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Centers for Disease Control

On the reaction by some people to the new mask recommendations

I have one thing to say to this.

Texas Republicans in Congress are fuming over new mask requirements on Capitol Hill and recommendations from the CDC that even vaccinated Americans begin masking again as an extra precaution in parts of the country where the Delta variant is spreading, including Texas.

“Which is it, vaccines or masks?” said U.S. Rep. Chip Roy, a San Antonio Republican, in an impassioned speech on the House floor on Wednesday. “Do the vaccines work or they don’t work? Do the masks work or they don’t work? I’d like to know which it is.”

Health officials have been clear that the vaccines remain effective at preventing the worst outcomes of COVID, including hospitalization and death. The vast majority of breakthrough cases have been mild.

But COVID infections continue to climb throughout much of the U.S. — including Texas — and the Centers for Disease Control and Prevention this week revised its recommendations to urge even fully vaccinated Americans in those areas to wear masks indoors again.

That led to new mask mandates in the U.S. House and the White House, but Texas Gov. Greg Abbott has made clear he doesn’t not plan to require face coverings again in Texas.

Still, Republicans were outraged at the new guidance. U.S. Sen. Ted Cruz called mask-wearing “a virtue signal of submissiveness” as he referred to Democrats wearing face coverings again as “kabuki theater.”

If you are not fully vaccinated, have not made your vaccinated status known to others, and have not been a vocal advocate of vaccination, then you can take any and all complaints you may have about these new recommendations and go fuck yourself. Seriously.

I say again, with all the feeling I can muster: Go fuck yourself.

“Universal masking” for school children recommended

Seems like a sensible idea, especially given that children under the age of 12 can’t get the vaccine yet.

The American Academy of Pediatrics on Monday recommended that all children over the age of 2 wear masks when returning to school this year, regardless of vaccination status.

The AAP, which said its important for children to return to in-person learning this year, recommends that school staff also wear masks. The AAP is calling the new guidance a “layered approach.”

“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Sonja O’Leary, chair of the AAP Council on School Health. “Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”

The AAP said universal masking is necessary because much of the student population is not vaccinated, and it’s hard for schools to determine who is as new variants emerge that might spread more easily among children.

Children 12 and over are eligible for Covid-19 vaccinations in the U.S. And the FDA said last week that emergency authorization for vaccines for children under 12 could come in early to midwinter.

[…]

Universal masking will also protect students and staff from other respiratory illnesses that could keep kids out of school, the AAP said.

The Centers for Disease Control and Prevention recommended this month that vaccinated students do not have to wear masks in classrooms.

Dr. Francis Collins, director of the National Institutes of Health, said on MSNBC that the CDC may have been trying to be a little more lenient, allowing people to make judgment calls “depending on the circumstances in your school and your community.”

But he said he understands where the AAP is coming from.

“They will not be popular amongst parents and kids who are sick of masks, but you know what? The virus doesn’t care that we’re sick of masks,” Collins said. “The virus is having another version of its wonderful party for itself. And to the degree that we can squash that by doing something that maybe is a little uncomfortable, a little inconvenient … if it looks like it’s going to help, put the mask back on for a while.”

That was from last week. Yesterday, the CDC caught up.

To prevent further spread of the Delta variant, the US Centers for Disease Control and Prevention updated its mask guidance on Tuesday to recommend that fully vaccinated people wear masks indoors when in areas with “substantial” and “high” transmission of Covid-19, which includes nearly two-thirds of all US counties.

“In recent days I have seen new scientific data from recent outbreak investigations showing that the Delta variant behaves uniquely differently from past strains of the virus that cause Covid-19,” CDC Director Dr. Rochelle Walensky told a media briefing on Tuesday.

“This new science is worrisome and unfortunately warrants an update to our recommendations,” she said. “This is not a decision that we or CDC has made lightly.”

[…]

Earlier this month, the CDC’s Covid-19 school guidance noted that fully vaccinated people do not need to wear masks, and then about a week later the American Academy of Pediatrics issued stricter guidance recommending that everyone older than 2 wear a mask in schools, regardless of vaccination their status.

Now the updated CDC guidance recommends everyone in schools wear masks.

“CDC recommends that everyone in K through 12 schools wear a mask indoors, including teachers, staff, students and visitors, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with proper prevention strategies in place,” Walensky said. “Finally, CDC recommends community leaders encourage vaccination and universal masking to prevent further outbreaks in areas of substantial and high transmission. With the Delta variant, vaccinating more Americans now is more urgent than ever.”

The updated CDC guidance makes “excellent sense,” Dr. David Weber, professor at the University of North Carolina School of Medicine in Chapel Hill and board member of the Society of Healthcare Epidemiology, told CNN on Tuesday.

“Breakthrough disease clearly occurs, and for those cases, we know they’re much more mild in vaccinated people, but we don’t know how infectious vaccinated people are,” he said. “But clearly, if you want to protect your children under 12 or grandchildren, or protect immunocompromised people, as well as protect your own health — from even mild disease — then you should be wearing a mask, particularly in areas of high transmission when indoors.”

My kids have been vaccinated, but they’re still regular mask-wearers, especially the younger one. I fully expect them to continue to do so in school, at least for the fall. I’ve been wearing a mask again for indoor spaces as well. I will admit it’s kind of annoying, as we have been vaccinated for months now and have been pretty damn careful all along, but it is what it is. That said, I have a lot of sympathy for this position:

Some of that is happening in other states, but who knows, maybe we’ll get it for federal buildings and air travel, too. And who knows, maybe this will work.

As leaders in other parts of the country require government employees to get COVID-19 vaccinations, San Antonio and Bexar County are considering following suit, the Express-News reports.

Such a step would come as vaccination rates plateau and the highly contagious delta variant leads to a rise in infections, hospitalizations and deaths in Texas. California and New York City this week said they will make employees get the vaccine or submit to weekly coronavirus tests. Veterans Affairs became the first federal agency to mandate COVID vaccinations for frontline staff.

“We are supportive of the efforts of New York and California,” San Antonio Mayor Ron Nirenberg and County Judge Nelson Wolff said in a joint statement supplied to Express-News. “We will be reviewing the legalities and practicalities of requiring a COVID-19 vaccine and/or weekly testing in conformity with CDC guidelines in order to protect the health and well-being of city/county workforce.”

A city and county vaccine mandate would apply to roughly 18,000 workers, according to the daily, which reports that both Nirenberg and Wolff are unsure whether the requirement would be allowable under state law.

I think we can say with extreme confidence that the state would bring all its fight against such a move. That doesn’t mean it’s not worth the effort, but it’s not a move to be made lightly. Be prepared to hire a bunch of expensive lawyers, and have a solid communication strategy in place, that would be my advice.

As for masks in schools, well…

What did you expect? Greg Abbott has already said there won’t be any mask mandate in schools, and it’s impossible to imagine him changing his mind. It’s all up to the parents and school staff. I would not feel safe having my not-yet-vaccinated kids in school without a full-mask situation, which by the way is what we did in this past spring semester. I don’t even know what the argument against is. Doesn’t much matter when the power is on that side. The Trib and Daily Kos have more.

It’s not vaccinated people that are dying

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

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

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

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

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

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

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

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

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

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

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

And one more thing:

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

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

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

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

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

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

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

The risk of being unvaccinated

The numbers don’t lie.

Nearly all COVID-19 deaths in the U.S. now are in people who weren’t vaccinated, a staggering demonstration of how effective the shots have been and an indication that deaths per day — now down to under 300 — could be practically zero if everyone eligible got the vaccine.

An Associated Press analysis of available government data from May shows that “breakthrough” infections in fully vaccinated people accounted for fewer than 1,200 of more than 853,000 COVID-19 hospitalizations. That’s about 0.1%.

And only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8%, or five deaths per day on average.

[…]

The preventable deaths will continue, experts predict, with unvaccinated pockets of the nation experiencing outbreaks in the fall and winter. Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle, said modeling suggests the nation will hit 1,000 deaths per day again next year.

In Arkansas, which has one of the lowest vaccination rates in the nation, with only about 33% of the population fully protected, cases, hospitalizations and deaths are rising.

“It is sad to see someone go to the hospital or die when it can be prevented,” Gov. Asa Hutchinson tweeted as he urged people to get their shots.

As the story notes, this is an AP analysis of the available data. The CDC has not done its own analysis yet because the data is not complete – only 45 of the 50 states report breakthrough infections, and they vary in how they define them. But the overall point is clear: Even though COVID deaths are down over ninety percent from January, when vaccinations started rolling out, they could be down a whole lot more, if more people were vaccinated. The extent to which COVID is under control is the extent to which the population is vaccinated. That can vary by quite a bit, by state and by region, and so we will continue to see some level of hospitalizations and deaths from COVID. And that level is higher than it needs to be. Link via Daily Kos.

Our Delta future

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

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

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

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

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

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

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

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

[…]

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

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

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

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

Some more data, if you need it.

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

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

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

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

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

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

Kids still get COVID, too

And they need to get vaccinated if at all possible.

Since the Food and Drug Administration approved emergency use of the Pfizer vaccine for 12 to15 year olds on May 10, more than 300,000 Texas adolescents and teenagers have received at least one dose. Girls in this age range are receiving the vaccine at a higher rate (153,000) than boys (149,000), according to Texas Health and Human Services. Nationwide, more than 626,000 12 to 15 year olds have received two doses, according to the CDC.

Though young people can now receive shots, the number of children and adolescents being hospitalized is increasing. The Centers for Disease Control and Prevention released data from the first half of 2021 that shows nearly one-third of adolescents who are hospitalized with COVID-19 require intensive care. Five percent of those patients need to be put on ventilators with supplemental oxygen, as well.

The CDC reports that nearly 400 children and adolescents are currently in hospitals across the country with COVID or complications from the virus. More than 16,000 under the age of 18 have been hospitalized from COVID since the start of the pandemic, and more than 300 of them have died from it, said Dr. Jim Versalovic, interim pediatrician-in-chief at Texas Children’s Hospital.

“This is a huge setback for a child or adolescent with time spent out of school or activities,” Versalovic said. “There’s a long recovery time even if the infection is mild initially.”

He attributes the increase to fewer masks and stagnating vaccination rates.

More than half of all Texans are vaccinated with at least one dose, but that doesn’t mean Houston is free of several coronavirus variants that are more transmissible and deadlier than the original virus.

In the last month, fewer people are masking up in public outdoors and indoors after the CDC said it was safe for vaccinated people to go masklessThree-day holiday weekends and the onslaught of summer weather has turned Houston into the partying swamp city it was before the pandemic, too.

[…]

Versalovic said about 10 percent of children diagnosed with the virus at his hospital require hospitalization. This rate is nearly three times greater than the seasonal flu, which the CDC reported killed nearly 600 children between 2017 and 2018.

Child survivors sometimes have a whole new set of problems when the initial infection clears. Several weeks after other symptoms have gone away, children who had mild COVID develop other symptoms that typically require hospitalization. This is called Multisystem Inflammatory Syndrome in Children, or MIS-C.

MIS-C symptoms include fever, stomach pain, diarrhea, vomiting, neck pain, random rashes and bloodshot eyes. Extreme fatigue is also a symptom, but it’s usually blamed on other problems.

Texas Children’s has vaccinated more than 18,500 12 to 15 year olds since early May. Any person age 12 and older is eligible for a free Pfizer vaccine from the hospital, regardless of whether they are currently a patient. Vaccines are available at six Texas Children’s sites across Houston Monday through Saturday.

The hospital is partnering with Houston-area school districts now to immunize their students, so middle and high schools can open safely for the fall semester, he added.

“We are going to be very busy during the summer months as we seek to immunize as many children as possible,” Versalovic said. “It’s important to protect adolescents to stop the spread of COVID as they get ready for summer activities, camps, sports and the school year in August.”

Not much to say here that we haven’t said already, many times. Get your kids vaccinated. As long as there are unvaccinated and/or immunocompromised members of your household, you should continue with pre-vaccination safety protocols as much as possible, which I know is vastly more difficult now that masks are being removed all over the place. It is true that the health risks to kids from COVID are lower than they are with adults, but they are not zero and they can be serious. For all the progress we’ve made, we’re not out of danger yet.

Threat level down

Been waiting for this for some time.

Harris County finally will downgrade from its highest COVID-19 threat level, County Judge Lina Hidalgo said Monday evening, after 47 weeks of urging residents to stay home.

Hidalgo said the effectiveness of the COVID-19 vaccines and improving local metrics were among several factors that convinced her to revise the threat level system the county debuted last summer. The U.S. Centers From Disease Control also told fully vaccinated Americans last week they may resume their pre-pandemic lives.

“We’re very much at a turning point,” Hidalgo said. “We don’t want to claim victory because there certainly there’s a possibility that amongst the unvaccinated, the virus gets out of control. But we do have reason for celebration.

Hidalgo said she would make a formal announcement Tuesday. Remaining guidelines would only apply to unvaccinated residents.

The two Republican county commissioners had urged the Democratic leader for weeks to abandon Level Red, which states that virus outbreaks are uncontrolled and worsening; data show the opposite is true.

The pair, Jack Cagle and Tom Ramsey, have said that while COVID-19 still must be taken seriously, the Level Red designation obscures the progress the county has made in containing the virus.

[…]

Currently, Harris County meets four of five criteria to downgrade to the next-highest threat level, including 14-day averages of new cases below 400 and share of ICU beds occupied by virus patients below 15 percent.

The remaining barrier is a test positivity rate below 5 percent; currently that metric stands at 9.4 percent. That result differs greatly than the positivity rate recorded by the Texas Medical Center system, which currently is 3.7 percent.

The TMC rate comes from tests conducted on patients at member hospitals in the Houston region; the county rate comes from tests taken by the Houston and Harris County health departments, as well as local pharmacies.

Hidalgo said experts she consulted said since few residents were being tested, Harris County’s rate likely was artificially high. She said her team would revise the metrics so positivity rate and new cases are secondary criteria.

See here for the previous update, which was a month ago. We’re a lot farther along on vaccinations, and all of the numbers have moved in accordance with that. I like the fact that we’re being true to the metrics, and that we are making adjustments to them based on new facts on the ground. I commend Judge Hidalgo for consistently doing the right thing, which would have been a lot easier to do if we didn’t have Threat Level Super Duper Bright Red stupidity and malevolence from other parts of our government. The later story also notes that government buildings would reopen to 50 percent capacity, and the county is reviewing that dumb anti-mask mandate order. The Press and the Trib have more.

Abbott ends mask mandates

This guy, I swear.

Gov. Greg Abbott announced Tuesday that public schools can no longer require masks on their campuses starting June 5. The decision was part of a new executive order that bans governmental entities in Texas — like cities and counties — from mandating masks in the fight against the coronavirus pandemic.

Starting Friday, any government entity that tries to impose a mask mandate can face a fine of up to $1,000, according to the order. The order exempts state-supported living centers, government-owned or -operated hospitals, Texas Department of Criminal Justice facilities, Texas Juvenile Justice Department facilities, and county and municipal jails.

The order is arguably the most consequential for public schools. After Abbott ended the statewide mask requirement in early March, school systems were allowed to continue with their own mask-wearing policies unchanged. But after June 4, “no student, teacher, parent, or other staff member or visitor may be required to wear a face covering,” according to Abbott’s new order.

While 30% of Texans have been fully vaccinated against COVID-19, the vast majority of children are unvaccinated. The Pfizer vaccine was authorized last week for children as young as 12. The Moderna and Johnson & Johnson vaccines are still only authorized for those 18 and older. School-age children have seen lower infection rates than other age groups. COVID-19 cases among those 5-17 years old make up 10% of total cases in the country, according to the latest CDC data.

Last week, the Centers for Disease Control and Prevention said fully vaccinated people no longer have to wear masks outdoors in crowds and in most indoor places.

The Texas State Teachers Association called Abbott’s latest move premature. In a statement, the head of the association, Ovidia Molina, said Abbott should have waited until the CDC issued updated guidance on masks for the 2021-22 school year. Molina acknowledged that some Texas school districts have already ended their mask requirements but said the association believes “that also is ill-advised.”

“The health and safety of our students, educators and communities must remain our first priority as we attempt to emerge from this pandemic,” Molina said.

Abbott’s new rules will take effect as the school year is winding down for most students — or already over. The last day of classes for the state’s biggest school district, Houston ISD, is June 11, while May 27 is the last day for most students in the state’s second biggest district, Dallas ISD.

Why can’t you just wait another week? School is almost over here in Houston, and it will be over in some parts of the state before this kicks in. Vaccination levels still aren’t that great, though we can reasonably expect them to be significantly better by August, and we know that fully reopening schools when we did increased the COVID infection rate. Surely Abbott isn’t that afraid of little ol’ Don Huffines. One more week, that’s all that was needed. The Chron has more.

You can lose the mask if you’re fully vaxxed

Do your part, reap the reward.

Federal health officials reversed course Thursday and advised that people who are fully vaccinated can stop wearing masks and observing social distancing in most indoor and outdoor settings.

It’s welcome news for many who have grown weary of the safety precautions more than 14 months into the global public health crisis and is a significant milestone in returning to pre-pandemic life. But the announcement will likely give new life to the debate about requiring vaccinations that has been playing out in Texas and across the nation — and it comes as less than a third of Texans are fully vaccinated.

“We have all longed for this moment,” Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said from the White House on Thursday. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”

But Walensky cautioned that the CDC’s guidance comes with exceptions. Vaccinated people should continue to wear masks and distance themselves from others in medical settings and around high-risk populations, such as doctor’s offices, hospitals and long-term care facilities, and while traveling aboard airplanes, busses and trains. Incarcerated people and people in homeless shelters should also continue to observe safety precautions.

[…]

More than 11 million Texans had received at least one dose of the COVID-19 vaccine as of Tuesday, according to state data. Nearly 31% of the state’s residents are fully vaccinated. But the rate at which Texas is vaccinating its residents has slowed despite ample supply. An April poll by the University of Texas at Austin and The Texas Tribune found that 36% of Texans said they were either reluctant to receive the vaccine or would refuse to get it, including nearly half of the state’s Republicans.

Peter Hotez, a preeminent infectious disease expert and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, said on Twitter that he supported the announcement, but that it carries a risk in places like Texas.

“COVID19 immunization rates in my part of the country, TX + South, are still lagging the rest of the nation, so I worry about a 5th wave this summer in the South like last summer,” he said.

As noted in the story, this comes on the heels of the approval of the vaccine for 12 to 15 year olds. I’ve already seen pictures of a bunch of my friends’ kids getting their first shot; ours will do so later today. Our vaccination numbers in Texas can certainly be better, but that’s one part helping people overcome the obstacles in their path to getting a shot, and one part giving whatever answers or reassurances the hesitant folks have. Not much you can do about the flat-out resisters, but if we can limit the damage to just them we’ll be all right. I also suspect that over time we’ll see higher vax numbers in the urban areas than elsewhere, or at least we will if we do the job of making it as accessible as possible. In the meantime, those of us who have gotten our shots can show our faces again, and just in time for summer. That’s gonna feel good.

(To be sure, some number of unmasked people are the same chuckleheads who refuse to be vaccinated, and they’ve been walking around unmasked for a long time now. There is an argument that the CDC’s new guidance isn’t a good idea. And of course, individual retailers and restaurants and what have you may continue to require masks in their establishments for the time being, since there’s no way to tell who is and isn’t vaccinated. You can take your mask off where you can if you’re vaxxed, just as always be thoughtful and considerate about it.)

Pfizer shot approved for younger kids

Yes!

The Food and Drug Administration cleared the first coronavirus vaccine for emergency use in children as young as 12 on Monday, expanding access to the Pfizer-BioNTech shot to adolescents ahead of the next school year and marking another milestone in the nation’s battle with the virus.

The decision that the two-shot regimen is safe and effective for younger adolescents had been highly anticipated by many parents and pediatricians, particularly with the growing gap between what vaccinated and unvaccinated people may do safely. Evidence suggests that schools can function at low risk with prevention measures, such as masks and social distancing. But vaccines are poised to increase confidence in resuming in-person activities and are regarded as pivotal to returning to normalcy.

“Adolescents, especially, have suffered tremendously from the covid pandemic. Even though they’re less likely than adults to be hospitalized or have severe illness, their lives really have been curtailed in many parts of the country,” said Kawsar R. Talaat, an assistant professor of international health at the Johns Hopkins Bloomberg School of Public Health. “A vaccine gives them an extra layer of protection and allows them to go back to being kids.”

Expert advisers to the Centers for Disease Control and Prevention are scheduled to meet Wednesday to recommend how the vaccine should be used in that age group, and the vaccine can be administered as soon as the CDC director signs off on the recommendation.

In a news briefing Monday evening after the announcement, FDA officials said the Pfizer authorization for 12- to 15-year-olds was a straightforward decision because the data showed that the vaccine was safe and that the response to the vaccine was even better than among the 18- to 25-year-olds who got the shots.

Our almost-17-year-old has had her shots. We’ll be getting the 14-year-old signed up as soon as we can. “Herd immunity” may never be a thing we achieve with COVID, but having a greater share of the population vaxed is a good thing, and adding this group to the eligible list moves towards that goal. I’m ready for this.

Now it gets harder to vaccinate people

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

The Hobby poll on ending COVID restrictions

A little while ago I blogged about the recent UH Hobby Center poll regarding the winter freeze and blackouts and responses to them. At the time I mentioned the poll had a separate section about Greg Abbott lifting the COVID restrictions on mask wearing and business capacity. I thought there might be another story that referenced those results, but if there was I never saw it. So, let’s go back and look at that part of the poll ourselves. Here’s the relevant data, and as before the landing page for the poll is here. From the poll data for the questions on the restrictions:

On March 2, 2021, Texas Governor Greg Abbott issued Executive Order GA-34, which lifted statewide COVID-19 restrictions. The order rescinded, beginning on March 10, the governor’s previous mandate (GA-29) that Texans wear face coverings (masks) and allowed all businesses to operate at 100% capacity as long as the area in which the businesses are located does not surpass a high hospitalization threshold. This threshold is defined by an area where COVID-19 patients as a percentage of total hospital capacity exceeds 15% for seven consecutive days.

The survey respondents were asked five questions related to Governor Abbott’s executive order regarding the lifting of COVID-19 restrictions, and the responses were cross-tabulated with ethnicity/race, age, gender, education, and partisanship.

37% of Texans support Governor Abbott’s decision to end the statewide mask mandate while 56% oppose the decision. The remaining 7% neither support nor oppose the decision.

42% of Texans support Governor Abbott’s decision to allow all businesses to operate at 100% capacity and 49% oppose it. The remaining 9% neither support nor oppose the decision.

When provided with the following information, “According to recent data, the daily counts of COVID-19 hospitalizations and deaths in Texas are trending downward, although the rates remain relatively high. The head of the federal Centers for Disease Control and Prevention and other medical experts say that while caseloads are flattening out, variants of the coronavirus could bring another wave of the pandemic and that mask and business capacity restrictions should stay in place at this point in time,” 37% support Governor Abbott’s decision to end Texas’s statewide mask mandate and to allow businesses to operate at 100% capacity in light of the recommendations of medical experts while 51% oppose the decision. The remaining 12% neither support nor oppose the decision.

[…]

When asked whether they agree or disagree with the statement that Governor Abbott’s ending the mask mandate and allowing businesses to operate at 100% capacity will help restore jobs and return a sense of normalcy to Texans’ lives, 44% of Texans agree with the statement and 37% disagree. The remaining one-fifth (19%) neither agrees nor disagrees with the statement.

[…]

When asked whether they agree or disagree with the statement that Governor Abbott’s ending the statewide mask mandate and allowing businesses to operate at 100% capacity will result in an increase in the number of COVID-19 infections, hospitalizations and fatalities in Texas, a slight majority (51%) of the respondents agree with the statement compared to slightly less than a third (30%) who disagree with it. The remaining one-fifth (19%) neither agrees nor disagrees with the statement.

I’ve noted the partisan numbers in the sample before, so go review my previous post for that discussion. I’d love to see more polling on the lifting of the mask mandate, and I’d be very interested to see if it changes over time, but I’m not expecting much on that front. We know that Texas’ COVID case rate has remained fairly low despite the dropping of the mandates, a result I mostly attribute to people continuing to wear masks anyway. It may well be that people wind up disagreeing less with Abbott’s actions if this continues, or it may mostly be a proxy for partisan feelings. I’m noting it here in case we do get more data down the line.

No flu

I would never say that there was any such thing as a silver lining to the COVID pandemic, but it is true that basically nobody died from the flu this year because of masking and social distancing.

What medical officials worried would be a “twindemic” at the end of last year — the concurrence of influenza and COVID-19 sicknesses overwhelming Houston’s hospitals — turned out surprisingly well.

At Memorial Hermann, just three patients tested positive for influenza during the 2020-2021 flu season, compared to 983 patients during the 2019-2020 flu season. Doctors test for both flu and COVID-19 as a precaution.

The same public health measures that prevent SARS-CoV-2 from spreading — masks, social distancing and regular hand-washing — kept influenza strains from sickening people.

“When we were looking internally, we just weren’t seeing flu,” said Dr. James McCarthy, chief executive physician at Memorial Hermann.

Flu infections are down nationwide, with a hospitalization rate of 0.7 per 100,000 people, according to the Centers for Disease Control and Prevention. During the last flu season, the rate was nearly 100 times higher — 66.1 per 100,000 patients. Pediatric deaths also decreased, from 189 last year to one this year.

[…]

Researchers wondered whether being infected with the coronavirus would wipe out the chances of getting the flu, and say it may be a factor that contributed equally to declining flu rates.

“Part of it is because we had a worse virus that was spreading faster,” McCarthy said.

Knowing to wear masks and get a flu vaccine could be a huge step toward eradicating deadly flu seasons. But will people continue to practice those public health measures? Doctors don’t know.

“We’re recognizing that not only can we protect our friends and loved ones from COVID, but we can also do it from influenza with precautions for medically vulnerable folks,” McCarthy said.

I’ve gotten a flu shot every year for as long as I can remember, and as far as I know I’ve never gotten the flu. I will certainly continue to get those vaccines as before, and I’d strongly consider wearing a mask during the flu season going forward when doing things like grocery shopping. Hard to see any reason why not to at this point.

What to expect when you’re fully vaccinated

The CDC has released some guidance that will help people understand what is safe to do and what precautions they will still need to take once they are fully vaccinated.

Fully vaccinated Americans can gather with other vaccinated people indoors without wearing a mask or social distancing, according to long-awaited guidance from federal health officials.

The recommendations also say that vaccinated people can come together in the same way — in a single household — with people considered at low-risk for severe disease, such as in the case of vaccinated grandparents visiting healthy children and grandchildren.

The Centers for Disease Control and Prevention announced the guidance Monday.

The guidance is designed to address a growing demand, as more adults have been getting vaccinated and wondering if it gives them greater freedom to visit family members, travel, or do other things like they did before the COVID-19 pandemic swept the world last year.

“With more and more people vaccinated each day, we are starting to turn a corner,” said CDC Director Dr. Rochelle Walensky.

During a press briefing Monday, she called the guidance a “first step” toward restoring normalcy in how people come together. She said more activities would be ok’d for vaccinated individuals once caseloads and deaths decline, more Americans are vaccinated, and as more science emerges on the ability of those who have been vaccinated to get and spread the virus.

You can see their guidance here. Among other things, this should make a lot of grandparents happy:

A lot more people will get those vaccines in the coming weeks. The need for continued mask-wearing is simply because you can still get and carry the SARS-CoV2 virus after being vaccinated, you are just much less likely to become sick if you do. Basically, you can still be an asymptomatic carrier, and so for the safety of the not-yet-vaccinated, especially in public places, your mask is still needed at this time. But that will eventually decrease, as the vaccination numbers swell. We just had to wait a little longer. We can and must still do the right thing in the meantime. Vox, the Chron, and Daily Kos have more.

What can we expect from the maskless mandate?

More COVID, obviously.

The Centers for Disease Control is increasing pressure on Republican leaders in states like Texas that have eased COVID restrictions, publishing a study on Friday showing evidence that the measures — such as the mask requirement that Gov. Greg Abbott rescinded this week — clearly decrease COVID cases and deaths, while opening up restaurants causes them to spike.

“We have seen this movie before: When prevention measures like mask mandates are rolled back, cases go up,” CDC Director Rochelle Walensky said. “I know the idea of relaxing mask wearing and getting back to everyday activities is appealing, but we’re not there yet.”

[…]

On Friday, Walensky continued to sound the alarm. She said that COVID cases and deaths have started to plateau for more than a week at levels similar to the late summer surge — just as some states are easing restrictions that helped drive those cases down.

White House officials said Friday the trend is concerning, especially as progress has been made on vaccinations. Nearly 55 percent of people 65 and older have received at least one vaccine dose, up from just 8 percent six weeks ago, senior White House COVID-19 adviser Andy Slavitt said.

More than 3.5 million Texans have received at least one dose of the vaccine, and nearly 2 million have been fully vaccinated, out of a population of 29 million. Still, the state ranks among the lowest for the percentage of people vaccinated, at 13 percent.

“It’s better to spike the football once you’re safely in the end zone, not once you’ve made a couple of completions,” Slavitt said.

The CDC released a new report on Friday that showed COVID cases and death rates decreased within 20 days of the implementation of state mask mandates. That progress was quickly reversed with the opening of restaurants, however, the report said. COVID cases rose between 41 and 100 days after states allowed dining in restaurants and daily death rates rose between 61 and 100 days after.

“Policies that require universal mask use and restrict any on-premises restaurant dining are important components of a comprehensive strategy to reduce exposure to and transmission of SARS-CoV-2,” the study said. “Such efforts are increasingly important given the emergence of highly transmissible SARS-CoV-2 variants in the United States.”

I think what’s so infuriating about this is that we really are in the home stretch now. Texas is at the back of the pack in terms of vaccination rate (though Harris County is doing reasonably well), but we are making steady progress. Anecdotally, I know so many more people now who have gotten at least their first shot compared to just a month ago. It would have been so easy to say that we just need to hold on until (say) Memorial Day or something like that, when we can expect to have a significant number of people who have been vaccinated, then we can really begin to ease up. We can emphasize outdoor events first, and be clear about when masks aren’t needed (when everyone involved has been vaccinated) versus when they should still be worn. We’ve come this far, we can see where we want to be, we just need to finish the job. Why was that so hard?

You may say, as Abbott was quoted in the story, that we haven’t actually enforced the mask mandate in Texas that just urging people to wear them while explicitly not requiring it isn’t all that different. I’d say first that the reason we haven’t enforced it is because Greg Abbott was so frightened by the likes of Shelley Luther that he cowardly backed down from any kind of official enforcement. What that has meant in practice is that responsibility for mask requirements falls squarely on the shoulders of frontline workers, who at least had the backup of an executive order when confronting some maskhole. But now even that is going away, which means we’ll have a lot more of this:

Fidel Minor, a Houston Metro bus driver, said Gov. Greg Abbott’s mask rollback will incite “mass chaos” on city buses as drivers like him try to enforce federal mask requirements for transit.

“It’s already a hard enough job as it is without having conflicting directives,” said Minor, a driver for Houston Metro.

Abbott relaxed requirements on businesses Tuesday, lifting statewide mask mandates and reducing capacity restrictions on restaurants and retailers. The order, effective March 10, sent chills through frontline workers across the region who say they still face risks on the job.

Asking customers to wear masks means being met with a daily dose of attitude, said Stacy Brown, bakery manager at Phoenicia Specialty Foods, a grocery store on the ground floor of One Park Place downtown. Now she fears that attitude will spread.

“We’re gonna have people come into the store, not wanting to comply just because of what (Abbott) says,” she said, noting she feels it’s especially important that her customers wear masks because as a diabetic she’s in a high-risk group.

[…]

David Lee, a deli manager at Kroger in Galveston who got sick with the virus in December, said it’s scary to know he and his colleagues will be surrounded by more of the maskless customers he believes exposed him to the virus in the first place. “I think (Abbott) should wait at least two more months,” he said. “It’s going to be scary now.”

For its part, the family-run Phoenicia will keep its mask mandate at its two Houston stores and restaurants, said owner Haig Tcholakian. Requiring masks inside his stores is about health and safety for staff and customers, first and foremost, he said. But also because when workers get sick or exposed, it affects business, too.

“It disrupts operations quite a bit, and if there are multiple (illnesses) across all businesses that would probably limit us and make us scramble to make up for that,” he said.

Tcholakian said he and his employees have to ask people to leave a handful of times a week. Like Brown, his bakery manager, he’s concerned that enforcement will get more difficult now. “We’ll have to prepare for it.”

For Teresa McClatchie, an escalator monitor at Bush Intercontinental Airport, the governor’s policy change seems at odds with the facts on the ground. She said her coworkers are still ill with the virus — one may need to stay on oxygen on an ongoing basis because of damage the virus did to her lungs.

“We still have some employees out,” she said, “and some, they may not be back.”

The number of restaurants and other businesses that will continue to require masks is inspiring and may just help blunt the effect of Abbott’s foolishness, but it still shouldn’t fall on these people to ensure that the jackasses out there don’t endanger them or others.

And for those of you who may be mad at HEB for urging but not requiring masks at their stores, it’s exactly with this in mind that they made this call.

H-E-B President Scott McClelland has the explanation why the store won’t require customers to wear masks in light of Gov. Greg Abbott’s Tuesday announcement.

While it has the power to require customers to wear masks before entering, McClelland said H-E-B won’t take that step – in part because of belligerent customers who have caused nearly 2,000 in-store incidents surrounding masks at Houston stores alone.

If a customer walks into the store without a mask, a worker will ask them to put one on, McClelland said. If they don’t have one, they will be offered a mask.

If they still refuse to put one on, McClelland said “we are not going to escalate.”

“What’s important to me is, I’ve got to ensure for the physical safety of both my employees and customers in the store,” McClelland said. “That’s what we have been doing, and frankly it’s the same thing we’ll continue to do.”

I confess, I recently yelled at one dipshit at HEB who was walking around with his mask on his chin. It wasn’t smart, and it wasn’t considerate of the other customers in the yogurt aisle who had to be wondering if something was about to go down, but I was so mad and I felt like someone needed to do something. McClelland is right about not escalating, and I will just have to keep that in mind. And I have already spent more time and energy thinking about this than Greg Abbott ever will.

President Biden disagrees with the maskless mandate

I mean, duh.

President Joe Biden

President Joe Biden said Wednesday that Texas made a “big mistake” by removing its statewide mask mandate and suggested the decision reflected “Neanderthal thinking.”

The comments by the Democratic president came a day after Republican Gov. Greg Abbott announced he was not only ending the mask requirement but also allowing businesses to reopen at full capacity. A small fraction of Texans have been fully vaccinated, and while coronavirus numbers have been generally declining in the state, they remain substantial.

“Texas — I think it’s a big mistake,” Biden said at the White House. “We are on the cusp of being able to fundamentally change the nature of this disease because the way in which are are able to get vaccines in people’s arms. The last thing — the last thing — we need is Neanderthal thinking in the meantime.”

Biden’s administration has urged states not to let up on restrictions as vaccinations pick up. Rochelle Walensky, Biden’s director of the Centers for Disease Control and Prevention, reiterated that earlier Wednesday during a White House coronavirus briefing when asked about Abbott’s announcement.

“I think we at the CDC have been very clear that now is not the time to release all restrictions,” Walensky said.

Asked about the Texas news a short time later, White House press secretary Jen Psaki did not directly address Abbott’s actions but said “the entire country has paid the price for political leaders who ignored the science when it comes to the pandemic.”

Abbott’s announcement came four days after he joined Biden for a tour of Houston that was partly about the state’s vaccination efforts. In remarks at the end of the trip, Biden stressed it was “not the time to relax” practices to curb the spread of the virus.

“We have to keep washing our hands, staying socially distanced,” Biden said. “And for God’s sake, wear your mask.”

See here and here for the background. I’m sure we can all surmise what Abbott’s opinion of Biden’s opinion is, but then Abbott only cares about what a few people think. He won’t be unhappy if Biden gets mad at him.

Please don’t take your mask off yet

Seriously, what’s the rush?

Gov. Greg Abbott said Thursday that Texas is looking at when it will be able to lift all statewide orders related to the coronavirus pandemic and that an announcement is forthcoming.

Abbott made the comments at a Corpus Christi news conference where he was asked when the statewide mask mandate would end as Texans continue to get vaccinated. That requirement has been in effect since July.

Abbott called it a “great question.”

“We’re working right now on evaluating when we’re gonna be able to remove all statewide orders, and we will be making announcements about that pretty soon,” Abbott said, without giving a specific time frame.

[…]

The Centers for Disease Control recommends that people who have received two doses of the vaccine continue to avoid crowds, stay at least 6 feet away from people who live outside their households, and wear masks to cover their nose and mouth.

Dr. Anthony Fauci, the nation’s top infectious-disease doctor, has repeatedly said that he does not know when Americans will be able to return to normal, but that they may still need to continue wearing face masks into 2022.

Note that at this point about five percent of Texans total have been fully vaccinated. We need to get to over 70% to achieve something like herd immunity. Maybe Abbott is speaking of some hypothetical date well into the future to lift the mask mandate, but he deserves no benefit of the doubt. Why do we always have to learn these lessons the hard way? There’s absolutely no reason to rush this. The Chron and the San Antonio Report have more.

We should be vaccinating grocery workers

The only disagreement I have with this is that we should have more broadly classified “essential workers” from the beginning, and it should include more people who do not have the ability to work from home.

Nearly a year into the pandemic, Ryan’s experience that day reflects the challenges that grocery store workers across Texas are facing in their stores every day. For months, workers have risked their health to keep shorthanded grocery stores open, all while dealing with increased hours and customers refusing to wear masks.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices urged states to include front-line essential workers in Phase 1B of vaccine allocation. But Texas decided not to include any essential employees like grocery store workers in the state’s current vaccine priority groups. Without any guarantee of vaccine prioritization, grocery workers now find themselves overwhelmed and continually exposed to the virus with no end in sight.

[…]

Back in April, when people made a rush for essential supplies like toilet paper and soap, Gov. Greg Abbott tweeted a message of support for grocery store workers, saying that “everyone across our state appreciates your hard work to help Texans respond to the #coronavirus.” Since then, workers say they have felt forgotten and abandoned by the state government.

In December, the Texas Expert Vaccine Allocation Panel, in charge of designating each population currently eligible to receive vaccinations, decided against including front-line essential workers in Phase 1B. The Department of State Health Services said that the panel wanted to reserve vaccine doses for those at the highest risk of death, which includes people over 65 and anyone over 16 with a chronic medical condition that puts them at higher risk.

At least 8 million Texans currently qualify for Phase 1A or 1B of vaccine allocation, but the state has received fewer than 4 million doses thus far. The panel is currently considering potential priority groups for Phase 1C of vaccine rollout, and its decision will depend on epidemiological data about virus transmission, according to DSHS Director of Media Relations Chris Van Deusen.

However, at least 11 states and the District of Columbia followed CDC recommendations by deciding to put front-line essential workers, including grocery store employees, in the their latest rounds of vaccine allocation, according to The Washington Post. New York allowed grocery workers to start getting the vaccine last month. Arkansas has also started vaccinating teachers and educators in the first round of essential workers to receive doses, and the state plans to expand distribution to other essential workers later this month.

“You feel like you don’t matter when your own state goes against every recommendation that there is out there,” said Dawn Hand, who works at a Kroger in Houston. “Why don’t we matter? What’s your answer to that?”

I personally feel that prioritizing people who had to do in-person work, as some states have done, was the better choice than making group 1B open to the over 65 crowd, and I say that even knowing quite a few people who have gotten their vaccine as a result of that choice. Big employers, like grocery stores and big-box retail – plus all of their delivery workers – could have been brought in to help distribute and administer the shots. This would target people who are clearly at risk, and as the story notes would also have helped with the equity problem. Another group of essential workers that should have been prioritized are meatpacking plant employees, who have not only been extremely hard-hit by COVID (due in large part to the inhumane practices of their employers) but are also lower-income, often non-English-speaking people who are harder to reach for the vaccine. In their case, I’d want to send clinicians to their locations, and use whatever threats and incentives are needed to make sure their bosses give them the time and space to get vaccinated. We could still do all of this in round 3, but I don’t blame any one of these folks for thinking that they were left behind.

As the COVID mutates

Just another reminder that we need to continue trying not to spread the virus while we wait for everyone to get vaccinated.

A more contagious variant of the coronavirus first found in Britain is spreading rapidly in the United States, doubling roughly every 10 days, according to a new study.

Analyzing half a million coronavirus tests and hundreds of genomes, a team of researchers predicted that in a month this variant could become predominant in the United States, potentially bringing a surge of new cases and increased risk of death.

The new research offers the first nationwide look at the history of the variant, known as B.1.1.7, since it arrived in the United States in late 2020. Last month, the Centers for Disease Control and Prevention warned that B.1.1.7 could become predominant by March if it behaved the way it did in Britain. The new study confirms that projected path.

“Nothing in this paper is surprising, but people need to see it,” said Kristian Andersen, a co-author of the study and a virologist at the Scripps Research Institute in La Jolla, Calif. “We should probably prepare for this being the predominant lineage in most places in the United States by March.”

Dr. Andersen’s team estimated that the transmission rate of B.1.1.7 in the United States is 30 percent to 40 percent higher than that of more common variants, although those figures may rise as more data comes in, he said. The variant has already been implicated in surges in other countries, including Ireland, Portugal and Jordan.

“There could indeed be a very serious situation developing in a matter of months or weeks,” said Nicholas Davies, an epidemiologist at the London School of Hygiene and Tropical Medicine who was not involved in the study. “These may be early signals warranting urgent investigation by public health authorities.”

[…]

“There’s still a lot that we have to learn,” said Nathan Grubaugh, a virologist at Yale University who was not involved in the study. “But these things are important enough that we have to start doing things now.”

It’s possible that chains of B.1.1.7 transmission are spreading faster than other viruses. Or it might be that B.1.1.7 was more common among incoming travelers starting new outbreaks.

“I still think that we are weeks away from really knowing how this will turn out,” Dr. Grubaugh said.

The contagiousness of B.1.1.7 makes it a threat to take seriously. Public health measures that work on other variants may not be enough to stop B.1.1.7. More cases in the United States would mean more hospitalizations, potentially straining hospitals that are only now recovering from record high numbers of patients last month.

Making matters worse, Dr. Davies and his colleagues at the London School of Hygiene and Tropical Medicine posted a study online on Wednesday suggesting that the risk of dying of B.1.1.7 is 35 percent higher than it is for other variants. The study has yet to be published in a scientific journal.

And if you’re worried about that, you can also be worried about this.

The likely more transmissible variant of COVID-19 first detected in South Africa has arrived in the Houston area, according to Houston Methodist Hospital.

The hospital system said it found the region’s first case of the new, faster-spreading variant on Saturday while sequencing the genomes of positive test results. It also found two cases of the variant first discovered in the United Kingdom. The UK variant first was confirmed in the Houston area in early January.

The infected person is a Fort Bend County man, who tested positive weeks ago and has recovered from the illness, said Dr. Jacquelyn Johnson Minter, Fort Bend County Health & Human Services Director. The patient had traveled domestically before his diagnosis. His household members have tested negative, and he did not work while infected so there was no exposure at his job, Minter said.

Still, Minter said she would not be surprised to learn the South Africa variant was spreading through the community.

[…]

Dr. Wesley Long, who works with the Methodist sequencing effort, said there is no evidence from the clinical trials of Pfizer and Moderna vaccines that they are less effective against the variants, especially the U.K. strain. He said there is limited evidence that certain other vaccines and therapies that target the spike protein of COVID-19 may be less effective against the South African variant, though they still should provide benefits to most people.

The U.S. Centers for Disease Control says “rigorous and increased compliance” with mitigation strategies like social distancing and wearing masks is needed to combat the spread of the virus.

Yes, the same basic techniques to avoid spreading the disease are still effective – masking, social distancing, washing hands, avoiding indoor gatherings – but they have to be strictly followed, because the newer versions of the virus are easier to transmit. So far there’s no evidence that these mutations are resistant to the vaccine, but the risk there is that the more infections, the greater the chances of further mutation, and thus the greater the chances that such a variant could emerge. All of this is to say, stay vigilant. Infection numbers are finally starting to drop, and with that comes the temptation to ease up. It’s still way too early for that.

The second shot portal

People are going to need this, too.

Houston officials plan to launch a website this week that will let people schedule appointments for their second doses of the COVID-19 vaccine.

Health Director Stephen Williams on Monday said officials plan to send out that link to people who got their first shot from the city “later this week, and maybe even as soon as tomorrow.”

The new process would be welcome news to people waiting on their second doses, many of whom have grown uneasy as their windows for the booster shot approach. Currently, city health workers call vaccinees to schedule their shots in the week before the 28-day window when the second dose is recommended.

The city has cited new guidance from the U.S. Centers for Disease Control that the second Moderna dose should be given as close to 28 days as possible after the first, but can be given as far out as 42 days. The Health Department has said it anticipates everyone who gets a shot from the city should be able to get their second one within 28 days. The city has asked residents to avoid calling the city unless they are less than 48 hours from their 28-day window.

Mayor Sylvester Turner said the city has given out more than 2,300 second shots already and has scheduled another 11,971. He said the city has received 18,600 doses for second shots. That is in addition to 41,950 doses for first shots, of which the city has administered 33,839 — about 80 percent of its supply.

The city closed its senior wait list — operated by the Harris County Area Agency on Aging — on Friday after more than 70,000 people called to enroll. Williams said it is “hard to discern” when the city will reopen that portal. It is separate from Harris County’s wait list, which launched last week, and has grown to more than 165,000 people.

I’ve seen chatter on Twitter and Facebook from people who have gotten the first shot (or helped a family member get it) and been confused about how to schedule the second one. Hopefully this will help with that, because obviously people will need to get that in a timely and orderly manner. And, not to put too fine a point on it, the volume of second shots will need to ramp up to meet the volume of first shots in short order. The first shot volume is starting to accelerate, but it will need to increase well beyond that. Help is coming, we’ve got to do the best we can until then.

Nowhere to go but up with COVID vaccines

Starting from scratch.

Newly sworn in President Joe Biden and his advisers are inheriting no coronavirus vaccine distribution plan to speak of from the Trump administration, sources tell CNN, posing a significant challenge for the new White House.

The Biden administration has promised to try to turn the Covid-19 pandemic around and drastically speed up the pace of vaccinating Americans against the virus. But in the immediate hours following Biden being sworn into office on Wednesday, sources with direct knowledge of the new administration’s Covid-related work told CNN one of the biggest shocks that the Biden team had to digest during the transition period was what they saw as a complete lack of a vaccine distribution strategy under former President Donald Trump, even weeks after multiple vaccines were approved for use in the United States.

“There is nothing for us to rework. We are going to have to build everything from scratch,” one source said.

Another source described the moment that it became clear the Biden administration would have to essentially start from “square one” because there simply was no plan as: “Wow, just further affirmation of complete incompetence.”

The new administration has asked some of the key players who worked on Covid and vaccines under Trump to resign from their roles, including Operation Warp Speed chief scientific adviser Moncef Slaoui and Surgeon General Jerome Adams. It has kept on others such as Dr. Anthony Fauci, who is now serving as Biden’s chief medical adviser on Covid-19. Adams was asked to stay on as an adviser.

Prior to Inauguration Day, some of Biden’s Covid-19 advisers had wanted to be careful not to be overly critical in public of the Trump administration’s handling of the virus and vaccine, given that the Biden transition team was already having a hard time getting critical information and cooperation from the outgoing administration, the source said.

Now that the transition of power has taken place, the Biden administration is hoping that they can quickly start to get a clearer picture of where things actually stand with vaccine distribution and administration across the country, going through something of a “fact-checking” exercise on what exactly the Trump administration had and had not done, they added.

I trust none of this comes as a surprise. This would be a big challenge even if Team Biden were getting a handoff from a competent, caring, and diligent administration. And remember, right now we’re still experiencing over four thousand COVID deaths per day, with hospitals coast to coast full to bursting. We’re likely still not at the peak from the Christmas-celebration phase of the pandemic.

To be fair, it’s in the Biden administration’s political interests to emphasize what a crappy job Trump did with pandemic response, so that any blame they place on their predecessor for the inevitable bump or stumble sounds credible. And for all the justified criticism, the US is not doing all that badly when compared to other countries when it comes to getting people vaccinated. I’ve said before, the single most important thing that Biden can do to give Dems a fighting chance in the 2022 midterm election is to put the country back on a good track, and the two things he can do to make that happen are get the economy humming again and get everyone vaccinated. The incentives are lined up with the plan of action, the rest is all about getting it done. TPM and Daily Kos have more.

Can we get enough people vaccinated?

It’s going to take a lot of work.

In poll after poll, alarming numbers say they don’t plan to be inoculated with the vaccine, whose 95 percent efficacy rate in trials exceeded everyone’s expectations. It’s scientists’ nightmare: create one of medicine’s landmark achievements only to have large numbers of people not bother to get it.

But that appears to be the reality. Although the numbers appear to have improved since drugmakers Pfizer and Moderna reported their impressive trial results last month, about 40 percent of Americans tell poll takers they don’t plan to get a COVID-19 vaccine. In Texas, only 42 percent say they will.

Public health officials fear such numbers will hinder the campaign to shut down the greatest scourge since the 1918 Spanish influenza.

At stake is a possible squandering of the chance to get COVID-19 under control by late summer, to save countless lives that will be lost the longer it takes to stop the spread of the virus. Also at stake is an increased potential for a more lethal or contagious strain of the virus to emerge, always a threat as long as an infection continues to circulate.

“The hesitancy is bad for getting the population vaccinated to obtain herd or community immunity, which would allow for activities to become normal again,” said Kirstin Matthews, a fellow in science and technology policy at Rice University’s Baker Institute. “The Biden administration will need to find ways to gain public trust in the Centers for Disease Control and Prevention and FDA to ensure communities take the vaccine.”

A national task force led by Johns Hopkins Center for Health Security and Texas State University’s anthropology department added that “if poorly designed and executed, a COVID-19 vaccine campaign in the U.S. could undermine the increasingly tenuous belief in vaccines and public health authorities who recommend them, especially among people most at risk of COVID-19 impacts.”

[…]

Vaccine mistrust has been building for years, fueled by a small but growing movement that works to exempt children for “reasons of conscience” from school-required inoculations. But the COVID-19 vaccine has brought a new audience to such groups, like Texans for Vaccine Choice. Its leader told publications this summer that its phones were ringing off the hook with calls from people who said they’d gotten other vaccines but don’t want this one.

Neil Johnson, a physicist at George Washington University who studies anti-vaccine groups on social media, has estimated that in recent months, 10 percent of people on Facebook asking questions about vaccines have switched to anti-vaccine views.

“It’s going to be a bumpy road,” said Peter Hotez, a vaccine scientist at Baylor College of Medicine. “Given media scrutiny and an aggressive anti-vaxxer movement, particularly in Texas, any adverse vaccine events are going to be amplified.”

The story cites this Texas Tribune poll from October. I feel like things are probably a bit better now, mostly because it’s clear we will now have a competent administration that takes the pandemic seriously in charge of getting the vaccine out. For sure, messaging is going to be key to this, and all of us will need to play a part to make sure our family and friends have good information and make good choices. This Twitter thread has some good advice.

There will no doubt be significant resistance no matter what, and we may have to reach a point where we impose sanctions on people who could get the vaccine but haven’t. I don’t know what that might look like, and honestly I’m not sure if there’s a practical way to do what I’m suggesting. It’s way premature at this point anyway, but it’s best to be prepared for all possibilities. And as much as anything, we need to be prepared to fight off any effort in the Lege to coddle the anti-vaxxers, who already have had way too much influence, and success. If we can just avoid not making things worse, that will be a big win.

UPDATE: See this NPR story for evidence of growing confidence in the COVID vaccine.

Bar owners still mad at Abbott

Can’t blame them, but the situation is complicated.

As Gov. Greg Abbott outlined his latest reopening plan this week, bar owner Greg Barrineau watched in disbelief. Abbott, who announced that Texas restaurants could expand dine-in service to 75% capacity, said bars must remain closed.

“Some bars and their associations have offered some very helpful ideas,” Abbott said of reopening, “and we will continue to work with them on that process.”

But Barrineau, who has laid off his 12 staff members and suffered hundreds of thousands of dollars in losses at Drink Texas, a bar with locations in San Antonio and Boerne, said that assertion of collaboration is “insanity — he doesn’t care about small businesses.”

Michael Klein, the head of Texas Bar and Nightclub Alliance, which represents thousands of bars, said that Abbott’s statement about working together was “incorrect,” carefully choosing his words. The TBNA laid out a six-point plan to reopen in August, but Klein said the governor, whom he referred to strictly as “anti-business Abbott,” has not responded to the plan.

“We’ve never heard back from them,” Klein said. “We believe that he is disingenuous.”

Abbott’s office did not respond to requests for comment.

While restaurant owners applauded Abbott’s move to allow them to increase operations, Klein said Thursday’s ruling was “completely unacceptable” for many bars and other facilities where alcohol sales make up more than half of the revenue. It could leave 30% of Texas bars and 39% of distilleries permanently closed within six months, industry leaders said.

[…]

Spread from conventional bars and nightclubs has been widely documented throughout the U.S., and infectious disease experts caution going inside establishments that don’t follow social distancing protocols.

Kristin Mondy, chief of the infectious disease division in the University of Texas at Austin’s medical school, said there is increased risk in spreading the virus if strangers mingle in a tight, closed space, especially as drinking could cause bar customers to loosen their inhibitions.

Klein said the industry’s plan would reduce those issues by complying with Centers for Disease Control and Prevention requirements.

Some of the requirements in TBNA’s plan include ensuring all patrons are seated at their own tables, barring dance floors and mingling among groups, requiring face masks for all servers and customers when not at their tables, and conducting temperature checks upon entry. Mondy said these procedures could help as long as mask-wearing and social distancing are enforced.

[…]

Cord Switzer, who has helped run Fredericksburg Winery for almost 25 years with his family, said he has been able to technically and legally become a food server — but no one that comes is actually eating the food. That’s not why they go to a winery, he said.

“It makes no sense to me,” Switzer said. “We have never been interested in being in the food service business. We have no intent of doing that in the future, but it was our only choice.”

Switzer started wine tastings on Saturday for the first time in two months and hopes to begin recouping his losses after making 30% of last year’s revenue. But he doesn’t understand the governor’s categorization, and industry advocates share Switzer’s confusion.

“Texas winery owners continue to be perplexed by Governor Abbott’s steadfast refusal to recognize that the lion’s share of Texas alcohol manufacturer’s tasting rooms have little, if anything, in common with bars and nightclubs,” said Patrick Whitehead, the president of the Texas Wine and Grape Growers Association, in an email. “Governor Abbott’s arbitrary, and frankly unfair, act of lumping our tasting rooms into the category of bars is like a surgeon operating with a chainsaw rather [than] a scalpel.”

Switzer’s money troubles are not unique; nearly half of distilleries surveyed by the Texas Whiskey Association have experienced revenue losses greater than 60%. Spence Whelan, the head of the association, which represents distilleries across Texas, said continued restrictions could be disastrous for the industry, which normally relies on a big fourth quarter in holiday sales to stay afloat. This fall, with little or no visitors, that could be wiped out. Under Texas law, whiskey distilleries cannot ship or deliver whiskey directly to customers, nor can they sell more than two bottles of whiskey per person.

At the very least, Whelan said, those rules should be relaxed. Many places don’t want to open yet anyway, and there are other ways to bring in money. He said the industry has sent more than 15,000 letters to the governor’s office asking to waive those restrictions and has received no response.

Let’s acknowledge that bars are a high-risk environment for COVID-19, and the reopening of bars in May was a significant contributor to the subsequent outbreaks that swept the state in June and July. We should also acknowledge that there’s evidence that the reopening of restaurants, even at lower capacities, is also a risk factor in spreading COVID-19. The bar owners’ complaint – and wineries’, and distilleries’, and craft breweries’ – is that Abbott has been particularly rigid about how these risks are categorized, and has been unresponsive to any input that would allow these entities to operate in a lower-risk fashion.

I have a lot of sympathy for these complaints. Some bars have been able to reopen by creative interpretation of the 51% rule, by incorporating to-go service, and by a recent rule change that lets them have food trucks on their premises. But this doesn’t work for every bar, it imposes extra costs on them, and it doesn’t change the fundamental nature of their business. The only good thing that may come out of it is the expanded allowance for to-go service, and maybe if we’re very lucky a broader rethinking of our antiquated regulatory scheme for alcohol. I don’t know how effective the risk-mitigation strategies that have been proposed by the various industry groups would be, but we could study them and try the ones that comply with known best practices. We could surely let the places that have ample outdoor space like wineries and craft breweries with beer gardens take advantage of those spaces (to some extent we already are permitting this), and we could make allowances for those that have large and well-ventilated indoor spaces where social distancing would work. And, you know, Abbott and Dan Patrick could put a little pressure on the two Republican Senators to support a relief bill in Congress that included funds for bars and other places that rely heavily on alcohol sales (such as music halls) that just can’t be allowed to reopen right now. Abbott has done none of this, and as noted in the story has been repeatedly unwilling to engage in any discussion about it.

So this is both a legitimate set of concerns by members of a significant sector of the Texas economy, and a real opportunity for Democrats going forward. Dems don’t need to pander or reverse course on their properly-held principles about minimizing COVID risk. They just need to be willing to consider the various risk-mitigation strategies that have been proposed, and to continue to push for a response from Congress that truly addresses the broad economic pain that much of the country is still experiencing. Good policy is so often good politics, and the opportunity to do both here is enormous.

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.

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 hidden toll

Another reason why the reported death count from COVID-19 is too low: People who didn’t know they were infected and die at home may never be tested or counted.

As coronavirus cases surge, inundating hospitals and leading to testing shortages, a rapidly growing number of Houston area residents are dying at home, according to an NBC News and ProPublica review of Houston Fire Department data. An increasing number of these at-home deaths have been confirmed to be the result of COVID-19, Harris County medical examiner data shows.

The previously unreported jump in people dying at home is the latest indicator of a mounting crisis in a region beset by one of the nation’s worst and fastest-growing coronavirus outbreaks. On Tuesday, a record 3,851 people were hospitalized for the coronavirus in the Houston region, exceeding normal intensive care capacity and sending some hospitals scrambling to find additional staff and space.

The uptick in the number of people dying before they can even reach a hospital in Houston draws parallels to what happened in New York City in March and April, when there was a spike in the number of times firefighters responded to medical calls, only to discover that the person in need of help had already died. These increases also echo those reported during outbreaks in Detroit and Boston, when the number of people dying at home jumped as coronavirus cases surged.

While far more people died of COVID-19 in those cities than have died so far in Houston, researchers and paramedics say that the trend of sudden at-home deaths in Texas’ largest city is concerning because it shows that the virus’s toll may be deeper than what appears in official death tallies and daily hospitalization reports.

Many people who die at home are not tested for COVID-19, said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston. In New York City, for example, only 16 percent of the 11,475 at-home deaths between February and June have been attributed to COVID-19, according to data from the U.S. Centers for Disease Control and Prevention.

“There’s no reflexive testing,” Faust said, noting that medical examiners are selective about the cases they take. “There’s no pressure to call it a COVID death.”

The rise in at-home deaths may also reflect people who are afraid to go to the hospital because of COVID-19, and who die of heart attacks, strokes, diabetes and other conditions not tied to the coronavirus, Faust said.

Ultimately, Faust said, public health experts trying to assess the toll from COVID will need to study how many excess deaths there are in a particular region and whether the demographics of those who died are different from what one might expect. “If there’s a huge spike in at-home deaths but no real spike in overall deaths, it’s just sort of rearranging deck chairs.”

There’s more, so go read the rest. I don’t have anything to add other than the usual disclaimer that none of this had to happen. We could have had a federal government that actually prepared for COVID-19. We could have had a state government that cared about reopening in a safe and scientifically-driven manner. We have neither of those things – yet – and so here we are. Keep that in mind, today and every day, not just through this November, but through November of 2022.

We need to understand what we did wrong

So yeah, we need this.

Two of the nation’s most influential experts on the coronavirus pandemic, both based in Texas, are calling for an independent, nonpartisan investigation of the U.S. response to the novel coronavirus.

“We must prevent this from happening again,” said Gerald Parker, who directs the pandemic and biosecurity program at Texas A&M’s Bush School of Public Service. “This is not going to be our last pandemic.”

Peter Hotez, a Houston-based vaccine researcher and frequent commentator on cable news, noted that the current virus, SARS-CoV-2, is the third coronavirus to pose a major health threat in the last 20 years. And given that outbreaks had already wreaked havoc in China and Europe, U.S. public health systems were notably slow to respond.

“What hurt Wuhan was what hurt New York City,” said Hotez, “which is that virus transmission went on for six weeks before there was any public health intervention.”

In a videotaped interview with John Sharp, chancellor of The Texas A&M University System, Parker suggested an investigation modeled on the nonpartisan 9/11 Commission.

[…]

Hotez, who also participated in the interview with Sharp, said later that he feared a congressional panel would become “a political circus.” Instead he proposed a review by the National Academies of Sciences, Engineering and Medicine.

Among the questions Hotez wants answered: How, for the whole month of February, did the U.S. miss evidence that the virus was already here? Given the crowding and high number of underlying conditions in low-income neighborhoods, what was done to prepare African-American and Hispanic communities in the early days? Why didn’t the CDC have a centralized epidemiological model, including models of cities and metropolitan areas? And how can the U.S. prepare for future epidemics?

For those who are fans of comparing government to business, this is a very standard business thing to do. Call it an after-action review, or a root cause analysis, or just a plain old audit, it really is vital to learn from experiences, good and bad, so that you can understand what happened and why it happened, and what you can do better next time. I think we can all agree that there is plenty to be learned from this saga, and we all owe it to ourselves to do that. I would hope that much is non-controversial.

But let’s be real, there’s no way to do this that won’t involve politics. You can put together the bluest of blue ribbon panels, staff it with the bona fidiest of experts, and stick entirely to a just-the-facts narrative, it’s still going to be political. That’s because the single biggest actor in this drama was Donald Trump, and his influence on the decisions made at the state and local level was entirely political. Any review that doesn’t do a thorough accounting of this isn’t worth the effort. If Republicans haven’t figured out that Trump’s mishandling of this is what’s killing them in the polls right now, I can’t help them, but I would think they’d want to help themselves. If we manage to get an all-Democratic government next year (please, please), I won’t really expect Republicans to like anything such a report would say. That’s shouldn’t be the point, or anyone’s concern. Do a thorough review, get all the facts out into the open, learn everything there is to be learned, and let the chips fall where they may.

Please wear a mask

Don’t be that person. Seriously.

Kara McIntyre remembers the day she likely contracted COVID-19 — she wasn’t wearing a face mask.

She was at Target and began to feel dizzy. Later she checked her temperature and had a fever. So she got tested for the novel coronavirus, and a few days later her results came back positive.

The 39-year-old radio deejay did not wear a face mask before she was infected in March, something she said she feels guilty about now.

“I know I came in contact with a person who tested positive for it,” McIntyre said. “I wasn’t going out much, but I put gas in my car, went to the grocery store. Knowing I went through that and may have gotten other people sick, that’s terrifying.”

As the state reopens restaurants, shopping malls, gyms and salons, whether or not to wear a mask has become a hot-button issue. To some, it’s a way to signal one has their neighbor’s health and well-being in mind. To others, it’s an inconvenience or an attack on American freedoms.

[…]

The Centers for Disease Control and Prevention recommends everyone wear a face mask in public, in addition to practicing social distancing and frequent hand washing. But the president and vice president are often photographed without them.

Face masks have become a divisive issue even in Houston, where residents are known for coming together during times of crisis like Hurricane Harvey, said Cathy Power, 51.

“What I gather is that there is a narrative out there that masks are for the weak. This is wrong — masks are worn to protect others; they are not for protecting yourself,” said Power, who lives in the East End, and suffers chronic health issues. “They reduce the risk by keeping droplets from traveling as far as they would if you were not wearing a mask. It works best if we all wear them.”

People wear masks to protect others around them as studies have shown it has little to do with our own ability to not be infected, said Dr. David Persse, Houston’s health authority.

“Take a mirror, breathe on it and see the mist that forms. If you’re ill, the mist is full of virus,” Persse said. “Do the same thing with the mask in front of you; you’ll see far less of any mist on that mirror at all. That’s how it works.”

This is the sort of assumption that drives post-reopening models that predict a large increase in COVID-19 infections. If people are literally and figuratively letting their guard down, we’re going to be right back where we were in early March before all the shutdowns. We don’t want that, right?

So that leaves two viable options. One is to continue to stay home as much as possible and be relentless about social distancing and avoiding crowds. If you’re doing that, then for the most part you don’t need to wear a mask. But when you are out in public, in places where you are interacting with or just in close contact with other people, then you really do need to wear one. Grocery shopping? Wear a mask. Getting your hair cut? Wear a mask. They do make a difference.

More to the point, if we all agree that the cost of keeping the economy on ice is very high, the key to reopening is to find ways to reduce risk while out in public. Wearing a mask is a low-cost method of risk mitigation. The more we do it, the more free we can be with our movements and interactions.

That’s really all there is to it. If we do this together, we can get that curve down to zero, which is the best-case scenario short of a vaccine. (Which an astonishingly large percentage of people say they won’t take, but that’s a rant for a different day.) Remember, lots of people have no choice about this – health care workers and people in all kids of retail and service jobs have been wearing masks all day every day for a long time now. It’s not that often that you can do a fairly small thing and make a big difference. This is one of those times. Wear your mask. Thank you.

Hollywood’s plans to come back

I’ve posted a few times about how sports leagues like MLB are making plans to return to action from coronavirus shutdowns. The larger entertainment industry, including TV and movie making, are in a similar position as the sports leagues, and they too are starting to game out how they can (safely) return to doing what they do. This story gives a good outline of where that stands.

We are still months away from cameras rolling — studios’ most optimistic projections are for July-August production restarts, and the more realistic ones are aiming to be up and running by September. California is still under a stay-at-home order, which currently expires on May 15.

There are many different issues we will cover, starting today with the resumption of location and soundstage shoots.

Getting up and running again in this brave new world is going to be very difficult to navigate. For one thing, insurers are unlikely to cover productions for COVID-19 cases when business resumes, according to multiple sources in the know. Producers all over filed multimillion-dollar claims triggered when civil authorities — governments — prevented filming from continuing and forcing production shutdowns. When the business starts up, that will now be considered an identified risk, and insurers will not cover it, sources said, just as CDC is warning of a second coronavirus wave.

What does that mean? Most likely, everyone on a film or TV production will be required to sign a rider, similar to ones they sign covering behavior codes in areas like sexual harassment, to indemnify the productions. “You acknowledge you are going into a high-density area, and while we will do our best effort to protect you, nothing is failsafe and if you contract COVID-19, we are not liable,” said a source involved drawing up these guidelines. “There is no other way we can think of to address this. If you don’t want to sign, don’t take the job.”

Conversations about how to return to production began ramping up late last week amid stabilizing levels of new COVID-19 cases and deaths in Los Angeles County, boosted by an encouraging drop in new infections over the weekend. Unfortunately, the optimism was short lived — Tuesday and Wednesday brought record spikes in deaths– but discussions continue because the business cannot begin to recover until an industry goes back to work.

So far, there are no protocols on which studios have settled, but active discussions continue, including with the film commissions in New York and Los Angeles, we hear. AMPTP and IATSE are leaning in hardest here to map lists of safety concerns and solutions, and every major studio in Hollywood has top people trying to figure out every scenario that needs to be addressed before shows can get up and running. The same conversations are taking place in other areas that touch the business, from the offices where people work and congregate, to hotspot eateries and movie theaters.

A lot of this starts with the state of California’s plan to gradually ease up on restrictions. Studios will still need to contend with any remaining local restrictions. There’s a lot in here, from catering to heavier use of green screens to avoid filming crowds to extra special handling of topline stars, and some of the items listed will likely be similar to the steps other businesses will have to take to reopen their own offices. Check it out.

Mask up

Time for the next step in virus mitigation.

Judge Lina Hidalgo

Harris County Judge Lina Hidalgo on Wednesday ordered residents to cover their faces in public, the latest effort by local governments to slow the spread of the novel coronavirus.

The new rules, which require residents 10 and older to cover their nose and mouth when outside the home, take effect Monday and last 30 days. Acceptable garments include a homemade mask, scarf, bandana or handkerchief. Medical masks or N-95 respirators are not recommended as they are most needed by first responders and health workers.

Under the order, the county’s 4.7 million residents must cover their faces at all times except when exercising, eating or drinking; the exemptions also include when individuals are alone in a separate single space, at home with roommates or family, or when wearing a mask poses a greater risk to security, mental or physical health. Violating the mask rules is punishable by a fine of up to $1,000, though Hidalgo urged police to use discretion.

Unlike previous restrictions announced by the city and county executives, Hidalgo’s mask order drew fierce, partisan rebuke, highlighting what has become a national political divide over coronavirus restrictions.

[…]

Employers at businesses deemed essential under Harris County’s stay-at-home order must provide face coverings and training to workers whose jobs require them to come into contact with colleagues or the public. Hidalgo has yet to determine whether to extend the stay-at-home rules, which expire April 30.

Hospitalization data suggests the curve of new cases is flattening here, Hidalgo said at a news conference Wednesday. The region still is susceptible to another wave of infections, she warned.

“If we get cocky, we get sloppy, we get right back to where we started, and all of the sacrifices people have been making have been in vain,” Hidalgo said while wearing a homemade mask. “Let’s not get complacent. Let’s remember that we still have work to do.”

Hidalgo said the mask rules were spurred by her team’s realization the outbreak would require a long-term health response that extends beyond the end of stay-home rules.

Houston Mayor Sylvester Turner endorsed Hidalgo’s plan. He thanked residents for their sacrifices to date and said he would announce a plan Thursday to distribute 70,000 masks to vulnerable residents.

Masks are a crucial tool to prevent a surge in cases as businesses and public spaces reopen, said Firas Zabaneh, an infectious disease expert at Houston Methodist. He said they also serve as a visual reminder to maintain social distancing.

“The public will be safer with masks on,” Zabaneh said. “As we ease the restrictions, more and more people are going to be interacting with each other.”

The Centers for Disease Control recommends wearing masks when social distancing is not possible, such as at a grocery store. Many people who have coronavirus do not show symptoms, and the disease can be spread through speaking, coughing or sneezing.

I omitted all the partisan criticism, which included a particularly whiny response from the police union president, because sniveling is pathetic and life is short. As the story notes, Laredo and Dallas and San Antonio have issued similar orders without any of the fuss; I’ll leave it to you to decide why the same thing from Judge Lina Hidalgo inspired such vitriol. The police guy went running to AG Ken Paxton to ask if she was allowed to do that, and he demurred, while reminding the cops that they do have the discretion to not issue citations.

Anyway, look. The way forward with this pandemic, certainly until we have an effective treatment regimen and eventually a vaccine, is going to include things like masks, plus continued social distancing and universal testing and a whole lot more hand sanitizer and bleach wipes. This is the new normal, whether we like it or not. It would be nice if everyone went along with this willingly, but we’ve already seen that a significant portion of the population doesn’t take any of this seriously. This is where we are.

Galveston and Montgomery Counties have not followed suit. For what it’s worth, they were behind the curve in issuing stay-at-home orders, too. With Greg Abbott’s forthcoming order to “reopen” the economy, it’s possible that Hidalgo’s order will be quite short-lived, since Abbott seems to have remembered that he doesn’t like letting local governments do things. As is so often the case lately, I have no idea what happens next. Buckle up, it’s gonna be bumpy. The Press has more.

Ridiculous Hotze lawsuit now in district court

We are all dumber by the mere existence of this.

The Texas Supreme Court has dismissed a lawsuit challenging the constitutionality of Harris County’s stay-at-home order, though the legal fight is set to continue in state district court.

The Wednesday ruling came at the request of the suit’s plaintiffs, including longtime conservative activist Steve Hotze and the pastors of three Houston-area churches.

Earlier this week, Jared Woodfill, the group’s attorney, filed a new case in Harris County that similarly claims County Judge Lina Hidalgo’s stay-at-home order violates the plaintiffs’ First Amendment rights because it allegedly continues to restrict church services even after Hidalgo revised it to align with Gov. Greg Abbott’s executive order deeming churches “essential businesses.”

The governor’s March 31 directive, akin to the stay-at-home orders issued by counties across Texas, came one day after anti-LGBTQ Republican activist Hotze and pastors Juan Bustamante, George Garcia and David Valdez filed a petition arguing that Harris County’s order violates the Constitution by ordering the closure of churches and failing to define gun shops as “essential” businesses.

The four original plaintiffs remain on the new lawsuit, and they are joined by Tom DeLay, the former House Majority Leader who represented a district in the Houston area until 2006. The plaintiffs also have challenged Montgomery County’s stay-at-home order in a different state district court.

[…]

Last Friday, Hidalgo revised her order to “permit in-person religious services that comply with the CDC’s guidelines,” according to a court filing by the county attorney’s office. The plaintiffs are continuing to challenge Hidalgo’s order in state district court, Woodfill said, in part because it imposes penalties — up to 180 days in jail and a $1,000 fine — that Abbott’s does not.

Hidalgo’s amended order says: “Per the Texas Attorney General’s guidance on this topic, if religious services cannot be conducted from home or through remote services, then religious services may be conducted in churches, congregations and houses of worship.”

Woodfill said he interprets that language to bar most churches from meeting in person, because most are capable of holding services remotely.

“Just about every church has the ability to do that,” Woodfill said. “Maybe there are some small churches that don’t. That doesn’t mean your parishioners have internet or the ability to access the service. We think that’s clearly government coming in to the church and issuing edicts and mandates that are an infringement on religious liberties.”

See here for the background. All this and Tom DeLay, too, because you can’t spell “stupid, evil, and corrupt” without Tom DeLay. Bear in mind, Hotze got what he wanted from Abbott’s executive order. It’s just that he’s special, so very special, and the rules of law and man don’t apply to him. I could sit here and spew invective at him all day, but what’s the point? He’s a sociopath, and this is what he does. If you get hurt as a result, that’s not his problem.

The Republican death wish

It would be one thing if they were just putting their own lives at risk, but that’s not how viruses work.

After Dallas County Judge Clay Jenkins became the first to announce a mandatory stay-at-home rule, conservative groups including Empower Texans began ringing alarms in opposition to Jenkins and to Republican Gov. Greg Abbott, who they say paved the way for the move.

Abbott had said he would applaud local leaders who felt they should issue stay-at-home orders for their communities.

“I’m extremely concerned about what Dallas Co just did, and Abbott’s apparent sanctioning of it,” Empower Texans president Ross Kecseg wrote on Twitter.

So far, Lt. Gov. Dan Patrick is the highest-ranking state official to echo those concerns.

“What I’m living in fear of is what is happening to this country,” Patrick said in a Fox News interview. “I don’t want the whole country to be sacrificed.”

Patrick, who turns 70 next week, went on to say he’d be willing to risk his own life and well-being to help preserve the way of life for other Americans — a statement that drew harsh rebukes on social media and inspired hashtags such as #DieForTheDow.

[…]

Critics of the stay-at-home orders are contradicting the advice of public health authorities at every level of government, from the World Health Organization to the national Centers for Disease Control and Prevention to local health officials. Epidemiologists have stressed that keeping people apart is the best way to fight back against a new virus for which there is no vaccine, and that aggressive early steps are the only way to get ahead of COVID-19.

The discord in Texas mirrors what’s going on at the national level with Republican governors showing more reluctance than Democratic ones, like Cuomo, to shutting down their states, said Timothy Callaghan, assistant professor of health policy and politics at the Texas A&M School of Public Health.

“On the one hand, they certainly want to protect the public health, but they are also afraid about hindering the freedoms of their citizens and they’re also concerned about the economic impact of having society in many ways shut down,” Callaghan said. “It’s a tricky balancing act for many politicians on the conservative side.”

Not only does that send Texans a mixed message but Callaghan said it could also reduce the effectiveness of the orders.

“If you want to see a true impact of flattening the curve throughout the state of Texas, it’s important for it to be a statewide policy,” Callaghan said. “Certainly in those areas that choose to enact some sort of shelter in place policy, you’re going to see some effect, but we don’t know if it’s going to be a smaller effect than if the entire state had chosen to do something.”

See here for the background. It’s not actually clear that they want to protect public health, since everyone who knows anything about public health and epidemiology is practically shouting from the rooftops that these shutdowns are necessary and we risk having literally millions of people die without them. Indeed, rightwing magazines are touting the virtues of deliberately spreading coronavirus, in a ridiculous and dangerous belief that it’s preferable to social distancing. I suspect there’s a certain amount of cognitive dissonance going on, since the one thing that can mitigate the economic impact of the stay-at-home orders is massive government action to put money in people’s pockets to replace the income they’d be losing, and that would seem to be the thing that Dan Patrick fears more than his own death. It’s clear that they’re taking their direction from Donald Trump, because that’s what they do these days and Trump is getting tired of the whole pandemic thing. It will be interesting to see if actual elected Republicans turn on Greg Abbott if he however reluctantly orders a statewide shutdown. In the meantime, I don’t know what there is to say other than there’s one way to get through this without a lot of people dying, and what these Republicans are agitating about is not it.

Further delay for Opening Day

Mid-May at the most optimistic, and that’s very likely too soon.

Major League Baseball pushed back opening day until mid-May at the earliest on Monday because of the new coronavirus after the federal government recommended restricting events of more than 50 people for the next eight weeks.

Baseball Commissioner Rob Manfred made the announcement following a conference call with executives of the 30 teams.

“The clubs remain committed to playing as many games as possible when the season begins,” the commissioner’s office said in a statement.

The Centers for Disease Control and Prevention recommended Sunday that gatherings of 50 people or more be canceled or postponed across the country for the next eight weeks.

“The opening of the 2020 regular season will be pushed back in accordance with that guidance,” Manfred said.

No telling at this point when games will start. The All-Star Game at Dodger Stadium in Los Angeles on July 14 could be in jeopardy.

“We’re not going to announce an alternate opening day at this point. We’re going to have to see how things develop,” Manfred told the St. Louis Post-Dispatch at Cardinals camp in Jupiter, Florida. He didn’t want to speculate about the possibility of playing in empty stadiums, saying part of that decision would depend on timing.

See here for the background. This assumes that after eight weeks we will not be under a general directive to greatly limit public gatherings, and that MLB players will be more or less ready to go as soon as that happens. I’ll take the over on this best and assume that sometime in June is a more realistic target. The NBA is currently aiming for mid-to-late June, and if that is how it works out for MLB as well, I’ll be reasonably satisfied. That could yield an MLB season of between 90 and 120 games, depending on when in June things could start and whether the end of the season could be pushed back and/or whether there might be more doubleheaders. I’m sure there will be plenty of discussions between the league and the union, as there are now about pay and service time and what have you. Three months seems like forever now, but if we’re at a point of normality again where sports have returned, I for one will be pretty damn happy. I mean, there are plenty of worse alternatives at this time.

The Houston healthcare community is preparing for COVID-19

I sure hope it’s enough.

With last week’s new certainty that the novel coronavirus is loose and being transmitted in Houston, the region’s medical providers are bracing for the current handful of known cases to blaze into an outbreak like nothing in modern memory.

“We had been saying, ‘It’s not a matter of if, it’s a matter of when,’” said Umair Shah, executive director of Harris County Public Health. “That’s not the case anymore. It’s now.”

By shutting down events and closing schools, officials aim to “flatten the curve” — to stop too many people from getting sick at the same time and overwhelming the region’s hospitals and medical providers.

Much about the highly contagious new virus remains unknown, and projections of its future behavior vary wildly.

Based on scenarios from the Centers for Disease Control and Prevention, the New York Times estimated that anywhere from 2.4 million to 21 million people in the United States could require hospitalization, “potentially crushing the nation’s medical system, which has only about 925,000 staffed hospital beds.”

For most people, the virus is expected to be mild. But up to 20 percent of cases — mostly people over 60 or with underlying medical conditions — may require hospitalization.

If everyone gets sick more or less at once, area hospitals almost certainly would not have enough rooms, critical care or ventilators. In Italy, where officials waited to control the outbreak, an extraordinary surge of cases has left the medical system on the verge of collapse.

Based on Harris County estimates, County Judge Lina Hidalgo said recently that if 30 percent of Harris County residents were to become sick at the same time and 20 percent of those people needed hospital care, medical infrastructure would be overloaded.

“We simply do not have enough hospital capacity to assume all of those people,” Hidalgo said. “We can’t afford to have a sudden spike in cases.”

Even the best case — a slowed outbreak that continues for months — is almost certain to pose significant challenges to the area’s hospitals, clinics and doctor’s offices.

[…]

The virus poses particular threats to hospital personnel, who will be working long hours under stressful conditions — and facing coronavirus-related personal problems such as a lack of child care due to school closures. In the worst scenario, seen in China, medical personnel become ill themselves, and their colleagues have to take care of them.

Testifying before Congress earlier this month, Dr. Peter Hotez, a Baylor College of Medicine vaccine researcher and infectious disease specialist, urged that special attention be paid to hospital workers.

“If health care professionals are out of work because they’re sick, or if they’re being taken care of by other health care professionals in ICUs, that’s a disaster,” he said.

And just this weekend, two ER doctors, one in New Jersey and one in Kirkland, Washington, have tested positive for coronavirus. Even with the best preventative measures, this thing is going to spread. All we can do – all that we must do – is take every action we can to try to limit how quickly it spreads. That’s our best hope.