Off the Kuff Rotating Header Image

Houston Department of Health and Human Services

Please get your second shot

I hope this is mostly a function of incomplete data.

Millions of Americans — including tens of thousands of Houstonians — either have delayed or are forgoing their second dose of a COVID-19 vaccination.

As of late last month, roughly 51,000 people who received their first inoculation through the Houston Health Department were “overdue” for their second dose. The department’s number is preliminary but includes any person who has gone at least 42 days since their first round without returning for a second shot.

Statewide, more than 630,000 of the roughly 11 million people who’ve received one dose are more than six weeks overdue, the Texas Department of State Health Services told the Houston Chronicle.

“We need a lot of those folks from February to come back in and get their second dose now,” Dr. David Lakey, a DSHS commissioner who sits on Texas’ COVID-19 Expert Vaccine Allocation Panel, said last week.

Part of the gap, however, is likely due to people who opted to receive their second dose through other health care providers as vaccine availability expanded.

It’s not cause for alarm just yet, said Rice University health economist Vivian Ho, though she said the trend does not bode well for the overall goal of herd immunity.

[…]

Ho said people shouldn’t be dissuaded from rescheduling appointments that they missed, as they’ve been shown to give additional antibodies even if they come late.

“The first dose really does boost your antibodies, but it’s the second that really gives you the second umph,” she said.

Houston Methodist radiologist Dirk Stotsman worried that some people are forgoing their second round of inoculations because the first doses of Moderna and Pfizer have been proven highly efficacious against the virus.

While the first dose offers a good level of protection, he said, the extra antibodies provided by the second dose will be integral to prevent the spread of more infectious and dangerous strains of the virus.

Getting just the one Pfizer or Moderna shot is better than nothing, but it’s not as good as it should be. If you’ve gotten one shot and for whatever the reason not gotten the second one, it’s not too late. Go ahead and make an appointment or do a walk-in where available.

In related news:

With the rescission of the mask mandate and full reopening of businesses, medical experts worried spring would bring a debilitating fourth wave of COVID-19 infections to Texas.

But as vaccination rates slowly leveled off in recent weeks, the rate of infections and hospitalizations did as well. More than a year after businesses closed, offices sent workers home and traffic vanished from Houston’s concrete jungle of freeways, public health officials are cautiously optimistic efforts to quell the spread of the virus and vaccinate as many people as possible are working.

Yet despite claims from officials like Gov. Greg Abbott that this downturn is linked to “herd immunity” — the mysterious target ranging between 60 and 80 percent fully vaccinated against COVID-19 — experts say Texas cannot rely on vaccinations alone to achieve what some think may mean the end of the pandemic.

“Nobody knows for sure what’s going to happen,” said Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health in Houston. “But my educated guess would be as more of the population becomes either vaccinated or immune through natural infection, we won’t see as many cases.”

Fewer than 3,000 patients have been hospitalized across the state for the past five weeks, according to a Chronicle data analysis. It’s the longest streak with that few patients since June 2020.

Dr. Carl Vartian, chief medical officer at HCA Houston Healthcare’s Clear Lake and Mainland hospitals, worries the public conflates “herd immunity” with “ending COVID-19.” But COVID-19 may not truly end. Rather, experts suspect it will become “endemic,” never fully leaving the population — like influenza, which still infects hundreds of thousands of people a year in the U.S.

Again, what we have now is better than what we had before, but not as good as it could be. Even at “herd immunity levels”, there’s still a lot of unvaxxed people. The difference is that it becomes harder for the virus to really take off as it has done before. But people can and will still get sick and die if they’re not vaccinated. It’s up to us what the level of those illnesses and deaths are.

The second shot portal

People are going to need this, too.

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

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

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

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

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

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

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

There is a website for COVID vaccine signups in Houston

You can’t use it right now, but it’s there.

Houston’s Health Department launched an online portal for residents to apply for an appointment at its COVID-19 vaccine clinic Monday but quickly ran out of available slots for the remainder of the month.

“The response to Houston’s first COVID-19 vaccine clinic was massive, quickly filling the appointment slots for the department’s current vaccine allocation,” Mayor Sylvester Turner said at a City Hall news conference where he was about to get his own shot in the arm.

“The vaccine clinic appointments are booked for the rest of this month, and the department is not taking additional appointments at this time.”

Turner said the city is working to set up additional sites and create additional capacity, although it is unclear when new appointments will be available. Turner said the city hopes to open a “mega site” on Saturday.

The portal, available at houstonemergency.org/covid-19-vaccines, added another way for qualifying residents to book for an appointment. A hotline also is available at 832-393-4220.

The city clinic vaccinated nearly 2,000 residents with the Moderna vaccine in two days. It is accepting residents from the first two phases of the state’s distribution plan, which include front-line emergency workers, people 65 and older, and those over 16 with certain high-risk health conditions.

It’s a good start, but at 2K shots a day, we’re talking two years to get to 75% distribution in the city. We’d like to go a little faster than that. Obviously, the city is limited by how much vaccine it can get, as well as the state regulations. Harris County had its own rough rollout thanks to confusion over who was allowed to sign up. On that first front at least, help is on the way, so maybe in another month or two we’ll see much higher numbers. And at least there is now a central location for this for Houston residents, something that had been sorely lacking before.

There’s some more vaccine coming to Texas, but it’s still not a lot.

On Monday, state health officials announced that 325,000 additional vaccine doses would be getting into the hands of 949 providers in 158 Texas counties over the next week, part of the first round of vaccinations for front-line health workers as well as nursing home residents, Texans over 65 and those with certain medical conditions, among others. Some 121,875 doses are earmarked for long-term care facilities such as nursing homes and assisted-living centers.

But with the number of vaccine doses available still falling far short of what’s needed to cover those who are eligible — and with state officials pushing hospitals and other providers to administer vaccine doses that the providers say they don’t have, aren’t sure are coming or have already administered — confusion and frustration have surrounded the initial few weeks of the vaccination rollout.

Providers have 24 hours to report their vaccination statistics to the Department of State Health Services, and the agency updates its numbers each afternoon with data reported by midnight the day before, so the state’s numbers could lag up to two days behind the reality on the ground.

Officials from the White House down to local doctors have warned that it would take months to have vaccine doses available to everyone who wants one.

“The problem is unrealistic expectations based on the reality on the ground,” said Marshall Cothran, CEO of the Travis County Medical Society, which received 700 doses through a local partnership and had them all scheduled within 48 hours for physicians and staff who are not affiliated with hospitals or other care organizations.

With the new shipments this week, the state has been allotted a total of 1.5 million doses through the first four weeks of distribution, officials said Monday. Providers in 214 of the state’s 254 counties will have received shipments by the end of the week, health officials said.

Some 793,625 doses had been received by providers by midnight Sunday, according to the Texas Department of Health Services.

Of those, 414,211 — just over half of those delivered — had been administered, according to the agency’s dashboard.

Hardesty said the nearly 16,000 doses his facility received are being administered “fast and furiously,” and about 10,000 people have gotten their first dose, with second doses to start in the next week.

“We’re giving them as quickly as we can,” he said.

I don’t doubt that, but let’s be clear that 1.5 million doses is five percent of the state’s population, and that 414K is just a bit more than one percent. Seven hundred doses for Travis County, with 1.3 million people, is a drop in the bucket. If you vaccinated 700 people a day in Travis County, it would take you six years to get everyone. In the end, this won’t take anywhere near that long, but we are talking months, and in the meantime the hospitals are also dealing with an insane surge in new cases. I can’t emphasize enough how much we needed to keep a lid on this, and how badly we failed at that.

Anyway. Here was the Harris County website for vaccine registration, which is still up but doesn’t have any method for signing up for a COVID shot at this time. Dallas County has its own website, while Bexar County had a similar experience as Houston did. It will get better, I’m sure, but the early days are going to be chaotic.

More people in Houston than you think have had COVID

About one in seven, which is an awful lot.

Mayor Sylvester Turner

Nearly 1 in 7 Houstonians have been infected with the coronavirus, city officials announced Monday, the infection’s true prevalence according to a study of antibodies in blood samples taken from people at their homes.

The study, conducted by Baylor College of Medicine and the city health department, found 13.5 percent of people tested had antibodies to the virus in their blood in mid-September, about four times the number revealed through diagnostic testing at the time.

“Thank God a vaccine is on the way because without one, given these numbers, we would need five to six times the number of infections to achieve herd immunity,” said Dr. Paul Klotman, president of Baylor. “It would also mean five to six times the number of deaths.”

[…]

Dr. David Persse, the city’s health authority, said he wasn’t sure if the Houston antibody percentage “is good news or bad news.” He said “the takeaway is that the virus is more active in the community than we can otherwise tell.”

Klotman and some others said the percent of Houstonians infected was less than they had expected. The head of the Centers for Disease Control and Prevention last summer said the number of people who’ve been infected is likely 10 times higher than the number of confirmed cases, and one study found New York City was about 20 percent in late April.

The Houston finding suggests about 250,000 Houstonians had been infected as of Sept. 19, the last day blood samples were collected. Only 57,000 infections had been identified by traditional viral testing at that time.

Persse said it is nearly impossible to predict what the percentage will be in January, but Klotman said he believes it has grown appreciably in the past nearly three months.

The test identifies those who previously have been infected with the virus by the presence of antibodies, proteins the immune system makes to fight infections. It is not a diagnostic test that identifies people with active disease, COVID-19.

The study was done by city health employees calling households in randomly selected Census blocks and asking for volunteers to give a blood sample for testing. Harris County launched a similar effort next month, and the city of Houston will do another round in early 2021. I’ll be very interested to see how the three compare. So far, the antibodies people get for having and recovering from COVID-19 are known to last a few months, and beyond that it’s not fully clear how susceptible such a person is. This also shows the dire need for masking and social distancing, because there have been – and are, and will be – a lot of people walking around who don’t know they’re sick. They themselves may be fine, but they could wind up infecting others who won’t be. The vaccines will be a huge help, but we’re still a long way away from that blessed day. So yeah, please keep wearing your mask and avoiding indoor gatherings. The Press has more.

It’s still not too late to prevent a big spike in COVID infections

But it will be soon.

A rise in COVID-19 cases has health care officials and government leaders pleading with Houstonians: Act now to prevent, or at least minimize, a third wave of infections across Greater Houston.

“This feels a lot like late May, early June when we saw the early warning signs that things were beginning to increase,” Dr. Marc Boom, president and CEO of Houston Methodist, told the Chronicle on Tuesday, “and then things slipped out of our control.”

According to a Chronicle analysis, the seven-day rolling average for newly reported cases was 1,044.2 as of Monday in an eight-county Houston area. That’s the highest since Oct. 8. In the summer, the rolling average peaked July 17 at 2,432.7.

The rate at which the virus is spreading, called the reproduction rate, reached 1.18 across a nine-county Houston area as of Monday, according to the Texas Medical Center. A number below 1, which the Houston area did report for a few weeks, means the virus is burning out. A number above 1 means that virus spread is increasing. During the COVID-19 spike this summer, Houston’s reproduction rate was in the 1.5-1.7 range when things were getting out of control, Boom said.

Finally, the seven-day average for COVID test positivity rate was 4.2 percent for TMC hospital systems as of Monday. It had been 3.4 percent last month.

For the city, Mayor Sylvester Turner on Monday reported the positivity rate was 6.5 percent as of Oct. 21. Statewide, the positivity rate was 9.42 percent as of Monday.

[…]

Houston-area case increases are not as severe as in other parts of the country and state. In the U.S., 489,769 new cases have been reported since Oct. 20. There are surges in Wisconsin and other Midwest states. In El Paso, state health officials converted a convention center into a makeshift hospital to ease the crush of patients.

Still, Shreela Sharma, an epidemiologist at UTHealth School of Public Health, knows how quickly COVID cases can climb. And she said the number of new cases in the Houston region is roughly 40 percent higher than when the summertime peak began. That means if a third wave does occur, it would start with a higher baseline.

The time is now to wear masks, practice social distancing and wash your hands.

“Our window is right now,” she said. “We could rapidly lose that window over the next few weeks.”

Yes, that is the one piece of good news. We know how to get a handle on this, and we’ve been doing it all along. Wear your mask – yes, wear it while voting, too – maintain social distancing, and avoid indoor gatherings. This week’s colder weather excepted, we’re in much better shape to handle the winter than the northern climes, because for most of our winter it’s still perfectly amenable outside for activities and dining and whatnot. Again, just don’t be an idiot. Do the things that you know you need to do. The alternatives are so, so much worse.

One more thing:

Researchers with Houston’s Health Department will monitor the wastewater flushed from 60 schools and 15 senior living homes in the city for COVID-19 in hopes of catching outbreaks before they arise in clinical testing.

City council on Wednesday unanimously approved $11.5 million in federal COVID-19 spending. Included in that was $221,000 to buy the sampling equipment needed to expand the city’s existing wastewater testing program into K-12 schools in areas with high positivity rates.

People shed the novel coronavirus through feces, regardless of whether they experience symptoms. The samplers will be installed in manholes outside the schools, and researchers will analyze them, looking for the virus.

“It’s very granular,” said Dr. Loren Hopkins, the health department’s chief environmental science officer. “We don’t expect to see any positives at all, we expect to see nothing… If we see something in a school and we see it two days in a row, then we know someone in that school is shedding the virus.”

The department would then alert the school and deploy the more traditional, clinical testing, according to Hopkins.

Don’t laugh, this is an effective method of contact tracing. It’s already been used successfully by the city. Now, if there are people who can test wastewater to see if your poop has the COVID virus in it, you can damn sure keep wearing your mask.

GOP sues over cancelled convention

As the night follows the day.

The Texas Republican Party on Thursday sued Mayor Sylvester Turner and Houston First Corp. for canceling the party’s in-person convention that was scheduled for next week in downtown Houston.

The lawsuit, filed in Harris County state district court, alleges that Turner erred when he invoked a “force majeure” clause of the contract between the Texas GOP and Houston First, the city’s public nonprofit that operates the George R. Brown Convention Center. The Republican Party also is suing Houston First President Brenda Bazan and the city of Houston.

Turner, who ordered Houston First to cancel the convention on Wednesday, said the clause allows one side to cancel over something that is out of its control, including “epidemics in the City of Houston.” In its petition filed Thursday, the GOP said Turner simply does not want to hold the convention, thus failing to meet the force majeure standard.

“Houston Mayor Sylvester Turner’s use of the force majeure clause is just a pretext to his intent to treat the Republican Party of Texas differently than other groups, such as those we have seen from recent protests in the city of Houston,” the party said in a statement Thursday. “It should go without saying that a political viewpoint cannot be the basis for unequal treatment.”

Turner said he called off the convention based on concerns about Houston’s recent COVID-19 surge and input from various medical professionals. A spokeswoman for the mayor said he would address the lawsuit at a 3 p.m. news conference.

In the lawsuit, Texas Republican Party officials are seeking a temporary restraining order that would allow the convention to continue as planned and damages due to Turner’s “anticipatory breach of contract,” including the cost of all losses and the “increased costs of handling the Convention elsewhere.”

The party argued that Turner and Houston First violated the “equal rights clause” of the Texas Constitution, and that Gov. Greg Abbott stripped Turner’s power to cancel the convention in one of his COVID-19 executive orders.

See here for the background, and here for a copy of the lawsuit. I’d love to hear from any of the attorneys out there about the merits of this one. I can’t remember where I saw this now – probably Twitter, my brain is mush – but Jared Woodfill (who is of course the plaintiffs’ attorney for this, along with fellow genius Briscoe Cain) said he was going to try to get a hearing today and secure a temporary block on the cancellation. I can imagine that happening, at least long enough for a judge to make a preliminary ruling. (UPDATE: Per a press release from the Texas GOP received at 7:30, they were indeed denied a motion to block the cancellation. They will appeal directly to the Supreme Court. Stay tuned.) Beyond that, who knows? Insert giant shrug emoji here. Texas Lawyer and the Trib have more.

UPDATE: Jasper Scherer tweets about the TRO denial. Apparently, there’s a second lawsuit as well, by Steven Hotze, because of course there is. Both motions were denied.

UPDATE: An updated Chron story, with more details on the TRO denials. Also, too, this:

The mayor also encouraged party officials to move their convention to Montgomery County, where County Judge Mark Keough offered to host the event and vowed “there will be no last-minute changes.”

“I think Judge Keough in Montgomery County is more than happy to host the 6,000 delegates (there),” Turner said. “I think they should go to Montgomery County.”

Seems like a match made in heaven to me.

City cancels Republican convention

Game on.

Mayor Sylvester Turner

Mayor Sylvester Turner announced on Wednesday that the city has canceled the Texas Republican Party’s in-person state convention in downtown Houston next week.

Houston First, the public nonprofit that serves as the city’s convention arm, sent a letter to the party’s executive committee notifying it that the convention has been canceled.

The letter triggers a part of the contract called a “force majeure” clause, which allows one side to cancel for an occurrence out of its control. The definition included “epidemics in the City of Houston,” according to the Houston First letter.

Earlier Wednesday, Texas Republican Party officials said they were preparing for a legal fight after Turner said the Houston First and the city attorney’s office would review its contract with the party for using the George R. Brown Convention Center for the convention July 16-18.

Turner said he sought the review after Dr. David Persse, the city’s health authority, called the planned convention “a clear and present danger.”

The mayor had been hesitant to leverage his authority to cancel the convention out of fear of politicizing it, and he repeatedly had asked the party to meet virtually instead. He said Wednesday’s decision was prompted by rising numbers and an alarming letter from Persse, who reports to the mayor, outlining the danger of moving forward.

“It is a letter that as the mayor of Houston, that I simply cannot ignore or overlook,” Turner said. “The plan is to exercise those provisions, to cancel this agreement today, to not go forward with this convention.”

Persse’s letter called the spike in Houston an “unparalleled and frightening escalation” since Memorial Day.

“Now, COVID-19 infections are three times greater than they were at the peak experienced earlier this spring,” Persse wrote to Turner and Brenda Bazan, the president of Houston First. “Houston is now among the the national epicenters of the current COVID-19 outbreaks.”

See here and here for the background, and here for the announcement on Twitter. Before anyone gets their Hot Take machines fired up, please note that Greg Abbott and Dan Patrick were going to give their speeches via video, because they apparently had better things to do than bathe in a viral stew for three days. The RPT says they are reviewing their legal options, and I’d bet a year’s supply of N95 masks that someone will file a lawsuit over this. The real question is whether they’ll be able to get an expedited hearing, something the TDP was not able to get from SCOTUS with their vote-by-mail lawsuit. Priorities, you know. Anyway, Republicans should look on the bright side, because they just got something they surely prefer to a dumb convention, namely the chance to play the victim at the hands of a mean old Democrat. All that and a lower chance of death by ventilator – it’s a total win-win. The Trib, the Chron editorial board, and the Press have more.

UPDATE: Right on schedule:

We’ll see if they try for a quick ruling that disallows the cancellation. My head is spinning already.

GOP declines Turner’s invitation to cancel their convention

The ball is back in your court, Mr. Mayor.

The Texas Republican Party is proceeding with an in-person convention next week in downtown Houston, a rejection of Mayor Sylvester Turner’s formal request Monday to move the event online amid a local escalation of the COVID-19 pandemic.

James Dickey, chairman of the Texas GOP, in a statement Tuesday said the party has been “proactive in implementing safety measures” and had “extensive conversations” with Houston First, the public nonprofit that serves as the city’s convention arm and operates the George R. Brown Convention Center. The convention is set to take place there from July 16 to 18.

“With these precautions currently in place, the Republican Party of Texas intends to proceed with an in-person convention next week in Houston,” Dickey said.

The chairman also responded to the list of conditions Turner, a Democrat, said the GOP would need to follow if it holds the convention. Those guidelines include denying entry to anyone who has tested positive for COVID or come in contact with a COVID patient between July 2 and July 15, requiring attendees to wear masks, and providing touchless hand sanitizing stations throughout the convention center.

“Mayor Turner must not have had the information about the measures being voluntarily implemented,” Dickey said. “The Republican Party, delegates, and guests are looking forward to a safe and productive Convention next week.”

Turner said he was “incredulous” that the GOP is moving ahead with an in-person convention, and reiterated that health department officials would shut down the event if they find people are not following COVID-19 guidelines.

See here for the background. For what it’s worth, the Greater Houston Partnership has also implored the GOP to cancel the in person convention.

The Greater Houston Partnership has called on the Texas GOP, along with state and local officials, to cancel the in-person Texas Republican Convention in downtown Houston next week.

Citing the health and safety of event-goers, staff and volunteers, the group of Houston business leaders said an indoor event as large as the convention — which is expected to draw thousands of people — would be unsafe.

In a letter sent Tuesday afternoon to Gov. Greg Abbott, Mayor Sylvester Turner, Harris County Judge Lina Hidalgo, and state GOP Chairman James Dickey, the GHP asked “those with the authority to cancel” the event to do so.

“In normal times we would welcome an event that was expected to draw some 6,000 delegates from across Texas to the George R. Brown Convention Center,” the letter read. “Unfortunately, these are not normal times.”

You can click over to see their letter. Of course, the modern Republican Party of Texas doesn’t really represent business interests any more (see: the bathroom bill, for one), so I would not expect this to have any effect. But at least you know, it’s more than just Mayor Turner versus the state GOP.

The one person who could (maybe) put an end to this is Greg Abbott, but I think we all know that ain’t gonna happen. So for now we have this game of chicken, and we hope there’s no significant collateral damage. And if it does come down to the city health department, well, there’s this:

Those “face mask legal exemption” cards are complete BS, in case you were wondering. Not that anyone who has printed out one of those cards for themselves will believe that, of course. If there’s a better definition of “shit show” right now, I don’t want to know what it is.

Mayor Turner asks GOP to not hold its convention

Good luck with that.

The city of Houston will deploy health inspectors to enforce COVID-19 restrictions at the Texas Republican Convention, and potentially shut down the event if guidelines aren’t followed, Mayor Sylvester Turner said Monday.

In a letter to Texas GOP executive director Kyle Whatley, Turner on Monday laid out a series of conditions the party would have to follow if it proceeds with an in-person convention at the George R. Brown Convention Center from July 16 to 18. The guidelines are aimed at limiting the transmission of COVID when an anticipated 6,000 people descend on the convention center.

Those conditions, according to Turner’s office, include denying entry to anyone who has tested positive for COVID or come in contact with a COVID patient between July 2 and July 15, requiring attendees to wear masks, and providing touchless hand sanitizing stations throughout the convention center.

Party officials also must limit attendance and seating capacity “or host smaller events in larger rooms,” and modify room layouts to “promote social distance of at least 6 feet.” The mayor’s letter did not include a specific cap on how many people can attend the convention.

Turner also said he is “strongly encouraging” the Texas GOP to call off the in-person convention, which he said is the only conference or convention in Houston that has not been canceled or rescheduled for next year.

“I believe canceling the in-person convention is the responsible action to take while we are in a critical moment in our battle against the COVID-19 pandemic,” Turner said. “I’ve not yet talked to a medical professional who has said that this is a good idea to hold this convention at this time.”

Echoing Turner’s message, Houston public health authority David Persse said “the wise, prudent thing to do would be for the Texas GOP to reconsider their position” to hold the event in person.

See here for the background, and here for a thread from the official Twitter account of the Mayor’s office that makes things a bit more explicit. I have a hard time believing that the health department will actually step in and order the convention closed because it would be one hell of a political bombshell to do that, but it’s not out of the question. The Trib adds some details.

According to the Houston Chronicle, Turner recently removed language from an executive order and effectively took away his own authority to cancel the convention.

Turner also called on event sponsors to push the party to move the event online, tweeting that all other conferences had already been rescheduled or canceled for the rest of the year. The Texas Medical Association, the state’s largest medical group, has called on the party to follow suit and withdrew as a convention advertiser.

“With or without masks, an indoor gathering of thousands of people from all around the state in a city with tens of thousands of active COVID-19 cases poses a significant health risk to conventiongoers, convention workers, health care workers, and the residents of Houston,” Dr. Diana Fite, TMA’s president, said in a statement.

Meanwhile, various other indoor conventions across the state have recently been canceled or moved online. The Texas High School Coaches Association announced Monday it is canceling its in-person, indoor convention scheduled for July 19 to 21 in San Antonio. The THSCA conference was expected to draw 5,000 attendees who would not have been required to wear face masks, according to the association’s rules.

“It was a tough call to make but in our efforts to support the preventative protocols set forth by our Texas school administrators, the UIL [University Interscholastic League] Executive Staff and governing authorities at both state and local levels, we are choosing to prioritize health and safety first,” the THSCA wrote in a press release.

The Texas Girls Coaches Association also canceled their convention for this week. The state GOP really is alone in their push to gather thousands of people into an interior space like this. I don’t fully understand why Mayor Turner amended his executive order removing his own authority to shut down a gathering like this convention, but my guess would be he was advised it would put the city in a precarious legal position to do so – basically, we’d get our butts sued for it and probably lose. Certainly, in every possible way, the cleanest solution here is for the GOP to decide on its own to cancel and hold their convention online instead. I don’t have any reason to think they’ll do that, but I’ll be happy to be proven wrong.

Can we make it past July?

That’s when it looks like we’ll hit the peak of the pandemic here. And it could be ugly.

A surge in COVID-19 cases since Memorial Day could set the Houston area on track for a peak of 2,000 daily hospitalizations by mid-July, according to a model from a Baylor College of Medicine epidemiologist.

The region’s intensive care units would be overwhelmed by that number of patients, a nearly 50 percent increase from current levels, though thousands of general hospital beds remain available, said Dr. Chris Amos.

City of Houston Health Authority David Persse said several area hospitals already are at or over capacity, and warned that shifting patients to facilities in other cities, a common practice in natural disasters, may no longer be possible.

“The difference this time is the hurricane, if you will, is infecting the entire state,” Persse said.

With government restrictions on business and travel removed, the epidemiologist and hospital executives from the Texas Medical Center said the only hope for the Houston area to avoid that outcome is for residents to practice social distancing, wear masks and avoid unnecessary contact with others.

Too many residents, they said, appear to have mistaken the end of Harris County’s stay-at-home order as a cue to resume normal life, while the virus poses a greater threat today than it did on May 1.

“The alarming situation could be that we have rampant COVID spreading throughout our society,” Houston Methodist CEO Dr. Marc Boom said. “If we don’t take control, it takes control for us.”

See here for some background. Hey, remember that May projection from the PolicyLab at Children’s Hospital of Philadelphia that was based on social distancing data? It suggested we would get up to over 2,000 hospitalizations per day, right around where we seem to be headed now. Their graph had us hitting that mark in early June, while Baylor is suggesting July. Never would have been much better than late, but here we are anyway.

Elected officials and their public health experts are grappling with the idea that Harris County may have squandered much of this spring’s success in slowing the growth of the virus during the six-week stay-home period.

The shutdown dealt severe damage to the economy, including half a million lost jobs. Since Gov. Greg Abbott began reopening the state in May, however, the Houston area has set new records for cases and hospitalizations.

“All of the good work that we did, shutting down, closing conferences and conventions … we’re wiping away the success that we collectively achieved, and the sacrifices that people made in March, April and in May,” Houston Mayor Sylvester Turner said.

The mayor lamented that local officials have had little authority to issue restrictions since Abbott has implemented his phased reopening plan, and urged residents, at a minimum, to follow County Judge Lina Hidalgo’s mask order, which went into effect Monday. The order mandates that Harris County businesses require their customers to wear face coverings.

Abbott defended his strategy during a news conference in Austin, saying it achieved its primary goal of preventing hospitals from being overrun. He said the rate of new cases across the state was unacceptable, however.

See here for more on that mask order, which we could have had weeks ago had it not been for Abbott’s ridiculous, cowardly refusal to talk straight. This is all on you, Abbott. I hope the knowledge of your craven behavior haunts you for the rest of your days. I hope even more it’s what finally forces you out of office in 2022. May we all end up being overly panicked about this, because if not this is really going to suck. The Chron editorial board has more.

The reopening metric we should be heeding

From Twitter:

Here’s that link:

Abstract

We report a time course of SARS-CoV-2 RNA concentrations in primary sewage sludge during the Spring COVID-19 outbreak in a northeastern U.S. metropolitan area. SARS-CoV-2 RNA was detected in all environmental samples and, when adjusted for the time lag, the virus RNA concentrations were highly correlated with the COVID-19 epidemiological curve (R2=0.99) and local hospital admissions (R2=0.99). SARS-CoV-2 RNA concentrations were a seven-day leading indicator ahead of compiled COVID-19 testing data and led local hospital admissions data by three days. Decisions to implement or relax public health measures and restrictions require timely information on outbreak dynamics in a community.

Introduction

The most common metric followed to track the progression of the COVID-19 epidemic within communities is derived from testing symptomatic cases and evaluating the number of positive tests over time.1 However, tracking positive tests is a lagging indicator for the epidemic progression.2, 3 Testing is largely prompted by symptoms, which may take up to five days to present4, and individuals can shed virus prior to exhibiting symptoms. There is a pressing need for additional methods for early sentinel surveillance and real-time estimations of community disease burden so that public health authorities may modulate and plan epidemic responses accordingly.

SARS-CoV-2 RNA is present in the stool of COVID-19 patients5-7 and has recently been documented in raw wastewater.8-10 Thus, monitoring raw wastewater (sewage) within a community’s collection system can potentially provide information on the prevalence and dynamics of infection for entire populations.11 When municipal raw wastewater discharges into treatment facilities, solids are settled and collected into a matrix called (primary) sewage sludge, which has been shown to contain a broad diversity of human viruses including commonly circulating coronavirus strains.12 Primary sludge provides a well-mixed and concentrated sample that may be advantageous for monitoring SARS-CoV-2. As viral shedding can occur before cases are detected, we hypothesize that the time course of SARS-CoV-2 RNA concentrations in primary sewage sludge is a leading indicator of outbreak dynamics within a community served by the treatment plant.

So in plain English, if you know what the level of SARS-CoV-2 is in your municipal wastewater, you will have a very accurate predictor of the new COVID-19 case rate in your community. And guess what? The city of Houston is tracking this very data. I don’t know if it’s being published anywhere, but it sure could shed some light on how things are really going around here. Other cities should be doing this as well – if they aren’t doing it already, they need to start – and that information should be collected and published at the state level as well. What are we waiting for?

From the “Shit happens” department

I apologize, I couldn’t help myself.

City health officials and Rice University scientists have begun testing Houston wastewater samples for COVID-19, a process they hope will reveal the true spread of the new coronavirus as clinical testing continues to lag.

The city-led effort makes use of studies that show traces of the virus can be found in human feces. By testing samples of sewage collected at the city’s wastewater treatment plants, officials hope to uncover the scale of the outbreak in Houston and, perhaps, locate hotspots undetected by in-person tests.

“It’s an evolving field. We hope that it will help give us just more information on where the virus is and how much of it is out there,” said Loren Hopkins, a Rice University statistics professor who also serves as the health department’s chief environmental science officer.

[…]

For now, plant workers are collecting wastewater samples across a 24-hour period once a week, before sending them to Rice and health department officials who then analyze the samples for COVID-19, the illness caused by the new coronavirus.

If successful, the project will reveal COVID-19 trends over a span of weeks and months in certain areas of Houston and citywide, Hopkins said. Though less precise than directly testing people for the coronavirus, the analysis will produce case estimates that include people who lack symptoms, because asymptomatic people still shed the virus in their stool. And because workers at the treatment plants are collecting samples across a 24-hour period, the results may provide a more accurate snapshot than the number of positive in-person test results, Hopkins said, because that data is impaired by days-long delays in receiving results.

Where the data may prove especially useful, experts said, is in locations where wastewater samples indicate the virus has spread more widely than clinical testing has revealed. Officials can then direct more testing to those areas, including through a mobile unit that launched earlier this week.

This is an attempt to address the serious gap between our need for testing and our capacity for testing. We hope it will help identify trends and emerging hot spots more quickly and effectively. It’s something that’s not been done before, and who knows if it will work the way we want. It’s surely worth a try.

Last minute health insurance enrollment help

From the inbox:

It's constitutional - deal with it

It’s constitutional – deal with it

The Houston Department of Health and Human Services (HDHHS) will open four of its multi-service centers on Sunday and extend their business hours next Monday to help people sign up for a health insurance plan by the Affordable Care Act’s March 31 deadline.

HDHHS will open Acres Homes, Denver Harbor, Northeast and Southwest multi-service centers on Sunday, March 30, from 12 p.m. to 6 p.m. It will also extend the four multi-service centers’ business hours on Monday, March 31, until 10 p.m., setting the last ACA enrollment appointment for 8 p.m.

Approximately 99,000 Houston-area residents have enrolled in one of the more than 40 low-cost ACA health plans available in the region. Those without health insurance have only one week left to sign up.

Residents can set up an appointment for one-on-one help from certified application counselors at HDHHS by calling 832-393-5423. The counselors are able to help residents compare health plans and find one that fits their budget and health care needs.

The phone number connects residents to an ACA call center that HDHHS set up as part of the Gulf Coast Health Insurance Marketplace Collaborative, a group of 13 agencies helping people obtain insurance coverage through the ACA.

Certified application counselors and outreach staff with HDHHS and the other agencies in the collaborative have met face to face with more than 151,500 area residents since the enrollment period began in October. They have also reached out or distributed ACA brochures and information to approximately 538,000 people.

Documents needed to enroll during an appointment include:

  • Proof of U.S. citizenship: social security number or copy of U.S. passport for all family members
  • State residency: driver’s license, housing lease or utility bill
  • Income:  W-2 forms or pay stubs; unemployment or disability; social security, pension and retirement income; or copy of 2012 tax return
  • Current health insurance: policy numbers for any current health insurance and information about job-related health insurance
  • Immigration status or legal residency: Immigration document status numbers.

The press release is here, and Stace was also on this. There are going to be a number of rallies and other events aimed at getting people signed up while they still can. Another event, via State Rep. Jessica Farrar, will be Saturday, March 29th from 9:00 a.m. – 1:00 p.m. at the Harris County Department of Education Conference Center, 6300 Irvington Blvd. Anyone who has questions about the exchange or is currently without health insurance is encouraged to attend. Here’s a Trib story about the pre-deadline push.

The Affordable Care Act requires most individuals to purchase health insurance by 2014, specifically by March 31, which will mark the final day of canvassing and enrollment outreach by nonprofits, local governments and community organizations.

At the start of March, 295,000 Texans had selected a coverage plan in the federal marketplace, but the number of total enrollees represents a small fraction of the uninsured in Texas.

National advocates for health reform have homed in on Texas’ enrollment in recent weeks, including U.S. Secretary of Health and Human Services Kathleen Sebelius, who was in Texas last week to promote enrollment efforts, including a final push to mobilize young adults to sign up for insurance through the marketplace.

Enroll America, a nonprofit group promoting the federal health reform law, launched a six-city bus tour through Texas last week to help people enroll in the exchange. Anne Filipic, president of the group, said it has focused on Texas because of the amount of people “who stand to benefit” from the federal health reform.

The organization has also set up a series of enrollment events throughout the state, including the one Donnell attended, as part of the final week of enrollment and is following up with individuals who started their process at one of the events to help them complete their enrollments.

Locally, state Democratic legislators have hosted their own enrollment efforts or have worked with entities like the Texas Organizing Project, a group that advocates for low-income Texans, to host regular enrollment events in Dallas, Bexar and Harris counties.

Federally qualified health centers in Texas also received more than $15 million federal grants to help individuals enroll in the marketplace. Lone Star Circle of Care clinics was among the top recipients in the state, receiving a combined $600,000 in grants to provide enrollment assistance.

Lone Star spokeswoman Rebekah Haynes said its 35 certified application counselors have seen an uptick in demand for enrollment assistance in the last few weeks, and they are working with hundreds of individuals to verify whether they qualify to purchase health insurance through the marketplace.

Texas could have delivered half of the enrollees the Obama administration is banking on. The Kaiser Family Foundation estimates that 3,143,000 Texans are potential marketplace enrollees, but only 9.4 percent of that population has enrolled. (Potential enrollees include uninsured Texans who are U.S. citizens and have incomes above the amount needed to qualify for Medicaid.)

You have to wonder what might have been if anyone in the Republican leadership cared even a little bit about the vast number of uninsured people in Texas. Be that as it may, if you know someone who needs coverage but still hasn’t signed up yet, do whatever you can to encourage them to get it done now. Time is very much running out.