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COVID-19 Modeling Consortium

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

The Delta surge is killing younger people

So many avoidable deaths.

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

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

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

[…]

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

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

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

[…]

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

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

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

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

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

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

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

Back to Code Red

Pretty much inevitable at this point.

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

For sure, stay the hell away from this.

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

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

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

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

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

Yikes.

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

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

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

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

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

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

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

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

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

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

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

One more thing:

White Linen Night is back — well, sort of.

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

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

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

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

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

We’re #2!

More people have died of COVID in Texas than any other state except California, as Texas surpasses New York’s total.

Texas has passed New York to become the state with the second-most COVID-19 deaths, a feat experts say was driven by an inability to control transmission of the virus here.

Texas reached the milestone Wednesday, hitting 53,275 deaths, despite trailing New York by more than 29,000 fatalities last summer. Since then, though Texas is 54 percent more populous, more than twice as many Texans as New Yorkers have succumbed to COVID-19. California, the most populous state, leads the nation with 64,372 virus deaths.

Spencer Fox, associate director of the University of Texas COVID-19 Modeling Consortium, said he was surprised Texas had not passed New York in mortality sooner, since the northeastern state did a far better job limiting the spread of virus after it endured a horrific surge last spring.

“They enacted really strong, precautionary measures that overall are well based in the available science,” Fox said. “It seems that many of the Texas policies were put in place to try and prevent health care collapse rather than trying to prevent transmission.”

By June 30 of last year, as the first wave of the COVID-19 pandemic swept through the United States, New York tallied 31,775 virus deaths. Texas had just 2,481.

While New York City hospitals were pushed to the brink in the spring and the region became a global epicenter of the virus, Texas had kept the virus at bay and begun to ease restrictions.

Over next 13 months, however, the states reversed roles. New York kept restrictions and mask rules in place longer and consistently maintained a lower positivity rate than Texas. In contrast, Texas endured two surges of the virus and is in the early stages of a third, as the Delta variant now sweeps the country as a fourth wave of the virus.

During that time, Texas steadily closed in on New York’s death tally, a Chronicle analysis found.

Another way to put it is this: Since June 30 of last year, 13 months ago, there have been about 51,000 COVID deaths in Texas. (That’s the official count, which as we know is too low for a variety of factors, but it’s what we’re using for comparison purposes.) In that same time period, there have been about 22,000 COVID deaths in New York. Texas, with 54% more people than New York, has had 131% more COVID deaths than New York in that time period. It’s mind-boggling, enraging, tragic, devastating, and all of it can be laid at the doorstep of Greg Abbott.

The rest of the story is a timeline of those past 13 months, the various things that governments in New York and Texas did and didn’t do to deal with the changing infection rates, and so on. New York has been far more restrictive than Texas has, sometimes to the point where its residents complained and experts questioned the risk calculation involved, but the numbers are what they are. New York also has a higher vaccination rate than Texas, so this trend is going to continue, and probably accelerate, in the foreseeable future. Indeed, given how much more vaccinated California is than Texas, we could conceivably catch up to them as well. Not a goal we should want to achieve.

But we’re well on the way, and Texas’ hospitals are bracing for impact.

When Terry Scoggin left work at Titus Regional Medical Center in Mount Pleasant on Tuesday evening, there were five patients at the facility being treated for COVID.

Overnight, six more people suffering severe coronavirus infections were admitted to the rural Northeast Texas hospital — pushing the facility to its capacity limit and putting Scoggin, the hospital’s chief executive, on high alert for what he’s calling “a fourth surge.”

“We’re at it again,” Scoggin said.

That same night, hospitalizations in Bexar County rose by nearly 8%. Almost 100 people were admitted with severe COVID to local facilities on Tuesday alone, Bexar County officials said on Wednesday.

“These numbers are staggering and frightening,” said Eric Epley, CEO of the Southwest Texas Regional Advisory Council for Trauma in San Antonio.

Hospital and health officials across Texas are seeing similar dramatic jumps, straining an already decimated health care system that is starving for workers in the aftermath of previous coronavirus surges.

[…]

Fueled by the highly contagious delta variant of the coronavirus, which is contributing to skyrocketing cases not just in Texas but across the nation, the rising hospitalizations rates have spread outside of the heavily populated metro areas that first began to report increases a few weeks ago. Now they are being seen in all corners of the state, triggering pleas from hospitals for state-backed staffing help to handle the increasing pressure.

Trend forecasters at the University of Texas at Austin’s COVID-19 Modeling Consortium said Wednesday that most regions of the state could see a return within a couple of weeks to the capacity-busting hospitalization rate facilities were experiencing in January — the height of the pandemic — if people don’t resume masking up and social distancing.

In Florida, hospitals are already seeing the numbers of COVID patients exceeding levels they saw during the worst of the pandemic, and consortium researchers told The Texas Tribune that Texas is not far behind.

“We are absolutely on a path to hit a surge as large, if not bigger, than the previous surges right now” said Spencer Fox, associate director at the consortium. “If nothing is done, we’re on a crash course for a very large third wave.”

The situation has caused health officials from both rural and metro areas to plead for more resources from the state.

“On behalf of the 157 rural hospitals across Texas, I am writing to ask you immediately take steps to provide additional medical staffing which we anticipate will be needed in our rural hospitals in short order because of the new COVID surge,” John Henderson, president and CEO of the Texas Organization of Rural and Community Hospitals, wrote in a July 26 letter to Gov. Greg Abbott.

And what was Abbott’s eventual response?

The story is behind their paywall, but the basics of it that I could glean were that the state of Texas is declining to use any COVID stimulus funds to pay for more hospital staff. Instead, the state is directing cities and counties to use their own COVID funds for that. Because we’re all in this together you’re on your own, Jack. And remember, it’s all your fault and will be your fault when more people have died of COVID in Texas than anywhere else in the country.

Please stay socially distant this Thanksgiving

It’s what we have to do.

Harris County Judge Lina Hidalgo on Tuesday urged residents to limit Thanksgiving gatherings to immediate family to limit the spread of COVID-19.

The county will send an emergency cell phone alert to all residents urging them to get tested for the virus, regardless of whether they have symptoms, as uncontrolled community spread has driven up new case and hospitalization numbers to a point higher than before Labor Day. Hidalgo and health officials fear a sustained surge like the one in June and July, which pushed Houston-area hospitals beyond their base ICU capacity.

“We reopened too soon,” Hidalgo said. “We’ve seen every indicator move in the wrong direction.”

Hidalgo’s requests is voluntary, since Gov. Greg Abbott in April stripped local officials of the ability to issue their own COVID-related restrictions. The governor rebuffed Hidalgo’s request in June for a new stay-at-home order; she warned during her annual State of the County remarks last week that new restrictions may be needed to combat this most recent wave of infections.

Before we get to the very well-known reasons why we should not be gathering in large quantities in our homes, let’s take a moment to consider this.

An estimated one out of every six Texans — roughly 4.75 million people — has contracted COVID-19, according to a recent statistical analysis by the University of Texas at Austin COVID-19 Modeling Consortium. The analysis estimates that the virus is spreading rapidly and so far has infected more than 16 percent of people in Texas, far more than the state’s tally.

“The speed at which things can get out of hand is a lot quicker than people expected,” said Spencer Fox, associate director of the consortium.

The consortium’s statistical modeling uses cell phone data to measure mobility and state hospitalization levels to determine where the virus is spreading and how many people have been infected. It is not a perfect predictor of the virus’ spread, Fox cautioned, but it dovetails with state estimates.

The researchers’ approximation of 4.75 million cases is “generally in the ballpark” of what state health officials believe is the true number of infections, said Chris Van Deusen, a spokesman for the Texas Department of State Health Services, which publishes the state’s official COVID-19 infection figures.

“It varies by condition, but we know and expect that all kinds of diseases are underreported,” Van Deusen said in an email.

In the Houston region, the UT consortium’s projections have worsened recently because of the growing number of new infections and hospitalizations. There’s a 76 percent chance the pandemic is growing here, according to the latest modeling, up from 47 percent on Friday. More than 1 million people — about 16 percent of Houston-area residents — have been infected with COVID-19, the UT researchers estimated.

[…]

The consortium estimated in October that there was at least an 80 percent chance the pandemic was growing in El Paso. That proved to be true. Cases and hospitalizations rose in that border city throughout late October and early November, overwhelming the local health care system. The model estimates that one in every three El Paso residents has contracted the virus since the start of the pandemic.

The modeling also shows the potential danger of letting the virus run rampant to establish herd immunity — a strategy that some critics of lockdowns say is worth trying.

In order for herd immunity to work before a vaccine is ready, roughly 60 percent of the population would have to be infected, or more than 17 million people, Fox said. Given the demand on hospitals in Texas now, with an estimated 16 percent of the population infected or recovered, the health care system would be overwhelmed if the coronavirus was allowed to spread unchecked.

“You can just think about what that would look like,” he said.

So there’s an excellent chance that someone at your Thanksgiving dinner has, or has had, COVID-19. If they are sick, they may not know it, which means they’re out there spreading it without realizing it. Why would you want to take the chance?

Look, the weather forecast for Thanksgiving is beautiful. If you want to celebrate outdoors, with family or friends in a socially-distant manner while masked when you’re not eating, you can reasonably do that. But don’t be part of the problem, and especially don’t be an asshole. Let’s all try to live long enough to be able to get vaccinated for this thing. The Trib has more.