may only care about the most fervid of Republican primary voters, but mayors and school boards have to answer to a broader electorate, and some of them will be facing that music this year. Maybe one of the HISD Trustee candidates, especially one in a district formerly held by a Republican, will base their campaign on an anti-mask platform, but if so I haven’t seen any evidence of it yet. If nothing else, this is a big campaign issue for next year, when we finally get a candidate for Governor out there.

Back to college, COVID-style

Not the return anyone was hoping for.

Texas A&M University’s new president M. Katherine Banks said this spring that she anticipated a “fall [semester] of joy” when the university reopens after 15 months of lockdowns and remote learning.

She wasn’t alone. As coronavirus case numbers dropped throughout the spring, higher education leaders across the state excitedly announced the return of in-person classes, 100% capacity at football games and an end to social distancing requirements for the fall.

But just a few weeks before students are expected to return to campus, university leaders are faced once again with uncertainty as the highly contagious delta variant of the coronavirus spreads throughout the state and country. This time, public university administrators are tasked with trying to mitigate the virus on campus without the ability to reinstitute mask mandates or require vaccines due to Gov. Greg Abbott’s executive order banning such directives. They’ll be limited in how they can respond even as the Centers for Disease Control has advised fully vaccinated people to wear masks indoors to prevent the spread of the virus and some students and faculty have expressed worry about how safe their return to campus will be.

“As the fall semester approaches, I have a feeling of déjà vu, albeit an unwelcome one,” wrote University of Texas at Austin President Jay Hartzell in a letter to the university community on July 30. “I recall last summer and winter, as we prepared to start semesters in the face of a COVID-19 virus that has an uncanny ability to time increasing threats to coincide with the academic calendar.”

While universities say they are monitoring the delta variant and whether they’ll need to pivot, many are moving ahead with previously decided reopening plans, including full football stadiums and in-person classes, while encouraging everyone to wear a mask and get vaccinated. Yet faculty and some students say they are increasingly worried about how they can effectively protect themselves and others on campuses where leaders can’t prevent unmasked or unvaccinated students and employees from entering and unknowingly spreading the virus.

[…]

Much of the frustration among faculty, staff and students is due to Abbott’s executive orders limiting masks and vaccine mandates. The faculty senate at A&M is scheduled to vote next week on a resolution calling on the state to allow universities to make their own decisions and “follow the science in their efforts to combat COVID-19.”

“There are heavy concerns when you think about the fact that institutions like A&M, the University of Texas … have a rich history based on the study of scientific principles,” said Dale Rice, speaker of the Texas A&M Faculty Senate. “And now they’re being constrained from following the science.”

Last week, a group of student leaders at UT-Austin slammed the governor for not allowing universities to make decisions on their own campuses, but also urged UT-Austin to do more.

“[I]t is also irresponsible for the University of Texas to plan for a full re-opening with little to no virtual classes available,” the letter from student leaders across various colleges read. “We have been made witness to the vast benefits of virtual learning for students, faculty, and staff who are disabled, have to work 2-3 jobs to keep up with the rising living costs in Austin, or have adapted to working or learning from home.”

For sure, the vast majority of people would prefer to be back on campus if that can be done safely, but as long as it cannot then remote learning for those who want or need it must be provided as well. Really, though, this is about vaccines and mandates. All of these campuses would be vastly safer if the overwhelming majority of people on them were vaccinated, and the only way to get there is to mandate it. You know, as they have done for decades for things like measles and whooping cough and meningitis. Legally speaking, there’s nothing to stop any campus from such a requirement, as past precedent and current judicial rulings demonstrate. The barrier is the threat that Abbott and the Republicans in the Legislature would zero out their funding.

(Note that I drafted this two weeks ago – there’s been too much damn news, y’all – and since then Rice University has announced that it will begin with virtual learning, though students are on campus.)

I can’t and don’t speak for any of these institutions. Some of them claim to be doing quite well on the vaccination front (we’ll see that in a minute), and good for them if so. But for any school that’s not well above the 80% mark – not just students, but faculty and staff and volunteers and contractors and pretty much everyone else who is regularly on campus – I’d be taking a hard look at our risks, both in terms of an outbreak and how likely the Lege actually is to follow through on a de-funding threat. Where is the bigger exposure? They all need to try to answer that question.

UTEP’s leaders said they feel they can reopen safely due to high vaccination rates in the surrounding community, citing in a note to the school community that more than 80% of El Paso residents 12 years or older have had at least one dose of the vaccine. The school has also ended testing for faculty and staff, encouraging them to use community testing centers, but will provide testing for students throughout the fall semester.

UTEP, along with some other Texas public and private universities, has asked students to voluntarily share their vaccine status.

Officials at UTEP estimated two-thirds of students and 90% of employees are fully vaccinated. Texas Tech University in Lubbock estimated about 75% of students and 90% of faculty are vaccinated, based on a voluntary spring survey. Baylor University said in a note that 47% of the campus community is vaccinated. Texas Christian University is also asking students to share their vaccine status ahead of the fall semester, but are not requiring vaccines and has said masks are “expected” but not required for unvaccinated students (NOTE: See update at the end).

[…]

Some private universities across the state have reacted to the increase in positive cases with stricter measures, though vaccines remain optional. On Tuesday, Rice University in Houston announced masks will be required indoors in group settings. Rice is also asking all students and employees to share their vaccination status. Those who are fully vaccinated must get tested every two weeks. Unvaccinated members coming to campus must test two times per week.

Trinity University in San Antonio is also requiring masks indoors and weekly tests for those who are unvaccinated. Baylor told students it will require weekly COVID-19 testing for the first part of the fall semester for students and employees, except for fully vaccinated students and students who have had a positive test within the last 180 days. St. Edward’s University in Austin initially said it would require a vaccine for all students, but later stated students could be exempt from that requirement under the governor’s executive order.

Emphasis mine. If you needed a reason to avoid Waco this fall, there you have it. There is definitely room here for colleges and universities, public and private, to at least put some of the costs of Delta on the unvaccinated. More frequent testing is an obvious one, but let’s not stop there. Require a vaccine or a positive test to attend sporting events, participate in intramural sports, attend any kind of public indoor event like lectures or movies or parties or concerts, eat in the cafeterias, and so on. Get vaxxed or stay distant, for your safety and everyone else’s, simple as that. That’s more likely to draw a lawsuit than a legislative response, but if so then there’s a decent chance you can get some people vaccinated before you’re forced to put the policy on hold, and maybe you won’t be forced to pause at all. See my earlier comment about evaluating risks and acting accordingly. Anything that results in more vaccinations should be strongly considered, even if it winds up being a short-term measure. Push that envelope, the long-term payoff is worth it. The Chron has more.

UPDATE: I received a message from TCU informing me that their policies have changed since that Trib story was published. They now require masks for indoor spaces. My thanks to them for the feedback.

Yes, the wastewater is also pointing to a COVID surge

In case you were wondering.

There is more COVID-19 in the city’s wastewater system now than at any time in the pandemic, city officials said Wednesday, the latest warning that the virus is spreading at an unprecedented rate.

Dr. David Persse, the city’s health authority, said there is more than three times as much virus in the system as there was last July. The volume also is higher than in January, during the most recent spike. Persse said that wastewater data, a precursor to other data points, show the surge will only grow worse in the coming weeks.

“We are at a level of virus in the wastewater that we have never seen before,” Persse said. “The wastewater predicts what we’ll see in the positivity (rate) by two weeks, which predicts what we’ll see in hospitalizations by about two weeks.”

[…]

The findings came during a news conference in which the city announced it will partner with Harris County and up to 17 school districts to vaccinate students over 12 and their families every Saturday in August, an effort they are calling “Super Saturday.” The inoculations will occur in school buildings throughout the region.

Persse described the state of the surge in stark terms, pointing to dire situations in area hospitals and rising cases and hospitalizations. The Lyndon B. Johnson Hospital declared an “internal disaster” Sunday night amid a nursing shortage and an influx of patients, circumstances officials said are occurring in other area hospitals, as well.

Texas Medical Center CEO Bill McKeon earlier this week said the region is “headed for dark times,” and the hospital system has exceeded its base intensive care capacity, opening unused wards to care for new patients.

“If you are currently unvaccinated, you need to consider that you represent a potential danger to yourself, and others, and most particularly your own family,” Persse said. “If you are not vaccinated… your chances getting through this without having to become either vaccinated or infected, is essentially zero.”

Just over 64 percent of Houstonians over 12 have received their first dose of the vaccine, according to city data, and 54.3 percent are fully vaccinated. The numbers among youth residents are more paltry, though: 28.1 percent of 12-17-year-old Houston residents are fully vaccinated, and 38.5 percent have received their first dose.

“If your child is 12 or older, stop and get them the shot,” said Houston ISD Superintendent Millard House II. “Increasing vaccination rates among our communities will help ease the worries of our families and their children returning to school.”

This is another one from earlier in the month, as things were really starting to get bad. We are familiar with this project, and it has been a big success. I just wish it had better news for us, but this is where we are. Getting more of those 12-and-older kids vaccinated would make a big difference as well, so I hope that effort is successful. We’re on our own, so we’d better act accordingly.

I don’t know what to make of these Spectrum/Ipsos polls about COVID and mask mandates

I’m going to present to you three Spectrum News stories about a poll they commissioned regarding COVID issues, and then I’m going to tell you what I think about them. (Spoiler alert: The post title more or less sums it up, but I will go into more detail.)

Spectrum News/Ipsos poll finds Texas parents want common-sense precautions against COVID in schools.

Most Texans are not aligned with Gov. Greg Abbott when it comes to mask mandates and requiring vaccinations for teachers, students and staff at schools, according to an exclusive Spectrum News/Ipsos poll released this week.

The poll, which comprised more than 1,300 people, including more than 400 parents of school-aged children, was intended to gauge the pulse of how Texans are feeling about state policies, specific politicians and a few hot-button issues.

Generally speaking, the survey suggests, parents’ attitudes toward how the state is handling various issues related to education and schools are all over the place, said Mallory Newall, vice president of public affairs for Ipsos, a French-based analytics company. For example, about two-thirds of parents said they feel their child would be safe returning to school, yet two-thirds also fear their child will catch COVID-19.

“On one hand, a majority of parents are confident that their child will be able to make up lost ground [from missed time],” she said. “They feel that their child would be safe attending school, but there is this concern in the back of their mind about them catching COVID at school.

“So, I would say that in all of that together, parents’ concern isn’t necessarily outweighing their desire for their kids to return to in-person schools,” she continued. “However, most parents want to see common-sense policies in place to protect their kids and to keep them safe. And for those that want them, they feel that virtual options should still be made available.”

[…]

The Spectrum News/Ipsos poll showed Texans generally disapprove of Abbott’s handling of COVID-19, and when it comes to certain proposals around COVID-19 and back to school, the public is also misaligned with the governor. For example, only 17% of all Texans, and 22% of parents with a school-aged child, believe students who test positive for COVID-19 should not have to quarantine. In another example of Texans disagreeing with Abbott’s orders, nine in 10 believe schools should be required to notify parents if a child or teacher tests positive — regardless of whether it’s in their classroom (92% support) or in the school as a whole (89% support).

Around half of the people surveyed said they are worried about their children’s mental health (49%), and roughly the same number said their children suffered during the pandemic (47%).

Also, breaking with the governor’s actions, the poll showed broad support for requiring vaccines for teachers and students and providing virtual learning in schools. Support for these proposals is significantly different by party. Though there is low support among Republicans, significant majorities of Democrats and independents favor these policies, leading to overall high levels of support.

Spectrum News/Ipsos poll finds COVID is a major factor in back-to-school concerns.

Parents feel safe allowing their children to return to in-school learning, but, at the same time, most fear their child will catch COVID-19. This seemingly contradictory revelation is part of an exclusive Spectrum News/Ipsos poll released this week.

As the debate about how to handle getting children safely back to school continues nationwide, Ipsos, a global research insight and analytics company, gathered data on this and other current news topics from more than 1,300 Texans, including more than 400 parents of school-aged children.

The poll found that two-thirds of parents (64%) said they feel their child would be safe returning to school, yet two-thirds (66%) also fear their child will catch COVID-19.

The poll revealed that Texans’ feelings toward COVID-19 don’t generally align with Gov. Greg Abbott’s orders, but they are still supportive of classrooms being open — for those who want it.

[…]

Around half of parents, 49%, approve of Abbott’s plans for sending children back to school, and parents do not differ from the general public on this (47% of parents with kids 4-17 approve). Notably, just 39% of Texans agree that policymakers in the state are making decisions about COVID-19 that are based on science. Republican parents are the only demographic group in the survey in which a majority agree with this statement.

The survey found about half of Texas parents say they are worried about their child right now (49%), that their mental health has suffered during the pandemic (47%), and that they do not/would not have enough time to help with remote learning (49%).

Spectrum News/Ipsos Poll finds Texans are leery of policymakers when it comes to COVID.

As Texans are left to fend for themselves against COVID, Abbott’s popularity has taken a hit. The Spectrum News/Ipsos Poll found that only 46% of Texans approve of the job he’s doing overall, compared to just over half last year. Most (53%) disapprove.

Overwhelmingly, the pandemic is the issue most Texans are focused on, the poll found, and it’s also the issue Abbott is doing worst on. Now, just 43% approve of the job he’s doing on COVID-19, compared to 49-58% for other issues in the survey. Last year, his approval rating on the coronavirus was more evenly split (48% approved, 43% disapproved in 2020).

The only person Texans trust less than Abbott on COVID is former president Donald Trump. Exactly half, on the other hand, trust President Joe Biden to provide them accurate information on COVID-19.

One demographic that appears to struggle with Abbott’s decisions related to COVID is parents, who are left to grapple with the prospect of sending their children back to schools that offer little state-mandated protection against the deadly virus.

The Spectrum News/Ipsos Poll found 72% of parents support mask requirements in K-12 schools. The data showed significant differences of opinion by race, ethnicity and political party. However, even half or more Republicans support mask requirements in offices, grocery and retail stores, transit hubs and sports stadiums.

When it comes to certain proposals around COVID-19 and back to school, the public is once again misaligned with the governor. For example, just 17% of all Texans, and 22% of parents with a school-aged child, support the following proposal: “Students who test positive for COVID-19 should not have to quarantine.” On the other hand, nine in 10 believe schools should be required to notify parents if a child or teacher tests positive — regardless of whether it’s in their classroom (92% support) or in the school as a whole (89% support).

There is broad support for requiring vaccines for teachers and students alike. Support for these proposals is significantly different by political party. Though there is low support among Republicans, significant majorities of Democrats and independents favor these policies, leading to overall high levels of support.

I found the first link via Reform Austin. The other two I found via Google search, though as you can see there’s some overlap among them.

This is normally where I would link to the poll data, and that is my first and biggest problem with this: I can’t find any link to poll data, in any of these stories. That means I know nothing about the sample used – it seems clear this is a poll of all adults, but it doesn’t say how many are registered to vote, and of course there’s no breakdown by age, race and ethnicity, gender, partisanship, etc – or whether it was a phone or online poll or a hybrid, or what the question wording was, etc etc etc.

Note how inexact some of the data points cited in the stories are – “significant majorities of Democrats and independents favor these policies”, “even half or more Republicans support mask requirements”, “he only person Texans trust less than Abbott on COVID is former president Donald Trump”, and so on. What does any of that mean? How wide are the partisan splits? Especially for the approval questions, the partisan makeup of the sample, and how they voted in 2020 – and how many of them didn’t vote in 2020 – is a big deal. All I have here is vague gestures.

I mean, none of these results strike me as outlandish. The national polling data we have (see here for an example, and I just now noticed that’s also an Ipsos poll, released at the same time as this poll, which makes me wonder) suggests that Abbott’s extreme stances are out of line with what normal people think, and I can believe/absolutely want to believe that his approval rating has dipped as a result. But you know the mantra: It’s just one poll, and it has no data that I can parse. I can only go so far with that.

If we’re lucky, this means that there’s about to be some more polling to come. It’s been a couple of months since the last round of polls, and so maybe the usual suspects will be out in the field soon. Lord knows, there’s plenty for them to ask about. I’ll be keeping an eye out as always.

A few words from the CEO of the Medical Center

From an interview he did with Lisa Gray.

What we’re seeing, sadly, is more of the same, only with more intense numbers. The number of people who are testing positive in our community continues to escalate month over month. The test positivity rate is now at 15.1 percent.

But probably the most accurate reflection is our hospitalizations. We just reached an all-time high: 421 people were admitted to our hospitals for COVID yesterday.

Step back for a second and look at that relative to the entire pandemic. Back in June and July, we had two weeks where the average number of hospital admissions was over 300. That was in the second wave.

Fast forward to wave three: We had four weeks that averaged over 300.

Now we are into our second week with no slowing the pace. At 421 today, we are seeing the highest peak of all of the pandemic going back 18 months now.

It’s largely a pandemic of the unwilling — people unwilling to be vaccinated. Now 44% of Houstonians are unvaccinated. Those are the vast majority of the people that are showing up in our emergency rooms and and in our ICUs. They’re very sick.

Many people thought that they were young, and therefore their immune system would be strong enough to protect them. That is not the case with this deadly delta variant, which is three times more transmissible than the earlier alpha variant.

Our hospitals’ staffs are 18 months into this. They’re exhausted.

And we have far fewer nurses than we used to have. They’re being recruited to other states, like Florida, that are even worse off than Texas.

The saddest fact is, 18 percent of all the new cases so far in August are children.

With the alpha variant, everyone thought, “OK, it’s 65 and older.” So we went after the nursing homes, and we did a brilliant job at protecting the elderly population and those who are immunocompromised.

But now, that vulnerable population is children under 12, who are not able to be vaccinated. We are predicting a mess in our schools. With nearly 20 percent of new cases being children, now we’re going to huddle them together in schools? Some may have masks. Some may not. It’s a recipe for disaster.

You can read the rest or give it a listen, but his answer to the first question tells you most of what you need to know. Hospitals around the state have been facing a similar crisis. I keep harping on this because it needs to be harped on, as we have a governor who can’t follow his own dictum about “responsible behavior”, a felonious Attorney General who’s soliciting snitches so he can go after rogue mask mandates, and a Legislature that wants to ban mask mandates forever. This is what we’re up against.

I don’t know if I’d call this “good news”, but the projections say we can see the beginning of the end from here.

While hospitalization numbers are nearing the heights they reached during the state’s most fatal surge in January, public health projections indicate that the latest wave will result in fewer deaths — mostly because senior citizens are widely vaccinated and hospital patients are now much younger. Still, state health officials are preparing for the worst, preemptively ordering a fleet of five mortuary trailers from the federal government in case infections spiral.

Public health experts still expect at least some increase in coronavirus deaths over the coming weeks, as fatalities are a lagging indicator — cases rise first, then hospitalizations, then intensive care usage, then deaths.

Now, the state is averaging about 100 daily deaths, a number not expected to exceed 150 over the next month before tapering off. That’s nowhere near the 350 COVID deaths per day that the state saw in January.

“We’ll go up some, but again, not to the levels that we saw back in January,” said Dr. David Lakey, the vice chancellor for health affairs and chief medical officer at the University of Texas system, referencing the forecasts.

Still, the precipitous rise in hospitalizations is a cause for concern. More than 12,000 Texans were in the hospital with the virus on Wednesday, with dozens of Texas hospitals running out of ICU beds (during the winter surge, hospitalizations peaked at just over 14,000). Patients are younger than they were in the first two waves of the virus, and almost everyone facing severe illness is unvaccinated.

[…]

Projection models following Texas’ daily COVID case and hospitalization counts anticipate a rise in deaths in the near future. By mid-September, a model offered by the U.S. Centers for Disease Control and Prevention estimates that the Lone Star State will see about 790 deaths per week, or roughly 113 per day.

Another model, produced by researchers at the Institute for Health Metrics and Evaluation at the University of Washington, projects about 125 deaths per day by mid-September in a worst-case scenario. In both forecasts, it appears that the state has already seen the brunt of its COVID deaths.

That’s largely because the vast majority of Texas’ over-65 population — those most vulnerable to the coronavirus — have received at least one dose of the vaccine, experts said.

“Those that were most at risk of having severe disease have some protection, and that’s good protection because of the vaccine,” Lakey said.

While a spike in hospitalizations and ICU bed usage does portend fatalities, the relationship between those data points will be less “linear” during the third wave, he said. It remains to be seen whether young patients will have other, long-term side effects of the virus — what some are calling “long COVID.”

Deaths will also decrease as more people become vaccinated or recover from the illness, said Dr. Ali Mokdad, a professor of health metric science at the University of Washington’s Institute for Health Metrics and Evaluation. The institute’s researchers estimate that about 74 percent of Texans will be immune to the delta variant, either through infection or vaccination, by Dec. 1.

“The virus is running out of people to infect,” he said.

The forecasts should not be interpreted as an assured outcome, though. Public buy-in on safety precautions, including mask-wearing, will ultimately determine the trajectory of the third wave.

In other words, don’t expect a best-case outcome, because we’re not allowed to do the things we need to do to make this less awful. Note also that while extensive vaccinations among older folks will help to limit fatalities, there will still be an excess of deaths in the coming weeks because of the overfilled hospitals – people with other serious conditions will die as a result, as was the case in the previous waves. Now is a very bad time to have a heart attack or be in a car crash.

At least there is a rise in the rate of people getting vaccinated, now that the threat is so much higher. Some of that is the result of mandates and restrictions on unvaccinated people, some is due to pressures and enticements from employers, and some is due to straight up financial rewards. Whatever it takes, whatever it takes.

SCOTx demurs

Very interesting:

This was for the Harris County litigation, which included Austin and several South Texas school districts. As such, Harris County’s mask mandate is still in effect. This is a procedural ruling, just telling Ken Paxton he needs to follow the law and go through the appellate courts first, and as such it buys some time. Given how accommodating SCOTx has generally been, it’s nice that they’re not fast-tracking any of this. I doubt it makes much difference in the end, but it matters now.

By the way, if you heard that Greg Abbott was dropping enforcement of school mask mandate bans, that simply isn’t so. Abbott and Paxton can go via the appellate courts as before and as they should have here, and the case will eventually make its way back to SCOTx, where they will likely give the state what it wants. Everything is temporary and in a state of flux right now.

Speaking of the appellate courts:

After Gov. Greg Abbott appealed a temporary order that allowed for mask mandates in schools and city- and county-owned buildings, the 4th Court of Appeals ruled Thursday that the order still stands.

On Monday, Judge Antonia “Toni” Arteaga of the 57th Civil District Court granted San Antonio and Bexar County a temporary injunction, allowing the mask mandates in city- and county-owned buildings and in schools to continue until a trial is held. The city and county sued the governor earlier this month over the ability to issue mask mandates.

Texas Attorney General Ken Paxton appealed the district court’s ruling on behalf of Abbott, arguing that his appeal automatically blocked the San Antonio and Bexar County mask mandate. While city attorneys disagreed, they still asked the 4th Court of Appeals on Tuesday to officially uphold the temporary injunction.

In an order issued Thursday, the 4th Court of Appeals reasoned that allowing local governments to have policies to protect public health maintained the status quo, while Abbott actually changed it with his July executive order prohibiting governmental entities from mandating masks.

The court also cited testimony given during the Monday hearing from Dr. Junda Woo, the medical director of the San Antonio Metropolitan Health District, and San Antonio City Manager Erik Walsh. Both said that requiring masks will help slow the spread of the delta variant, which is much more transmissible than previous coronavirus strains. They also pointed to the vulnerability of schoolchildren under the age of 12 who are not yet eligible for the coronavirus vaccine.

“Based on the temporary injunction order and the evidence attached to the emergency motion, the City and County have demonstrated that reinstating the trial court’s temporary injunction is necessary to prevent irreparable harm and preserve their rights during the pendency of this accelerated appeal,” the appellate judges wrote. “The circumstances of this case are unique and, quite frankly, unprecedented.”

See here for the background. This ruling means that the Bexar County mandate can remain in place until the hearing for the temporary injunction, which will be December 13. Except, of course, that Abbott and Paxton can appeal this ruling to SCOTx, and having gone through the proper channels this time, the same reason to reject the other TRO will not be in effect. Expect this to get a ruling from SCOTx in the next couple of days.

In the meantime:

A Fort Bend County district judge on Thursday granted the county’s application for a temporary injunction, siding with local officials in their fight against Gov. Greg Abbott’s ban on mask mandates.

Judge J. Christian Becerra of the 434th District Court approved the county’s application for the temporary injunction following a day’s worth of testimony in his courtroom.

The Fort Bend County public health director and a local hospital administrator testified to the healthcare emergency currently facing the Southeast Texas region. Both said they believe mask mandates would help mitigate the spread.

Fort Bend ISD had not gone along with implementing a mask mandate initially. This may change that, we’ll see. This was a late-breaking story, there will be more details to come.

And finally, just to show that you can’t keep Ken Paxton down:

Texas Attorney General Ken Paxton sued the San Antonio Independent School District Thursday after its superintendent said he’ll require all staff to get vaccinated against COVID-19 before an October 15 deadline.

The suit, filed in Bexar County District Court and shared by Courthouse News Service, argues that a July 29 order by Gov. Greg Abbott bars any public entity in the state from mandating that people take the vaccine. That order supersedes SAISD’s ability to require inoculations of its staff, the state claims.

“Defendants challenge the policy choices made by the state’s commander in chief during times of disaster,” according to the petition.

SAISD is believed to be the first large Texas school district to make vaccines mandatory. Superintendent Pedro Martinez’s demand comes during a statewide surge of COVID-19 cases as children too young to be vaccinated head back for a new school year.

“For us, it is about safety and stability in our classrooms,” Martinez told the Express-News this week. “We cannot afford to have threats to those two goals.”

Martinez also told the daily that the legal implications of his order weren’t a consideration.

A mask mandate is one thing, a vaccine mandate is another, at least in terms of waving a red flag in front of Abbott and Paxton. I expect Paxton to prevail, though we’ll see if he gets his restraining order from the district court judge or if he has to go up the ladder.

UPDATE: Here’s the Trib story about that SCOTx refusal to put a stay on the Travis County judge’s rulings, and here’s the Chron story. There’s so much damn news these days I just go with what’s in front of me when I’m ready to start writing, and circle back as needed.

Abbott tests positive for COVID

I’m going to be succinct about this.

Gov. Greg Abbott tested positive Tuesday for COVID-19, according to his office.

Abbott, who is fully vaccinated, is not experiencing any symptoms and is isolating at the Governor’s Mansion, spokesperson Mark Miner said in a statement. He is getting Regeneron’s monoclonal antibody treatment.

Public health officials have noted that while breakthrough cases like Abbott’s are occurring, vaccines are still proven to be effective at reducing the severity of the virus.

“The Governor has been testing daily, and today was the first positive test result,” Miner said. “Governor Abbott is in constant communication with his staff, agency heads, and government officials to ensure that state government continues to operate smoothly and efficiently.”

Miner added that “everyone that the Governor has been in close contact with today” has been informed of his positive test. The first lady, Cecilia Abbott, tested negative.

Abbott addressed the diagnosis in a video posted to his Twitter account about two and a half hours after his office’s announcement. He reiterated he was not feeling any symptoms and suggested one reason for that may be the fact he is vaccinated. Abbott got his first shot late last year, and the vaccine is known to prevent serious cases.

[…]

Abbott has kept up public appearances in recent days. He spoke Monday night at what he called a “standing room only event” in Collin County, later tweeting photos of him addressing a maskless crowd. His campaign tweeted video of him mingling with the crowd, taking photos.

The Collin County event was organized by the Heritage Ranch Republican Club. Neither the club nor Abbott’s office immediately responded to requests for comment on the event.

Less than three hours before his diagnosis was announced Tuesday afternoon, Abbott tweeted pictures of a meeting with guitarist Jimmie Vaughan. The musician’s team said in a statement Tuesday evening that “Jimmie and family have tested negative and are doing fine.”

I don’t want anyone to get COVID. I don’t want anyone to die from COVID. I hope Greg Abbott recovers fully from his bout with COVID. I hope every maskless person at that packed event has the sense to quarantine and get themselves tested so they don’t get COVID and especially so they don’t give it to anybody else. And I never, ever want to hear anyone talk about how “personal responsibility” is what we need to beat COVID.

Fired Methodist employees file another lawsuit

In state court this time, in what should be one of the friendliest venues available to them.

A new lawsuit filed Monday in Montgomery County against Houston Methodist claims the hospital wrongfully terminated 62 employees over their COVID-19 vaccine requirement.

The suit, filed by attorney Jared Woodfill, alleges the hospital’s COVID vaccine mandate goes against Gov. Greg Abbott’s statement that the government can’t mandate vaccine passports in Texas, that breakthrough infections pose a problem with the current COVID-19 vaccines available and that there was no exception for people who have not been vaccinated because they previously caught COVID-19 as a result of their employment.

In June, a federal judge tossed a lawsuit filed against Houston Methodist Hospital over its COVID-19 vaccine requirement, finding that the mandate “was not coercion.”

Houston Methodist became the first hospital in the nation to require a COVID-19 vaccine as a condition of employment. The health system’s human resources policy required employees to be fully vaccinated by June 7, or risk suspension and eventual termination.

[…]

Woodfill, the former Harris County GOP chairman who is representing the 62 plaintiffs, noted in an interview that Abbott has repeatedly said vaccines will not be mandated by the state.

Specifically, he noted Abbott’s most recent order, in which the governor said Texans “have the individual right and responsibility to decide for themselves and their children whether they will wear masks, open their businesses and engage in leisure activities.”

Woodfill said Abbott’s order “articulates or identifies a public policy for the state of Texas, that you can’t just force people to comply with.”

In the first lawsuit filed against Houston Methodist, Woodfill and more than 100 plaintiffs argued the vaccine requirement was unlawful. The complaint likened the vaccine requirement to a violation of the Nuremberg Code, the set of medical ethics created following World War II in response to Nazi atrocities.

U.S. District Judge Lynn Hughes called the comparison “reprehensible” in his June ruling tossing the lawsuit. Woodfill and the plaintiffs have appealed the ruling.

More than 170 employees at Houston Methodist were fired after not receiving the COVID-19 vaccine by the June deadline, according to the hospital.

Houston Methodist CEO Marc Boom said Monday he was “not surprised” by the complaint.

“It just seems to completely rehash the other lawsuit, which was very clearly and definitively overturned and dismissed by Judge Hughes,” Boom said. “We would expect the same thing in this case.”

See here, here, and here for some background on the federal lawsuit. While Montgomery County is likely to be as pro-COVID a location as Jared Woodfill could find for this nonsense, the fact remains that Texas is a strongly pro-employer state, and that will be a high hurdle to overcome. As the story notes, multiple other hospital systems including (finally) Texas Children’s and St. Luke’s have initiated similar mandates, so there doesn’t seem to be any fear of the legal risk on their part. I expect this will get swatted back, but with Montgomery County you can never be too sure. We’ll keep an eye on it.

Abbott’s migrant roundup order still blocked

Good.

A federal judge in El Paso on Friday extended her order blocking Gov. Greg Abbott’s directive to state troopers to pull over drivers transporting migrants “who pose a risk of carrying COVID-19.”

U.S. District Judge Kathleen Cardone lengthened her restraining order by another two weeks after a hearing Friday, according to a court filing. Her original order on Aug. 3 was set to expire Friday.

In July, Abbott ordered state troopers to pull over civilian drivers giving rides to recent immigrants who may be infected with the virus and redirect the drivers to their origin point. If the driver didn’t comply, the troopers should seize their vehicles, the order said.

Soon after, the U.S. Department of Justice sued Texas and Abbott, describing the governor’s executive order as “dangerous and unlawful.”

In the lawsuit, the DOJ said Abbott’s order would disrupt federal immigration officials’ network of contractors and nongovernmental organizations that help host recently arrived migrants while their legal cases are pending.

See here and here for background on the suit filed by the Justice Department. There’s also now another lawsuit filed by the ACLU on behalf of several groups; as far as I know there has not yet been a hearing for that. In keeping with my earlier posts, I don’t know how this is likely to play out, but as a rule any time Greg Abbott and Ken Paxton lose in court, it’s probably a good thing.

It’s a bad time to go to a rural hospital

Only gonna get worse, too, at least in the short term.

For the past week, Brooke Hale has been told “no” about 80 times a day. The executive assistant at Altus Lumberton Hospital has spent her shifts on the phone in a windowless office, repeatedly asking other facilities within an 800-mile radius the same question: Can you take one of our critical COVID-19 patients?

On Thursday, there were three. They needed intensive care, and without it they could die. Hale tried hospitals in Texarkana and Tyler, Lubbock and Lufkin, Oklahoma, Louisiana and Mississippi. None had room.

“I feel helpless,” Hale said through her green N95 mask. “I feel like I can’t help patients like I need to.”

The same scene is being repeated throughout Southeast Texas, as rural hospitals and freestanding emergency rooms are scrambling to send critical patients to other regions and states because Houston medical centers, full with COVID-19 patients, refuse to accept transfers.

For small facilities, what once was a routine transport to local hospitals has become a frantic process of cold calling and cajoling health care providers in hopes of securing an open bed. In the meantime, patients who must receive intensive care languish in places that are unable to provide it.

By Thursday afternoon, 543 patients in the 25-county hospital region anchored by Houston were waiting for staffed hospital beds, according to the SouthEast Texas Regional Advisory Council; 62 more waited to be admitted to an ICU. The gridlock also extends to ambulance crews, who wait longer outside of crowded ERs to admit patients.

And health officials predict the region’s COVID-19 hospitalizations, which have grown for three straight weeks to more than 2,500, will swell further through August.

The result is a strained health care system that is more dangerous for anyone in need of acute care, from a critically ill COVID-19 patient to a car accident victim who requires surgery. And like last summer’s surge, researchers fear this wave will bring an increase in non-COVID deaths, attributable to delays in care caused by the pandemic.

“Typically, it takes less than an hour to find a bed,” said Dr. Swapan Dubey, chief medical officer at Texas Emergency Care Center, which has two Houston-area freestanding ERs. “Nowadays in my own centers, we’re hearing cases that are taking 30 to even 50 hours.”

I mean, this is the same song we’ve been singing for the past few weeks. We experienced this before, in previous COVID waves, and at least at some level the lesson never took, because here we are again. We know exactly what we need to do to make this better, and we have a much better tool available to us this time with the vaccines, and yet here we are again. I don’t know what else to say, but I do know who to blame, and that’s Greg Abbott. Even in this part of the state, which includes some of the reddest counties around, we need to make more people see it that way, too.

Abbott flails about on the COVID surge

He remains committed to the bit.

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

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

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

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

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

[…]

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

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

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

There needs to be more defiance of Greg Abbott and his no-mandates mandate

I find a bit of a pattern in this story and wonder if there may be something to it.

School districts, local officials and hospitals are pushing back on Gov. Greg Abbott’s executive order barring mask and vaccine mandates, setting the stage for legal showdowns over coronavirus safety measures just as cases are surging in Texas and hospitals are filling up.

Houston ISD signaled its intention to require face coverings when students return this month. The University of Texas Medical Branch in Galveston requested an exemption to mandate COVID-19 vaccinations for staff, but was denied. Dallas County Judge Clay Jenkins required face masks at a meeting this week; he’s now being sued.

[…]

Dr. Mark McClellan, who advised Abbott earlier in the pandemic, said local officials need flexibility based on conditions in their area.

“There is evidence that wearing a mask, especially at times of high community transmission which Texas has right now, does help significantly,” said McClellan, former commissioner of the U.S. Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University.

“I appreciate that wearing a mask is inconvenient, I would rather not do it,” he said. “But if there are high rates of transmission in the community I think it’s important for local authorities to have the ability to make a decision that works best for their students and their population.”

Early last year, Abbott said he would rely on data and doctors in making decisions to promote public health. McClellan was one of Abbott’s four original medical advisors, but is no longer playing that role.

Abbott has remained in regular contact with one of the original advisors, Department of State Health Services head Dr. John Hellerstedt, since the beginning of the pandemic, according to spokeswoman Renae Eze. Hellerstedt did not answer questions about whether he agreed with Abbott’s executive order.

[…]

It remains to be seen whether other school districts follow suit in defying Abbott’s order. El Paso officials wrote to Abbott this week urging him to give school districts a choice in whether to require masks or not. Dallas ISD did not respond to a request for comment.

Violations of Abbott’s order can result in a fine of up to $1,000. Georgina Pérez, a State Board of Education member from El Paso, volunteered to raise money to help pay fines for school districts that defy the governor’s order by mandating masks.

“Knowingly not protecting children from harm goes against everything that teachers stand for,” she said.

Abbott’s office did not immediately respond to questions about whether any fines have been levied to date. Houston Mayor Sylvester Turner has faced no pushback since he told the city’s roughly 20,000 workers on Monday to resume wearing masks at work, according to a spokesperson.

[…]

Some institutions that sought exemptions from Abbott’s order have been rejected. The latest version blocks a wide swath of government entities, including cities, counties, universities and publicly funded hospitals, from requiring staff get the vaccine while full FDA approval is pending.

The University of Texas Medical Branch would want to require vaccination of its frontline clinical staff and requested an exemption, but was told to abide by the governor’s order, according to Dr. Janak A. Patel, director of the Department of Infection Control & Healthcare Epidemiology.

Dr. John Zerwas, the UT system’s vice chancellor for health affairs, raised the exemption request with Abbott recently, who was not willing to change his position, he said.

Parkland Hospital, a publicly funded organization that falls under Abbott’s order, plans to require its employees get vaccinated as soon as the FDA fully approves the shot. In anticipation, Parkland alerted staff this week that the first dose will be required by Sept. 24 and the second — or single Johnson & Johnson dose — by Oct. 15. Approximately 71% of staff are already vaccinated against COVID-19.

“These steps are necessary to protect Parkland’s complex patient population who, due to their socio-economic status, often have no choice in where they receive care,” said Michael Malaise, senior vice president of communications and external relations for Parkland, in an email.

The main thing I notice is that for the most part, the entities that have just gone ahead and done the thing they wanted to do that was in violation of Abbott’s executive orders have – so far – not received any pushback for doing so. The exception is Dallas County Commissioners Court, which got a stern letter from Ken Paxton after barring one of the commissioners from entering without a mask, but even that letter didn’t spell out any particular actions Paxton would take. The difference between UT Medical Branch hospital and Parkland Hospital is particularly instructive. Moreover, even if a cease-and-desist letter or some other legal action comes down on Parkland, by the time the dust settles they probably will have gotten some number of previously unvaxxed employees to get their shots, and that’s all that matters.

So, my advice to El Paso ISD and austin ISD, which may be considering its own mask mandate, is to just do it. Mask mandates are something that a lot of parents want, especially parents of medically fragile children or who have immunocompromised family members at home, and especially given the limited remote learning opportunities that exist now. The thousand-dollar fine, which doesn’t appear to have a clear mechanism for enforcement, isn’t very much even if it’s a thousand dollars a day, and that may be challenged in court on the grounds that it is discriminatory against students with health issues. But really, it’s the right thing to do, and maybe – just maybe – Abbott has gotten out a bit over his skis here. For sure, asking is going to get you nowhere. Take action and take it now, if all else fails it should be something that can be taken back. Do what you must to protect the kids.

UPDATE: Someone agrees with me:

The nursing shortage

Just gonna leave this here.

A nursing shortage and a high volume of patients prompted Lyndon B. Johnson Hospital on Sunday night to declare an “internal disaster” in the emergency room, where wait times swelled to 24 hours, Harris Health System officials said Tuesday.

Internal disasters limit the flow of ambulance traffic to the hospital and are usually triggered by infrastructure problems, such as fires or diagnostic machine failures.

On Sunday, however, the hospital could only staff 16 of its 24 ICU beds. At one point, about 130 people were in the ER waiting room from an “onslaught” of patients with a variety of health problems, said Dr. Esmaeil Porsa, president and CEO at Harris Health System. The rise in patients came as the state of Texas is dealing with an acute surge of COVID-19 hospitalizations; on Tuesday, the state reported 7,305 hospitalized patients, an increase of 38 percent over last Tuesday.

The system needs about 250 more nurses to fully staff both LBJ and Ben Taub Hospital, said Porsa.

“It got a point where it was actually unsafe for us to accept more patients because we just did not have enough staff,” he said.

Porsa said the 215-bed hospital is no longer under an internal disaster but remains at capacity. It has since added staff for two ICU beds.

The disaster designation was first brought to light by an emergency room doctor who emailed State Sen. John Whitmire Sunday night about the “untenable” situation there. The email, obtained by the Houston Chronicle, pleaded for more nurses.

Just a reminder, a lot of doctors and nurses are thoroughly burned out from the earlier COVID waves. They had every reason to believe that things were finally better and they could get back to their regular, normal jobs, but that was not to be. And now we’re asking them do it all again, for an even bigger surge with no help at all from state government in sight. It’s just going to get worse from here.

Another lawsuit filed against Abbott’s migrant transport order

Bring them on.

Immigrant rights groups backed by the American Civil Liberties Union filed a federal lawsuit against Texas Governor Greg Abbott over his executive order restricting the transportation of migrants, claiming it goes against federal law and amounts to racial profiling at the southern border.

The legal challenge was brought by the nonprofit Annunciation House, a migrant shelter provider in El Paso, along with immigrant advocacy groups Angry Tias & Abuelas of the Rio Grande Valley and FIEL Houston,. They are represented by attorneys with the ACLU’s Immigrants’ Rights Project and the ACLU of Texas.

This lawsuit, filed late Wednesday in El Paso federal court, comes six days after the U.S. Department of Justice sued Abbott to block the order. On Tuesday, a federal judge in that case issued a temporary restraining order blocking enforcement of the order until a hearing on an injunction can be held.

Echoing the DOJ’s claims, the ACLU and immigration groups allege that the order violates the supremacy clause of the U.S. Constitution by attempting to regulate the movement of migrants, which is for the federal government to decide. They also say the order unlawfully attempts to regulate the federal government.

[…]

In Wednesday’s lawsuit, the ACLU argues the order will directly impact people who have been released from the federal government’s custody into the country to await their immigration hearing. Those people will be unable to get any form of transportation after being released from CBP custody, according to the complaint, which points out that state law enforcement officials would be taking migrants back to CBP after the agency released them.

The groups also claim the order allows Texas police to racially profile travelers along the border region.

“It directs state officers to make their own determinations about passengers’ immigration status, wholly independent of the federal government, and to impose harsh penalties based on those unilateral immigration decisions,” the lawsuit states. “It opens the door to profiling, standardless detention, questioning, vehicle seizure, rerouting, and heavy fines. The executive order is already having a profound chilling effect on people’s movement in border communities and throughout the state.”

In addition, the immigrant advocacy organizations say they will be directly affected by the order if it is allowed to be enforced. Annunciation House transports migrants who have been released from federal immigration custody to its facility, which houses migrants in the El Paso area. Angry Tias funds numerous services for migrants, including a taxi service that is kept on retainer. Both groups say they would be unable to provide such services under the governor’s order, would face having their vehicles impounded and would be left with no way of assisting migrants.

See here and here for background on the suit filed by the Justice Department. As before, I don’t really know enough to say much of value – I’m not fully clear on the differences in the claims made by the two groups of plaintiffs. It may be that this suit winds up getting combined with the other one, as often happens. Whatever the case, I’m rooting for the plaintiffs. The Texas Signal and Daily Kos have more.

Who favors a vaccine mandate?

A lot of people, apparently. Don’t expect it to make much difference, though.

Most Texans support measures requiring all eligible people to get vaccinated against COVID-19, according to a recent survey.

More than 65 percent of Texans said they would support vaccine mandates issued by federal, state or local governments; the national average was 64 percent. More than 70 percent of Texans would support vaccine requirements to board an airplane; more than 62 percent would support vaccine mandates for children returning to schools; and 67 percent would support them for students returning to universities.

The findings come as some private businesses begin requiring vaccines, but government leaders have resisted such mandates as they’ve struggled to convince large numbers of Americans to get vaccinated, even as the more contagious delta variant spreads. Less than 53 percent of Texans are fully vaccinated, according to state data.

President Joe Biden last week announced that federal workers will have to sign forms attesting they’ve been vaccinated or else be required to wear masks, take weekly tests and more.

Texas Gov. Greg Abbott, meanwhile, issued an executive order last week barring local governments from limiting the capacity of restaurants and other businesses or requiring facial coverings, even if they are located in a hospital region with a high level of COVID-19 patients.

Abbott and other Texas Republicans have vocally opposed the idea of mandating vaccines.

The national poll was conducted in June and July by the COVID States Project, a group of researchers at Northeastern University, Harvard University, Rutgers University and Northwestern University. It included a survey of 707 Texans and findings in the state carried a margin of error of 4.7 percentage points.

The survey found Americans strongly support vaccine mandates, but there big gaps between Democrats and Republicans, and urban and rural residents.

The poll is here, and here’s the description: “Between June 9and July 7,2021, we surveyed 20,669 individuals across all 50 states plus the District of Columbia. The survey was conducted by PureSpectrum via an online, nonprobability sample, with state-level representative quotas for race/ethnicity, age, and gender (for methodological details on the other waves, see covidstates.org). In addition to balancing on these dimensions, we reweighted our data using demographic characteristics to match the U.S. population with respect to race/ethnicity, age, gender, education, and living in urban, suburban, or rural areas. This was the latest in a series of surveys we have been conducting since April 2020, examining attitudes and behaviors regarding COVID-19 in the United States.” In other words, a poll of adults, not registered voters, which tends to produce results more favorable to my preferred position. There was greater support, overall and in Texas, for requiring a vaccine to get on a plane, and varying levels for requiring a vaccine to go to school or college.

Like I said, I don’t know how much difference this makes. There are mandates of varying aggressiveness going out now for federal employees, some big private companies like WalMart and Disney, and some hospital systems here in Houston. I think a mandate for getting on an airplane is doable, and I hope that happens in the next week or so. Beyond that, it’s hard to say. It’s incredibly crappy that our malevolent governor refuses to let local governments mandate it for their employees, but maybe more private companies will step up. And hopefully soon we’ll get the final FDA approval, as well as initial approval for kids under the age of 12. Vax numbers are trending up a bit nationally now, especially in the hardest-hit states as some of the holdouts there are starting to get the message. It’s not fast enough and of course we never should have been in this position in the first place, but it’s better than what had been happening before. It’s going to be a rough month or two, so hold on and stay safe. Vox has more.

Back to Code Red

Pretty much inevitable at this point.

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

For sure, stay the hell away from this.

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

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

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

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

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

Yikes.

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

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

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

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

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

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

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

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

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

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

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

One more thing:

White Linen Night is back — well, sort of.

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

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

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

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

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

Judge halts Abbott’s “pull over migrants” executive order

For now, anyway.

A federal judge on Tuesday blocked Gov. Greg Abbott and the state of Texas from ordering state troopers to pull over drivers transporting migrants “who pose a risk of carrying COVID-19.”

U.S. District Judge Kathleen Cardone granted a temporary restraining order against Abbott’s move, meaning it will be blocked while the case continues to unfold. The U.S. Justice Department sued Abbott and Texas on Friday, a day after U.S. Attorney General Merrick Garland threatened to take legal action if Abbott didn’t rescind his order, calling it “dangerous and unlawful.”

In a statement later Tuesday, Abbott’s press secretary said the state looks forward to presenting evidence that supports his order.

“The Court’s recent order is temporary and based on limited evidence,” Press Secretary Renae Eze said in the statement.

Cardone still must decide whether Texas’ move is constitutional, and her temporary restraining order is set to last until the court’s next hearing on Aug. 13. Abbott has defended his order as necessary to help prevent the spread of COVID-19 in Texas, while advocates for migrants say it would disrupt federal immigration efforts and invite troopers to racially profile people.

See here for the background, and here for a copy of the restraining order. This is all pretty technical and I don’t have the knowledge to say anything cogent, so I will give you a bunch of links at the end of the story for more reading, and we’ll go from there. This tweet made me think about what may come next:

It certainly won’t surprise me if Abbott takes another crack at this if he loses. He has every incentive to push at this until he can claim a victory of some kind. Buzzfeed, the Chron, Daily Kos, and TPM have more.

Mayor Turner tells city employees to mask up

We’ll see how it goes.

Mayor Sylvester Turner

Mayor Sylvester Turner told city employees Monday that they again must wear masks when they are at work and unable to socially distance, a requirement that could run afoul of Gov. Greg Abbott’s latest executive order.

Turner’s memo mentioned the recent uptick in cases because of the delta variant of the coronavirus and the importance of remaining vigilant against the spread of the virus.

“Therefore, effective Wednesday, August 4, 2021, all city employees able to medically tolerate a face covering shall wear a face covering that fully covers the individual’s nose and mouth upon entering the city premises and while on city premises in an area where social distance measures are difficult to maintain,” Turner wrote.

That includes bathrooms, elevators, meeting rooms and offices where people cannot sit at least 6 feet apart, Turner said.

The governor’s order, signed last week, appeared to bar such mandates. Abbott’s office Thursday evening did not respond to a request for comment.

“No governmental entity, including a county, city, school district and public health authority, and no governmental official may require any person to wear a face covering or to mandate that another person wear a face covering,” the order stated.

Mary Benton, the mayor’s communications director, said the city was within its rights to take the action, despite the governor’s order.

“The mayor has a right and responsibility to ask city employees to wear face coverings indoors to help stop the virus from spreading,” Benton said. “With the rise in the delta variant cases and high numbers of unvaccinated individuals, Mayor Turner is doing what is necessary to keep (city) employees healthy, so they can provide for their families and the city can ensure that government services are provided to the public without interruption.”

I mean, we’ll see. Not only has Abbott refused to consider any state action to fight COVID, he’s issued an executive order banning localities from taking any action, which includes school districts and also includes mask mandates. I have a hard time believing that neither he nor Ken Paxton will respond, though to be fair the last time Paxton tried to block a city from doing a mask mandate, he was largely unsuccessful. Sure seems like it can’t hurt to try at this point, though I hesitate to suggest that there’s not a next level Abbott could take this to.

The Chron story notes that Dallas County courts have put out their own mask mandate as well. I would like to see Harris County follow suit on that. If nothing else, flood the zone a little. Fort Bend County has raised its threat level, which comes with a blanket call for everyone to mask up, while retail outlets are starting to move in that direction as well, because they kind of have to. The more everyone actively works to limit the spread of COVID, the worse and more out of touch the actions of Greg Abbott will appear.

One more thing:

Today would be an excellent day for the Supreme Court to rule that Abbott’s veto of legislative funding was unconstitutional.

UPDATE: This is also good.

President Joe Biden directly called out Gov. Greg Abbott’s order banning mask mandates in a speech Tuesday in which he begged Republican governors to “please help” curtail a rapidly growing fourth wave of COVID infections.

Biden condemned states that have banned public schools and universities from requiring workers and students to wear masks or get vaccinated, saying “the most extreme of those measures is like the one in Texas that say state universities or community colleges can be fined if it allows a teacher to ask her un-vaccinated students to wear a mask.”

“What are we doing?” Biden said. “COVID 19 is a national challenge and … we have to come together, all of us together, as a country to solve it.”

“If some governors aren’t willing to do the right thing to beat this pandemic, then they should allow businesses and universities who want to do the right thing to be able to do it,” he said. “I say to these governors: Please help. If you aren’t going to help, at least get out of the way of people who are trying to do the right thing. Use your power to save lives.”

“Lead, follow, or get out of the way” can apply to many situations. This is one of them. As above I’m sure Abbott will have something to say in response, but maybe this time he will find it a challenge to defend the indefensible. One can hope, anyway.