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The great state of Texas

Even the White House thinks Texas sucks at COVID response

I mean

The White House Coronavirus Task Force says Texas is in the swing of a “full resurgence” of COVID-19 and the state’s mitigation efforts “must intensify,” while Gov. Greg Abbott and other leaders decline to take some of the steps the Trump administration is recommending.

A report issued by the task force before the Thanksgiving holiday calls for Texas to significantly reduce maximum occupancy for public and private indoor spaces and to conduct weekly coronavirus testing of teachers, college students, county workers, hospital personnel and others.

“Texas continues to be in a full resurgence and mitigation efforts must intensify,” the Nov. 22 report says. “The silent community spread that precedes and continues to drive these surges can only be identified and interrupted through proactive, focused testing.”

The White House sends such reports to states weekly, but they are not typically made available to the public. The report was published by the Center for Public Integrity.

Three days before the report was issued, Abbott was assuring the public that local officials had been provided with all the tools they need to slow outbreaks, including a requirement that Texans wear masks indoors in public places and when patronizing businesses.

Abbott has also enacted mandatory occupancy reductions — including closing bars — in regions where the number of hospitalized COVID-19 patients exceeds 15 percent of capacity for seven straight days.

But Abbott has declined to go further, instead focusing his message on treatment, touting a newly approved drug as proof that “the cavalry is coming.”

There are plenty of local officials who would disagree with Abbott’s assertion that they have all the tools they need.

Mayor Sylvester Turner on Tuesday said he agreed with the White House report’s findings and implored Abbott to take a harder line or give local officials back the powers they had in the spring.

“We determined what the occupancy limits were going to be in large part. We had the ability to say ‘no,’” said Turner, who took questions from reporters after a holiday-themed event at City Hall. “The tools that we had in March and April, we no longer have. We are not driving this car. County judges and mayors are more like passengers. The state is driving the car.”

In addition to Abbott’s May preemption of local restrictions, bars that collect less than 51 percent of their revenue from alcohol also can reopen as restaurants, and the Texas Alcoholic Beverage Commission in August made that easier by broadening the scope of revenue they can count as not stemming from alcohol sales.

“Bars can be open. So, we’re doing what we can to limit gatherings, but that’s a big, big problem,” Harris County Judge Lina Hidalgo said during Tuesday’s regularly scheduled meeting of Commissioners Court. “Because these things have been allowed, we’re seeing the numbers we’re seeing again now.”

Measures of the virus’ spread, Hidalgo noted, approximate the levels being reported when she placed the county at its worst, “red” threat level in June.

“It was soon after that that the governor pulled back a little bit, and the numbers kept climbing until finally they peaked at a level where they routinely exceeded base hospital capacity” in intensive care units, she said. “And so if we go much longer without action, we’re going to be in a bad place.”

One option the city does have is a curfew, which has been implemented in El Paso and San Antonio. Turner said he reserves the right to implement one in Houston, but views that as a “nuclear option” that punishes good actors along with the bad.

The mayor said he is trying to keep people alive for the next few months, until vaccines become available and strengthen the fight to contain the virus’ spread.

“My appeal to the governor is to join with us and do the same,” he said.

Remember how they once had to solve the riddle of the Sphinx to unlock some of those tools in the first place? Boy, those were the days. The Chron story notes that while the local numbers aren’t as bad as they were in July, they are all on an upward trend. That ain’t good.

What could be done? In addition to letting the locals actually do the things they want to do, Abbott could issue a new mask mandate, with enforceable penalties attached, and take the heat from the wingnuts for it. He could order more enforcement of bar and restaurant occupancy limits, to crack down on the bad actors. It also remains true that Abbott could be exhorting our two Republican Senators to get off their asses and support a big COVID relief bill that would get affected businesses through the next few weeks. Even this wholly inadequate effort would be better than nothing. “Doing nothing while we wait for the vaccine and try out new treatments for the many people who get sick” and “completely shutting down everything with no financial relief for anyone” aren’t the only options available. The Trib has more.

More on DPS and data protection

A followup from the DMN about that data breach involving every drivers license number you’ve ever had.

Some other states do not sell [drivers’ license] data, but Texas does. State lawmakers could change the law in their 2021 session.

I first reported this in 2015 when I learned that several state government departments sell information to outsiders. In an open records request that year, I learned that in 2014 the Department of Motor Vehicles earned $2.4 million in sales.

This year, CBS 11/KTVT reporter Brian New updated those numbers. DMV made more than $3 million in 2019 selling drivers’ names, addresses, phone numbers, email addresses and VIN information, he reported.

[…]

The buyers are data-mining companies, insurance companies, banks, police departments, car dealers, toll companies, school districts, corporations, private investigators, tax-collecting law firms, tow truck companies and electricity companies, to name a few.

Follow this — the biggest loophole. In Texas, it’s against the law for companies who buy the information to use it to sell to us. So to get around that some companies sell the lists to other marketing companies, which go ahead and use the information to sell — and annoy us.

Because our information isn’t sold directly to marketers, the state doesn’t have to give us a privacy statement when we buy a car or apply for a driver’s license. We don’t get to opt out, as residents of California are now allowed to do.

State lawmakers could fix this, giving us privacy statements and allowing us to opt out of the information sold. Or they could go one better and prohibit the sale of the databases entirely. Other states do.

If you bring this up, state departments other than DMV complain loudly about how these are open records that often can help consumers. (For example, your car is towed, and the towing company can figure out who it belongs to). Besides, selling our data makes a lot of money for the general fund.

One way to see how loosey-goosey Texas is with our information is on the paid subscription lookup site, PublicData.com.

Years ago, there were multiple states listed where you could quickly look up a person’s driver’s license information. Now there’s only Florida and Texas. The other 48 now have higher standards of privacy.

Same goes for vehicle information. Only five states are listed for searching, but four are marked “[OLD].” The fifth is up to date and active. That’s us.

If you get unwanted spam email, postal mail or phone calls and wonder how they got your information, often enough it’s because of our state’s lax laws. Thank you state leaders.

When it comes to cheap and easy data distribution that violates our privacy, we’re number one. Hoo-ray for Texas.

See here for the background. California has a data privacy law that is modeled on the European GDPR scheme. I work with GDPR quite a bit, and it gives people a lot of control over their data while putting some real teeth into enforcement. One of the main ways that GDPR works is that it requires notifications to affected individuals when their personal data is stolen, deleted, or otherwise inappropriately accessed. That’s a lot better than what we have now.

There’s some federal data privacy legislation out there, which largely has the support of the big players like Facebook and Google, which on the one hand means it has a chance to pass but on the other hand means it’s not anything those companies consider to be bad for their business models. I’d rather see something more stringent than that – to me, GDPR is a starting point. We’re not going to get anything like that in Texas, I feel confident saying that. But feel free to call your State Rep and State Senator and tell them that you would like to have the ability to opt out of having your drivers license data sold by DPS. The amount the state takes in for these sales is pennies compared to the state budget. We can very easily do with less of that.

UPDATE: This Slate story about the need for a federal data privacy law is a good read, and addresses the ways we can learn from GDPR for an American version of that law.

Crossing a red line

Will Greg Abbott notice?

North Texas crossed a critical threshold in the number of hospital patients fighting COVID-19 that could trigger bar closings and lower occupancies at stores and restaurants if such cases don’t decrease within a week.

With more than 2,300 patients testing positive for the coronavirus in the 19-county hospital region, 15.05% of all beds were occupied by a person with COVID-19, according to state data.

Hospitals had been approaching the 15% red line — set by Gov. Greg Abbott in October — for several days before the Thanksgiving holiday as the state continued to report record-breaking numbers of new coronavirus cases. On Friday, Texas reported 2,473 new cases and 51 new deaths — a drastic drop compared to recent results likely due to labs being closed for the holiday.

Currently, most businesses in the area may operate at 75% capacity. But under Abbott’s Oct. 7 executive order, businesses will be forced to limit capacity to 50% if they are in a region where more than 15% of hospital patients have tested positive for the coronavirus for seven consecutive days. The rate must drop below the red line for one week before business capacity can rise again.

“As the number of positive cases grows, our health care heroes need your patriotism and sacrifice,” said Dallas County Judge Clay Jenkins in a statement Friday. “Please put off get-togethers and avoid crowds to protect public health and the economy.”

The 19-county region includes both Dallas and Tarrant counties as well as smaller counties, including Rockwall, Cooke and Hunt.

A total of 8,518 people were in a Texas hospital Friday with COVID-19, the state reported. That’s about 2,400 shy of the state’s peak, set in July.

Nine of the state’s 22 regions reported at least one day above the 15% threshold this week. And another hovered just below it Friday. The region that includes El Paso was by far the worst, with about 35% of all its hospital patients fighting COVID-19.

Abbott on Friday tweeted a rosier outlook, highlighting that the rate of infected patients at El Paso counties had dropped for two weeks in a row, and the state’s positivity rate has been declining.

Earlier this month, Abbott rejected the idea of once again scaling back the economy statewide. Another shutdown would have a disastrous effect, he said. At the time of his comments — just eight days ago — six of the state’s regions were above the line.

At this point, we’ve basically surrendered. I have no expectation that Abbott will take any action, other than maybe to cheerlead treatment options, for those who will be able to use them. If you don’t want to be complicit in this, do your part – wear your mask, maintain social distancing, avoid public gatherings, and so on. I don’t know why our leadership is so terrible, but it is and it’s up to us to keep our own selves safe.

The vaccine distribution challenge

Having a vaccine for COVID-19 is wonderful. Being able to make it available to everyone who needs it is a big challenge.

With cases spiking to over 10 million, the virus is everywhere, and spreading deeply into every corner of the country. This is where the Biden administration will face its biggest challenge, especially as it pertains to rolling out a potential vaccine.

My home state of Texas is a great example. A 2016 report from the Texas Department of State Health Services illustrates the terrible state of rural health care. According to DSHS, 235 of Texas’ 254 counties were medically underserved. There were many isolated counties with little to no access to health care. Some even lacked a single doctor.

This has been a crisis a long time in the making. As the Texas Observer recently noted, in 2019, Texas budgeted $17.7 million for infectious disease surveillance, prevention, and epidemiology—and over $400 million for border security. So even when a vaccine is delivered, it will be going to a state that is understaffed and underfunded.

Lipscomb County, population 3,302 as of 2010, in the northeast corner of the Texas panhandle, doesn’t have a doctor. It is worth noting that Lipscomb County is a 550-mile drive from Austin. Portland, Maine, is a closer drive to Washington, D.C., than those 3,302 isolated souls.

Given this isolation and lack of resources, the vaccines themselves present a logistical challenge alone that borders on the impossible for rural America. The Pfizer vaccine, now the leading contender, will require ultra-cold storage of at least -94 degrees Fahrenheit and two rounds of shots. Another leading vaccine candidate from Moderna also requires cold storage, albeit not to the same extent, according to the company. Typically, hospitals and large clinics have this capability. Small towns lacking even the most basic health clinics do not.

To deploy the Pfizer vaccine or any other one, health planners will have to figure out a way to deliver it to rural areas while maintaining its required temperature long enough to ensure that the population receives both doses. This scene will be repeated all across small-town America. This presents a big risk: An uncoordinated federal roll out of vaccines requiring ultra-cold storage could leave state and local governments competing for resources much like they were competing for PPE earlier in the pandemic.

The Trib expands on this.

How effectively public health officials can prioritize and distribute millions of doses of the new vaccines across a state that covers 270,000 square miles and more than 170 rural counties will determine how quickly Texas turns a corner in a pandemic that is again surging across the state and pushing hospitals to the brink in West Texas and the Panhandle.

The task is made more difficult because the Texas Department of State Health Services, which is largely responsible for the distribution effort, won’t know which vaccines it’s receiving, and how many doses, until one or more is approved by the U.S. Food and Drug Administration.

They will also have to combat misinformation and persuade vaccine skeptics — and those unnerved by the coronavirus vaccines’ historically swift development — of the benefits of being inoculated. World Health Organization experts have said that up to a 70% vaccine coverage rate for COVID-19 may be needed to reach population immunity through vaccination. In the 2019-20 flu season, only about 37% of adults younger than 65 received a flu vaccine. The rate was about 65% for seniors.

“We haven’t seen any efforts that are this broad since probably a polio vaccination in the 1950s,” said Dr. Mark McClellan, a former head of the FDA who has advised Abbott about the pandemic.

“The people who are most likely to benefit from vaccination are people who may have difficulty connecting to health care,” such as elderly people and residents of low-income communities who often lack health insurance, he added — compounding the logistical challenges.

The vaccine is expected to initially be in short supply, and will be first distributed to a state-selected group of people considered to be essential workers or most vulnerable to being severely sickened.

[…]

It’s still unclear, beyond a list of murky priority groups such as health care workers, who will get the vaccine during the initial months when supplies are scarce. In the coming weeks, a state panel of experts is expected to publish more specific recommendations about who will be eligible for a vaccine and when.

Early estimates from the Texas Department of State Health Services found there are more than 5 million people who are vulnerable or work in front-line jobs that increase their exposure risk. That includes more than 3.9 million people who are 65 or older, more than 638,000 health care personnel, more than 327,000 acute care hospital employees, more than 137,000 nursing home residents and more than 66,000 emergency medical workers.

The state’s adult population also includes more than 9.4 million Texans with underlying medical conditions that could increase their risk for severe illness associated with COVID-19.

So yeah, it’s a big problem, and there are many questions that need to be answered, some of which will spark heated debate. In the meantime, as both stories noted, the pandemic rages on, meaning we could be trying to vaccinate people while we’re still in conditions that still demand social distancing and will put everyone involved in the process at risk. So you know, maybe we should try a little harder to contain the spread right now. Just a thought.

UPDATE: From the Trib:

Health care workers will be the first people in Texas to receive a COVID-19 vaccine once one receives emergency approval from the U.S. government, and on Monday a state panel of vaccine experts and politicians revealed which workers in the health field will receive top priority.

The “first tier” recipients, according to the panel’s new guidelines, include:

  • Hospital-based nurses, doctors, custodians and other workers who have direct contact with patients
  • Staff of nursing homes or other long-term care facilities who work directly with residents
  • Emergency medical services providers such as paramedics and ambulance drivers
  • Home health aides who manage “vulnerable and high-risk” patients

Certainly reasonable. We’ll see how it goes after that.

An ounce of cure

It’s certainly nice to have this, it’s just that there isn’t nearly enough of it.

Texas has received 5,800 doses of the newly approved coronavirus treatment that Gov. Greg Abbott heralded on Thursday and will receive even less next week, underscoring the massive challenge that remains as the state scrambles to tamp down its latest outbreak.

While the medication, made by Eli Lilly, is welcome news to many in the state’s health care community, its supplies are so limited that some hospitals are weighing how to ethically prioritize eligible patients, and others have opted out altogether.

“We recognize that this therapy could provide some modest benefit, but it requires space, staff and additional training around infusions that are hard to come by right now, as we are currently strained just taking care of the patients we have in house,” said Dr. Ann Barnes, the executive vice president and chief medical executive at Harris Health System in Houston.

[…]

Carrie Williams, a spokeswoman for the Texas Hospital Association, said executives huddled Tuesday with state leaders and “were largely very supportive of having the opportunity to have their hands on this therapeutic.”

“It’s an outpatient infusion therapy and requires significant space and staff time, which obviously is taxed right now,” Williams said in an email. “That said, we welcome all the help we can get to decrease demand on hospitals right now.”

Texas is expected to receive another 3,200 doses next week, according to data from the U.S. Department of Health and Human Services. That would make it the second largest state recipient, just behind Illinois.

Still, it’s not keeping pace with Texas’ mounting infections. Health officials reported more than 50,000 new positive cases this week through Friday alone, and there are 152,000 estimated active cases statewide. More than 8,000 people were hospitalized with the virus as of Friday.

And the drug is not a cure-all; in clinical trials, it was shown to reduce hospitalizations among high-risk patients but not eliminate them. Federal officials have said they expect close to 400,000 doses to be available nationwide through the end of the year; 80,000 of those have already been distributed.

To be effective, the treatment has to be administered early in an infection, before severe symptoms emerge, and it is meant only for people over age 65 who have chronic conditions such as diabetes or high blood pressure. It’s administered intravenously over the course of an hour.

In Lubbock, where cases are surging and the governor traveled on Thursday, hospitals received 172 doses this week, according to Dr. Drew Payne, a physician and associate program director at Texas Tech University. He said they have scrambled since to determine how best to get the doses out and hoped to begin administering them over the weekend.

“It’s good to say, ‘Hey, everybody needs this medication and we need to give it out,’” Payne said. “But then the logistics of having nursing staff, a place to bring COVID-positive patients into, a way to give that medication, a plan if there’s an adverse reaction to that medication — those are all things we’ve been dealing with.”

Lubbock reported nearly 500 new positive cases on Friday, with 5,700 active cases overall.

See here for the background. The numbers are clear – this new treatment will help at the margins, but we need to bring down the number of new cases. Until we really prioritize that, it’s all just band-aids.

DPS needs to do better with data protection

Oops.

You’ve been hacked. We’ve all been hacked.

No one else has said it, but The Watchdog will. This is likely the largest and one of the more significant data breaches ever to hit Texans.

About 27.7 million Texas driver’s license holders are affected.

If you haven’t heard about this, that’s part of the problem. It’s almost like no one wants you to know.

Why 27.7 million affected licenses when Texas’ total population is around 28 million? Because the number includes former state residents and dead people who were issued licenses before February 2019. So, it includes just about everybody who held a Texas license going back an unknown amount of years. It doesn’t include children.

The Watchdog has the story.

Yes, the information involved here is already available on a paid data site such as PublicData.com, although that site is not always current. But there you have to look up each individual. With this breach, all the information is already bundled and in one place.

What do the crooks have? Your license information (name, address, DL number), the color, model, year and VIN of your vehicle and the lender to whom you make car payments.

I’ll show you how this happened, what crooks can do with the information and how you can be prepared.

The culprit here is a company you probably never heard of — Vertafore of Denver, which, like many companies, buys data from state governments. Vertafore works with the insurance industry to concoct ratings that help agents, brokers and others.

“As a result of human error,” Vertafore says in a news release, “three data files were inadvertently stored in an unsecured external storage service that appears to have been accessed without authorization.”

Someone found the information and grabbed the files before Vertafore realized it, the company says.

The FBI and state law enforcement are investigating.

It appears to The Watchdog that although this data breach began in March and continued to August, our Texas Department of Motor Vehicles, which stores vehicle information, and the Texas Department of Public Safety, which handles licenses, probably didn’t know about the hack until recently because their own databases were not compromised.

There’s more and you should read the rest, including the bit about some likely ways that the attacker could use this information. It could have been worse – no Social Security numbers were stolen, apparently – but it’s still not great, and the complete ignorance about the theft by DPS and DMV is not great at all. Putting my cybersecurity hat on for a moment, DPS and DMV need to do a thorough audit of the security policies and processes used by everyone that has access to their data, because those are clear points of vulnerability. It doesn’t matter how sound DPS and DMV’s own security practices are if their business partners are lax.

(This would a fine opportunity for a member of the Legislature to file a bill that mandates minimum standards for third parties that handle personal data, and for the state agencies that do business with them to proactively ensure they are doing it right.)

The other thing DPS and DMV – and any other state agency that handles personal data – need to do is to subscribe to a service that scans the Internet for data of theirs that may have been stolen. (Experian either does this themselves or subscribes to someone who does, which is how they knew about it before it was officially announced.) It’s an article of faith in the cybersecurity world that security incidents and data breaches are going to happen, so a top priority has to be to detect them as quickly as possible so the loss can be minimized and the damage can be remediated. The history of most large scale cyber incidents is that the attackers had been operating inside the victimized firm for months, sometimes more than a year, before their activities were discovered.

There’s not a whole lot more info about this out there – ZDNet and Insurance Journal add a little more, but that’s really about it. I do hope the state demands a full report from Vertafore, and learns lessons from it. Next time it could be more serious than this.

Prevention > treatment

I mean, more treatments for COVID is a good thing, but you know what’s better? Not getting COVID in the first place. Maybe we can try doing better on that?

Gov. Greg Abbott traveled to Lubbock on Thursday to tout a newly approved coronavirus treatment, without saying how many doses are available or announcing any new restrictions to slow the virus’s spread as infections continue to surge.

Speaking at his first news conference on the pandemic in over two months, the governor said the treatment, made by Eli Lilly and similar to the one that President Donald Trump received last month, has already been distributed to Lubbock and other areas with overcrowded hospital systems, including Midland, Amarillo and El Paso.

“They have enough right now where they can begin the process and treat patients at least for the next several days,” Abbott said. He said he expects additional treatments to arrive in the coming weeks, as well as the first few shipments of a coronavirus vaccine, which could arrive by late December and would go to first responders.

“The cavalry is coming,” he said.

The governor added firmly that the state will not be locking down again, a measure used this spring to slow the initial wave of infections, and insisted that local officials have all tools they need to slow local outbreaks, including a mask mandate in place since the summer and mandatory occupancy reductions for regions where the number of COVID-19 patients exceed 15 percent of total hospital capacity for seven straight days.

In a companion article, Abbott gives three pieces of “good news”, which are this new treatment, that new treatment, and the forthcoming vaccines. All of which is great, and I can’t wait till the vaccines are widely available, but none of that really deals with the current crisis. Effective treatments assumes a fully functional health care system, and right now we have overcrowded hospitals and doctors and nurses who are getting thoroughly burned out. I also assume these treatments aren’t free, and in case you’d forgotten the state of Texas is one of the plaintiffs in a lawsuit that if successful would take away health insurance from millions of people – that’s on top of the millions who already don’t have it here in our state. Plus, and I can’t say this often enough, the economy is not going to get back to full steam until people feel safe from the virus. It’s not enough to say “if you get sick we’ll help you get better”, especially if you’re a person who is immunocompromised or has various co-morbidities or doesn’t have sick leave or child care or health insurance. How many more people need to get sick and die before Greg Abbott can be bothered to care?

Greg Abbott has no interest in fighting COVID

It is what it is at this point.

On June 26, Texas was reporting 5,102 people had been hospitalized due to the coronavirus, breaking a new record for the state. The positivity rate — the portion of tests that come back positive — had hovered above Gov. Greg Abbott’s “warning flag” level of 10% for more than a week.

Abbott swept into action. For a second time in months, the Republican governor shut down bars and rolled back restaurant capacity. Six days later, he took arguably his most drastic action yet, announcing a statewide mask mandate.

This week, more than 7,400 Texans are hospitalized for COVID-19, and the positivity rate has exceeded 10% for over three weeks.

But the governor’s strategy as the state heads into the holidays is to stay the course, relying on a 2-month-old blueprint to claw back reopenings regionally based on hospitalizations. The mask order remains in place, but last week he ruled out “any more lockdowns,” and tensions are again rising with local officials who want more authority to impose safety restrictions.

“We need the state to step in and lead or get out of the way and let us lead,” Harris County Judge Lina Hidalgo told reporters Tuesday.

Public health experts and elected officials acknowledge they are up against a stronger sense of “COVID fatigue” than ever — a malaise that appears to be reflected in the state response.

“The numbers are quite alarming, to be honest, because it’s not showing any sign of slowing down,” said Rajesh Nandy, associate professor of biostatistics and epidemiology at the University of North Texas Health Science Center. However, Nandy added, “it seems like at this point, there’s not a lot of will, even among people, for a full-scale stay-at-home [order] like [Abbott] did in March because, of course, it has other consequences.”

That much is true, as far as it goes. There are economic consequences for shutdowns. There are also economic consequences for letting the virus rage out of control – restaurants and bars and gyms and so forth may be open now, but lots of people don’t want to go to them because it’s not safe, and no amount of puffy-chested posturing from our Republican leaders will change that. At any time in the past six months, Abbott could have asked one or both of our Republican Senators – publicly or privately – to support another COVID relief bill, so that businesses and their employees that have been affected by COVID could safely shut down and not go bust. You would have to ask him yourself why he hasn’t done that, if he ever deigns to answer questions from the public or the non-sycophantic media again.

I mean, maybe we’ll get some kind of relief package from the lame duck session. Maybe the Dems will win both Georgia Senate runoffs and will have the ability to pass a real relief bill. Maybe enough people will stop doing dangerous things like attending indoor events and going about their lives un-masked, and the infection rate will drop again. Maybe we’ll manage to not die before the vaccines get circulated. Anything can happen, I guess.

Of course, one thing that could happen is that our hospitals get so overwhelmed that the death rate for non-COVID sufferers also spikes:

Since Abbott announced the 15% threshold, it has been the subject of some scrutiny. Abbott initially defined the threshold as 15% of “all hospitalized patients” in a region, though he later changed it to 15% of “total hospital capacity” — or total beds — in a region. That redefinition is problematic, according to hospital administrators in parts of Texas that have seen the most infections.

“They’re assuming that all those licensed beds can somehow be utilized for a COVID-19 surge, and that’s simply not true,” Dr. Brian Weis, chief medical officer at Northwest Texas Healthcare System, said last month during a coronavirus briefing for the city of Amarillo. “By using that number, that overestimates our capacity to handle COVID-19 patients.”

[…]

Exhibit A in the state-local tensions is hard-hit El Paso County. Attorney General Ken Paxton has gone to court to stop the shutdown order that County Judge Ricardo Samaniego issued late last month, saying it oversteps Abbott’s statewide rules. A state appeals court blocked the order for a second time Friday.

Abbott blasted the order shortly after it was issued, saying Samaniego “failed to do his job” enforcing existing rules to slow the spread of the virus “and is now illegally shutting down entire businesses.”

In an interview, Samaniego said the criticism from Abbott felt politically motivated and failed to address the biggest issue El Paso faces — that people are getting sick, being hospitalized and dying at staggering rates. Samaniego said he did everything within his power to limit the spread of the virus. He, like other local officials, wants more authority to take precautions in his county.

“It was about saving lives, not about whether I was right or wrong or he was right or wrong,” he said.

He also noted that El Paso’s share of hospital beds occupied by COVID-19 patients is several times Abbott’s 15% trigger, but it’s still artificially low because the county added 580 spots to its hospital capacity.

“This is a governor that issued a stay at home order,” Samaniego said. “And now he’s upset that I did when my numbers are 10 times worse than when he issued it. It’s just a political approach to our community.”

It’s not just El Paso County, though, where local officials are pushing for more latitude from Abbott. In Lubbock County, where cases have ballooned to more than 400 per day on average in the last week, the county judge, Curtis Parrish, said he is grateful for the state’s help with hospital capacity — the state has provided three large medical tents and personnel to go with them — but that he wants more enforcement power.

“My hands are tied,” Parrish said. “We operate under the governor’s order. We can’t do any detaining.”

In Laredo, the City Council voted Monday to limit private gatherings to 10 people plus household members. City Council member Marte Martinez said he would have liked to do more, such as implement a curfew and beef up enforcement for businesses that violate state rules.

“I felt powerless in my plight to save people’s lives,” said Martinez, a doctor. “You’re going to be in a full shutdown within a few weeks unless the state allows municipal governments and county governments to make more firm action.”

There is especially an urgency in Laredo and its hospital region, where the number of coronavirus patients has exceeded 15% of the capacity for the past three days. That means the state’s reopening rollback will kick in in four days if the figure remains above 15%.

What’s happening in El Paso right now is grotesque and disgraceful. Maybe what happens is that we begin to see death and misery like Italy had in the spring, at such levels and in so many places that even Greg Abbott will not be able to ignore it. I really hope it doesn’t come to that, but I don’t know what short of that will make him take this seriously.

Who’s concerned about the state’s coronavirus spike?

Not Greg Abbott, or Dan Patrick, or Ken Paxton, that’s for sure.

The Oregon governor is calling it a “freeze.” In New Mexico, it’s a “reset.”

Across the country, state elected officials are frantically rolling back their reopening plans to slow the burgeoning surge in coronavirus infections.

But in Texas, Republican leaders remain unwilling to change course in the face of soaring hospitalizations and an early uptick in deaths from the virus that has public health experts increasingly alarmed.

Gov. Greg Abbott has yet to impose new restrictions or allow county officials to take additional measures. Attorney General Ken Paxton has intervened to strike down locally adopted restrictions. Other requests to further limit gatherings, close nonessential businesses or impose stricter mask requirements have been blocked.

On Friday, a state appeals court halted a temporary shutdown of nonessential businesses in El Paso County, where cases have skyrocketed and mobile morgues have been rushed in to handle all the casualties. Paxton and a group of restaurant owners had sued to block the order, claiming the governor has final say on any new restrictions.

“I will not let rogue political subdivisions try to kill small businesses and holiday gatherings through unlawful executive orders,” Paxton said in a statement celebrating the appeals court ruling. On Twitter, he added: “We must never shut Texas down again!!”

[…]

Since September, Abbott has relied on a reopening plan that ratchets up restrictions in regions that have growing numbers of people hospitalized with COVID-19; the threshold is now seven continuous days of coronavirus patients filling at least 15 percent of all available beds in that area.

Few if any other states are using a similar threshold, and public health experts have long cautioned against relying on hospitalizations alone because they provide a delayed glimpse into the state of an outbreak — it takes someone several days to be hospitalized after they contract COVID.

Rebecca Fischer, assistant professor of epidemiology and biostatistics at Texas A&M, said it’s important to consider multiple factors, including the rate at which people are testing positive for the virus, emergency room visits and infections at nursing and other long-term care facilities. And she said local governments need decision-making power to best respond to their situations, which may differ even within a given region.

“When I see county judges that are trying so hard to work toward the public health of their constituents and then are just cut off and told no, it kills me,” Fischer said. “Everybody in the public health realm is left scratching their head as to why that would be the case.”

Let’s be clear:

1. They don’t care. Abbott doesn’t want to talk about coronavirus. Paxton will sue any local official who tries to take action to save lives. Dan Patrick has never walked back his comments about letting Grandma die so businesses can reopen.

2. They will never give any authority to local officials. If anything, there will be further bills in the upcoming Lege to restrict what local officials can do even more.

3. They will go straight to Defcon 1 the minute the Biden administration attempts to take any action to combat the virus.

How many people get sick and die as a result is not their concern. They could not be more clear about this.

We’re number one (million)!

One million COVID cases in Texas. Hooray?

Texas’ grim distinction as the national leader in terms of COVID-19 infections came as little surprise to some local medical experts, who blamed politicians for conflicting messages about the virus and warned the worst is yet to come.

Texas this week breached a milestone of 1 million cumulative cases since the start of the pandemic, recording more infections than any other state in the U.S. For reference, more people have been infected in the Lone Star state than live in Austin, the state’s capitol.

If Texas were its own country, it would rank 10th in terms of total cases, according to data from Johns Hopkins University, placing it higher than European hotspots like Italy.

The big numbers are not a shock in a state that’s home to roughly 29 million people. The number of cases per 100,000 residents is lower here than in about half of the states in the country. But Texas also had more newly reported cases in the last seven days — an average of about 8,200 — than other large, hard-hit states such as New York, California and Florida. Only Illinois has a higher seven-day average.

Dr. David Callender, president of the Memorial Hermann Health System, called the 1 million cases “a sobering statistic.”

“It’s not a surprise in the context of all that’s happened,” Callender said. “But it’s a significant number — 3 percent of the population — and cause for worry about the trend continuing as we go forward.”

Callender attributed the high number to “too much division” in the attempt to contain the virus.

“To me, politics entered in an inappropriate way,” said Callender. “People making a political statement with their behavior — that the pandemic is a hoax, that no one can make them wear a mask — really interfered with efforts. It was the wrong mindset.”

To be fair, California is a couple of days behind us, and may have passed one million by the time I publish this. Of course, California also has ten million more people than Texas, so.

The state’s positive test rate is now 11.24%, compared to 7.64% a month ago.

Hey, remember when a 10% positivity rate was considered to be a “warning flag” by Greg Abbott? You know, as part of his famous “metrics” for reopening the state?

Abbott’s office didn’t immediately respond to messages Tuesday.

Too busy propping up Donald Trump’s ego to deal with this kind of trivia, I suppose.

Meanwhile, in El Paso

The number of coronavirus patients in Texas hospitals has nearly doubled since October, and average infections are at their highest point in almost three months — leaving health officials bracing for a potential crush of hospitalizations going into the holidays.

In El Paso, hospitals are so overwhelmed with COVID-19 patients that in early November the Department of Defense sent medical teams to help, and the county has summoned 10 mobile morgues to hold dead bodies. Local funeral homes are readying extra refrigerated storage space, as the number of hospitalized coronavirus patients in the far West Texas city has shot up nearly tenfold since the start of September.

The new wave of infections stands in contrast to the summer surge, when Gov. Greg Abbott held regular press conferences about the virus and mandated that face coverings be worn, earning him the ire of the far-right. Now, state officials seem reluctant to crack down on the virus’ spread by further curtailing economic activity — and are fighting the El Paso county judge’s attempt to impose a curfew and a stay-at-home order in the face of record-breaking cases.

The state will not do anything to help, and you local leaders are not allowed to do anything to help. You’re on your own. If you’re very lucky, maybe you won’t have your health insurance taken away while you recover. Did I mention that disaster and emergency response ought to be a big theme of the 2022 election? Texas Monthly has more.

UPDATE: Nothing to see here.

Will Greg Abbott ever talk about COVID-19 again?

Signs point to No.

On Wednesday, Gov. Greg Abbott knocked on doors in the Fort Worth suburbs, fist-bumping with police officers and warning residents that Democrats want to raise their taxes.

That night, he opened Game 2 of the World Series at Globe Life Field in Arlington, belting out a hearty “play ball” before a stadium partly filled with cheering fans.

With the Nov. 3 election fast approaching, the state’s top Republican is in full campaign mode, trying to block Democrats from retaking the Texas House.

But away from the choreographed appearances, the governor is facing another challenge: Coronavirus infections are rising again, filling up hospitals in parts of the state. Unlike when cases mounted earlier this summer, Abbott has been all but silent about COVID-19’s resurgence.

The governor hardly has mentioned the uptick, which has been most severe in parts of North and West Texas. In news releases, he has announced that he’s sending resources and medical staff to hot spots, but he has downplayed or failed to even mention the outbreaks — part of a third wave sweeping the South and Midwest.

Abbott hasn’t held a public briefing on the pandemic in more than a month.

For a governor who made a point of being on television every night as cases spiked this summer, making himself the face of the state’s response, the silence is notable and likely strategic.

“There’s no advantage to Abbott coming out now to acknowledge the spiking numbers, which say Texas isn’t doing a good job, which say he isn’t doing a good job,” said Brandon Rottinghaus, a political science professor at the University of Houston. “With a week until the election, that would not be beneficial for him.”

[…]

Nearly 5,000 people were hospitalized Thursday with COVID-19, a 55 percent jump since Oct. 3. The average of new daily infections has been rising steadily for two weeks, and the rate of people testing positive for the virus is now just shy of 9 percent, after dipping to a low of 6.3 percent in September.

In Tarrant County, where Abbott appeared Wednesday, health officials have warned residents of substantial community spread, meaning the virus is being transmitted through workplaces and schools.

“The signs are pointing to a big surge coming,” Tarrant County public health director Vinny Taneja told WFAA-TV in Dallas on Wednesday.

Abbott has been an important figurehead in the state’s coronavirus response. When the number of people hospitalized with the coronavirus reached 5,000 in late June, he responded by closing the bars and cutting maximum occupancy for restaurants to 50 percent. He later issued a statewide mask mandate, which remains in effect.

Asked about the new trends Wednesday as he door-knocked for a fellow Republican, Abbott told reporters the state is preparing for a vaccine rollout as soon as late November, a claim that conflicts with remarks from top federal health officials.

The state’s own health officials aren’t planning for a wide rollout of a potential vaccine until July of next year.

Earlier this month, amid mounting pressure from conservatives, Abbott released a video announcing bars could open in counties with local approval, hoping to show a state that had put the worst of the pandemic behind it as voters prepared to head to the polls.

“The good news is that even with more businesses opening, even with more students returning to school and more gatherings like football games, Texans have shown that we can contain the spread of COVID,” Abbott said.

Anyone remember Abbott’s four metrics for reopening? Because I’m pretty sure he doesn’t at this point. Part of the problem, I admit, is that everyone is focused on the election – I sure am – and that means there’s basically no public pressure on Abbott to take action. But this has been building for weeks, and we’ve got kids back in schools while bars are open and people are attending live sporting events – college football appears to be a non-trivial factor in community spread – while a bunch of jackasses are going around the state demanding that we open up even faster. And of course there’s a malevolent President who’s doing all he can to ensure that things are getting worse. Is anyone surprised that Greg Abbott can’t be bothered to at least remind everyone that they should be wearing masks and avoiding crowds?

As little as I think of Abbott, I do expect he’ll have to start talking about this again after the election. If nothing else, we’ll be embarking on a legislative session soon, and we need to decide how we’re going to handle that. I just hope we get something that resembles leadership from Abbott before too many more people are hospitalized or dead.

So what’s up with that National Guard story?

Hell, I don’t know.

Governors can deploy troops for numerous reasons, from natural disasters to border security.

But observers found it rare to the point of extraordinary when the Texas National Guard revealed that Gov. Greg Abbott has directed troops be prepared to respond to disturbances after the Nov. 3 election in major cities across the state.

Abbott has not explained his reasons, so far.

Ben West, a security analyst at the RANE subsidiary Stratfor, a consulting firm, said he anticipates most of the forces will be sent to Houston and Austin, which saw the bulk of the state’s racial justice protests this summer. Guard officials have compared the new mission to its response in June to the unrest.

While an election-related deployment is uncommon, 2020 might be the exception, West said.

“When everything is just upside down, things that in any other year would have been extraordinary get lost in the wash,” he said.

The governor has pushed hard in recent weeks to convey to voters his allegiance to law enforcement, and has proposed new laws that would stiffen punishments for unruly protesters, including mandatory jail time.

The Guard said Monday it would send up to 1,000 troops to Houston, Austin, Dallas, Fort Worth and San Antonio as early as this weekend. A top guard official, retired Maj. Gen. James K. “Red” Brown, said the deployment was in case of “postelection” disturbances, to support local law enforcement and the Texas Department of Public Safety.

He said the guardsmen’s role would be similar to that during last summer’s George Floyd protests, and the troops would act “as we previously did to deter any civil disturbance at sites in various cities in Texas.”

This was the original story. Since then, Abbott has assured officials in San Antonio there will be no troops sent there after they complained, and there was a clarification that none of the troops would be sent to polling locations. On Wednesday, Abbott finally spoke about the issue.

Gov. Greg Abbott on Wednesday answered questions about the deployment of Texas National Guard troops to Texas cities on Election Day, saying they will play no role whatsoever in the election process.

“Our job is to make sure that cities are safe and along those lines, we want to make sure that in the event there are any protests after the election that we will have adequate personnel in place to make sure that we will be able to address any protests that could turn into riots,” the governor said.

When asked specifically about the assignment of troops to Houston, Abbott indicated those decisions will be made on an as-needed basis.

“It is erroneous to say we will have a presence here,” he said.

My guess is that this was a typical politics-first move by Abbott that wasn’t very well thought out and neither took into account any stakeholder input, nor anticipated their reactions. It will probably not amount to much in the end, which is also typical of Abbott. I suppose this is as good a place as any to point out that violence from far-right groups is a much greater threat than people protesting police brutality, though I know there’s a zero percent chance Abbott knows or is much interested in that. It is what it is, as they say. The Press and the Trib have more.

“On the cusp” of another COVID surge

The numbers are already trending up. You know what that means.

Cases of COVID-19 in parts of Texas surged to near catastrophic levels this summer as some hospitals were forced to put beds in hallways, intensive care units exceeded capacity and health officials struggled to stem the tide of the virus.

After peaking in late July and August, cases fell and leveled off in September, and the state’s seven-day positivity rate — or the proportion of positive tests — reached its lowest point since early June.

But health officials are now eyeing a worrying trend: New infections are rising again, and the number of patients hospitalized with COVID-19 is also ticking upward. The state reported 2,273 new cases Monday, and the seven-day average was up by 862 from the previous week. On Monday, at least 4,319 patients were hospitalized with COVID-19, far below the more than 10,000 in July, but that number has steadily risen during the last month.

“I’m no longer pondering if we’re going to see a surge,” said Dr. James McDeavitt, dean of clinical affairs at the Baylor College of Medicine. “We’re already seeing it.”

Eight months since Texas recorded its first case, experts say the state is more prepared to handle another wave, but they fear that if the state fails to control the outbreak, it could quickly spiral out of control.

“The question is whether it’ll be a modest surge, or something like we saw in July, or worse,” McDeavitt said.

[…]

At Houston Methodist, one of the region’s largest health care systems, medical staff were stretched thin this summer, said President Marc Boom. At its peak in July, the system’s staff treated nearly 850 patients with COVID-19 each day. Since then, Boom said, the medical community’s understanding of the virus has evolved, along with how to treat the disease.

Remdesivir, an antiviral medication, has shown promising results in minimizing the severity of illness, especially when administered shortly after symptoms develop. Houston Medical was the first hospital to use convalescent plasma, a therapy in which antibody-rich blood from people who have recovered from COVID-19 is administered to ill patients, Boom said.

“We’ve had tons of experience gained, better outcomes, shorter lengths of stay,” Boom said. “But this is still a serious illness.”

While health authorities are better equipped to deal with new spikes, including an adequate supply of protective gear and sizable quantities of drugs like Remdesivir, a fall surge could still be equally as taxing on hospitals, said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association. As colder weather forces people inside and families gather for the holiday season, the chances for transmission increase, she said.

“We certainly have been tested, and we know the beast that it is, and have shown that we were able to make it through those first two spikes,” Kroll said. “But we don’t want to test the limit by putting patients into hospitals.”

See here for the previous update. It’s getting bad all around the country, too. Just a reminder, the July surge was bad, and it took Greg Abbott way too long to react to it. In the meantime, various assholes have decided that it’s a good use of their time to sue everyone in sight to limit the government’s ability to respond to COVID-19. I have one small bit of local optimism in that Harris County has not backed down from being at the top threat level even as the numbers were improving. Our numbers are also trending up, but they’re not as bad as other places. Yet, anyway.

“The trends are going in the wrong direction,” said William McKeon, president of the Texas Medical Center. “You hate to see the sacrifices we made and the successes we achieved lost because people let their guard down.”

Dr. Marc Boom, president of Houston Methodist, said, “We’ve definitely turned the wrong corner. The numbers aren’t growing in an out-of-control fashion, but there’s no doubt we’re in a significant growth trend that we need to stop before the holiday season.”

[…]

The Houston numbers are well below those in other parts of the country, particularly the Midwest and the West. As of Monday, 16 states had added more COVID-19 cases the past week than in any other seven-day period.

The surge is even greater in Europe. There the total of new cases in the five most-affected countries — France, the United Kingdom, Russia, Spain and the Netherlands — was nearly 42 percent greater than the U.S. increase a week ago.

Nor does Houston’s increase compare to the Panhandle and El Paso. El Paso health officials Monday reported their highest number of COVID-19 hospitalizations since the pandemic began — 449 in one day — and said just seven of the city’s ICU beds were unoccupied.

Still, increases in Houston area’s key metrics since early October are cause for concern, said local health officials. Those provided by the Texas Medical Center include:

• The rolling average of 497 COVID-19 cases reported the week ending Sunday represents a 33 percent increase from late September, when the number was 373. It increased gradually the weeks in between.

• The number of COVID-19 patients admitted to TMC hospitals exceeded 100 last week, up from the 80s the previous week and 70s the week before that.

• The TMC COVID-19 test positivity rate, 3.4 percent early in October, has been at 3.9 percent the past week, an 8 percent increase.

• The so-called R(t), or reproduction rate, the rate at which the virus is spreading, did drop to 0.99 Tuesday, but that remains a 55 percent increase over the Sept. 29 rate of 0.64, when the spread was decreasing. The rate last week hit 1.14, which means the virus’ spread was increasing.

“We’re in a yellow zone, not a red zone”, is how one doctor put it. “COVID fatigue”, they say this is. I get that, but you can see what happens when we start to take this less seriously. Until there’s a widely available vaccine, wear your damn mask, stay out of crowded indoor spaces, maintain social distancing, and hope for the best. At least our mild winter weather means we can largely stay outside. It could be worse.

Don’t look now, but COVID numbers are ticking up again

In the state as a whole.

Texas reported more than 4,100 people hospitalized with the coronavirus on Wednesday, its largest total in six weeks and one that comes amid rising infections in El Paso and North Texas.

Hospitalizations hit a low in late September after a summer surge, but have risen incrementally for the past 10 days, reaching 4,133 on Wednesday. Other key metrics were also up slightly from a week earlier, including the reported rolling average of new daily infections and the number of people testing positive for the virus.

Public health officials said the increase is likely due to a combination of factors, including pandemic fatigue and expanded reopenings, especially bars. Bars were only allowed to begin reopening in select counties on Wednesday, but many have already been opened for weeks after reclassifying as restaurants — a loophole that the state created in hopes it would lead to better social distancing.

[…]

The biggest increases appear to be in West Texas and areas in and around Dallas.

Dallas County Judge Clay Jenkins raised the county’s pandemic risk level back to red on Wednesday, and earlier this week Gov. Greg Abbott sent medical staff and supplies to El Paso to help respond to a wave of new COVID-19 cases.

“With a new and quickly escalating wave of COVID-19 cases hitting North Texas, it is more important than ever that we make good decisions,” Jenkins tweeted.

And here in the Houston area.

Houston-area COVID-19 numbers, trending in a positive direction for the last couple months, have taken a turn for the worse.

Four key coronavirus metrics all show an increase in the past week, according to the Texas Medical Center, which tracks the data for the complex’s seven major hospital systems. Those numbers had started trickling up the previous week in daily reports produced by the center.

The latest numbers from Wednesday’s report:

• The number of COVID-19 cases reported Tuesday, 671, represents a 62 percent increase over last week’s daily average of 412 cases per day.

• The number of COVID-19 patients admitted to TMC hospitals Tuesday, 102, represents an 18 percent increase over last week’s daily average of 86 patients per day.

• The TMC COVID-19 test positivity rate of 3.8 percent represents an 8 percent over last week’s daily average.

• The so-called R(t), or reproduction rate, the rate at which the virus is spreading, hit 1.16 Tuesday, an 18 percent increase in the past week. On Sept. 29, the number was 0.64, which meant the virus’ spread was then decreasing significantly.

The latest metric is probably the most concerning to health officials. A number below 1.0 means the virus is burning out in the area; a number above 1.0 means the spread is accelerating. After 32 consecutive days in which the metric showed the virus was burning out in the Houston area, it now shows the virus is again picking up steam.

And as was the case in the month of June, it’s already too late to stop this. The best we can do now is go back to what we had been doing before to bend the curve back in the downward direction. First and foremost, wear your goddamn masks, and practice social distancing. Don’t be this guy.

As for bars, I want them to survive, and I’ve been up front about the arbitrariness of the state’s definition of what a “bar” is versus what a “restaurant” is. I support the various ways that have been suggested to help bars survive by being more like restaurants, and by enabling to-go and outdoor service. And we really need a federal rescue bill for bars and restaurants and theaters and music halls and other public-gathering businesses that have been so devastated by this pandemic. But we have to be real and recognize that there are no circumstances under which crowding a bunch of people into indoor spaces is a good idea. How many times are we going to have to learn this lesson? The Trib has more.

Abbott to allow bars to reopen

Sort of. It’s kind of the most Abbott thing ever.

Gov. Greg Abbott announced Wednesday that bars in Texas can reopen for in-person service next week — as long as their county governments choose to allow it.

Effective Oct. 14, bars in counties that opt in will be able to resume in-person service at 50% capacity, though all customers must be seated while eating or drinking. The governor will impose no outdoors capacity limits on bars or similar establishments.

“It is time to open them up,” Abbott said in a Facebook video. “If we continue to contain COVID, then these openings, just like other businesses, should be able to expand in the near future.”

But soon after Abbott’s announcement, the state’s two most populous counties indicated they would not go along with the reopening plan. Dallas County Judge Clay Jenkins said on Twitter that he “will not file to open them at this time,” noting that “our numbers are increasing.” Harris County Judge Lina Hidalgo said in a statement that “indoor, maskless gatherings should not be taking place right now, and this applies to bars, as well.”

In addition to bars being allowed to reopen, businesses currently limited to 50% capacity may now expand to 75% capacity — including establishments like movie theaters, bowling alleys, bingo halls and amusement parks.

But Abbott said in his order that bars in regions of the state with high hospitalizations for coronavirus won’t be able to reopen. He defined those regions as areas where coronavirus patients make up more than 15% of hospital capacity.

“It is time to open up more, provided that safe protocols continue to be followed,” Abbott said. “If everyone continues the safe practices, Texas will be able to contain COVID and we will be able to reopen 100%.”

The announcement drew mixed reviews from bar owners. Some applauded the step, while others complained that Abbott left the power in the hands of counties.

“The truth is we remain closed until someone else makes the decision to open us up based on whatever parameters they deem appropriate — data, politics, personal animus, you name it,” said Michael Klein, president of the Texas Bar and Nightclub Alliance. “Abbott has forced 254 other people to make this decision for him with no guideposts as to how to make that decision. He’s officially passed the buck.”

Klein predicted that most urban counties, where the majority of his organization’s members are located, will not reopen.

You can add Bexar County to that “no bars yet” list as well. There’s a very good reason why most counties will likely decline this invitation from Abbott:

You have to admire Abbott’s consistent strategy of making local officials be the ones who have to make the tough decisions – when he lets them – and otherwise grabbing the power and glory for himself. Naturally, Republican-led counties are all over this, so be sure to keep an eye on the infection rates in places like Montgomery over the next month. To be sure, many bars have been able to operate with various workarounds as restaurants. And for things like outdoor service and to-go service, I support all that. It’s not enough for most bars, and the best thing we could have done about that is allocate a bunch of federal money to help them all – bars, breweries, wineries, distilleries, restaurants, music clubs, hotels, you name it – get through this, to the point where the disease is under control and it is safe for everyone to gather again. Abbott and his buddies were never really interested in any of that, though, so here we are. I feel like I’ve said this before, but I sure hope this works out. I don’t expect that it will, but I hope so anyway.

UPDATE: At least initially, only Denton County among the ten most populous counties will go forward with bar reopenings.

And so the re-reopening begins

Are we really ready for this?

Gov. Greg Abbott announced Thursday that most of Texas will be able to loosen some coronavirus restrictions, including letting many businesses increase their capacity to 75%, as soon as Monday.

Retail stores, restaurants and office buildings, which have been open at 50% capacity, will be permitted to expand to 75% capacity. Hospitals will be allowed to offer elective procedures again and nursing homes can reopen for visitations under certain standards.

The new reopening stage applies to 19 of the state’s 22 hospital regions. The three hospital regions excluded are in the Rio Grande Valley, Laredo and Victoria. Abbott said those regions’ hospitalizations are still “in the danger zone,” which he defined as places where coronavirus patients make up 15% or more of all hospitalizations.

At the same time, Abbott said the state was not yet ready to reopen bars, saying they are “nationally recognized as COVID-spreading locations.” He stressed, though, that the state is looking for ways to let bars reopen safely.

[…]

“Gov. Abbott’s press conference today was notable for what he didn’t say,” state Rep. Chris Turner of Grand Prairie, who chairs the House Democratic Caucus, said in a statement. “There was no mention of a contact tracing program, no mention of improving the state’s unreliable data and no mention of expanding Medicaid to increase access to health care for the millions of Texans who are uninsured.”

The Texas Democratic Party said Abbott is “basing his decisions on dirty data.”

Abbott began the news conference by hailing the state’s progress in the fight against coronavirus, saying the “biggest reason” for improvements has been that Texans are taking the pandemic seriously and exercising personal responsibility.

The governor reminded Texans that doctors have said the goal is not to eradicate the virus but to “contain the disease, to limit its harm and to maximize the health care system’s ability to treat both COVID patients as well as other medical needs of the community.”

When it comes to further reopenings, he emphasized the state will consider all data but “rely most heavily” on hospitalizations, calling that metric the “most important information about the severity of COVID in any particular region.” It is also the “most accurate information available on a daily basis,” Abbott said.

To that end, the regions that will be allowed to further reopen must have seen coronavirus hospitalizations make up less than 15% of all hospitalizations for seven consecutive days, according to the governor. If coronavirus hospitalizations rise above the 15% threshold for seven consecutive days in a region, a “course correction is going to be needed,” Abbott said, suggesting the solution would be a reversal of the area’s latest reopenings.

Given that many other countries have essentially eradicated the virus, one could certainly disagree with Abbott’s assertion about what the goal should be. Though to be fair, it does seem impossible to set such a goal while Donald Trump is President, so perhaps this is just Abbott acceding to that reality. The Chron adds some details.

The new regional threshold marks a significant shift for the Republican governor as the state’s pandemic response moves into the fall, with flu season arriving and many schools about to reopen for in-person instruction. He previously resisted committing to a regional approach, and said he would rely on a range of metrics — not just hospitalizations — to determine policies.

But the state’s health agency has been dogged by data backlogs, and some counties said they had lost confidence in state metrics such as the number of new daily infections and the percent of positive COVID tests, also known as the positivity rate. While the state has remedied at least some of the issues, hospitalization data have been more reliable throughout the pandemic.

Other large states, including New York and California, are currently using regional reopening plans based on several criteria, including new cases and test positivity. Public health experts caution against relying on hospitalizations alone, since they lag behind infections and therefore provide a delayed glimpse into the community spread of the virus.

All but two of the state’s 22 hospital regions have previously surpassed the new 15-percent threshold, according to the state’s calculation. The governor did not provide the methodology for how they calculated the percentages, and a spokesman did not immediately respond to questions about how the benchmark was selected.

The state has reported nearly 700,000 infections since March and nearly 14,500 deaths, a toll similar to that in other large states, including California and Florida. New York has reported fewer infections but more deaths, stemming from a surge earlier this year.

Texas has been below 10 percent test positivity for at least two weeks now. Earlier this week, state health officials unveiled a new method of calculating the rate, which shows it first dropped below 10 percent in mid August. Abbott has said before that he would consider further reopenings once the state remained below that threshold for two weeks.

Yes, our lousy data quality is an issue. I get that there’s a lot of pressure to let businesses get back to “normal” again. But let’s be real here: One, plenty of people will still not change their habits to what they were in the Before Times until they feel confident that the pandemic is truly under control. Public opinion is clear that most people do not feel this way, and as such this greatly limits the upside of any reopening scheme. Two, we have been down this road before, and the last time we went this way Abbott basically ignored all the metrics that he himself set and just went about loosening restrictions even though none of his own stated criteria were being met. There’s no reason to believe he has learned this lesson. Three, even if we had complete clarity on hospitalizations, that’s a lagging indicator, meaning that by the time the hospitals have started to fill up again, it’s already too late to stop it. Four, see above about the lack of our data quality, which again strongly suggests that even if Abbott is sincere about turning the car around at the first sign of trouble, that first sign may not be at all apparent when it’s happening.

Finally, the reason why people finally started to take the pandemic seriously is because Greg Abbott finally started taking it seriously, and conveying a message that we all needed to be wearing face masks and social distancing and avoiding large gatherings, especially indoors. We certainly haven’t gotten that message from Donald Trump or his biggest toadies like Dan Patrick. If you want to praise everyone for their personal responsibility, then you need to emphasize that they have to continue being personally responsible, which means wearing masks and so on. If that makes the rock-filled heads of Steven Hotze and his ilk explode, then so be it. Abbott loves being in front of the parade, but he does a crappy job of leading it. As I said the last time we re-opened, I really hope this works out. And I really hope Abbott is serious about backing off at the first sign that it isn’t. A statement from Mayor Turner is here, and the Dallas Observer, Reform Austin, the Texas Signal, and the Houston Press have more.

We suck at COVID data, the continuing story

Would have been nice to have known this when it was happening.

State health officials published new data this week that showed the state’s positivity rate was higher in the spring that originally disclosed, even as public officials cited the data to justify business reopenings during the pandemic.

The Department of State Health Services on Monday announced a new method for calculating the positivity rate, or the proportion of positive tests, and conceded the previous method obscured the extent of viral transmission by combining old and new cases. The new formula relies on the date a coronavirus test was administered, rather than the date it was reported to health officials and verified as a case.

As Texas prepared for the first phase of reopening in late April, Gov. Greg Abbott repeatedly pointed to the state’s positivity rate, even as the number of new cases and deaths continued to rise. Announcing his initial reopening order on April 27, Abbott declared that the “COVID-19 infection rate has been on the decline over the past 17 days.”

The following week, the governor downplayed a new single-day record in new COVID-19 cases by again pointing to the positivity rate.

“Despite concentrating on areas where we think there may be a high level or number of people who could test positive, the fact remains that more than 95% of the people who were tested test negative,” Abbott said during a May 5 news conference.

State data at the time placed the seven-day average positivity rate at 5.84%, near the 5% benchmark recommended by the World Health Organization before governments ease restrictions. The actual rate, however, was higher. According to the new method employed by DSHS, Texas’ seven-day average positivity rate was actually 8.4%, near the 10% threshold Abbott had called a “warning flag” indicating a high level of community spread.

Following the reopening of bars, restaurants, stores and child care centers throughout May, Texas saw a surge in cases beginning in June. The state’s reported seven-day average positivity rate under the old method jumped from 4.27% at its lowest point in late May to 17.4% at its peak in mid-July. After revising the data, the state’s new chart shows that the positivity rate jumped from 5.81% in May to a peak of 21% in early July.

See here, here, and here for earlier entries in this chronicle. This stuff is hard, I don’t want to minimize that. Doctors and scientists have made mistakes and have changed their tune on COVID-related matters over time, as new data has come in and revised our understanding of what we thought we knew. Maybe no one could have known this at the time, I’m not in a position to judge. But as we’ve said before, the state rushed to reopen on Greg Abbott’s orders even as the Abbott-defined metrics for reopening were not being met. Now we know we were even further from the desired levels than we thought, and many more people have gotten sick and died or are suffering from long-term effects of the virus. We can have some level of sympathy for Greg Abbott, we can recognize that anyone would have made bad decisions if they were given bad data, and still hold him responsible for the outcome. His decision to reopen as he did was risky at the time, and it’s so much worse now. That’s all on him.

Scrambling to finish the Census

It’s a hell of a job, and it’s so important.

With a deadline looming for local governments to complete a population count for the 2020 Census, Houston Mayor Sylvester Turner is warning that the city could miss out on billions in federal funding for services such as road repairs and school lunches.

The reason? Less than 57 percent of the city’s residents have filled out the census form, a nine-question survey that can be completed by mail, phone or online. The city of Houston was planning a major outreach effort to avoid an undercount among young and poor people, immigrants and communities of color. The pandemic and economic insecurity from shuttered businesses, however, hampered outreach efforts and hobbled participation, officials say.

“September is the final month to respond to the Census,” Turner tweeted this month. “Over 40% of Houstonians have yet to answer 9 questions @mycensus2020.gov which could cost Houston $1500 person per year for 10 years. Please do so now.”

Sasha-Joi Marshall Smith, a city planner who has been coordinating outreach efforts, attributed low participation to political interference, civil unrest and the coronavirus pandemic. She is “terrified” about the economic and social reverberations of an undercount that’s now running about 15 percentage points behind 2010.

Every 1 percent of the population that’s not counted means $250 million in federal funding that the city is entitled to will be directed to another city, she said. “It’s that serious.”

“I tell people, ‘It’s our federal tax dollars… God forbid it goes to Dallas,’” she said. “Whether you were born here or not, it’s our job to make sure people here have basic services.”

Harris County faces a similar predicament, with just under 61 percent of residents having participated.

“There are so many pockets in Harris County where we haven’t heard from most people — perhaps a fraction of the people have responded but most have not responded,” said Tazeen Zehra, a senior census staffer in Houston.

Galveston County has had such a low return rate — 58 percent — that census workers have sought helpers from neighboring counties. Montgomery County is doing slightly better with just under 66 percent reporting. Fort Bend County has the highest participation rate in the state with more than 73 percent responding overall, including nearly 80 percent in Sugar Land.

The current deadline for local governments to complete their counts is Sept. 30. But outreach workers are hoping a federal judge will extend that deadline to Oct. 31 for the entire country at a court hearing in California next week. Harris County Commissioners Rodney Ellis and Adrian Garcia joined as plaintiffs in the California case because they’re concerned that their districts will be undercounted without an extension. The Trump administration previously offered an extension, then withdrew the offer.

We’ve discussed the challenges of the Census many times. The undercounting issue is so pervasive that even our retrograde state leadership has been forced to try to do something about it. There’s a temporary restraining order in that California lawsuit to which Commissioners Ellis and Garcia are parties, with a hearing scheduled for the 17th. I think the odds are good that the plaintiffs will prevail since “arbitrary and capricious” is the standard operating procedure for this administration, but even with those extra 31 days it’s going to be tough to get an adequate count. As with so many other things these days, this did not have to happen.

On a related note:

A three-judge federal panel in New York has ruled that the Trump administration cannot keep undocumented immigrants from being counted when lawmakers reapportion congressional districts next year — an effort that could have potentially cost Texas several seats in Congress.

In a significant departure from the way representation is typically divided up, President Donald Trump signed a memorandum in July directing Secretary of Commerce Wilbur Ross to exclude undocumented immigrants from the base population used to distribute seats in Congress. But in its Thursday ruling, the panel of judges deemed the memo an “unlawful exercise of authority granted to the President.”

The constitutionally mandated count each 10 years of every person residing in the country is used to determine congressional representation from each state. Excluding undocumented residents from the counts used to parcel out congressional districts would likely lead to a drastic realignment of political power throughout Texas.

Trump pursued the change by arguing that the U.S. Constitution does not define “which persons must be included” in that base population. But the New York panel of judges blocked Ross, who oversees the census, from providing any information on the number of undocumented people in each state.

See here for the background. This would almost certainly cost the state of Texas at least one if not two of the Congressional seats that it’s otherwise likely to get. Not that any of our state leaders care, going by their utter lack of any reaction to that memorandum. The courts can’t save us from everything, but they have been there at times like this.

We are not ready to re-reopen

I don’t know who needs to hear this, but…

Texas COVID-19 hospitalizations have declined the most significantly — 4,144 Tuesday, down from 10,893 on July 22 — but new cases, positive test rates, daily deaths and viral spread are all dropping. They are dropping enough that one Texas modeler, Spencer Fox of University of Texas at Austin, went so far as to say he thinks that Texas may have seen the worst of the pandemic — as long as people continue to wear masks and keep their guard up.

A number of other health experts warned against lifting restrictions, noting that the coming Labor Day weekend, the expected resumption of schools and seasonal weather changes have the potential to cause a resurgence like Texas experienced earlier in the summer. They also said the amount of transmission, although improved, is still way too high.

“I don’t want to be Debbie Downer, but we’ve been surprised before,” Catherine Troisi, an infectious disease epidemiologist at the UTHealth School of Public Health, said last Friday. “It’s a double-edged sword when things start looking better. The virus is still out there, but people think things can go back to normal.”

Troisi added that some experts are hesitant because of the state’s data reporting problems, because it’s possible some other issue will surface. Those problems include under testing, coding errors that caused backlogged results and combining positive diagnostic and antibody tests.

Chris Amos, a Baylor College of Medicine quantitative scientist, said “the timing could not be worse for rolling back.”

“Given the number who test positive reflect perhaps 10 times as many individuals who have not been tested but are positive,” said Amos, “there remains a large pool of individuals who can spread COVID-19 if they begin interacting with many others, and particularly if we allow large groups to start coming together again.”

Amos acknowledged that optimism about opening up is natural given the slowing of COVID-19’s spread. The spread is measured by a value, known as reproductivity, that suggests a slowing or growing of the virus. Over 1 means each infected person transmits it to an average of more than one person and the epidemic grows; under 1 means the virus is transmitted to less than one person and the epidemic won’t sustain itself.

The value for the state overall has been under 1 since July 20.

According to Amos’ calculations, if the state maintains the current trend, with the number around 0.87, it would take 38 days to reduce the COVID-19 burden by another 50 percent.

It’s important to keep reducing that burden before students resume in-person classes, Amos said. He and others advised against a one-size-fits-all approach.

“Not every community or county in Texas is experiencing the same burden of disease,” said Angela Clendenin, an epidemiologist with the Texas A&M School of Public Health. “In some places, it may be justified to roll back some restrictions whereas in others, it’d be ill-advised to do so. It will be critically important that rolling back restrictions does not send the message that we are somehow ‘all clear.’”

See here for the background. The basic fact remains that we are still at levels well above where we were in early June, when we first re-opened. There’s no question that if we re-reopened like we re-opened the first time around, we will get the same result. To me, three things are clear. One we shouldn’t change anything until we are back at early-June levels. Two, we should have sensible objective metrics that we can actually measure with accuracy and that we stick to, unlike the first time around. And three, give some discretion back to local jurisdictions so that the counties with a sufficiently low infection rate can be more open (though still within state guidelines) while those that aren’t ready for that kind of openness can continue to do what they need to do to get there. All of this should be screamingly obvious after what we just went through, but I see no reason to believe that Greg Abbott or Dan Patrick have learned anything from that experience.

Wait, there’s a Census going on?

I smack my forehead so hard.

Through a small notice tucked into the state’s business register, Texas appears to have acknowledged that the 2020 census count is going badly.

With just a month of counting to go in the crucial decennial census, the self-response rate for Texas households has barely topped 60%. As census workers have followed up in person with households that haven’t responded, the share of households accounted for has risen to 79.5% — but Texas is still far behind several other states and several percentage points behind the national average.

On Aug. 26, the Texas secretary of state’s office quietly put out word that it has up to $15 million to spend on an advertising campaign intended to urge residents to get themselves counted. The effort — which Texas will pay for by dipping into federal dollars meant to address the coronavirus pandemic — amounts to a last-minute about-face by the state, whose Republican leadership had previously shot down any significant state funding for efforts to avoid an undercount.

The urgency the state is feeling a month out from the census deadline is apparent in the timeline of its request for proposals for a broadcast, print and digital campaign to “educate Texans on the significance and value of participating in the 2020 Census” and drive up response rates. The notice was posted last week, and bids are due by Wednesday. The contract is projected to begin two days later. Counting for the census is set to end Sept. 30.

The latest census figures showed that households in urban, Democratic-leaning areas of Texas had filled out the census online, by phone or by mail at higher rates than those in more rural, Republican-controlled areas and South Texas communities. The U.S. Census Bureau’s door-to-door campaign to follow up with households that did not self respond to the census is ongoing.

Wait, you’re telling me that the deliberate choice made by the Republican leadership to not give a dime to Census outreach efforts may actually be coming back to hurt them politically? That’s a plot twist I hadn’t anticipated. Now it all makes some sense – if it was only Dems that were in danger of being screwed, for sure they wouldn’t care now.

The state’s sudden pursuit of a multi-million advertising campaign to promote the count comes more than a year after it left local governments, nonprofits and even churches to fill the organization void in chasing an accurate count.

“It’s frustrating that we’re doing this at the last minute,” said Luis Figueroa, the legislative and policy director for Every Texan, a left-leaning think tank previously known as the Center for Public Policy Priorities that has been at the forefront of census efforts in the state. “We hope there is enough time for it to be meaningful and effective. There’s an adage about ‘better late than never,’ but there is also ‘a day late and a penny short’.”

[…]

If enough Texans are missed in the count, it would jeopardize the three additional seats in Congress the state was expected to gain after this census.

Even as other states put millions of dollars to mount census campaigns, Texas lawmakers during last year’s legislative session declined to put additional state dollars toward the census, rejecting proposals by Democratic lawmakers to create a statewide outreach committee and set aside millions of dollars in grants for local outreach efforts.

Already without state funds, the local canvassing and outreach efforts were derailed by the coronavirus pandemic. Then, the U.S. Census Bureau announced it was cutting moving up the deadline for responding up by a month. Combined with the strain on outreach efforts brought on by the pandemic, the earlier deadline has heightened the risks that Texas will be undercounted and that some Texans, particularly those who are low-income or Hispanic, will be missed in the count as the pandemic continues to ravage their communities.

“Republicans had an opportunity to address this. They refused to do this, and now the secretary of state is in the fourth quarter of the game, in the final seconds, trying to throw a hail mary, and it ain’t going to work,” said state Rep. César Blanco, an El Paso Democrat who had unsuccessfully pursued state dollars for the census. “This is an embarrassment.”

See here for more on that earlier deadline, which is now even earlier than before thanks to continued malfeasance from the federal government. This was a deliberate choice by our Republican state leaders. We will pay the price for that choice for the next ten years.

From the “Those who forget the past are condemned to repeat it” department

Who’s ready to re-reopen Texas?

Gov. Greg Abbott signaled he may be preparing to roll back some emergency restrictions put in place this summer at the height of the state’s coronavirus surge.

Responding to concerns from the battered restaurant industry, the governor tweeted Monday night that new infections and hospitalizations from COVID-19 are receding, and added, “I hope to provide updates next week about next steps.”

“Since my last orders in July, COVID numbers have declined—most importantly hospitalizations,” said Abbott, a Republican.

The governor gave no indication about what steps he might take, and a spokesman did not respond to questions. Abbott has previously said he would consider allowing bars to reopen and restaurants to open further if positive trends continue.

Statewide, new daily infections and hospitalizations are declining, though they remain well above where where they were when Abbott began reopening the state in May — hospitalizations are now double, and average new daily infections are four times as high. It’s also unclear whether the rate of people testing positive, a key metric, is anywhere near where public health experts recommend before opening more businesses and allowing children back into schools.

What could possibly go wrong? See here for a statement from Mayor Turner, who unsurprisingly urges caution. You should also read this Politico profile of County Judge Lina Hidalgo, which I will blog about separately, and remember that at every step of the way in this crisis, Lina Hidalgo has been right and Greg Abbott has been wrong.

We are finally making progress in getting COVID-19 under control

Good news is always welcome, but be aware of the context.

Houston-area hospitalizations of COVID-19 patients dropped below 900 Sunday, the lowest amount since the summer surge peaked in mid-July.

Some 893 people confirmed or suspected of having COVID-19 were admitted to hospitals in the nine-county area around Houston Sunday, the fifth straight day under 1,000, according to data compiled by the Houston Chronicle. The latest number represents a 67 percent decline since July 14, when hospitalizations hit a high of 2,694.

The last time the number was under 900 was June 15. The number hospitalized then was 820.

COVID-19 related patients in intensive care units also hit a post-surge low Sunday. There were 402 such patients in ICUs Sunday, down from a high of 1,057 July 18. Sunday’s amount was the lowest since June 17, when Houston-area hospitals reported 398 ICU patients.

[…]

The decline in hospitalizations continue a trend of improving COVID-19 numbers in the Houston area. Other key metrics include a TMC COVID-19 positive test rate of 6.7 percent over the past seven days, down from 8.6 percent a week ago and 16.8 percent a month ago; and the 14th straight day in which the rate of the disease’s spread was below 1.0, meaning those infected are passing it on to an average of less than one person each.

That’s all very good, and you should click over to the story to see the embedded charts. I would just note that on the first chart, which shows the daily count of COVID-19 patients in hospitals affiliated with the seven healthcare systems based in the Texas Medical Center, the total daily hospitalizations due to COVID are way down from the peak in July, it’s also more than fifty percent higher than it was in early to mid-June, at the start of the rapid increase in infections. For example, on June 5th the total number of hospitalizations due to COVID-19 (ICU plus general beds) was 537, very close to what it was in mid-April. On August 22, the total number was 908. That is indeed way better than the mid-July peak that topped 2,400, but we still have a way to go and we can’t afford to loosen up just yet.

The story is similar in San Antonio.

The coronavirus positivity rate in Bexar County dipped to 9.9 percent on Monday, a measure that officials consider “very good news” when it comes to efforts to mitigate the impact of the virus.

The positivity rate – the percentage of those tested for the novel coronavirus who test positive – is considered a key indicator of how localities are faring against the coronavirus. Calculated on a weekly basis, it was at 11 percent last week, and Mayor Ron Nirenberg said Monday marked “the first time the positivity rate has been below 10 percent since early June.”

The positivity rate in Bexar County was as high as 25 percent in early July, he said.

With 109 new coronavirus cases reported Monday, the total stands at 45,364 since the pandemic began.

[…]

Local hospitalization rates continue to improve, with 473 people currently being treated at area hospitals, down five from Sunday. Of those, 207 are in intensive care and 139 are on ventilators. However, officials said the hospital system continues to be under high stress.

Four more deaths were reported Monday, raising the overall death toll to 725.

The seven-day moving average (the average number of positives within a 7-day period) in Bexar County increased only slightly to 148 on Monday, but continues to trend in the right direction, officials said.

Again, good news, but again look at the chart. This one shows the seven-day average of new coronavirus cases in Bexar County, which on June 5 was 74 and on August 22 was 137. That’s way down from the peak of 1,600, but still almost double what it once was.

I don’t want to underplay this, these numbers are so much better than they were a month ago, and the trend is clearly going in the right direction. We may get to those April/May/June levels in another week or two at this rate, and that’s excellent. But remember, April is when we were under the strictest shutdown orders, May is when the numbers were at their absolute lowest and also when we started reopening, and June is where it all started to fall apart. We can cautiously start to reopen again once the numbers are back down to these levels, but only if we stay committed to wearing masks and social distancing and avoiding large indoor gatherings. I would like to think that this time we really did learn the lessons we needed to learn to keep this virus at a manageable level, but it would be very easy for us to forget it all again, and repeat this cycle as if we knew nothing. The choice is ours.

Who knows what our positivity rate is?

From the We Still Suck At Data Department:

As schools begin to reopen and Gov. Greg Abbott faces pressure to relax shutdown measures, it is impossible to determine where Texas stands on a COVID-19 metric that has guided the governor’s decisions on when to tighten or loosen restrictions on businesses and public activity.

Over the past week and a half, the state began reporting coronavirus data from a backlog of 500,000 viral tests that officials say accumulated because of coding errors from Quest Diagnostics, Walgreens and CHRISTUS Health — all private entities that process the tests.

The result has been an ongoing miscalculation of the “positivity rate,” the rate at which people test positive for the virus.

Last week, it reached as high as 24.5 percent, and suddenly dipped back down again to about 11 percent this week as more backlogged tests were included in the data. Abbott has said a sustained positivity rate below 10 percent would allow for further reopenings in the state.

The influx of backlogged tests, dating as far back as March, has also exposed a convoluted reporting system that requires state officials to receive lab results, send them back to counties and wait for them to return to the State Department of Health Services before counting them.

The result is a mess of information reported recently to the public in “data dumps” that include test results from months prior, skewing statewide coronavirus statistics and positivity rates.

“The timing of it is horrible because it’s right at the beginning of opening the schools, when you want your data to be as accurate as possible, and it’s not,” said Darrell Hale, a Republican commissioner in Collin County.

The county on Wednesday pasted a disclaimer to its COVID reporting site declaring “no confidence” in the state’s numbers, which Hale said have ballooned in recent days even as lab-confirmed COVID-19 hospitalizations have declined.

[…]

Abbott faulted private labs for the glitches, as well as technological issues in the state’s own reporting system, which did not have the capacity to process more than 48,000 tests per day until Aug. 1. The state did not disclose the issue as it built up throughout July, when as many as 67,000 tests were conducted each day.

It may well be that the private labs can’t keep up with the demand. But:

1. Greg Abbott knew about this problem for at least a few weeks without ever saying anything about it.

2. The positivity rate was and is one of Abbott’s key metrics that were supposed to guide how and when we reopened things. Greg Abbott is currently not allowing local health authorities to make their own decisions about whether it is safe to open schools even though the data that we all need to know what the risks are cannot be trusted.

3. Greg Abbott continues to support and defend the federal government and its completely disastrous response to the pandemic, even though the federal government is the one entity in the country that could have marshaled the responses to meet the demand for testing. Nearly six months into this crisis, the federal government, under Donald Trump, which Greg Abbott supports, has made zero headway on this issue.

So yeah. Our data sucks, we are reaping the consequences of that failure, and the responsibility for it in this state rests with Greg Abbott.

Time for another COVID roundup

Let’s start with some good news, which comes wrapped in a warning.

The number of coronavirus patients crowding hospital wards in the Houston area is now in its sixth week of steady decline, a welcome reversal of the virus’ alarming surge in June and July.

The headcount of COVID-19 patients has fallen by half since its mid-July peak in hospitals affiliated with the seven systems based in the Texas Medical Center. And the number of intensive care patients at those facilities has dropped by a third.

The subsiding wave has merely shifted civic leaders’ concerns, however — and not only because hospital headcounts, new cases, and other metrics remain well above their levels before the spike.

Worried that Houstonians will invite another crisis by concluding it is safe to attend cookouts or crowd onto restaurant patios, public officials and medical leaders are stressing that the best measures of success are not empty intensive care beds but an absence of widespread infections.

“I do worry about people listening to this news and taking it the wrong way, saying, ‘Whew that’s over, now let’s go back to life as normal,’” said Dr. Esmaeil Porsa, CEO of Harris Health, the county’s public hospital district. “This is not the time.”

[…]

In every case, these metrics suggest the Houston region remains well short of containing the virus. The testing positivity rate, for instance, is about 15 percent in the city and county, and 10 percent among TMC institutions.

What about case counts? Harris County over the last week has averaged more than two and a half times as many daily cases as the 400 it would take to step down from Hidalgo’s top threat level. And the nine-county Houston region is averaging almost nine times as many new daily cases as the TMC goal of 200.

Another of Hidalgo’s metrics calls for the share of intensive care patients who have COVID-19 to not exceed 15 percent; the share of ICU patients in the county who have COVID-19 remains more than double that.

We’re headed in the right direction, but we’ve still got a long way to go. Stay home. Maintain social distancing. Wear a mask. Wash your hands.

And while case numbers may be coming down, fatality numbers are higher than we’ve counted.

Since the start of the COVID-19 pandemic in Texas, the state’s death toll from all causes has soared by thousands above historical averages — a sobering spike that experts say reveals the true toll of the disease.

Between the beginning of the local pandemic and the end of July, 95,000 deaths were reported in Texas, according to U.S. Centers for Disease Control data. Based on historical mortality records and predictive modeling, government epidemiologists would have expected to see about 82,500 deaths during that time.

The CDC attributed more than 7,100 deaths to COVID-19, but that leaves roughly 5,500 more than expected and with no identified tie to the pandemic. The CDC’s chief of mortality, Dr. Bob Anderson, said these “excess deaths” are likely from a range of pandemic-related problems, including misclassifications because doctors did not initially understand the many ways that COVID-19 affects the circulatory system and results in a stroke or a heart attack.

“It can cause all sorts of havoc in the body,” he said.

The CDC data offers an opaque but important estimate of how deadly the virus has been in Texas, which suffered from testing shortages for weeks as COVID-19 case counts climbed.

“It has shocked me to see people think that there’s overcounts of the COVID deaths, because I can’t even imagine that that’d be the case,” said Mark Hayward, a professor at the University of Texas who studies mortality trends. “The undercount is so dramatic.”

And there is a clear racial disparity in the undercounts. Between March and the end of July, Texas recorded more than 21,000 deaths of Latinos — more than 5,000 higher than epidemiologists predicted. Of those, about 2,100 were attributed to COVID-19. That leaves more than 3,000 deaths in excess of the expected number, many of them in border counties that lack resources for testing.

This is a phenomenon we’ve seen literally around the world. We’ve certainly known that it’s happening in Texas. The expert opinion is that we’ve already passed 200K deaths nationally, or about 25% more than the official count. If you could read one of the names of those 200K dead Americans every second, it would take you over 55 hours, nonstop, to read them all. Think about that for a minute. Or for 55 hours.

Also, too, we still suck at testing.

After plummeting for days, the number of COVID-19 tests reported in Texas suddenly jumped by 124,693 on Thursday, which state health officials said was a result of coding errors and a system upgrade.

Backlogs at a hospital lab and a commercial lab accounted for most of the tests, which could not be added to the state’s official tally until the coding errors had been fixed, said Lara Anton, spokesperson for the Texas Department of State Health Services.

Of the 124,000 tests reported on Thursday, approximately 95,000 were from a lab that served several hospitals, Anton said, adding that the lab sent files containing an error in one of the data fields, which DSHS’ electronic system could not read.

DSHS doesn’t know when the tests were actually conducted and is working with local health departments to find out, she said.

[…]

Whether because of human error, shifting benchmarks or bureaucratic changes, it’s not the first time that Texas officials have corrected their data since the beginning of the pandemic. Almost every major data point has come with caveats, sometimes blurring for days the big picture of the pandemic in Texas.

It is what it is. I don’t know what else to say.

Finally, the coin shortage is real, y’all.

Some retailers have started posting signs notifying customers that they might not be able to provide exact change for their purchases, and instead ask for them to pay with a credit or debit card or exact payment.

“It’s not like coins are not there,” said Venky Shankar, professor and director of research at the Center for Retailing Studies in Texas A&M University’s Mays Business School. The coins are just being used less as business has slowed and more people stay home.

Another hurdle for coin usage, Shankar said, is the fear that money could carry the novel coronavirus, even though experts don’t know definitively whether cash actually poses a threat.

In order to keep coins circulating, the U.S. Mint has asked people to pay with exact change. “We ask that the American public start spending their coins, depositing them, or exchanging them for currency at financial institutions or taking them to a coin redemption kiosk,” the mint said in a news release. A new task force — the U.S. Coin Task Force — has also been charged with determining how to reinvigorate the supply chain.

[…]

According to Shankar, roughly 45 to 50 percent of sales in smaller stores — places such as convenience stores — are made in cash. But big grocers such as H-E-B, Kroger and Walmart have also faced a shortage of coins.

In response to the shortage, some retailers and restaurants have started to pay or reward customers for their coins.

The U.S. Mint has also increased production from 1.2 billion coins in June to 1.35 billion coins per month for the rest of 2020, according to a Statista review.

But that doesn’t solve everything.

“That still will not unlock the coins that are already in the drawers and the banks,” Shankar said.

Laundromats, which rely heavily on coins to function, are among the businesses directly impacted by the coin shortage.

Yeah, that would suck if no one has any damn quarters. This is a problem all over, and offhand I have no idea what to do about it. I normally like paying for things in cash, but have barely used any since March. This is a teeny tiny reason for saying this, but we live in very strange times.

Who needs testing?

It’s the surest way to see the infection rate decline, am I right?

The number of Texans being tested for the coronavirus has fallen sharply in recent weeks, a trend that has worried public health experts as officials consider sending children back to school while thousands more Texans are infected each day.

In the week ending Aug. 8, an average 36,255 coronavirus tests were administered in Texas each day — a drop of about 42% from two weeks earlier, when the average number of daily tests was 62,516.

At the same time, the percentage of tests yielding positive results has climbed, up to 20% on average in the week ending Aug. 8. Two weeks earlier, the average positivity rate was around 14%.

On Saturday, the state set a record for its positivity rate, with more than half of that day’s roughly 14,000 viral tests indicating an infection.

Taken together, the low number of tests and the large percentage of positive results suggest inadequacies in the state’s public health surveillance effort at a time when school reopenings are certain to increase viral spread, health experts said.

“Opening the schools is a really complicated problem, and the best thing we can do is get the number of cases down so kids can go back to school safely,” said Catherine Troisi, an infectious disease epidemiologist at UTHealth School of Public Health in Houston. “There are so many reasons why kids need to be in school, particularly younger kids, but we’re finding out more and more they can get infected, and the concern is them bringing it home and spreading in the community and spreading to teachers.

“I think the worst thing would be for schools to open, then close,” she said. “That really makes it hard on parents, that unpredictability, and there’s a lot of costs associated with opening the schools safely.”

[…]

The number of tests performed in Texas has “never been great,” said Vivian Ho, a health economist at Rice University and Baylor College of Medicine, but “it’s extremely troubling” that the numbers have dipped since last month.

“It’s troubling because we can guess at some of the reasons, but we’re not sure,” she said.

She suggested that some people may have been discouraged by long wait times for test results, or less concerned about the virus’ toll in Texas after a frightening peak in July began to flatten out.

A declining number of tests is a particularly thorny issue for schools, Ho said. “No public school has the resources to do testing under the current circumstances. There are huge class sizes and crowded hallways,” she said.

Does any of that sound good to you? Because none of it sounds good to me. Again I say, remember when Greg Abbott’s plans for reopening included sufficient testing capacity and a positivity rate under ten percent? Boy, those were the days. Oh, and as the story notes, the TEA still hasn’t yet released any specifics on which districts will be able to receive waivers to limit in-person instruction beyond eight weeks or under what circumstances. So, you know, the school situation remains a mess. Isn’t this fun?

It’s like we don’t want any extra Congresspeople

As someone once said, where’s the outrage?

For months, as Texans have been asked to stay home to avoid the spread of the new coronavirus, Jennifer Edwards has been doing the rounds at gas stations in a trio of counties near the Texas-Louisiana border.

Volunteering as a census community organizer, the Tarleton State University professor reasoned that gas stations, like grocery stores, would continue to see foot traffic during the pandemic. Setting up a booth just outside the front doors offered her face time with essential workers to deliver an essential message — please fill out the census.

“When we’re meeting with people in front of the tractor supply or the dollar store or the gas station … the communication is focused on ‘Well when does it end, what’s the deadline?’” said Edwards, who had been sharing the pandemic-induced October deadline for counting every person living in the U.S. for the once-a-decade census.

But on Monday evening, the U.S. Census Bureau upended the timeline Edwards and hundreds of other organizers, volunteers and local officials had been working under. After previously stating the census would run through Oct. 31, the bureau announced it was cutting the count short by a month, moving up the deadline for responding to Sept. 30.

The October cutoff had offered organizers crucial overtime for the count after the coronavirus pandemic derailed a ground game for canvassing and outreach efforts that in some regions of the state had been in the works for years. Now, the earlier deadline is heightening risks that Texas will be undercounted and that some Texans, particularly those who are low-income or Hispanic, will be missed in the count as the coronavirus pandemic continues to ravage their communities.

The schedule change comes at a key point in the count. The bureau has started its door-to-door campaign to follow up with households that have not yet filled out the census online, by phone or by mail, but census workers won’t reach some communities in Texas, like the Rio Grande Valley, that are at the highest risk of being missed until next week.

“It seems like not only are they cutting back the time they’re giving themselves to do this nonresponse follow up, but they’re also allocating the least amount of time in the hardest-to-count places in the state,” said Lila Valencia, a senior demographer at the Texas Demographic Center.

This follows Donald Trump’s efforts to exclude certain people from the Census data for redistricting purposes, as well as the state’s refusal to pay for any effort to do a thorough Census count. It’s like there’s a conspiracy to keep Texas from getting the up to three additional members of Congress that it would be due if everything went as it should. And also, you know, billions and billions of federal money that our taxes contribute to that will instead flow to other states because the Census says we have a lot fewer people than we actually do. I get what Trump’s motivations are here. I have a much harder time understanding why this isn’t a problem for Greg Abbott and Dan Patrick and Ken Paxton and John Cornyn and Ted Cruz and every Republican running for Congress. Why do they all want to hurt Texas like this? It’s a question that should get asked, a lot.

When Houston is more like Austin

In a climate sense. Which is to say, drier because of climate change.

A new study predicts that Texas’ climate is going to get drastically drier because of climate change. The journal Earth’s Future recently published the study looking at historical drought records, and it projected that the second half of the 21st century could be Texas’ driest of the last thousand years.

One of the study’s authors, Texas State Climatologist John Nielsen-Gammon, spoke with Texas Standard host David Brown on Tuesday about the future of the states’ climate and water supply.

“Conditions, on average, would be drier than we’re used to, and when we get extreme droughts, those will be drier as well,” he said.

Nielsen-Gammon said that could initiate a westward shift in the state’s climate – meaning, San Angelo’s climate becomes more like Midland’s; Houston’s climate becomes more like Austin’s, and so forth.

Reducing carbon emissions is the long-term solution to the problem that comes from a warming planet. But Nielsen-Gammon said that requires massive changes on a global scale that haven’t happened yet.

So Texans would be wise to prepare for drier conditions. And that includes planning for possible water shortages.

I’ve blogged about water issues and the challenges our state faces, as it sits at the crosswords of rapid growth, climate change, and a lot of people living in very dry places to begin with. Water conservation, wastewater recycling, desalinization, and on and on. The challenges we already face will be greatly exacerbated by climate change, and it’s going to change the state at a fundamental level.

The study highlighted a slew of looming problems for the state’s water supply. First, climate change will lead to even more megadroughts. In the latter half of the century, those droughts are likely to be worse than any of those previously on record.

“Our study shows that the drier conditions expected in the latter half of the 21st century could be drier than any of those megadroughts, depending on how you measure dryness,” lead researcher and A&M professor John Nielsen-Gammon wrote in a press release.

Second, the higher temperatures brought about by climate change will lead to more evaporation from the surface lakes that many parts of the state rely on. This problem will be particularly pronounced for Dallas, which relies entirely on surface water for its water supply, the study says.

Third, the state’s population is continuing to grow — from just under 30 million now to a projected more than 50 million in 2070 — meaning the demand for water will go up as the state gets drier.

“We’re warming up the atmosphere; that’s been happening and is projected to make the droughts more severe, but in cities like Austin, Dallas, Houston, the Rio Grande Valley and San Antonio, we know that populations are continuing to grow at a rapid pace,” said Jay Banner, a professor at UT-Austin who co-authored the study.

Merry Klonower, a spokesperson for the Texas Water Development Board, which offers water planning assistance to municipalities, said that each of 16 regional water planning areas throughout the state is required to take into account population projections for the next 50 years when making water supply decisions.

“And if there is a shortage, then the very next step is they have to determine how they are going to meet their water supply needs for that growing population,” she said. “So we have been doing this since the ’90s and it is a very robust process. So the state is well-prepared and is looking at future populations and water supply needs for municipalities.”

I’m sure we have been preparing and planning for years, but I’m also pretty sure we’ve been underestimating the scope of the problem all along. I mean, if we took it with an appropriate level of seriousness, we’d have a very different set of government leaders in place and would have had a much different set of priorities in this state. It’s still not too late to try to reduce the effects of climate change, but every day that passes is one day less we have for that, and one day closer to the future studies like this predict. What are we going to do about that?

We still suck at COVID data

I’m sure none of this is important.

The government’s official data on the coronavirus outbreak is startling: More than 4.6 million cases in the U.S. More than 440,000 in Texas. More than 70,000 in Harris County.

But those numbers don’t include all positive COVID-19 patients.

Texas, unlike 27 other states, excludes the results of increasingly popular, rapid COVID-19 tests from the numbers it reports publicly — obscuring the scope of the pandemic, records and interviews show. The antigen tests are used in doctor’s offices, hospitals and stand-alone clinics and deliver results in less than 30 minutes.

But conflicting guidance from the Texas Department of State Health Services created confusion among local health departments about what test results to report. A reliance on faxed test results has created a paper backlog that makes it impossible for the state to do its own tally.

And while there is no way to independently estimate the scope of the undercount, based on the 11 Texas counties that publish antigen tests results separately of their own accord, the state’s tally is short by at least tens of thousands of cases — but likely far more, a Houston Chronicle analysis found.

And the undercount is about to get worse. The federal government is rolling out a program to use thousands of antigen tests in nursing homes across the country — including Texas.

State Rep. Gina Hinojosa, D-Austin, who serves as vice-chair of the House committee that oversees the state’s public health agencies, said the lack of reliable data is hindering the overall COVID-19 response effort in Texas.

“The only way people will be inspired to act right without government mandates is if they have the information they need to make smart choices,” Hinojosa told the Chronicle. “And that has been just impossible to come by.”

The problem, apparently, is that the state considers a positive antigen test to be a “probable” positive for COVID-19, not a definite positive. I mean, I figure a couple of data geeks could work out a decent solution for this in less than a day’s work, so color me baffled by the confusion here. And if you’re confused for other reasons, please note that antigen tests are different from antibody tests, which determine if you have had COVID-19 in the past, and thus should be in a separate category. It would be nice if we could get this all straightened out. The Trib has more.

The Renaissance Festival will go on

I haven’t gone to RenFest in years, and I can’t say I was itching to go this year, but it will be there for those who want it.

The 46th annual Texas Renaissance Festival will go on as scheduled this year, but things will look a little different due to the pandemic.

Beginning Saturday, Aug. 1, tickets will be available for the 2020 festival, which starts Oct. 3 and runs through Nov. 29. Tickets will be date-specific, sold in advance online only and will not be available at the gate, according to the festival website. Tickets may also be purchased at participating H-E-B stores beginning Sept. 1.

The most visible change at the nine-week-long festival is that all staff, performers and vendors will be required to wear a face-covering and receive daily temperature checks before each shift, according to a press release.

If a statewide mask order is in place at the time of the festival, patrons will also be required to wear face masks. If no state order is in place, patrons will not be required but “strongly encouraged to do so.” In line with the festival’s long-standing tradition of themed weekends and creative costumes, a face mask contest will be held every day in search of the attendee with the most creatively decorated mask.

Texas counties with more than 20 coronavirus cases are currently under a statewide mask order. Grimes County, where the festival is held, has 828 confirmed COVID-19 cases, according to the latest available data from the Texas Department of State Health Services. The Houston region is still considered a COVID-19 hotspot and is currently at 98,565 cases total. Texas saw the second-highest day for newly reported deaths on Wednesday, per a Houston Chronicle analysis of state data.

[…]

[Texas Renaissance Festival Marketing Manager Marlena] Solomon said the festival’s 200-acre campground typically never meets 50 percent capacity during a normal season, so capacity limitations will not be issued for this season. She added that in anticipation of capacity limitations that could be issued closer to October, the festival grounds will be limited to 22,500 guests per day.

My interpretation of this is that all guests would be required to wear a mask at this time, since Grimes County is covered by that statewide mask order. But after reading this additional story, I’m not so sure of that.

The mask-optional policy has left some workers feeling that the festival will be unsafe. Niki Korontana has been working at the Renaissance Fest for 12 years, performing as a Transylvanian and pirate for 10 of those years.

She is anemic and has to have iron infusion treatments to correct the disorder. Her fragile immune system leaves her vulnerable to COVID-19, she said, and the festival’s resistance ro institute a mask order puts her in danger. She said she resigned via email and has not received a response from management.

“I do understand that we’re dealing with a lot of upheaval,” she said. “Maybe getting back to me is not a priority, but I put a lot into this job. There’s no way to socially distance in a lot of places. There’s limited access to water and hand-washing. The faire population, as a whole, is broke with no access to health care. On the regular we all get ‘faire sick’ every year even without the outbreak. We’re used to working through all of that, and I can easily imagine people infecting others.”

The festival has lost more than half of their performing staff this year, said marketing and communications manager Marlena Solomon. That estimate includes elderly workers, people in at-risk populations and those who may not want to wear masks in the hot early weekends of the event.

“We respect their decision not to come this season due to their concerns regarding facemasks,” Solomon said. “They will be welcome back next year. No one will be penalized for not being a part of this season.”

Ginnie Eatchel, who has worked at the festival for five years, doesn’t have health issues, but she said she’s quitting, too, without at mask mandate. She said she doesn’t understand how patrons can expect performers to work in full medieval dress, including suits of armor, while they balk at being asked to wear a mask.

“Many of these people at fair are of the Trump mindset saying, ‘No one can impede on my freedom’ or ‘If they make me wear a mask, I’m not buying a pass this year,’” she said. “It’s such a selfish mindset. You’re doing it for other people.”

Solomon said that partisan concerns are not behind the voluntary mask policy. “The decisions are not being made based on political views of our patrons,” she said.

Sure seems like a good case for mandating masks to me. I’d prefer that the RenFest require mask wearing, but I’m not likely to attend anyway, so who cares what I think. Honestly, I’m a little surprised to see that they’re open at all, since many other outdoor events have been cancelled. I would have thought RenFest is sufficiently spaced out that they can reasonably minimize the risks, but now I’m rethinking that. Sure would be nice to be able to do reliable contact tracing just in case. Anyway, RenFest has been going through some changes, so maybe this was just about trying to have a little more normality in our lives. I can sympathize with that.

So we really were undercounting the COVID-19 death rate

Can’t say I’m surprised.

After months of undercounting coronavirus deaths, Texas’ formal tally of COVID-19 fatalities grew by more than 600 on Monday after state health officials changed their method of reporting.

The revised count indicates that more than 12% of the state’s death tally was previously unreported by state health officials before Monday.

The Texas Department of State Health Services is now counting deaths marked on death certificates as caused by COVID-19. Previously, the state relied on local and regional public health departments to verify and report deaths.

Public health experts have said for months that the state’s official death toll is an undercount. State health officials said Monday that the policy change would improve the accuracy and timeliness of their data.

Texas law requires death certificates to be filed within 10 days.

“This method does not include deaths of people who had COVID-19 but died of an unrelated cause,” the Texas Department of State Health Services said in a news release.

[…]

After the number of infections in Texas soared to new highs in June and early July, the rate of deaths in Texas has been accelerating. It took 53 days to get from the first death to 1,000 deaths and 39 days to get from 1,000 to 2,000 deaths. On July 10, the state surpassed 3,000 deaths — 24 days after 2,000 deaths were reported. And it took only 10 more days for Texas to reach 4,000 deaths.

While Texas continues to report daily deaths in the triple digits, the number of new daily cases seem to be stabilizing. In the past week alone, state data appears to show new daily infections leveling off, albeit at nearly record highs.

The state recorded its largest number of daily new cases July 15, at 10,791. On Sunday, that number was 5,810.

I’m not sure I fully understand what was changed, so I don’t have much to say about this. I think one can argue that we’re still undercounting the true number of COVID-19 deaths, because it has been known for a long time that some people who almost certainly had the virus die at home without ever having been tested. More broadly, people have died as a result of delaying or skipping medical care for other issues because they feared catching COVID from going to the doctor’s office or emergency room. Maybe those aren’t “official” deaths, but they are deaths that wouldn’t have happened in a non-pandemic situation. I suspect we won’t really understand the scope until some years from now when academics can do a deeper analysis of all the data. In the meantime, this is what we have. The Chron has more.

The contact tracing debacle

Let us never forget about this.

Just as coronavirus infections began rising a few weeks ago in Texas, contract workers hired by the state to track down exposed Texans were spending hours doing little or no work, received confusing or erroneous instructions and often could not give people the advice they expected, interviews and records indicate.

Health authorities around Texas also say they are running into technical snags with new contact tracing software the state has deployed, known as Texas Health Trace, saying it isn’t ready for widespread use in their counties.

The chaotic beginning and technical glitches — combined with exploding case counts and widespread testing delays — have undermined the goals of boosting COVID-19 monitoring statewide and the state’s massive deal for a privatized contact tracing workforce.

“I know that a lot of local health departments are still trying to figure out how to utilize that contract and some have decided to do the work on their own,” said David Lakey, chief medical officer at the University of Texas System and former commissioner of the Department of State Health Services (DSHS). “There is concern with local health department individuals I’ve talked to related to how they are going to benefit related to this large investment from the state.”

DSHS said problems identified by the Houston Chronicle have since been fixed and that “every week” more counties are using its software.

Gov. Greg Abbott’s office said months ago that robust contact tracing capacity would help Texas “box in” the coronavirus. But after the state reopened its economy, infections, hospitalizations and deaths skyrocketed, making it impossible for many health departments to keep up with contact tracing.

“When you kind of jump the gun a little bit and open too soon, and you skip the processes that need to be in place, this kind of thing happens,” Harris County Judge Lina Hidalgo said. “You might have the most successfully designed contact tracing program or you may not, but honestly it’s not gonna make a difference because you’re setting yourself up to fail.”

At the state level, Texas moved to ramp up and modernize contact tracing in May, when the Texas Health and Human Services Commission quietly awarded a $295 million contact tracing deal to little-known MTX Group, a tech startup that has a headquarters in North Texas. Abbott’s office has staunchly defended the emergency expenditure, but it’s been controversial from the get-go.

The bid for the work, which was never publicly posted, was awarded to MTX without input from top state leaders, and more than a dozen legislators subsequently called for the state to cancel the contract.

More recently, four people who performed contact tracing work for MTX or one of its partners raised questions about the tech company’s performance. They spoke to the Chronicle on condition of anonymity because they weren’t authorized to speak on the record about their employment. Three said they fielded only a handful of phone calls during several weeks in May and June.

You can read on for details of the various failures of the program as implemented, and you can see here for more on Texas Health Trace. My point is that having a certain number of contact tracers in place, a number that was never met, was one of the four conditions of reopening set by Greg Abbott. The real failure here, as has been the case with everything else, was the complete lack of effort to meet those metrics that were set out. The failure to do so led directly to the situation we’re in now. The fact that MTX was given a no-bid contract on Abbott’s say-so and no one else’s input is a separate issue, one that deserves a fuller exploration, but not necessarily a main cause of the failure. It’s possible to imagine a scenario in which a legitimate and fully-resourced company could have gotten this contract in a similar fashion and done a better job with it. The process would have still been a problem, but at least the result was okay. Here we had both a bad process and a bad outcome, and both of those need to be investigated. They also need to be hung around Greg Abbott’s neck from now until November of 2022.

A very early glimmer of some possibly good news

We may be finally bending the curve, thanks to people finally taking seriously the need to wear face masks in public.

Three weeks after Gov. Greg Abbott required Texans to wear masks, epidemiologists and disease modelers say they are cautiously optimistic that the mandate is helping the state turn a corner in its efforts to contain an outbreak that has killed more than 4,500 Texans.

Throughout the summer, Texas’ coronavirus outbreak became grimmer by the day and by almost every metric: case counts, hospitalizations, deaths. But in the past week or so, Abbott and some of the state’s public health officials began to see hope in the daily case counts as they appeared to stabilize.

A growing body of evidence points to widespread mask-wearing as an effective strategy for containing the virus, and one North Texas researcher’s statistical analysis published this week argued that local mask orders in the region reduced viral transmission enough to avoid a lockdown. The governor, who has faced blistering criticism for his handling of the pandemic from members of his own political party, immediately seized upon those findings in defense of his statewide order.

“A community lock down is not needed as long as masks & other distancing strategies are used,” Abbott wrote Monday on Twitter, citing the analysis by Rajesh Nandy, a professor of biostatistics and epidemiology at the University of North Texas Health Science Center.

But public health experts warn that more restrictive lockdowns may still be appropriate in the state’s hardest-hit regions, as the disease continues to infect about 10 times as many people each day compared with two months ago, ravaging some parts of the state more severely than others.

State data now appears to show new daily infections leveling off, albeit at nearly record highs. There were around 9,100 daily new cases of the virus on average over the past week. The state recorded its largest number of daily new cases July 15, at 10,791. On Thursday, that number was 9,507.

“The downside is even though we are approaching another plateau, we are at a much higher level than in May,” Nandy said.

Yes, it would be good news if the case rate stops going up. But it won’t truly be good news until the number of infections starts to go down, and then continues to go down. You know, like it has in New York and Europe and Asia and other places with generally functional governments. It’s when we get the virus down to levels at or below where we were when we first shut down back in March that we can truly contemplate things like safely sending kids back to school and reopening the economy. You’d think this would be something that would be better understood by the elected officials who have been so resistant to taking basic measures to fight COVID-19 – poll data consistently shows that the public understands this, even if they’re not always great about doing it in the absence of leadership – but clearly for some people, these things have to be learned the hard way. And as they are learning this, the hospitals are still at capacity, and could get overwhelmed at any time.

The irony there is that it may take another broad, mostly national shutdown to get to the point we want to get to. That won’t happen under this President, and if it’s still a necessary thing under the next one, then my god have we effed this up beyond all comprehension. In the meantime:

Now Starr County is at a dangerous “tipping point,” reporting an alarming number of new cases each day, data show. Starr County Memorial Hospital — the county’s only hospital — is overflowing with COVID-19 patients.

The county has been forced to form what is being compared to a so-called “death panel.” A county health board – which governs Starr Memorial – is set to authorize critical care guidelines Thursday that will help medical workers determine ways to allocate scarce medical resources on patients with the best chance to survive.

A committee will deem which COVID-19 patients are likely to die and send them home with family, Jose Vasquez, the county health authority, said during a news conference Tuesday.

“The situation is desperate,” Vasquez said. “We cannot continue functioning in the Starr County Memorial Hospital nor in our county in the way that things are going. The numbers are staggering.”

That’s the same Starr County that was once lauded for its low infection rate and ability to keep the virus under control. That was back when local officials had the authority to make and enforce shelter-in-place orders, before Greg Abbott took that authority away. Starr County now plans to issue a new shelter in place order, though of course they won’t be able to enforce it. Greg Abbott could let them enforce it, and he could let other local governments that want to take a step back in an effort to get their numbers down do so, but that’s not something he has any interest in doing. And so here we are.

Here, have a COVID update

Things are going great.

Texas set yet another record for coronavirus deaths Thursday with 154 — the third day in a row above 100.

The previous record was July 8 when 112 deaths were logged, according to a data analysis by Hearst Newspapers that shows the state reported 105 deaths on Wednesday and 104 on Tuesday.

The streak in deaths comes two weeks after Republican Gov. Greg Abbott ordered most of the state’s 30 million residents to wear masks. Despite pressure from local authorities that he give back their ability to mandate stay-at-home orders, Abbott has insisted increased mask-wearing is the key.

Abbott told Houston’s Fox 26 on Thursday that “the last step that would ever be taken is to lock Texans back down” and said other measures would be taken before resorting to that.

“It seems like I get this question a thousand times a day, and there seem to be rumors out there about a looming shutdown,” Abbott said in the interview. “Let me tell you: There is no shutdown coming.”

It will take about three weeks, Abbott said, to see the effects of his mask mandate and his closure of bars in late June. Abbott claimed cases were flattening out in Harris County, though Hearst Newspapers’ analysis shows the county’s rolling average for new cases is more than three times higher than a month ago.

[…]

A new report from Kinsa, a company that uses internet-connected thermometers to predict the spread of diseases, showed that Texas’ rate of illness is spreading faster than those of other states. The company in the past few years has successfully anticipated outbreaks of the flu weeks ahead of the federal government.

The Kinsa data, which tracks whether an uncontrolled outbreak is likely using fever trends and other information, showed that the state is hitting above the threshold for the entirety of the past 30 days.

“This level of sustained, rampant disease transmission suggests that there is likely a lot more illness in the community than what has been reflected in the case numbers to date,” the company said in a press release Thursday. “In other words, there is no relief in store for Texas over the next few weeks, and we fear that the situation there may get much worse in the near-term.”

No, seriously, it’s just terrific.

A coronavirus patient in Anahuac was flown by helicopter to a hospital in El Campo — 120 miles away — because closer facilities could not take him.

Ambulances are waiting up to 10 hours to deliver patients to packed Hidalgo County emergency rooms.

And short-staffed hospitals in Midland and Odessa have had to turn away ailing COVID-19 patients from rural West Texas facilities that can’t offer the care they need.

As the tally of coronavirus infections climbs higher each day, Texas hospitals are taking extraordinary steps to make space for a surge of patients. Some facilities in South Texas say they are dangerously close to filling up, while hospitals elsewhere are taking precautionary measures to keep their numbers manageable.

Doctors warn of shortages of an antiviral drug that shows promise for treating COVID-19 patients. And epidemiologists say the state’s hospitals may be in for a longer, harder ride than places like New York, where hospitals were stretched to capacity in the spring and some parked refrigerated trailers outside to store bodies of people who died from COVID-19.

“It used to [be that] if one hospital got kind of overwhelmed … you would start transferring out ICU patients to other facilities that had ICU beds available,” said Dr. Robert Hancock, president of the Texas College of Emergency Physicians. “And there really is none of that now, because everybody’s in the same boat and they’re struggling to get their own patients admitted.”

You might say we’re red hot.

A document prepared for the White House Coronavirus Task Force but not publicized suggests more than a dozen states should revert to more stringent protective measures, limiting social gatherings to 10 people or fewer, closing bars and gyms and asking residents to wear masks at all times.

The document, dated July 14 and obtained by the Center for Public Integrity, says 18 states are in the “red zone” for COVID-19 cases, meaning they had more than 100 new cases per 100,000 population last week. Eleven states are in the “red zone” for test positivity, meaning more than 10 percent of diagnostic test results came back positive.

It includes county-level data and reflects the insistence of the Trump administration that states and counties should take the lead in responding to the coronavirus. The document has been shared within the federal government but does not appear to be posted publicly.

Dr. Ashish Jha, director of the Harvard Global Health Institute, said he thought the information and recommendations were mostly good.

“The fact that it’s not public makes no sense to me,” Jha said Thursday. “Why are we hiding this information from the American people? This should be published and updated every day.”

[…]

The 18 states that are included in the red zone for cases in the document are: Alabama, Arkansas, Arizona, California, Florida, Georgia, Idaho, Iowa, Kansas, Louisiana, Mississippi, North Carolina, Nevada, Oklahoma, South Carolina, Tennessee, Texas and Utah.

The 11 states that are in the red zone for test positivity are Alabama, Arizona, Florida, Georgia, Idaho, Louisiana, Mississippi, Nevada, South Carolina, Texas and Washington.

In May, the World Health Organization recommended that governments make sure test positivity rates were at 5 percent or lower for 14 days before reopening. A COVID-19 tracker from Johns Hopkins University shows that 33 states were above that recommended positivity as of July 16.

“If the test positivity rate is above 10 percent, that means we’re not doing a good job mitigating the outbreak,” said Jessica Malaty Rivera, science communication lead at the COVID Tracking Project, a volunteer organization launched by journalists from The Atlantic. “Ideally we want the test positivity rate to be below 3 percent, because that shows that we’re suppressing COVID-19.”

But don’t worry, Greg Abbott is on it.

As the number of new coronavirus cases in Texas continues to rise and hospitals grow more crowded, Gov. Greg Abbott said Thursday there is no statewide shutdown looming.

Abbott said last week that if the spread of the virus didn’t slow, “the next step would have to be a lockdown.” But in a television interview Thursday, he said that there have been rumors of such a move and stressed that they were not true.

“Let me tell you, there is no shutdown coming,” he told KRIV-TV in Houston.

Abbott pointed to measures he’s taken in recent weeks, including a statewide mask mandate and an order shutting down bars, to slow the spread of the virus. It will take a few weeks to see a reversal in coronavirus case surges, he said.

He has repeatedly stressed this week that, if people wear masks, he’ll be able to avoid shutting down the state. On Wednesday, he told KPRC-TV in Houston that it seems like people ask him about a shutdown “like a thousand times a day.”

“People are panicking, thinking I’m about to shut down Texas again,” he said. “The answer is no. That is not the goal. I’ve been abundantly clear.”

To also be abundantly clear, Abbott is correct that it will take a bit of time for the mask order and other interventions to work, just as there was a lag between the increasing case rate and subsequent increases in hospitalizations and deaths (not that we responded in time for them, but never mind that right now). He is also correct that universal face mask wearing would be a big help, though it may not be enough at this point, and he’s fighting headwinds from Donald Trump and his fellow Republicans on that score. And if we really want to be clear, we need to remember that Abbott mostly speaks in riddles these days, so we turn to an expert in the field for true clarity:

Yes, that’s the kind of straight talk you get from Greg Abbott.

Lawmakers quickly discovered something remarkable. It was possible to stare the man in the eyes, to speak with him for a half-hour or more, and walk away with no better idea of where he stood on important legislative matters. He seemed unwilling to speak forthrightly about nearly anything, drawing a veil around his positions, lest he alienate some key legislator or interest group.

When Abbott did make himself clear, it was to issue marching orders to those who had no reason to follow them, or to punish those who had defied him. “There was no comparison to Perry. [Abbott’s] concept of governing is ordering people around,” Republican state representative Sarah Davis told me in 2018. “He came into the regular session and kind of chided us, and then was absent for the rest of the session.”

And his public statements often contradicted his private ones. Publicly, Abbott endorsed the infamous anti-transgender “bathroom bill” in the 2017 session and pretended to advocate for its passage. But in private he reassured business groups—who worried the state would be boycotted by lucrative conventions and sports tournaments—that the bill would never pass. He was publicly accused of that duplicity by Republican state representative Byron Cook in 2018. The governor’s office has never addressed it.

[…]

Fast forward a few years, through 130,000 American deaths from the coronavirus, at least 3,500 of them from Texas so far, and the onset of the worst economic circumstances since the Great Depression. Now Abbott’s governing style is under strain. Arguably, the root cause of the current crisis is his tendency to talk a lot without saying much and his propensity to take the path of least resistance regardless of the circumstances, especially when confronted by the inchoate demands of the Republican party’s right wing. This modus operandi is on display every time Abbott gets in front of a television camera. But as we see more and more of it, the artifice is becoming more clear. Abbott’s disapproval numbers have been rising just a bit, even as other governors have seen a surge of popularity during the crisis.

Here, we could talk about Abbott’s quadruple-backflip on mask mandates; the time he issued a statewide lockdown disguised under a bureaucratic name while insisting it wasn’t one, before clarifying that it was the next day; the Shelley Luther saga, which saw him ordain that violators of his shutdown order should be punished with fines and jail time only to blame local officials for enforcing it, before retroactively nullifying what he had expressly commanded; or the way he opened the state for business before fixing the problems the lockdown was designed to address.

But instead, let’s consider a small but important test Abbott recently faced, one that seems instructive. Abbott’s party had long been planning to hold its state convention in Houston, one of the nation’s biggest coronavirus hot spots, which would have brought some six thousand attendees, many of them older and especially vulnerable to the virus, from all around the state for a crowded three-day fete. An in-person convention was a virtual guarantee that some delegates and service workers would get infected and possibly die, and that Houston’s seemingly potent strain of the virus would be spread around the state.

It was an incredibly bad idea that Abbott’s party nonetheless seemed hell-bent on pursuing. What did the governor have to say about it? Would he speak up, in an attempt to save the lives of his own party’s activists? “You’re the top Republican in the state, governor,” said an anchor for KDFW in Dallas on July 6, after Houston mayor Sylvester Turner begged the party to call off the gathering, then canceled it two days later. “What do you think should happen?”

The governor’s answer: “I know that the executive committee for the Republican Party of Texas have been talking about this. I think they continue to talk about it, and they weigh all of the consequences and the public health and measures … They’ll make a decision.”

The anchor persisted: “You don’t want to weigh in on what you think should happen?”

The governor paused and then gave his answer: “Obviously I think whatever happens—whether it be, listen, this convention or any action that anybody takes—we’re at a time with the outbreak of the coronavirus where public safety needs to be a paramount concern, and make sure that whoever does anything and whatever they do, they need to do to reduce the spread of the coronavirus.”

Huh?

A day later, an anchor for KENS in San Antonio tried a different tack: “Will you be attending in person?” Abbott dissembled, so the anchor tried again. “Yeah, listen, as for myself, as well as for everybody else,” Abbott said, “we will continue to see what the standards are that will be issued by the State Republican Executive Committee, by the state Republican Party to determine what the possibility will be for being able to attend.” To determine what the possibility will be for being able to attend.

Not only could Abbott not say whether he thought the convention was a good idea, he couldn’t even say whether he would be there. The interview went out during the KENS five o’clock broadcast. Not half an hour later, during a meeting of the SREC, the party’s executive director announced that elected officials would be pre-recording messages instead of giving in-person speeches. Abbott surely knew this important fact when he was on the air.

I hope this clears everything up.

Who wants to enforce Greg Abbott’s mask order?

Anyone? Anyone? Bueller?

Gov. Greg Abbott called on police across Texas to step up enforcement of his mask order amid the mounting pandemic, explaining Thursday that they can either “be part of the problem or part of the solution.”

Facing a revolt over the mandate within his conservative base, the governor acknowledged in a new round of interviews that masking is inconvenient, but said the alternative of locking the state down again is far worse.

“We have a short period of time in the next couple of weeks to bend the curve of this explosion in cases and hospitalizations,” he said in an interview on KSAT in San Antonio. “If we can enforce this, we will be able to keep the state open and reduce hospitalizations.”

Some local law enforcement officials, including the sheriffs in Montgomery and Gillespie counties, have refused to enforce the new order, citing personal liberties or enforcement logistics. On Wednesday, the Montgomery County Republican Executive Committee voted 40-0 to censure Abbott, joining at least three other county executive committees that have taken similar steps.

It’s more than just a few.

When Gov. Greg Abbott issued a statewide executive order requiring Texans to wear masks in public, he gave counties the opportunity to opt out if they have a low number of active coronavirus cases.

A week later, 78 counties have taken him up on that offer. And a handful of other local governments have insisted that they won’t enforce the order even though they don’t qualify for the opt-out provision. Officials cited a desire to preserve personal freedoms or concerns about enforcement.

“I think it’s an insult to Texans to be required to do something they should have discretion for,” said Hugh Reed, the top administrator for rural Armstrong County, near Amarillo, which opted out.

In a press release announcing the order, Abbott said that “wearing a face covering in public is proven to be one of the most effective ways we have to slow the spread of COVID-19.” Public health experts broadly agree that masks slow the spread of the virus, and the Centers for Disease Control and Prevention recommend face coverings for anyone 2 or older in public settings.

The order came as coronavirus cases have grown quickly in the state. As of Thursday, more than 9,600 people were hospitalized with the virus.

In order to opt out of the requirement, the counties need to have 20 or fewer active COVID-19 cases. Given the spread of the virus in recent weeks, only counties that are sparsely populated and rural tend to qualify. Most are in conservative areas of the state.

Rex Fields, the top elected official in Eastland County, said Abbott’s option for counties with low coronavirus case counts “gives people some personal freedom.”

But a few local officials without that freedom are also choosing not to enforce the order. In Montgomery County, which has a population of over 600,000 and has reported more than 2,700 coronavirus cases so far, the sheriff’s office said July 3 that it would not take action on the mask rule.

“This order includes specific language prohibiting law enforcement from detaining, arresting, or confining to jail as a means to enforce the order,” the agency wrote in a press release. “This language strips law enforcement of the necessary tools to enforce compliance with the law.”

Yeah, so maybe undermining the rule of law was not a great idea. Greg Abbott could be in a position to insist that his order be enforced, if only Greg Abbott hadn’t so clearly demonstrated that Greg Abbott’s executive orders regarding COVID-19 are just suggestions.

That said, some places are more serious about trying to stop the spread of COVID-19.

Gov. Greg Abbott signaled his encouragement Wednesday to Austin city leaders to move forward on “additional enforcement mechanisms” related to a recent order Abbott issued requiring Texans to wear masks in most public spaces.

In a letter to Austin Mayor Steve Adler, Abbott said the city’s consideration of new enforcement measures “to ensure compliance with my Executive Orders is an important step toward reducing the spread of the novel coronavirus (COVID-19).”

“As you know, these Orders were created and adopted based on advise from medical experts, and if these Orders are followed, we will be able to protect both public health and the livelihoods of our citizens,” he added.

The Austin-American Statesman reported Wednesday that the City Council will meet Thursday “to vote on a resolution that would allow for a fine of up to $2,000 for anyone violating a ‘health authority rule’ like not wearing a mask” and to take “civil action against any person who maintains a business or site that does not comply with minimum health standards.”

Another riddle solved, apparently. That resolution passed unanimously on Thursday. I’m sure it’s just a matter of time before the Hotze contingent files a lawsuit against this, but in the meantime it’s something. (Hey, Greg! Now do letting counties issue stay-at-home orders.)

Now to be fair, if I’m going to advocate for letting local authorities have some of their authority to make local decisions back, I’m going to be circumspect about criticizing a small rural county with a still-low infection rate for not wanting to enforce a mask order. But let’s be clear that all parts of the state are vulnerable, and those lightly populated places also tend to be many miles away from hospitals, so their residents are in greater jeopardy should they get sick. The approach I’m looking for here is one that says “this is the minimum that counties must do – they can go above and beyond it within reason, but they have to do at least this much”. That philosophy has been distinctly lacking in recent years in this state.

But here we are, and here we once again face the worst case scenario, at least as far as Greg Abbott is concerned.

With Texas continuing to break records for new coronavirus deaths and hospitalizations this week, Gov. Greg Abbott reiterated Friday afternoon that things will continue to get worse. And if people keep flouting his new statewide mask mandate, he said, the next step could be another economic lockdown.

“Things will get worse, and let me explain why,” he told KLBK TV in Lubbock. “The deaths that we’re seeing announced today and yesterday — which are now over 100 — those are people who likely contracted COVID-19 in late May.

“The worst is yet to come as we work our way through that massive increase in people testing positive.”

Texans will also likely see an increase in cases next week, Abbott said, and people abiding by his face mask requirement might be the only thing standing between businesses remaining open and another shutdown.

“The public needs to understand this was a very tough decision for me to make,” Abbott told KLBK of his face mask mandate. “I made clear that I made this tough decision for one reason: It was our last best effort to slow the spread of COVID-19. If we do not slow the spread of COVID-19 … the next step would have to be a lockdown.”

And then when sheriffs in heavily Republican counties refuse to enforce that, then what? Say it with me now: None of this had to happen. But it did, and it’s Greg Abbott’s fault.