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Harris County Public Health Authority

The contract health worker surge

Don’t know how sustainable this is.

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

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

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

[…]

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

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

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

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

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

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

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

[…]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Overflow COVID tents

This is fine.

Harris Health System’s intensive care units are nearly full as the delta variant sends more COVID-19 patients into hospitals, prompting the safety-net health system for the county’s indigent communities to construct tents for triaging patients.

As of Monday afternoon, Lyndon B. Johnson Hospital’s ICU was 100 percent full, and 63 percent of patients were being treated for COVID-19 complications. Ben Taub Hospital’s ICU was 95 percent full, with 27 percent of patients sickened by the virus.

“The trend line is vertical,” said Bryan McLeod, a spokesperson for Harris Health.

The tents apparent outside the hospital in northeast Houston could be used for COVID-19 overflow patients, but officials may also choose to use it for patients who come in with other illnesses. Last summer, they were used to diagnose coronavirus cases, McLeod said.

This year, they may just be used to treat non-COVID patients, or those with less severe infections. Staff are still installing operational and diagnostic equipment in the overflow area, which will take patients from the emergency room.

While LBJ is the only hospital currently using such tents, Memorial Hermann is creating additional space for overflow patients by converting beds in their pre- and post-anesthesia units into ICU beds.

[…]

Statewide, hospitalizations have been increasing rapidly; on Saturday 9,462 people were hospitalized, an increase of 30 percent over the previous Saturday, according to the Texas Department of State Health Services. This weekend’s hospitalization figures were the highest Texas has seen since Feb. 6.

Not just in Houston.

Dozens of Texas hospitals have run out of intensive care unit beds as COVID-19 surges faster than any other time during the pandemic, propelled by the new delta variant.

The state is divided into 22 trauma service areas, and half of them reported 10 or fewer available ICU beds on Sunday. As more than 9,400 COVID-19 patients fill the state’s ICUs, which are reserved for the patients who are the sickest or most injured, the trauma service area that includes Laredo reported no available ICU beds, while the area that includes Abilene reported having one.

At least 53 Texas hospitals have no available ICU capacity, according to numbers reported to the federal government during the week ending Aug. 5. In Austin, five hospitals were at or above 90% of their ICU capacity during the same period, with two reporting no available ICU beds.

“This surge is by far the fastest and most aggressive that we’ve seen. Almost all of our hospitalizations are due to unvaccinated patients developing severe illness,” Dr. Desmar Walkes, Austin-Travis County’s health authority, told reporters last week. “ICU staff are seeing a younger population in our hospitals. Patients in the ICU are sicker and stay in the hospital longer than with prior surges, putting more strain on hospital resources.”

Around 87.1% of all hospital beds in Texas are in use — the highest level since the start of the pandemic — with 14.1% of those beds occupied by COVID-19 patients. When Gov. Greg Abbott began to relax some COVID-19 restrictions on businesses in October, his order maintained reduced restaurant capacity and kept bars closed in regions in which 15% or more of hospital beds were filled with COVID-19 patients.

This week, COVID-19 hospitalizations reached higher levels across the state than when Abbott imposed a statewide mask mandate in July 2020. Abbott has maintained that he will not be reviving the mask mandate and has barred local authorities from issuing their own.

No, really, NBD.

More than 10,000 Texans are hospitalized for COVID-19, according to data released by the Texas Department of State Health Services Tuesday afternoon.

According to Tuesday’s report, 10,041 people were hospitalized with COVID-19 across the state of Texas on Monday, the highest rate since Feb. 4, as the delta variant continues to dominate new COVID-19 infections.

[…]

Monday’s figure represents a 37 percent increase over the number of hospitalizations one week prior.

But don’t worry, Abbott has asked for more nurses to move to Texas, so we’re going to be fine. Really, what more do you need him to do?

Harris County drops its vaccine waitlist

Sign up and get a shot if you haven’t already.

Harris County Public Health has ended its waitlist for COVID-19 vaccinations, County Judge Lina Hidalgo said Friday.

The new portal at ReadyHarris.org allows residents to register, after which they can pick and choose their appointment time, according to the website.

Hidalgo said there’s currently “more vaccine supply than ever” and encouraged people to sign up for vaccines, which are free and do not require insurance to receive.

She added that the county has 55,000 doses of the Pfizer and Moderna vaccines available for next week.

You can also call to schedule an appointment at 832-927-8787. There are equity issues to deal with, but making the vaccine more widely available, and to people who don’t have Internet access, will help.

That new Harris County vaccine signup page sure is popular

If you didn’t get through on Day One, keep trying.

Judge Lina Hidalgo

More than 49,000 people have managed to get onto Harris County’s new COVID-19 vaccination wait list Tuesday despite technical issues that diminished access for some to the county’s website.

Harris County Judge Lina Hidalgo’s office said 49,287 people were able to sign up as of 4:30 p.m.

Health officials said there has been an “overwhelming amount of people” trying to use the website at ReadyHarris.org.

“It’s down. It’s been down. We have had it crash several times,” said Martha Marquez, a spokesperson for Harris County Public Health said earlier Tuesday. “I know that, as we speak, they’re working on it.”

See here for the background. I assume this was mostly a first-day crush, but 49,000 people is roughly one percent of the Harris County population, so there could be quite a few more busy days ahead. I also assume that they’ll be able to scale the site up as needed, which in today’s world should be easy enough to do. In the immediate term, lack of vaccine supply is a looming problem, but that should be addressed in the slightly longer term. Has anyone tried this yet? How’d you do?

The COVID vaccine wait list

Good idea, and about time.

Judge Lina Hidalgo

Harris County Judge Lina Hidalgo announced Monday afternoon a new COVID-19 vaccine waitlist, in an effort to ensure those who are high priority don’t get overlooked and make for a smoother process.

Hidalgo explained the basics of how the waitlist will work. Hidalgo was joined by Dr. Sherri Onyiego, the interim local health authority for Harris County Public Health.

The waitlist is said to be weighted and randomized, meaning the website won’t necessarily favor whoever has the quickest internet connection. Once the portal opens Tuesday, everyone will be able to register.

If you fall under the 1A, 1B or seniors groups, then your registration will be weighted for priority, and it will then be randomized within the priority list.

The launch of this new portal and waitlist expands the previous process by allowing eligible residents to sign up for vaccines on their own directly, according to a press release from the county.

Eligible residents without internet access can also call 832 927-8787 once the portal is live to be placed on the waitlist.

The new system starts today:

That’s a good approach, and honestly it’s how we should be doing this nationwide. I’ve heard plenty of stories of people with good Internet skills or just the right about of persistence and life-hacking who have helped people sign up for vaccines, but it really can’t and shouldn’t be this hard. And honestly, even for the folks like me who are closer to the back of the line, just being able to register now and then wait to be called when it is our turn would likely relieve a lot of anxiety out there. This starts today and if it works as well as I expect it will, I hope other counties will follow suit. The Chron and Houston Public Media have more.

Meanwhile, on a related note.

Lt. Gov. Dan Patrick is pushing the state to refine its criteria for COVID-19 vaccination eligibility, saying that whittling down the list may better prioritize vulnerable Texans and clear up confusion over when shots will actually be available.

The state is currently offering the vaccine to frontline workers and vulnerable Texans, a group of more than 9 million people — even though the state is only receiving about 300,000 doses a week. That numerical reality has made for a confusing and frustrating process for Texans eligible for a shot, with many unable to find available doses or unsure where to look with demand far exceeding supply.

“Texans need to have a better understanding of the time it will take for everyone to be vaccinated in order to reduce lines, confusion and frustration,” Patrick wrote in a Thursday letter to the state’s Expert Vaccination Allocation Panel.

It will probably be May at the earliest before all members of that first priority group have been immunized, said Dr. David Lakey, a member of the state’s vaccine panel, in an interview this week with Hearst Newspapers. The Texans currently eligible are included in groups 1A — health care workers and nursing home residents — and 1B, those over 65 and anyone 16 or older with certain pre-existing medical conditions.

[…]

Patrick suggested creating subgroups within 1B over the next several weeks — perhaps by first taking two weeks to vaccinate those 75 and older, a group of about 1.5 million. Then, he said, a subgroup of roughly 65,000 teachers and school staff over 65 could become eligible.

“This would help give people an idea of reasonable expectations and reduce wait times and frustration each week,” Patrick wrote. “Right now, in many cities and counties when an announcement of available vaccinations is made, website sign-up pages crash and phone calls go unanswered.”

Seems reasonable, and as above it makes you wonder why no one had thought of this before. Including and especially Greg Abbott, who did not come up with this idea despite being the immovable object on everyone’s COVID plans. We’ll see what happens with this.

Schools are doing a good job not spreading COVID

Of great interest to me, as my kids have now returned to in person school.

As COVID-19 cases have risen dramatically in Texas and across the country, there is one place where the coronavirus seems to spread less than others: the classroom.

While Texas public school districts report about 41,000 students and 24,600 staff members testing positive since the start of the school year — equal to slightly less than 2 percent of those on campuses, according to state estimates — health experts said only a small share of those cases stem from in-classroom transmission.

In interviews this week, health officials from across the state described seeing “minimal,” “low” and “very, very little” spread in classrooms where students and staff are following safety recommendations. They attributed cases primarily to transmission occurring outside of schools, as well as during extracurricular activities, though it is difficult to pin down exactly where the virus is transmitted.

“In some of the schools we’ve observed where the kids can reliably stay six feet apart, can reliably wear masks, then the transmission rates appear to be very low,” said Maria Rivera, the co-leader of Harris County Public Health’s school advisory group. “Where we have seen in-classroom transmission become a problem is when the classrooms become crowded and it’s hard or impossible to keep the kids six feet apart, and when the masking may not be enforced.”

Let me note up front that not everyone cares for this description of the issue. Right now, a bit less than half of students are attending in person class. That can vary a lot by school district. Some risk factors that have been identified include extracurriculars, with sports being high on that list. Locker rooms and gymnasiums are risky places. There’s concern about kids coming back after Thanksgiving, especially if they traveled or celebrated with extended family – we ought to have a pretty good picture of that effect soon. On the flip side, the vaccine is coming, and teachers are hoping to be near the front of the line for it. My guess is we’re not back to in person learning as the norm till next school year, but maybe we’ll be able to do better than that. For now, as long as we can keep the kids and teachers and staff safe, that’s what matters.

A different kind of COVID tracking

Hope this works.

Harris County Public Health will survey residents for COVID-19 antibodies in an effort to determine how many people already have been infected with the novel coronavirus, the department said.

Beginning Sunday, health workers will visit randomly selected homes and ask residents to answer questions and provide blood samples.

Humans produce antibodies, proteins in the immune system, to fight infections from viruses and other pathogens. It can take days or weeks for antibodies to develop following exposure to the coronavirus, and it remains unclear how long they remain in an individual’s blood.

The Houston region has recorded 236,704 COVID-19 cases since the virus arrived here in March, according to a Houston Chronicle analysis, but health officials estimate this is only a fraction of the total number of infections.

Health officials hope the antibody tests will help the county determine how COVID-19 spread in certain communities, how transmission rates differ between neighborhoods, how effective containment strategies have been and how many residents contracted the virus but never exhibited symptoms.

“This survey is a very important way that local residents can help public health workers fight this virus,” Harris County Public Health Executive Director Dr. Umair A. Shah said in a statement. “By finding out how widespread the illness is, we can develop strategies that will help us control the spread of COVID-19.”

Participation in the program is voluntary, and only selected households are eligible. Teams of health workers wearing yellow vests will make their rounds from Nov. 15 through Dec. 15, from 8 a.m. to 5 p.m.

The point of this survey is to find the people who have COVID but didn’t know it and never got tested for it. This will help us know what the real level of infection is in the county, since the official stats are almost certainly too low. It may also help identify previously unknown hot spots, in the way that wastewater testing can do.

And speaking of official statistics:

Please wear your mask and stay socially distant, y’all. There’s only way one way out of this until that vaccine is ready.

Back to school

How’d it go for you and your kids?

On a normal first day of school, Texas children would wake up early to cram into school buses, eager to huddle and chat with their friends in the hallways before streaming toward their classrooms.

On Tuesday, as many of the state’s biggest urban and suburban districts return for their first day of in-person instruction, there is anxiety mingled with that excitement. Many parents will not be allowed to walk their kindergarteners inside for their first day. Teenagers will be shooed away if they congregate around their lockers. Meals will be grab-and-go, often eaten in classrooms instead of raucous cafeterias. Students and teachers will wear masks, trying to stay as far apart from one another as possible even as they come together for the first time in months.

Many kids will not be entering their schools at all. Some of the state’s biggest districts, including Houston and Dallas independent school districts, will not open their classrooms for in-person learning until late September or October, and they may even ask the state for more time if the virus isn’t under control.

In-person instruction will look very different from campus to campus. Some districts will bring students back in phases, starting with those who most need in-person education, like students with disabilities or those learning English. In San Antonio’s North East ISD, no more than five students will be in each classroom this week. Other districts are welcoming back all students who opted for in-person instruction at the same time.

Only about half of Seguin ISD’s students are expected to head into classrooms Tuesday morning for the first day of in-person instruction. They will walk past thermal scanners, which can measure the body temperature of about 30 people at a time and detect fevers that may be signs of illness. Middle and high school students will sit in desks spread apart, in many cases less than 6 feet with dividers, and younger students will be separated by dividers at large round tables.

Most teachers will be simultaneously instructing 12 to 16 students in their classrooms and more at home tuning in from cellphones or laptops. Some teachers will sit in empty classrooms and broadcast lessons to 20 or 30 students. A small number who have health conditions or young children received waivers to teach virtually from their homes.

Here’s the local view.

Students in Klein and about nine districts throughout the region will get their real first taste of the new learning environment on Tuesday as those districts welcome back those who opted to come to school rather than attend online. Among them are Cypress-Fairbanks, Katy, Conroe, Spring Branch, La Porte, Magnolia and Santa Fe ISDs.

It marks the biggest return of students to school campuses in six months, after schools were closed in mid-March to help slow the spread of COVID-19. Already, students in Lamar CISD and Humble, Alvin, Dickinson, Galveston and Barbers Hill ISDs have brought some of their students back in recent weeks.

The districts are forging ahead with plans to reopen campuses despite warnings from regional health authorities and some local leaders who say it still is too early. Harris County Judge Lina Hidalgo and Public Health Executive Director Umair Shah recommended in August that schools remain closed until there are fewer cases of COVID-19 and less community spread. The two set benchmarks for schools to begin reopening, but with current statistics, it would take weeks to reach them.

Hidalgo and Shah only can offer recommendations, after Gov. Greg Abbott said local government officials do not have the legal authority to preemptively close campuses. Instead, he said, those decisions should be left to school districts. In some Houston-area districts, school boards, parents and some educators have argued that the benefits of face-to-face instruction, especially after such a long hiatus, outweigh potential health risks.

“We can provide a schooling online, but we can’t provide an education online,” Cypress-Fairbanks ISD Superintendent Mark Henry said at a July board meeting.

Others have opted to keep their students learning remotely for the foreseeable future, including Fort Bend and Alief ISDs. In Houston ISD, the state’s largest district, students will return Tuesday to online-only classes, which are scheduled to remain in place until mid-October.

District officials estimate that about 18,000 students still lack the computer or internet access needed for online classes. As a result, HISD is directing those students to 36 “learning centers” with adult supervision and available technology. HISD officials said they are not publicizing the learning center locations.

“It just can’t be everyone showing up,” HISD Interim Superintendent Grenita Lathan said. “It’s truly assigned locations for students and staff.”

[…]

For those that already have opened classrooms, teachers and students still are adapting.

In Humble ISD, middle and high school students are coming into the buildings in alternating groups, with an A group coming on some days and a B group on others.

Superintendent Elizabeth Celania-Fagen said she has been surprised the elementary schoolers have not had as many issues with face masks and social distancing as some had feared.

“We’re starting to get our arms around it pretty well,” Fagen said. “Every day there are new metrics to monitor, and we hope we can get to a place for (more) in person in near future.”

For students at Klein ISD’s Mahaffey Elementary who chose in-person instruction, last Wednesday served as a crash course for their new school realities.

Staff practiced funneling students through entrances assigned by grade rather than the main doors in the front. They showed students how to keep their distance in hallways and spent class periods juggling between in-person students and those learning remotely on Zoom calls. They adjusted their cameras, helped parents troubleshoot technology problems and made sure the kids in their classrooms knew the new procedures.

It was a strange day here, as my girls started with remote learning. We’re used to that, in that we had done it before, but it was still strange to just transition from “no school” to “distance learning school”. Didn’t have that usual “first day of school” feel, you know? There were some connection issues on the HISD hub that affected Olivia’s school, but students were redirected to an alternate site that seemed to work, so no big deal. Ask me again in a week how it’s going.

For the schools that are reopening for in person instruction, I sure hope it all goes well. I hope the mask-wearing and social distancing and other protocols that are being adopted to (hopefully) keep virus spread to a minimum works as planned, not just for them but for the rest of us, who will be in the same position in six weeks. Unless it doesn’t go well, of course, in which case they’ll be in the same position as us. I absolutely want everyone to get back to school. I also absolutely want everyone to literally survive the year, with no adverse health effects lingering on. I don’t know that we can do both of those things just yet. I’m glad it’s not my kids’ schools that are the guinea pigs for that experiment, and I sincerely hope that experiment is a ringing success. I figure we’ll know, more or less, by the time it’s our turn to go back.

Some superintendents disagree about school opening delays

It takes all kinds.

Judge Lina Hidalgo

Superintendents leading 10 Houston-area school districts penned a letter this week opposing Harris County’s recommendations for reopening campuses, arguing that face-to-face instruction should resume earlier than health officials suggest.

In their two-page letter, the superintendents say guidance released last week by Harris County Judge Lina Hidalgo and Public Health Executive Director Umair Shah will keep campuses closed too long, denying valuable in-person class time to students. Superintendents are not required to follow the county recommendations, though the guidance serves as a key document in the debate over when to restart in-person classes.

“It is clear that we all have the same goal, which is to return students to in-person instruction as safely as possible, the superintendents wrote to Shah on Monday. “We thank you for the continued efforts of your departments on behalf of Harris County. With that said, we believe that the metrics outlined in the plan you have provided are not attainable to resume in-person instruction in the foreseeable future.”

The superintendents represent Clear Creek, Cy-Fair, Deer Park, Huffman, Humble, Katy, Klein, Pasadena, Spring Branch and Tomball ISDs. Combined, the districts serve about 457,000 students.

In response to the letter, Harris County Public Health officials said in a statement that the organization “has made it abundantly clear that current indicators are not safe to resume in-person activities in Harris County due to COVID-19.”

As the new school year approached and superintendents debated when to resume in-person classes, some education leaders called on county health officials to offer guidance on reopening campuses.

Hidalgo and Shah followed through by producing several public health benchmarks that should be met before in-person classes resume at the lesser of 25 percent capacity or 500 people in a campus. The metrics included cutting the 14-day rolling average of new daily cases to under 400, bringing the test positivity rate under 5 percent and ensuring less than 15 percent of patients in ICU and general hospital beds are positive for COVID-19.

Harris County likely remains at least several weeks away from meeting those metrics. For example, the county recently reported a rolling daily average of about 1,250 new cases and a test positivity rate of 16 percent.

In their letter, the superintendents only mentioned two specific health benchmarks with which they disagreed. The school leaders wrote that the recommendations would “essentially require indefinite closure of schools to in-person instruction while awaiting a widely available COVID-19 medical countermeasure or greater staffing capacity at Harris County Public Health for contact tracing.”

However, the guidance specifies that districts could start to reopen and ramp up to the lesser of 50 percent building capacity of 1,000 people on campus even without a “widely available COVID-19 medical countermeasure.” County officials did not detail what qualifies as a medical countermeasure in their written guidance, and they did not respond to written questions Tuesday.

See here for the background. As a reminder, Judge Hidalgo and Harris County have limited authority here – ultimately, if these districts decide to open, they can. It’s only when outbreaks occur that the county will have more power to step in. Humble ISD has already opened, the others have plans to have at least some students back by September 16. As the story notes, other districts including HISD, Aldine, Alief, and Spring did not sign this letter, but it was not clear if they had been invited to sign it or not.

I get the concern from these districts, and there’s room for honest disagreement. I don’t have any particular quarrel with their approach, though I personally prefer the more cautious path. As Chron reporter Jacob Carpenter notes in these two Twitter threads, the county now meets three out of seven criteria for reopening, and is trending in the right direction for the others. There’s no accepted national standard for what is “safe” to reopen – that’s a whole ‘nother conversation, of course – so one could argue that Harris County is being overly restrictive. Of course, we’ve also seen plenty of schools and universities that brought in students and then immediately suffered outbreaks that forced closures. Bad things are going to happen until this thing is truly under control, and it is not going to be under control any time soon while Donald Trump is President. That’s the reality, and all the choices we have are bad. Which ones are the least bad is still an open question.

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.

Harris County issues guidance for opening schools

They can’t issue mandates, so this will have to do.

Judge Lina Hidalgo

Harris County Judge Lina Hidalgo on Wednesday unveiled the county’s guidance for school reopenings, recommending based on a handful of COVID-19 metrics that schools offer only virtual instruction in the coming weeks until the virus is further curbed.

County officials are issuing the guidance as families and education officials continue to grapple with the idea of resuming in-person classes in the coming weeks, and after Gov. Greg Abbott barred local officials from ordering campus shutdowns to stem the spread of the coronavirus.

Under the non-binding guidance, Hidalgo and county health officials recommended that school districts offer only virtual instruction as long as Harris County, across a 14-day span, records more than 400 new COVID-19 cases per day, remains above a 5 percent test positivity rate or continues to devote more than 15 percent of hospital beds to COVID-19 patients.

School districts are advised to reopen with reduced capacity as those metrics improve and Harris County hospitals see a 14-day average flattening or decrease in their general and intensive care unit bed populations. At that point, school officials can consult with Harris County Public Health officials on their plans to reopen.

“We simply cannot responsibly reopen schools to in-person instruction right now,” Hidalgo said, acknowledging the frustration of parents, teachers and others. “But we can’t ignore this. We can’t tap our heels together and wish the current numbers away.”

Harris County officials are recommending schools remain closed longer than some other organizations.

[…]

County officials have not yet publicly released the rate of COVID-19 tests coming back positive, though Umair Shah, the director of Harris County’s public health department, announced Tuesday that the rate is between 15 and 16 percent. The Houston Health Department and Texas Medical Center on Monday reported positivity rates of 14.6 percent and 10.6 percent, respectively. The city’s 14-day average has continued to decline since peaking at nearly 30 percent in early July, but remains above the county roadmap’s 5 percent threshold.

Hidalgo and Shah lack the authority to order compliance with the roadmap before the school year begins. Abbott said July 31 that local school boards and state education officials can limit the reopening of buildings in the first eight weeks of the school year, but county officials may not shut down campuses preemptively.

The governor said local health authorities may shut down campuses in response to confirmed outbreaks in a building, but Texas Education Agency leaders said public school districts risk losing state funding if schools remain closed for longer than five days.

You know how I feel about this, so I’m mostly going to peace out here. Judge Hidalgo had ordered schools closed for in-person instruction until at least September 8, back when that was a thing the locals could do. HISD is beginning remote learning only on that date now, and even as a parent of two HISD students, I have no freaking idea when they will be ordered back to the classroom. You can see the Ready Harris roadmap here and the metrics for success here. Maybe if Greg Abbott took this stuff half as seriously as Judge Hidalgo does, we’d be in a better position to reopen schools with some confidence.

We don’t really know how many COVID-19 patients there are in Texas hospitals

For a variety of reasons, the data is hard to get a handle on.

Be like Hank, except inside

Texas is bracing for a pandemic that is projected to kill tens of thousands of people across the U.S., but health officials and state leaders are struggling to provide the public with timely updates on how many people are infected and how many hospital beds and ventilators are available for the critically ill.

Other states across the country have been providing coronavirus hospitalization figures for weeks. On Friday, Gov. Greg Abbott announced that 827 people have been hospitalized in Texas. But the true number of cases is likely far higher than the official tally due to a shortage of reliable tests and delays in delivering results, which can take up to 10 days.

Even with the limited number of confirmed positives, Harris County’s top epidemiologist says it feels like her team is constantly behind.

“It’s become overwhelming,” said Dr. Dana Beckham, director of the county’s Office of Science, Surveillance and Technology, which traces the steps of people who test positive for COVID-19 to determine how they got the disease and who they may have infected. “We’re always behind the eight ball.”

The county’s epidemiologists were pulling 12-to-16-hour days, seven days a week and they still couldn’t keep up, Beckham said. They brought in more workers – roping in other county government employees and hiring outside contractors – to prevent burnout and alleviate stress, tripling the number of people working in the unit to about 65.

It’s still not enough, she said.

As health officials scramble to mitigate the worst pandemic in generations, the level of detail released by Texas lags behind that of some counties and cities.

The Texas Department of State Health Services publishes a daily update of the official number of confirmed coronavirus cases — there were 5,330 statewide as of Saturday and 90 deaths. But the agency doesn’t routinely publish other key measurements that could show the potential for strain on Texas’ health care system in the coming weeks.

[…]

The 827 hospitalized coronavirus patients in Texas are confirmed COVID-19 cases — not suspected cases in which patients are exhibiting symptoms but have no test results, said Chris Van Deusen, a spokesman for DSHS.

Front-line health care workers in the Houston area have told the Houston Chronicle that many patients who should be tested and hospitalized are slipping through the cracks. They also worry that patients admitted with other conditions, such as a heart attack, who also are showing symptoms of the virus may not show up in overall counts.

Unconfirmed COVID-19 cases are likely taking up a significant number of hospital beds. According to the Southeast Texas Regional Advisory Committee, an organization tasked with tracking medical resources in Houston and the surrounding area, as of Thursday more than 700 patients with COVID-19 symptoms — which includes confirmed and suspected cases — had been hospitalized in Harris County alone.

More than 240 were being treated in intensive care units in the county, which has about 4.7 million residents. There were 480 patients on ventilators as of Thursday and 684 additional ventilators were available.

“Currently, we do not have any hospitals reporting that they are nearing capacity,” Darrell Pile, SETRAC’s chief executive officer, told the Chronicle in an email. “Available beds can actually rise if a hospital opens a closed wing, or opts to use beds in the recovery room or other specialty areas to care for inpatients.”

Van Deusen said the state health department had initially collected statistics on suspected cases from hospitals, but by Tuesday had only received reports on 629 patients statewide, raising questions about the accuracy of the state’s figures.

“Hospitalization reporting is a work in progress, and we’re definitely still refining the process,” Van Deusen said.

There’s too much to summarize, so I’d advise you to read that story and also this story about why the official reported numbers of COVID-19 cases in Texas is likely an order of magnitude too low. We’re not doing much testing, which means we can’t really track where the disease is trending, and we’re really just guessing about our hospital capacity and the potential for it to be overwhelmed. We can’t really tell if the local stay-at-home orders, which are now two weeks old, or the previous orders closing schools and canceling public events, which are coming up on four weeks’ duration, have had any effect on flattening the curve. The peak of the outbreak is likely still three or four weeks from now, so whatever the numbers are today, they are going to be a lot higher in the near future. That best-case IHME study Abbott is touting projects four to five thousand deaths in Texas; as of Sunday the official count was 127. That count is also likely low, for the same reasons – not everyone who needs it is getting tested, COVID-19 may be one of several causes of death but not the “official” one, etc – but the point is, we’re barely on the upswing of the curve. We have a lot of staying at home yet to do.

Younger people get coronavirus, too

Because that’s how viruses work.

More Houstonians younger than 60 are testing positive for the novel coronavirus than those who are most at risk of developing serious complications from the illness.

Of that number, middle-aged adults — those in their 40s and 50s — have garnered the brunt of the cases that have tested positive, according to a Houston Chronicle analysis.+

A review of 164 cases from March 4 through [March 23] in counties with confirmed diagnoses — Harris, Fort Bend, Montgomery, Brazoria, Galveston, Liberty and Chambers — show around 78 percent of COVID-19 cases in the greater Houston region are of children and adults under the age of 60. People older than that, who federal health authorities say they are more likely to require hospital care if infected, make up about 21 percent of those who have tested positive.

[…]

Even a handful of children in the Houston region tested positive for the novel coronavirus.+

Dr. Umair Shah, executive director of the Harris County Public Health, was aware of the trend of younger people contracting the novel coronavirus.

“People like me, who feel like they can go out and do everything — we, too, can test positive,” Shah said Tuesday morning at a news conference, where officials also announced a stay-at-home order.

“All of us have the potential of transmitting that to others,” he continued.

Maybe someone can tell Dan Patrick? It’s one thing for geezers like him to get sick and die, but people in their 40s and 50s aren’t Grandma and Grandpa, they’re Mom and Dad. And, as Dr. Shah notes, they’re all very capable of passing along the virus to whoever else they encounter, old and young. True, they’re less likely to die than old useless people like Dan Patrick, but 1) the chances are still greater than zero, and some people with zero risk factors have died from COVID-19; 2) plenty of younger folks have pre-existing respiratory issues and/or are immuno-compromised; 3) some people have had lasting after-effects of the disease; and 4) getting sick, and especially going to the hospital, can be very expensive. All of which to say, it’s better to not get sick. Which is what human beings with empathy and compassion, who are not sociopaths like Dan Patrick, are trying to accomplish with social distancing and stay-at-home requirements. I can’t believe I have to explain this, but here we are.

(Yeah, I drafted this last week, which now seems like a million years ago, and Dan Patrick has been blessedly quiet since then. He still needs to be raked over the coals at every opportunity for his hateful, nihilistic blatherings.)

Still trying to do something about the coronavirus risk in the jail

Time is extremely limited for this.

A federal judge Friday asked lawyers to hammer out a plan for releasing about 1,000 indigent inmates detained on bonds of $10,000 or less amid fear of a COVID-19 outbreak at the third largest jail in the country. The judge indicated she would take up the fate of another 3,400 people in the Harris County Jail awaiting trial on higher bonds next week.

The instructions by Chief U.S. District Judge Lee H. Rosenthal came in response to an emergency request Friday by the team of lawyers who challenged the county’s bail policies. They argued that thousands of poor defendants trapped in the jail simply because they couldn’t afford bail should be granted immediate bail hearings or be released.

The pleading laid a grave situation at the hands of a judge who has made many tough decisions in the criminal justice realm.

“A public health catastrophe of historic proportion looms in the Harris County Jail. Only this Court can avert it,” the motion says. “With every passing hour, the risk of disaster increases. All eyes turn to this Court in this dire moment.”

The bail lawsuit motion for a temporary restraining order and preliminary injunction seeks release of about half the jail’s population of nearly 8,000 if they cannot be afforded immediate bail hearings. This would mean thousands of people charged with nonviolent offenses would be allowed to await trial on bond outside the facility, as they would otherwise be able to do if they could post cash bond.

Other local officials, including the sheriff, state district judges and top county official have been tackling the potential public health threat from different angles over the past two weeks, seeking compassionate releases of medically vulnerable inmates, bonds for those accused of nonviolent offenses, or some cross-section of the two groups.

But early Friday lawyers from Civil Rights Corps, the Texas Civil Rights Project and pro bono counsel from Susman Godfrey, stepped in with a constitutional approach to the jail problem that could allow much more drastic cuts in the population than the compassionate release plans outlined by the sheriff and the county judge.

Rosenthal asked the lawyers for indigent defendants and attorneys for the sheriff and the county to assemble by Monday a list of thousands of people who might qualify for release based on their bond amounts, charges, criminal histories and risk factors. In addition, the judge indicated she would move swiftly on a subset of the indigent defendants who can’t pay their bond. She asked for confirmation that 1,000 or so people being held on bonds of up to $10,000 were not subject to other holds or detainers.

The sheriff and county officials told the judge that they had no objection to this first group being released if they fit the judge’s criteria. According to a lawyer for the plaintiffs, the only agency that opposed the release of those facing $10,000 bonds was the Texas Attorney General’s Office.

Sheriff Gonzalez had been working on this for the past week, trying to get individual judges to allow some inmates to be released, but the process was slow. County Judge Lina Hidalgo had been working on an executive order that would have released a larger number of inmates, but she shelved it after objections from the Attorney General’s office; you can read that story for the details. And I know, we’re all going to be murdered in our sleep by a rampaging horde of pot smokers and check kiters, but let’s do pause for a moment and consider what the alternative might be:

In another effort to address the issue, Harris Health System leaders on Friday sent a letter asking for the release of defendants with nonviolent offenses.

The county medical system’s president and CEO stressed that an outbreak in the Harris County Jail is not a matter of if, but when.

“The Harris County Jail and other large correctional facilities pose a real and immediate danger to the health of the community,” Esmaeil Porsa said. “An even limited outbreak of COVID-19 in the Harris County Jail has the potential to overwhelm our already overburdened hospital system. If this happened — and the likelihood is high — it could leave many vulnerable people in our community without access to care.”

Porsa urged the county to consider prioritizing inmates over 60 with pre-existing conditions such as cancer, diabetes, asthma and chronic pulmonary disease, heart disease and HIV. Jails are known to have higher concentrations of people in the high-risk group, he said.

He added that social distancing is nearly impossible, with dorm settings holding between 20 and 60 people in a close space. And quarantine is also unfeasible when inmates are booked in and out of the jail on a daily basis.

We could just let them all die, I suppose. I’m sure Dan Patrick would approve. I would rather not do that.

UPDATE: And now Greg Abbott is involved, and I’m confused.

As the first Harris County inmate tested positive for COVID-19 Sunday, Gov. Greg Abbott issued an executive order blocking any release of inmates from jails and prisons accused or convicted of violent crime.

“Releasing dangerous criminals from jails into the streets is not the right solution and doing so is now prohibited by law by this declaration,” Abbott said at an afternoon briefing.

The news comes as federal, state and local government officials continued to squabble over details of what a jail release would look like as they attempted to prevent a catastrophic outbreak among the approximately 8,000 people incarcerated at the downtown facility.

The governor was referencing Attorney General Ken Paxton’s motion to prevent Harris County from releasing 4,000 people awaiting trial on felonies, saying such a move would “allow dangerous criminals to roam freely and commit more crimes during the ongoing COVID-19 pandemic.”

“Protecting Texans is one of my highest priorities. It is vital that we maintain the integrity of our criminal justice system and continue to enforce state law during this pandemic,” Paxton said. “My office will not stand for any action that threatens the health and safety of law-abiding citizens.”

Hours earlier a federal judge convened an emergency hearing to address plans that plaintiffs in a federal civil rights case had hammered out over the weekend with lawyers for the sheriff and the county judge to release inmates accused of some nonviolent offense.

An official from Paxton’s office appeared telephonically at that hearing and said the AG planned to appeal an order by the federal judge to the 5th U.S. Circuit if it called for any blanket releases.

The judge set a hearing for Tuesday to address a possible appeal.

There wasn’t anything in the previous story about people accused or convicted of violent crimes, hence my confusion. I assume there are still plenty of people in the Harris County jail for misdemeanor charges, so it’s not at all clear to me what the extent of the dispute is. Maybe later versions of the story will make that more clear.

UPDATE: There’s now a more detailed version of the Chron story and also a Trib story, but this post is too long already. I’ll be back with more tomorrow.

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.

Thus endeth this year’s Rodeo

Surely not a surprise.

Mayor Sylvester Turner announced Wednesday the Houston Livestock Show and Rodeo will close due to concerns about coronavirus after a Montgomery County man with no recent travel history tested positive for COVID-19.

The case is the first example of community spread in the Houston region and was directly responsible for the decision to cancel the Rodeo, Turner and Harris County Judge Lina Hidalgo said at a news conference early Wednesday afternoon. Officials also announced that the man likely attended a barbecue cookoff for the Rodeo late last month, though it was unclear if he had symptoms at the time.

Turner said he will sign an emergency health declaration Wednesday that will remain in place for seven days, at which point City Council will decide whether to extend it. Under the declaration, all events produced or permitted by the city will be canceled through the end of March, Turner said. That includes Sunday’s Tour de Houston fundraising bike ride, which officials will attempt to reschedule, according to the mayor.

Rodeo officials said they were “deeply saddened” but agreed with the city’s move to cancel the livestock show and rodeo.

“As hard as this is to do, it is the right thing to do,” said Joel Crowley, president and chief executive of the Rodeo.

It’s a tough choice to have to make, and there’s a real cost to doing it.

The Houston rodeo generated $227 million in total economic impact last year, directly supporting nearly 3,700 jobs in 2019, according to a study by Economic Analytics Consulting commissioned by the Houston Livestock Show and Rodeo last year. The study measured new spending in the Houston region generated by outside visitors and spending by the Houston Livestock Show and Rodeo Inc.

[…]

The cancellation of CERAWeek, which was expected to bring 5,500 attendees from some 80 countries downtown, cost businesses an estimated $7 million in lost hotel, dining, rental and other direct spending, according to Holly Clapham, chief marketing officer for Houston First Corp., the city’s convention arm.

The rodeo’s cancellation is expected to be more costly for the local economy. It’s known as as the world’s largest entertainment livestock exhibition, and it’s one of Houston’s largest tourist events of the year, lasting for nearly the entire month of March and requiring the efforts of tens of thousands of volunteers.

Last year, the event attracted 273,000 out of town attendees during that time.

Economic projections like this, especially when sourced to the event in question, are unreliable. I don’t think anyone would doubt that the city, and especially the people who work at these events, will suffer for not having them. Still, this was the right thing to do, and will be less costly by any measure than continuing on with business as usual. Let us hope that the need for such drastic action will be short term and not longer. The city of Houston’s press release, which declared a public health emergency along with Harris County, is here. Texas Monthly and the Trib have more.

The state responds to coronavirus

Like it or not, we need to be prepared.

Texas officials are scrambling to remain prepared for a major outbreak of a pneumonia-like disease whose global spread one expert says is now moving into “the next phase.”

From the governor’s office to hospitals to state agencies, Texas officials are intensifying efforts to plan for scenarios that could unfold now that the coronavirus is no longer relatively contained to China and surrounding countries and the number of cases is soaring in countries in Europe and the Middle East.

“I think we need to call an audible,” said Peter Hotez, an infectious disease specialist at Baylor College of Medicine and Texas Children’s Hospital. “We need to refresh the algorithms about who’s at risk and when we should suspect someone has the virus. We’re not calling it an epidemic yet, but we should start operating as if it were.”

Hotez said the disease’s spread — the number of cases in Italy and Iran, now about 900, more than doubled in two days, for instance — has made basing screening on the individual’s travel history less relevant. He also noted some recent cases have been characterized by gastrointestinal symptoms rather than respiratory symptoms.

[…]

There are 10 patients with the coronavirus in Texas, including six confirmed by the CDC and four who tested positively in Japan but whose results have not yet been confirmed by the U.S. agency. Of the 10, two came from Wuhan on a State Department-chartered flight and eight came from the Diamond Princess cruise.

There are 15 cases in the U.S. — none in Texas — that weren’t imported.

But CDC officials warned this week that it’s a matter of “when, not if” the virus arrives in the U.S. in larger numbers. The officials said people should start preparing for significant disruptions to daily life.

Noting the alarm that caused in some people who rushed out to buy water or face masks, Dr. Umair Shah, executive director of the Harris County Public Health Authority, said the remarks glossed over the timeline at which the U.S. cases are likely to significantly ramp up. He said that likely won’t be soon.

“The containment strategy in China was effective for giving everyone more time to prepare for the virus,” said Shah, noting the realistic hope was always to delay the virus’ spread, not stop it. “Governments were able to get information out and alert people to be on guard, just as they should be for the everyday flu.”

Three basic things: One, don’t panic. Two, be extra careful about what you read and especially what you share regarding coronavirus. Don’t be one of those idiots who passes along rumors and lies because you couldn’t be bothered to do a little vetting first. And three, practice good hygiene. Cough and sneeze into your elbow, wash your hands frequently, and if you do get sick, stay home. We can all do our part to make a difference.