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Is this just the calm before the next COVID wave?

Things look good now, at least in the Houston area, but COVID never sleeps.

As the U.S. heads into a third pandemic winter, the first hints are emerging that another possible surge of COVID-19 infections could be on its way.

So far, no national surge has started yet. The number of people getting infected, hospitalized and dying from COVID in the U.S. has been gently declining from a fairly high plateau.

But as the weather cools and people start spending more time inside, where the virus spreads more easily, the risks of a resurgence increase.

The first hint of what could be in store is what’s happening in Europe. Infections have been rising in many European countries, including the U.K., France, and Italy.

“In the past, what’s happened in Europe often has been a harbinger for what’s about to happen in the United States,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “So I think the bottom line message for us in this country is: We have to be prepared for what they are beginning to see in Europe.”

Several computer models are projecting that COVID infections will continue to recede at least through the end of the year. But researchers stress there are many uncertainties that could change that, such as whether more infectious variants start to spread fast in the U.S.

In fact, scientists are watching a menagerie of new omicron subvariants that have emerged recently that appear to be even better at dodging immunity.

“We look around the world and see countries such as Germany and France are seeing increases as we speak,” says Lauren Ancel Meyers, director of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. “That gives me pause. It adds uncertainty about what we can expect in the coming weeks and the coming months.”

However, it’s not certain the U.S. experience will echo Europe’s, says Justin Lessler, an epidemiologist at the University of North Carolina who helps run the COVID-19 Scenario Modeling Hub.

That’s because it’s not clear whether Europe’s rising cases are related to people’s greater susceptibility to new subvariants they’ve not yet been exposed to. In addition, different countries have different levels of immunity.

“If it is mostly just behavioral changes and climate, we might be able to avoid similar upticks if there is broad uptake of the bivalent vaccine,” Lessler says. “If it is immune escape across several variants with convergent evolution, the outlook for the U.S. may be more concerning.”

In fact, some researchers say the U.S. is already starting to see early signs of that. For example, the levels of virus being detected in wastewater are up in some parts of the country, such in Pennsylvania, Connecticut, Vermont and other parts of the Northeast. That could an early-warning sign of what’s coming, though overall the virus is declining nationally.

“It’s really too early to say something big is happening, but it’s something that we’re keeping an eye on,” says Amy Kirby, national wastewater surveillance program lead at the Centers for Disease Control and Prevention.

But infections and even hospitalizations have started rising in some of the same parts of New England, as well as some other northern areas, such as the Pacific Northwest, according to Dr. David Rubin, the director of the PolicyLab at Children’s Hospital of Philadelphia, which tracks the pandemic.

“We’re seeing the northern rim of the country beginning to show some evidence of increasing transmission,” Rubin says. “The winter resurgence is beginning.”

As the story notes, we’re overall in a much better place because there’s a lot more immunity thanks to vaccinations and our previous high rate of infections. The COVID levels in wastewater here is low now, and while we’re hardly a leader in vaccinations, we at least have warmer winters so there are still plenty of opportunities to be outside, and fewer times where you have to be congregated inside. But also, not nearly enough people have had their bivalent boosters yet, and there are concerns about the flu season. So, you know, remain appropriately cautious – masking in places where you used to have to mask is still an excellent idea – and get those shots.

The wastewater is looking good now

In terms of COVID levels, anyway.

The COVID-19 viral load in Houston’s wastewater has sunk to its lowest point in seven months as the city puts the latest wave, driven by the highly contagious omicron subvariant BA.5, in the rear view.

The wastewater levels are 71 percent of what the Houston Health Department detected during the July 2020 wave, which the city uses as a benchmark, according to Texas Medical Center data published Tuesday. The COVID hospitalization rate and positivity rate also continue to decline steadily.

Harris County last week dropped its COVID community level from “medium” to “low,” which recommends staying up to date on vaccinations and testing if you have symptoms. Scientists are looking to other countries for signs of what comes next.

“Our history has typically been a winter surge,” said Dr. Luis Ostrosky, chief of infectious diseases with McGovern Medical School at UTHealth Houston. “So let’s enjoy it while we can.”

Several new omicron off-shoots have been detected in the United Kingdom, India, Singapore, Denmark and Australia, according to the journal Nature. BA.5 continues to dominate cases in the United States, though one subvariant, BA.4.6, has gained some traction and now makes up roughly 12 percent of cases, according to the Centers for Disease Control and Prevention. Ostrosky urged people to get their updated booster shots, which better target omicron variants.

The dashboard is here, and you can see it as a graph here. COVID from the omicron wave peaked in the wastewater in July, but it was at almost ten times the level as it had been in July of 2020. It is now at 71% of the July 2020 levels, which is much better in so many respects. Get up to date on your boosters – I got my bivalent booster the other day – and get a flu shot (got one of those as well, at the same time), because there’s concern this could be a bad flu season. And even with these levels going down, hopefully for the foreseeable future, it’s still a good idea to wear a mask in crowded indoor spaces. Might help you avoid catching a winter cold, too.

Metro looks beyond parking lots for its park and rides

I like the idea. It will need some careful thought and planning, but the idea seems to be on the right track to me.

The Metropolitan Transit Authority spent decades developing a network of parking lots where drivers could leave their cars and trucks and take transit to work. Now, its leaders are wondering whether those parking lots would be a attractive places for developers who may view those commuters as potential customers.

Metro officials are soliciting proposals for transit-oriented design, in which developers can submit proposals to synch transit center and bus depots with new apartments and shops.

“This is about bringing quality of life to areas adjacent to transit centers, to park and rides,” Metro Chairman Sanjay Ramabhadran said.

Metro’s interest extends to both properties it owns and those it leases from private developers. A number of park and ride lots are conventional bus shelters, with parking available in a commercial lot normally used by a grocery or department store that does not have high volumes during the work day.

The agency is starting slowly, after making some headway with a 2015 study to assess potential uses around park and ride locations. The board in August created a subcommittee tasked with joint development and land use, which met for the first time Sept. 14. Staff, meanwhile, issued a request for information to developers, the first step in seeing if any have ideas for using Metro spaces.

“I like the approach that we are asking the market to come to us,” said Diann Lewter, the Metro board member appointed to chair the new committee.

Though possibilities are just now beginning to take shape – a first round of proposals are due at the end of the month, followed by months of analysis and public meetings – some board members said they were eager to move ahead.

“I am really anxious to see it work as fast as possible,” Lewter said.

[…]

Metro already is sitting on very desirable land in the medical center. Located across Fannin from MD Anderson Cancer Center and across Pressler from UT Health’s health science center, the transit center has drawn interest for major projects, all willing to maintain its bus access.

When approached in 2018 with an unsolicited offer that later drew a competing proposal, however, Metro opted to keep things as they were because neither project, officials concluded, would improve transit access for existing riders. Instead, both projects had the potential to encourage hundreds of daily vehicle trips into the crowded medical center.

“Although both proposals provided estimated revenue streams and various amenities, the potential issues related to the customer experience was the overriding factor in … the decision to not move forward with this solicitation” Metro staff wrote in a summary to cancel the discussions.

As land becomes more scarce in key locations, though, Metro at the very least may have to rethink its current use of wide-open, flat parking lots.

“If you build structured parking, you free up a lot of land that can be used for workforce housing, said Barry Goodman, a former Metro president who now consults with Houston-area governments on transportation matters through his company, The Goodman Corporation.

It’s a long story, so read the rest. Not everyone on the Metro board thinks this is a great idea, there are some comparisons to other transit agencies that go both ways, and there’s the unfortunate return of a longtime anti-transit troll who’s back to spew some baloney. As I said, I like the general idea and think it’s worth a long look, but it’s fine if we take things slowly and conservatively.

The latest COVID wave may be peaking in Houston

Hopefully

Texas Medical Center data released Tuesday suggests the latest wave of COVID-19 might have reached its peak in the Houston area, though several key metrics used to track the virus remain high.

The medical center’s weekly data report shows that COVID-19 hospitalizations, the positivity rate of coronaviruus tests and the amount of virus detected at the city of Houston’s wastewater treatment plants all trended downward for the second straight week. Those trends indicate the Houston area has likely crested the peak of a recent surge caused by the extremely contagious BA.5 subvariant, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.

“All the numbers are pointing to the fact that we’ve peaked maybe a week, a week and a half ago,” McDeavitt said. “I fully expect we will continue to trend down over the next several weeks.”

The line graphs from the TMC show a mountain range of peaks from prior waves of COVID-19, such as those caused by the delta and omicron variants. The latest BA.5 wave shows that after several weeks of steady climbing, the line is finally on the descent.

During previous waves, the virus did not pick up steam again after the numbers started to trend downward, McDeavitt said. He expects the same trajectory from BA.5.

It appears the current wave has at least reached a plateau, said Dr. Ashley Drews, an infectious disease specialist at Houston Methodist. The fact that the key metrics have stabilized is an encouraging sign, she said.

“We’re cautiously optimistic that things are turning in the right direction, and we’re going down,” Drews said.

[…]

During the week of July 25, TMC hospitals admitted an average of 219 patients with COVID-19 per day. That’s down from an average of 226 during the week of July 18, and 240 during the week of July 11.

However, the numbers remain much higher than they were before the emergence of BA.5. Three months ago, TMC hospitals admitted an average of 80 patients per day.

The good news is that the percentage of patients who need to be treated in an ICU remains lower than prior surges of COVID-19.

Last week, less than 14 percent of the 912 patients admitted with COVID-19 were treated in an ICU, according to TMC data. That’s lower than the percentage of patients treated in an ICU at the peaks of the omicron wave (17 percent) and the delta wave (22 percent).

[…]

The amount of virus detected at the city of Houston’s wastewater treatment plants, which has been a reliable indicator of community spread, also fell for the second straight week.

Wastewater loads reached an all-time high during the week of July 11, at 927 percent higher than a baseline established in June 2020. That fell to 774 percent during the week of July 18, and to 725 percent over the past week.

The amount of virus in the wastewater is still much higher than before the recent surge. Three months ago, it was less than 100 percent higher than the June 2020 baseline.

So, the data is starting to go in the right direction, which is good. But there’s still a lot of COVID out there, and all of the levels are still a lot higher than they were before the wave began, even if they never approached the heights of the previous peaks, and that’s bad. You should still be exercising caution, which is to say wearing your mask and avoiding indoor crowds if you can. And of course, get vaxxed and boosted as needed. We may be back on the downswing, but there’s no reason to believe we won’t trend up again at some point, and we’ve still got a ways to go to get to the lower levels we want.

The current state of the hospitals

Worse than before, but not nearly as bad as before that.

A small but growing share of Houston healthcare workers are calling in sick with COVID, exacerbating long-running staffing issues at some hospitals amid the virus’s resurgence.

But despite spreading infections, medical leaders say the Houston-area healthcare system is managing this wave better than previous bouts with the virus, pointing to better therapeutics and fewer COVID patients requiring critical care.

Anecdotally, doctors say at least half of all COVID patients were admitted for reasons unrelated to the virus. While wastewater data reflects a soaring infection rate, daily new hospitalizations are climbing at a slower pace compared to the record-breaking omicron wave in January and February, according to Texas Medical Center data.

“I don’t anticipate we’re going to have major operational problems” among medical center hospitals, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.

The latest Texas Medical Center data, published Tuesday, show hospitalizations have nearly doubled over the last five weeks, from 121 in early June to 240 last week. In January, it took only five weeks for omicron to spark a nearly 600 percent increase in daily COVID hospitalizations, as admissions jumped from 74 to a record 515, according to TMC data.

Meanwhile, the increasing viral load detected in the city’s wastewater — 927 percent higher last week than July 2020 — appears to be as high as ever. Two weeks ago, the viral load was 843 percent of the July 2020 baseline. The citywide positivity rate also saw a slight increase from 29 percent two weeks ago to 31 percent last week, while the positivity rate in the medical center dropped slightly from 16.1 percent to 15.9 percent.

[…]

The number of sick hospital staff members reflects a small portion of the overall workforce at Houston hospitals. On Monday, Houston Methodist reported 402 staff members — 1.4 percent of all employees — had tested positive for COVID. Harris Health System said 245 staff members, or 2.4 percent of its workforce, had tested positive for COVID so far this July, compared to roughly 90 staff members throughout most of June.

Additionally, spokespeople for Memorial Hermann Health System, Texas Children’s Hospital and HCA Houston Healthcare say they are not experiencing major staffing issues or operational interruptions amid the current surge.

“Because of our vaccination and booster requirements, our staffing across hospitals is robust and fully intact,” said Dr. James Versalovic, chief pathologist at Texas Children’s Hospital. “I’m happy to say, we have prepared ourselves for this moment.”

More than two years into the pandemic, medical leaders now greet surges with more nuanced messaging, showing concern over rising infections and staffing struggles while assuring the public that hospitals are now better equipped to withstand rising infections.

Versalovic noted that Texas Children’s has seen its COVID population double over the last month. The 7-day rolling average of pediatric COVID patients is now more than 50 in the hospital system. He urged parents to seek out vaccinations as the start of school closes in.

On the one hand, this is basically good news. The hospitals are able to function without being overburdened, our overall vaccination level (and the good luck that this variant, however more contagious it is, isn’t particularly devastating) is helping keep levels in check, and while we’re worse off than we were a couple of months ago we’re much better off than we were in previous waves. One could argue that this is more or less what “endemic” looks like.

On the other hand, Stace is right. We’ve basically given up on trying to keep a lid on this thing – to be sure, there’s far less that governments can do now, thanks to a bunch of wingnut court rulings and Greg Abbott executive orders, but there are plenty of things we could be doing that we aren’t. A lot of leaders who should know better aren’t setting good examples. Even a milder form of COVID is potentially deadly to people with various comorbidities and risk factors, or who are immunocompromised in some way. Just having people mask up again as a matter of course would make all of their lives better, but we’re not doing that.

I’m definitely masking in indoor spaces again, but I’m also willing to be in indoor spaces, and to be among groups of people. I’ve mitigated some of my risk, but I’m engaging in riskier behavior than I had been before. It’s one part denial, one part pandemic fatigue, one part the perhaps naive hope that there will be another booster coming soon, and one part hoping that I’m being cautious enough. I don’t know what happens next if things do get worse from here. I very much hope I don’t have to find out.

COVID hospitalizations up in Houston

Welp.

COVID-19 hospitalizations have nearly doubled in the Houston area over the last month, according to re-published Texas Medical Center data, which paints a clearer picture of the risk associated with newer, increasingly transmissible versions of the virus.

The medical center discontinued its weekly reports in May, when the omicron wave had officially receded, and COVID drifted out of the public’s mind. But a new COVID surge prompted the medical center to post a revamped dashboard Tuesday, showing that the virus remains a persistent part of life.

Among the more urgent revelations: The average number of daily new hospitalizations rose from 121 in early June to 224 last week. That number is nearly half of the record-breaking hospitalization peak in early January, when an average of 515 COVID patients were admitted per day, according to the updated TMC data.

“Hopefully it’s peaking,” Dr. Paul Klotman, president and CEO of Baylor College of Medicine, said during a Tuesday news briefing. “It’s still a dangerous virus.”

[…]

The increase coincides with the rise of BA.5, a latest subvariant in the omicron lineage, which in a matter of weeks took over as the dominant strain in the U.S. First detected in South Africa, the subvariant made its way to the U.S. in early May and now makes up 65 percent of cases nationwide. In the Houston Methodist system, BA.5 comprises 57 percent of cases, while BA.4, another highly transmissible strain, makes up 19 percent.

BA.5 is concerning, experts say, because it appears to be more capable of re-infecting people and more resistant to vaccine-induced immunity. Even those who battled a COVID infection a few weeks ago could be susceptible to BA.5, said Dr. Wesley Long, a clinical pathologist and medical director of diagnostic microbiology at Houston Methodist.

“In previous waves, there was a thought that if you were infected, you had natural immunity for a couple of months,” he said. “With this shift from BA.2 to BA.5, that rule isn’t holding true.”

A recent study published in Nature found that BA.4 and 5 — which share similar mutations — are more likely to cause vaccine breakthrough infections compared to BA.2.12, the previously dominant strain. Waning vaccine immunity also compounds the risk.

Even so, vaccines are still effective at preventing severe disease, hospitalization and death, Long said.

“People shouldn’t get the wrong idea and think ‘I don’t need to get my vaccine’ or ‘I don’t need to get my booster,’” he said.

It’s still too early to say whether BA.5 is causing more severe illness than its predecessors. Early research shows it contains mutations found in the delta variant, which was linked to more acute sickness. But the rise in hospitalizations could simply be attributed to the volume of infections in the community, said Klotman.

Yeah, it could be worse. We’ve definitely seen worse. You know what you need to do to keep it from getting worse. All together now: You may be done with COVID, but COVID isn’t done with you. Stace and the Texas Signal have more.

Fifth Circuit upholds dismissal of Methodist vaccine mandate lawsuit

Good.

A federal appeals court on Monday upheld the dismissal of a lawsuit challenging Houston Methodist’s COVID-19 vaccine mandate, which last year thrust the hospital into the national spotlight as the first healthcare system in the U.S. to require the shots for its employees.

The lawsuit, filed on behalf of 117 Houston Methodist employees who refused to abide by the policy, was dismissed in June 2021 by U.S. District Judge Lynn Hughes, who at the time decried arguments comparing the requirement to those made under Nazi Germany.

In its opinion, the U.S. Fifth Circuit Court of Appeals said it affirmed the original ruling “because plaintiffs do not demonstrate any error in the district court’s judgment on the arguments made in that court but instead make an entirely new argument on appeal.”

The plaintiffs’ attorney, Jared Woodfill, said “this battle is far from over.”

“We believe employment should not be conditioned on your willingness to take an experimental shot,” he said in an email to the Chronicle. “During oral argument, the court indicated that one way to potentially address this case of first impression is to take it back to state court. We will pursue every legal avenue available to our clients, including taking this case to the United States Supreme Court.”

Woodfill added that a “companion case” has been filed in Harris County, though records of that lawsuit could not be found by press time.

[…]

The lawsuit brought three separate claims of wrongful termination, alleging violations of state and federal law. In their appeal, the plaintiffs “pivoted” from focusing on the federal law violations to state law, the appeals court notes in its opinion.

The plaintiffs “now even equivocate on whether federal law supports their claim,” according to the opinion. “Federal law does not, and the district court did not err in dismissing plaintiffs’ claim.”

See here for the previous update. As noted at the time, Texas state law isn’t exactly employee-friendly, so the odds of a better result for the vaccine refuseniks seems quite low. But hey, they have Jared Woodfill, Super Genius, on their side. What could possibly go wrong?

Are we about to get more COVID in Houston?

We could be.

New data from the Texas Medical Center shows COVID-19 cases have leveled off over the past week, but some trends suggest the Greater Houston area could be on the verge of seeing higher virus spread.

TMC hospitals reported an average of 351 new cases per day during the week of April 18, the same number it reported during the previous seven-day period. The number of new cases does not include anyone who used an at-home test and did not report a positive result.

Those numbers represent a significant decline from last month, when the hospitals were reporting an average of 2,592 new cases per day.

However, the effective reproduction rate – or the average number of people who will be infected by someone with COVID – increased to 1.0 last week, up from 0.82 one week earlier. The rate essentially measures how well collective behaviors like wearing masks and social distancing are slowing the spread of the virus, with any rate higher than 1.0 meaning that spread is increasing.

The amount of virus being detected at the city of Houston’s wastewater treatment plants has also increased to the highest rate since Feb. 7, according to data from the Houston Health Department. Twenty-one of the city’s 39 wastewater treatment plants saw an increase in viral load in samples that were collected and analyzed April 18. By comparison, 16 plants saw in increase in samples collected and analyzed one week earlier.

The TMC’s weekly update also shows new hospitalizations have increased to an average of 59 admissions per day during the week of April 18, up from 42 the week before. TMC hospitals admitted an average of 89 new patients per day last month.

The data isn’t strongly conclusive, but it’s also early in what could be a trend, and as we know with this virus once you really start to see an uptick, it’s already too late. On the other hand, lots of people have COVID antibodies now, and that plus the number of vaxxed people who haven’t had COVID is probably enough to mitigate any crazy spread, or at least to make it less harmful, at this time. But of course there are still plenty of high-risk people out there, and lots of kids haven’t been vaxxed, and no one wants to get even a mild case of COVID. So, you know, stay cautious. You can still wear a mask even if you don’t have to, and you can get that second booster if you’re eligible. It’s never a bad idea to minimize your exposure to this thing. Stace has more.

How low can COVID go?

I feel like this is more a function of time and evolution than anything else, but we’ll see.

New coronavirus cases across the greater Houston area dropped to their lowest level in four months, new data showed Monday, just days after Harris County’s COVID threat level dropped to yellow, signaling the virus is not immediately threatening the capacity of the region’s healthcare system.

The demise of the omicron wave appeared all but complete in the latest numbers from the Texas Medical Center, which collectively admitted 77 new COVID-19 patients daily last week, down 63 percent since February.

Across the region, daily infection rates are now roughly equal to those recorded during the lull that followed the delta wave in late November, before the more contagious omicron variant swept the globe. The figures come as the remaining indoor mask mandates expire across the country and as Americans report feeling increasingly exhausted — or altogether fed up — with pandemic restrictions.

Around 430 people tested positive for COVID each day last week, down 80 percent from last month, Texas Medical Center reported Monday morning.

Houston-area deaths from COVID have plummeted in tandem with falling case counts in recent weeks. A total of 4,288 residents have died since the pandemic began.

The figures confirm Houston is in a period of low transmission. How long it will last is uncertain. Some experts, including Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health, consider omicron’s relatively milder disease a “lucky” happenstance that may not be repeated in future iterations of the virus.

Viral waves typically arrive about six months apart, meaning another surge could begin by summer.

Well, the next wave may already be underway in Europe, though at this point it remains to be seen if it will result in anything like what we have seen before. At some level, if we can get enough people vaxxed and boosted, then at least the next wave should not be as hard on the hospitals and the mortuaries. That’s the goal at this point, minimize the damage. You would hope that by now we’ve learned from our past experience.

Have we reached peak omicron?

I sure hope so (fingers crossed).

Omicron’s swift and sudden surge may have peaked, experts said Monday, but hospitals are likely to remain full in the coming weeks, with the highly contagious COVID-19 strain not expected to recede until March.

Two key metrics — transmission rate and wastewater tracking — indicate the variant may be loosening its grip on the Houston area.

Texas Medical Center records show positive case rates are declining. Around 9,000 people tested positive for COVID each day last week in the greater Houston area, down about 40 percent from the previous week, when the region averaged about 13,400 new cases daily, according to TMC data.

But hospitalizations and deaths lag behind new infections, so health care workers still have a challenging couple of weeks ahead, said Dr. David Persse, Houston’s chief medical officer. Intensive care units around Texas are at 92 percent capacity, among the highest levels recorded since the pandemic began.

“It appears that we may have hit a peak,” Persse said. “However, our numbers are still really really high. I hesitate for anyone hearing that we may have peaked to think that its over. It is far from over.”

[…]

Houston’s declining rate of transmission — a statistic used to gauge how likely an infected person is to spread their illness to others — offers some clues. The rate of transmission fell below 1.0 last week for the first time since mid-December, according to new TMC data. That means each infected Houstonian is spreading the virus to less than one other person.

The city’s wastewater offers another optimistic sign of omicron’s decline. The wastewater virus load last week was about half what it was in December, and appears to be falling precipitously from its all-time high recorded on Jan. 7, officials said.

As a reminder, the wastewater dashboard is here. It’s still high, but compare to January 3, and you’ll see how much better things look now. As noted, hospitalizations lag cases, and deaths lag hospitalizations, so while the number of people getting COVID may now be trending down, we’ll still see high levels of hospital bed usage, and a higher death rate for the time being. But at least there we can begin to see the end as well. Hang in there, and stay safe.

Got to keep an eye on the hospitalizations

They’re up, but for now we’re still in reasonably decent shape.

More than 1,200 people were hospitalized for COVID-19 in the Houston area on Monday, according to data released by the state Tuesday afternoon. The Department of State Health Services reported that 1,224 people were hospitalized for COVID-19 in the nine-county region around Houston.

The figure comes one day after the state reported topping 1,000 hospitalizations for the first time since October as the delta wave tapered off.

The hospitalization rate represents a 93 percent increase over last Monday, when DSHS recorded 636 COVID hospitalizations in the Houston area. The surge corresponds with the rapid spread of the highly-transmissible omicron variant, which first appeared in South Africa in late November, and has swelled to account for more than 90 percent of local cases in recent weeks.

Houston’s hospitalizations are still well below their delta peak, which reached 3,500 on Aug. 24. But less than a week after Houston  logged its 300,000th case of COVID, data from the Texas Medical Center shows that local transmission is increasing at a steady rate.

The current transmission rate is high – basically, on average everyone who gets the omicron variant will pass it on to another two people – and our vaccination rates remain pathetically mediocre. Harris County is better than the state overall, but not by much. There’s still a lot of room for this thing to find vulnerable people. Use rapid tests, isolate if you get a positive result, and wear good quality masks. We really can get through this if we’re not too dumb about it.

Back to threat level orange

Thanks, omicron.

Harris County Judge Lina Hidalgo raised Harris County’s COVID-19 threat level to “significant” Monday, as the number of infections rise sharply, sparked by the spread of the omicron variant.

“Level 2: Orange,” is the second-highest threat level in the county. While it falls short of suggesting that residents stay home under all circumstances, Threat Level 2 recommends that people minimize all uneccessary contacts in order to stem the flow of the virus.

“Unfortunately, the Omicron variant has arrived in Harris County in full force,” Hidalgo said in a statement. “These trends are understandably frustrating — especially as we close out the year with friends and family. But we can still blunt the force of this latest wave if we take action.”

New cases in the area have nearly tripled in the last week, with the Texas Medical Center reporting about 2,094 cases per day compared to about 721 the week before.

The COVID-19 testing positivity rate has jumped from 2.7 percent to 6.2 percent in that span, and hospitalizations at the medical center have grown from about 68 people per day to about 110.

As noted, it was less than one month ago that the threat level had been lowered to yellow. Those were the days, huh? And now we’re back to this.

Jayne Johnston broke the bad news on Saturday to her 6-year-old daughter: Theater Under the Stars’ production of “The Little Mermaid” was canceled.

“She was crushed because she was so excited,” Johnston says. “I made this big deal about her getting vaccinated. I’d told her, ‘You’ll get to go inside places again, but you’ll still have to wear a mask.’”

The mother-daughter duo had planned to see the 2 p.m. performance at the Hobby Center. At the time, another show was also scheduled for 7:30 p.m., but it was canceled, too.

“While we had hoped to resume performances on Sunday, we have confirmed a positive COVID case among our performing company,” said TUTS artistic director Dan Knechtges in a statement. “Our paramount concerns are for the health and safety of our artists and audiences. It does, regrettably, put us in the position of making hard decisions and cancelling performances this weekend. Performances will resume on Tuesday, December 21.”

The spread of the omicron COVID variant and the recent spike in cases is beginning to affect live theater, sports and other public gatherings in Houston.

[…]

Similar to TUTS, Alley Theatre’s guest services team alerted patrons on Saturday a person working on ‘A Christmas Carol’ tested positive for coronavirus. Ticket-holders can requests seats to a future show date through Dec. 29, or any future Alley production. Refunds are available, too.

“It’s disappointing because we’ve done so well this whole run of ‘A Christmas Carol,’” says Dean R. Gladden, Alley Theatre Managing Director. “We’ve done a lot to prepare, but the biggest thing you can’t prepare for is when it happens to you — you just have to deal with it.”

Gladden explains that his actors are already kept separate in respective bubbles. When someone tests positive for COVID, everyone — including production — has to provide negative results. That didn’t happen in time for Sunday’s performance. “A Christmas Carol” is expected to return to the stage on Tuesday.

“Patrons have been so understanding to know that it’s nobody’s fault. This is a very active variant,” he says. “We’re seeing this across the country. Performing arts are taking a hit, sports are taking a hit.”.

On Sunday, Rice University postponed a men’s basketball home game against University of St. Thomas due to COVID-related issues within the Owl’s program according to a statement. The women’s basketball team canceled Sunday’s game at Texas A&M University due to COVID issues, as well.

“With contract tracing, we didn’t have enough players to play the games. Basketball is a smaller team,” says Chuck Pool, Sports Information Director at Rice. There’s a slim chance both games could be rescheduled if the dates work out. “I can’t really speculate. These would’ve been our last games before Christmas.”

Not just colleges, and of course not just live theater:

Yesterday, a little after noon, the Dandelion Cafe posted a notice to its Facebook page. It echoed the sign newly posted on the door of this Bellaire breakfast staple: “Due to a rise in COVID cases, including several among our staff, we feel it is in the best interest of our staff, customers and everyone’s families to close until everyone can work and be in a safe and healthy environment.”

This unwelcome news was the leading edge of what is likely to be a spate of restaurant and bar closures over the holidays and into January, as the highly transmissible Omicron variant of COVID begins traveling through Houston on top of our current Delta wave.

COVID “seems to be picking up in the industry again,” bartender and diner-about-town Chris Frankel posted on Dandelion Cafe’s Facebook page today. “I’ve recently noticed a number of responsible, vaccinated colleagues testing positive and being stuck in quarantine.” Omicron’s ability to break through vaccine defenses is complicating the situation.

It sucks, but this is where we are now.

Houston doctors worry omicron could sweep the city just as families gather for the holidays. Omicron accounted for 82 percent of new symptomatic Houston Methodist COVID cases as of earlier this week, hospital officials said, and is on track to overtake delta as the dominant strain.

“This virus is better able to evade better the immune response we have developed through vaccination and natural immunity,” said Dr. Pedro A. Piedra, a virologist at Baylor College of Medicine.

Piedra estimates omicron will replace delta in the months to come. He is not alone in predicting an omicron wave, even as its severity remains a question mark.

Three weeks ago, Houston’s rate of transmission for coronavirus — a key indicator health officials use to gauge community spread — was 0.67, according to the Texas Medical Center. That means each person with the virus was likely to spread it to 0.67 people – nonviral, essentially. That rate has more than doubled as of last week, with a 1.58 rate of transmission.

The number of COVID-19 tests coming back positive in Houston has quadrupled since last week. Hospitalizations among children have doubled in four days.

The reason for omicron’s rapid ascent is written in its spike proteins, found on the surface of the virus that causes COVID. The variant contains a high number of previously unseen mutations that account for its ability to infect people faster and more efficiently than any previous iteration of the virus.

While scientists hurry to understand its properties, one thing is certain: its astonishing rise was months faster than that of delta.

“We have seen a rather dramatic shift,” said Dr. James Versalovic, pathologist-in-chief at the Texas Children’s Hospital.

You know the drill by now. Get your booster shot. Avoid large indoor crowds. Wear your mask – N95s are cheap and readily available now. Ventilate well. Use rapid tests and for God’s sake isolate if you’re positive. Minimize your risk and do what you can to protect others. We’re very much in a better place to avoid severe consequences, but we still have to be cautious. Yes, it sucks. The alternative is worse. Stace and the Press have more.

COVID rate slows a bit, but ICUs still full

The good news.

So far, the delta variant has fueled a month of Houston-area COVID hospitalizations over 3,000, according to the Texas Department of State Health Services.

But Texas Medical Center records show positive case rates may be slowly declining. According to TMC’s daily report, 1,939 people tested positive Tuesday in the Greater Houston area, a decline that may be related to COVID testing site closures as a precaution before Hurricane Nicholas.

Also Tuesday, the medical center admitted 310 new COVID-19 patients compared to the average 328 per day last week. Hospitals in the TMC remain at 90 percent capacity.

Dr. Wesley Long, a microbiologist and medical director of diagnostic microbiology at Houston Methodist, has been tracking and analyzing the virus and its variants through the hospital’s COVID-19 genome sequencing operation.

While Long sees the increase slowing, he hesitates to say Houston is passed the peak of the surge.

“It’s like cresting the top of the wave, you don’t know what the backside of the wave is going to look like,” Long said. “In the beginning of this fourth wave, there were some people hopeful it would go up quickly and come down quickly. That’s not the case.”

The fourth wave’s peak has been broader than previous waves, which spiked and declined within about 25-30 days, Long explained. The big question with the delta wave is whether it will plateau at a high rate of hospitalizations or have a slow decline.

“It’s hard to know how other things like holidays and school will affect the case count,” he said. “It’s really important to keep masking, social distancing and staying home if you’re sick because it’s important to bring the fourth wave under control.”

Another way to look at it:

The not so good news.

COVID-19 hospitalizations have been declining across Texas and the Houston region, but the virus is still keeping a high number of people in ICUs, prolonging the strain on patients waiting for critical care beds.

Last week, the number of available adult ICU beds in Texas sunk below 300 for the first time in the pandemic, with 270 beds available on Sept. 8 and 279 available on Sept. 9, according to the Texas Department of State Health Services. There were 326 beds available this Wednesday, including 65 in the nine-county region surrounding Houston, the data show.

Texas Medical Center ICUs for weeks have been hovering around 90 percent full with “Phase 2” surge plans — which add 373 ICU beds to the 1,330 available in Phase 1 — activated.

[…]

ICU data is a lagging indicator of the virus’s impact, [Dr. Syed Raza, vice president of medical operations at CHI St. Luke’s Health-The Woodlands Hospital] said, because the sickest patients need care for a longer period of time. He said it is the “natural course of the pandemic” for ICUs to remain high after hospitalizations decline.

Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine, said the hospital strain appears to be easing overall. The number of COVID patients in ICU beds likely peaked at the end of August, when they took up 49 percent of all critical care beds, he said. As of Wednesday, that number dropped to 45 percent.

He said he is cautiously optimistic that “we’ll continue to see this trend move in right direction.” He compared the current ICU situation to flooding during hurricane.

“We are no longer stuffing towels under the door” to stop the water, he said. “But the water is still over our threshold.”

I mean, it could be worse. It’s still not good, and it’s going to continue to not be good for awhile, but it could be worse. Keep up with the precautions, they’re our best hope in the short term as more people get vaccinated.

A bit of good news in the wastewater

I’ll take it where I can get it.

Community spread of coronavirus is on the decline from its recent summertime high, but experts warn that Labor Day gatherings and kids’ return to classrooms could bring a rash of new infections in the coming weeks.

The latest samples of Houston’s wastewater — a highly sensitive method for tracking coronavirus — show diminishing traces of the virus across the region, said Loren Hopkins, the Houston Health Department’s chief environmental science officer. The results indicate a slight drop in person-to-person spread.

“The positivity rates are still alarmingly high, the wastewater rates are still alarmingly high, but it may be trending down,” Hopkins said Wednesday.

The decline could be short-lived.

The holiday weekend and the start of school, which spurred record infections among children, will likely keep the Houston area in “plateau mode” for the foreseeable future, said Bill McKeon, CEO of the Texas Medical Center.

On Tuesday, the Texas Medical Center reported that the rate of transmission across the Houston area was 0.87; the average for the previous week was 0.99. Both figures landing below 1.0 is a good sign; any number above 1.0 means the virus is spreading through the community.

Still, McKeon urged caution. Tuesday’s low daily transmission rate of 0.87 could be artificially deflated due to low testing rates, he said, which commonly occur over holiday weekends.

“We are just coming out of the Labor Day weekend and we typically do not see the impact of holidays for one to two weeks,” McKeon said.

[…]

Houston’s coronavirus hospitalizations slowed by 2.3 percent in the past week, but remained only slightly lower than August’s record peak. As of Tuesday, 3,370 people were in area hospitals for COVID-19, down from the record high of 3,500 on Aug. 24, according to the Texas Department of State Health Services.

Ballooning school transmissions are another concern, experts said, especially in districts that do not have mask mandates. Student infections are rapidly rising across the state, with the total number of positive cases among public school students surging by 90 percent just a few weeks into the new school year.

“We need mask mandates to protect our school children from getting infected and bringing it home to Mom and Dad,” said Catherine Troisi, an epidemiologist at Texas Medical Center’s School of Public Health.

The wastewater had documented to surge, and it will be the leading indicator when there is a real decline. I hope people were cautious over the Labor Day weekend, but we’ll know soon enough what if any effect that had. As for mask mandates in the schools, it seems to be working pretty well for HISD. I keep saying, none of this is a mystery, we know what we need to do, we just have to do it.

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.

A few words from the CEO of the Medical Center

From an interview he did with Lisa Gray.

What we’re seeing, sadly, is more of the same, only with more intense numbers. The number of people who are testing positive in our community continues to escalate month over month. The test positivity rate is now at 15.1 percent.

But probably the most accurate reflection is our hospitalizations. We just reached an all-time high: 421 people were admitted to our hospitals for COVID yesterday.

Step back for a second and look at that relative to the entire pandemic. Back in June and July, we had two weeks where the average number of hospital admissions was over 300. That was in the second wave.

Fast forward to wave three: We had four weeks that averaged over 300.

Now we are into our second week with no slowing the pace. At 421 today, we are seeing the highest peak of all of the pandemic going back 18 months now.

It’s largely a pandemic of the unwilling — people unwilling to be vaccinated. Now 44% of Houstonians are unvaccinated. Those are the vast majority of the people that are showing up in our emergency rooms and and in our ICUs. They’re very sick.

Many people thought that they were young, and therefore their immune system would be strong enough to protect them. That is not the case with this deadly delta variant, which is three times more transmissible than the earlier alpha variant.

Our hospitals’ staffs are 18 months into this. They’re exhausted.

And we have far fewer nurses than we used to have. They’re being recruited to other states, like Florida, that are even worse off than Texas.

The saddest fact is, 18 percent of all the new cases so far in August are children.

With the alpha variant, everyone thought, “OK, it’s 65 and older.” So we went after the nursing homes, and we did a brilliant job at protecting the elderly population and those who are immunocompromised.

But now, that vulnerable population is children under 12, who are not able to be vaccinated. We are predicting a mess in our schools. With nearly 20 percent of new cases being children, now we’re going to huddle them together in schools? Some may have masks. Some may not. It’s a recipe for disaster.

You can read the rest or give it a listen, but his answer to the first question tells you most of what you need to know. Hospitals around the state have been facing a similar crisis. I keep harping on this because it needs to be harped on, as we have a governor who can’t follow his own dictum about “responsible behavior”, a felonious Attorney General who’s soliciting snitches so he can go after rogue mask mandates, and a Legislature that wants to ban mask mandates forever. This is what we’re up against.

I don’t know if I’d call this “good news”, but the projections say we can see the beginning of the end from here.

While hospitalization numbers are nearing the heights they reached during the state’s most fatal surge in January, public health projections indicate that the latest wave will result in fewer deaths — mostly because senior citizens are widely vaccinated and hospital patients are now much younger. Still, state health officials are preparing for the worst, preemptively ordering a fleet of five mortuary trailers from the federal government in case infections spiral.

Public health experts still expect at least some increase in coronavirus deaths over the coming weeks, as fatalities are a lagging indicator — cases rise first, then hospitalizations, then intensive care usage, then deaths.

Now, the state is averaging about 100 daily deaths, a number not expected to exceed 150 over the next month before tapering off. That’s nowhere near the 350 COVID deaths per day that the state saw in January.

“We’ll go up some, but again, not to the levels that we saw back in January,” said Dr. David Lakey, the vice chancellor for health affairs and chief medical officer at the University of Texas system, referencing the forecasts.

Still, the precipitous rise in hospitalizations is a cause for concern. More than 12,000 Texans were in the hospital with the virus on Wednesday, with dozens of Texas hospitals running out of ICU beds (during the winter surge, hospitalizations peaked at just over 14,000). Patients are younger than they were in the first two waves of the virus, and almost everyone facing severe illness is unvaccinated.

[…]

Projection models following Texas’ daily COVID case and hospitalization counts anticipate a rise in deaths in the near future. By mid-September, a model offered by the U.S. Centers for Disease Control and Prevention estimates that the Lone Star State will see about 790 deaths per week, or roughly 113 per day.

Another model, produced by researchers at the Institute for Health Metrics and Evaluation at the University of Washington, projects about 125 deaths per day by mid-September in a worst-case scenario. In both forecasts, it appears that the state has already seen the brunt of its COVID deaths.

That’s largely because the vast majority of Texas’ over-65 population — those most vulnerable to the coronavirus — have received at least one dose of the vaccine, experts said.

“Those that were most at risk of having severe disease have some protection, and that’s good protection because of the vaccine,” Lakey said.

While a spike in hospitalizations and ICU bed usage does portend fatalities, the relationship between those data points will be less “linear” during the third wave, he said. It remains to be seen whether young patients will have other, long-term side effects of the virus — what some are calling “long COVID.”

Deaths will also decrease as more people become vaccinated or recover from the illness, said Dr. Ali Mokdad, a professor of health metric science at the University of Washington’s Institute for Health Metrics and Evaluation. The institute’s researchers estimate that about 74 percent of Texans will be immune to the delta variant, either through infection or vaccination, by Dec. 1.

“The virus is running out of people to infect,” he said.

The forecasts should not be interpreted as an assured outcome, though. Public buy-in on safety precautions, including mask-wearing, will ultimately determine the trajectory of the third wave.

In other words, don’t expect a best-case outcome, because we’re not allowed to do the things we need to do to make this less awful. Note also that while extensive vaccinations among older folks will help to limit fatalities, there will still be an excess of deaths in the coming weeks because of the overfilled hospitals – people with other serious conditions will die as a result, as was the case in the previous waves. Now is a very bad time to have a heart attack or be in a car crash.

At least there is a rise in the rate of people getting vaccinated, now that the threat is so much higher. Some of that is the result of mandates and restrictions on unvaccinated people, some is due to pressures and enticements from employers, and some is due to straight up financial rewards. Whatever it takes, whatever it takes.

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

Yikes.

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

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

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

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

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

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

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

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

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

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

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

One more thing:

White Linen Night is back — well, sort of.

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

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

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

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

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

Still surging

Hospitalizations.

The number of lab-confirmed COVID hospitalizations in Texas broke 4,000 on Friday for the first time since March, a worrying sign of the pandemic’s quick resurgence since the Delta variant was discovered in the state.

[…]

As of Saturday, Texas Department of State Health Services data reported 4,320 lab-confirmed COVID hospitalizations in the state, more than three times the cases it had at its low of 1,428 less than a month ago. In the span of one week, COVID hospitalizations had spiked nearly 50 percent.

The increases in COVID hospitalizations have been dramatic. In the week ending July 24, Texas averaged 3,710 people hospitalized with COVID, up from 2,537 in the week before and 1,838 in the week before that.

Texas Medical Center hospitals are seeing an influx of COVID patients in ICU beds, and medical leaders may soon consider postponing elective procedures, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.

“Everywhere is experiencing that same sort of explosive growth right now, so that’s obviously very concerning,” said McDeavitt, who has been closely tracking local COVID data since the start of the pandemic.

Positive tests.

More than 1,000 people are testing positive per day for COVID-19 in the greater Houston region, more than seven times last month’s daily average, according to the Texas Medical Center.

As the delta variant dominates new COVID-19 infections across the country, the Texas Medical Center is returning to daily coronavirus updates.

The takeaways, sent every morning from William McKeon, president and CEO of the Texas Medical Center, provide a glimpse into one of the world’s largest medical complexes as its clinicians treat infected patients. Previously released weekly, the switch back to daily missives illustrate how rapidly delta is spreading across the region.

Last week, an average of 1,069 people tested positive per day for COVID-19 in the greater Houston region, more than double the prior week’s daily average.

“The COVID-19 Delta variant is spreading rapidly throughout Texas as only 43 percent of our population is fully vaccinated,” McKeon wrote in a Monday email.

If you don’t know what to do by now, I can’t help you.

The fourth wave

We’re not ready.

One local hospital is reinstating visitor limits and Harris County Judge Lina Hidalgo is mulling a change to the county’s threat level amid a wave of COVID-19 variant cases that medical leaders warned Tuesday could overwhelm area hospitals and wreak further havoc as schools reopen next month.

The warning came amid massive spikes in hospitalizations across the Houston region, which Hidalgo’s office is closely monitoring to decide if the county needs to raise its emergency threat level from yellow to orange — or moderate to significant.

“We’re watching this very, very closely,” Hidalgo spokesperson Rafael Lemaitre wrote in an email. “The trends are moving in the wrong direction again and we are in a high-stakes race against the delta variant of this virus. Our message to the community is simple and clear: If you haven’t been vaccinated, take action now.”

In May, Hidalgo lowered the threat level from red — where it had been for nearly a year — to orange, then yellow a few weeks later, as COVID cases waned statewide.

But this month, hospitalizations across the state have more than doubled, ballooning from 1,591 on July 1 to 3,319 as of Tuesday, according to the Texas Department of State Health Services. The state’s hospitalization count peaked in January at 14,000.

Texas Medical Center CEO William McKeon said he fears the closing of many testing centers will make it more difficult to gauge the extent of COVID’s spread in the coming weeks.

“As this fourth wave begins in force, our radar is down,” Texas Medical Center CEO William McKeon said in a Tuesday conference call with reporters. “We have only a fraction of the testing…. We’re going to be running much more blind to the spread of delta variant in our community.”

[…]

Memorial-Hermann Health System plans to readopt visitor restrictions this week, and will test all patients for COVID, regardless of their vaccination status, said Dr. Annamaria Macaluso Davidson, vice president of employee health medical operations.

The hospital system had about 100 confirmed COVID cases on July 4; by Tuesday, there were more than 250.

We’ve been discussing this, and you know how I feel. The hospitalization numbers are still relatively low, but that’s a sharp increase, and there’s no reason to think there won’t be more. And I hadn’t even thought about the drastic reduction in testing facilities – I don’t know how big an effect that may have, but it’s not going to help.

I drafted this a couple of days ago, and before I knew it, Judge Hidalgo had already taken action.

Harris County’s emergency threat level was raised to orange — or “significant” — on Thursday and County Judge Lina Hidalgo called for resumed mask wearing amid a fourth wave of COVID-19 that has already caused hospitalizations to spike across the region.

“It’s not too late,” Hidalgo said. “But if we don’t act now, it will be too late for many people…. We are at the beginning of a potentially very dangerous fourth wave of this pandemic.”

The guidelines for the orange threat level are voluntary, and urge residents — namely those who are not vaccinated — to avoid large gatherings and businesses with poor safety procedures.

Hidalgo also said “everyone” should resume wearing masks to protect the County’s population who are not fully vaccinated. Currently, about 2.1 million county residents are fully vaccinated — 44 percent of Harris County’s total population.

She noted the county’s positivity rate is now doubling about every 17 days, quicker than any other point in the pandemic.

Get your masks back on, and hope for the best. I trust Judge Hidalgo to do everything she can to ameliorate this situation, but as we know, there’s not a lot she can do. Greg Abbott has seen to that.

One thing that could help is if more places of business begin putting in their own vaccination requirements, mostly for employees but also possibly for customers or business partners, depending on the situation. Putting some limits on what one can do as an unvaccinated person is one of the few effective ways to compel people to get their shots. That will have to come from the private sector, because it sure won’t come from the state. The FDA giving final approval to the Pfizer and Moderna shots will help, too. I just don’t know how long we can wait.

Methodist anti-vaxxers officially fired

I have three things to say about this.

More than 150 Houston Methodist Hospital employees resigned or have been fired as of Tuesday over a recent policy that required hospital employees to be vaccinated against COVID-19 by Monday.

All told, 153 people are no longer employees of the Houston health care chain, Methodist spokesperson Patti Muck said. The hospital has about 25,000 employees, nearly all of whom have abided by the policy, Methodist leaders have said previously.

The firings follow a contentious few weeks in which hospital employees staged protests and filed a lawsuit against the hospital, claiming the policy, announced in April, violated their rights. Methodist was one of the first large health care providers in the country to announce vaccine requirements.

“I’m so happy and relieved,” Jennifer Bridges, the lead plaintiff in the suit, said Tuesday. “I don’t want any part of Methodist.”

Earlier this month, a federal judge tossed the lawsuit filed by more than 100 Methodist employees, most of whom were not doctors or nurses. In it, the plaintiffs argued Methodist’s policy violated the Nuremberg Codes, a World War II-era agreement that bans involuntary participation in medical trials.

Bridges said Tuesday that she and others planned to protest outside Methodist on Saturday, and that conspiracy theorist Alex Jones will be in attendance.

See here and here for the background. My three things:

1. I strongly suspect Methodist would say that the feeling is mutual, Jennifer.

2. Inviting Alex Jones to your protest really makes one question the previous statements made about how these folks are not anti-vaccine, just super cautious about this particular vaccine.

3. As Methodist cardiovascular technician Deedee Mattoa says in this story, the real surprise here is not that Methodist followed through, but that Memorial Hermann and Baylor College of Medicine, which have made public promises to require COVID-19 vaccines but have not set deadlines for when staff will need the shots, have not yet followed suit. What are you guys waiting for? The Trib has more.

Methodist anti-vaxxers appeal lawsuit dismissal

As expected.

A group of Houston Methodist employees who sued the hospital system over its COVID-19 vaccine requirement have appealed a ruling dismissing the case.

Over the weekend, U.S. District Judge Lynn N. Hughes tossed the lawsuit, calling it “reprehensible” to compare the vaccine requirement to Nazi Germany’s medical experiments.

“Equating the injection requirement to medical experimentation in concentration camps is reprehensible,” Hughes said. “Nazi doctors conducted medical experiments on victims that caused pain, mutilation, permanent disability, and in many cases, death.”

[…]

Although the lower court judge thought the case had no merit, Woodfill could get traction from the 5th U.S. Circuit Court, known as one of the most conservative appeals courts in the country. On several recent occasions, the 5th Circuit has dealt blows to Hughes, a historically stubborn 79-year-old Reagan appointee.

The appeals court ordered him to re-sentence a defendant in a terrorism case who was accused of supporting ISIS overseas. After Hughes re-sentenced the man to the same abbreviated sentence, 18 months, which did not consider a sentencing enhancement, the government appealed and the 5th circuit removed the sentencing from Hughes’ court.

The 5th circuit also admonished Hughes for remarks he made on the record about female employees of the federal government. Hughes later barred the Houston prosecutor from appearing at the jury trial involved in that case.

More than half of frontline medical workers nationwide have received at least one dose of the COVID-19 vaccine, according to a survey from the Kaiser Family Foundation, a Washington, D.C.-based think tank. But as of April, nearly one in five said they did not plan on receiving a COVID-19 vaccine.

See here for the previous entry. It’s true that Judge Hughes can be a crank, but I kind of doubt that any of those previous instances will weigh on this case. For some analysis of the lawsuit and subsequent dismissal, this WaPo story has some good information.

Valerie Gutmann Koch, co-director of the University of Houston’s Health Law & Policy Institute, called the decision “another step in demonstrating the legality of these mandates, particularly in a health crisis like this.”

“There isn’t much there to rely on to argue these mandates should be illegal,” she said.

[…]

Akiko Iwasaki, an immunologist at Yale University, characterized the lawsuit’s claims as “absurd” in recent remarks to The Washington Post, noting that tens of thousands of people participated in the vaccine trials. The suit also repeats misinformation circulated widely online about the shots altering DNA.

The inoculations are seen as key to a return to normalcy, yet most employers have shied away from mandating them, concerned about the thorny politics and previously untested legal issues. Colleges and universities, along with Houston Methodist and a handful of other health-care institutions, are the exception.

Koch said the ruling shows “employer mandates of the covid-19 vaccine, particularly in the health care arena, are absolutely legal.” She said she expects to see more legal battles around vaccination mandates but noted she has “always predicted that they have very thin legal legs to stand on.”

There is precedent for vaccine requirements, she said, such as when health-care institutions require vaccinations during particularly bad flu seasons. Koch said she was “encouraged by the fact that this was dismissed as quickly and expeditiously as it was.”

Veronica Vargas Stidvent, executive director at the Center for Women in Law at the University of Texas School of Law, said the ruling is based on employment law in Texas, so the extent to which it sets a precedent for other jurisdictions is not clear.

“At least here in Texas, under this ruling, it’s pretty clear employers can require employees to get vaccinated,” she said.

Yeah, I don’t think it should be a surprise that Texas employment laws are much more favorable to employers than to employees. As Reuters notes, Judge Hughes wrote that “Texas law only protected employees from being fired for refusing to commit an illegal act and that the requirement is consistent with public policy.” I’ll be more than a little surprised if the Fifth Circuit decides that this is the place to take a stand in favor of the workers.

Lawsuit over Methodist Hospital vaccination mandate tossed

That was quick.

A federal judge has tossed a lawsuit against Houston Methodist over its policy to terminate workers who refuse to get the COVID vaccine, calling it “reprehensible” that plaintiffs compared the requirement to those made under Nazi Germany.

In the lawsuit on behalf of 117 Houston Methodist employees, lawyers likened the vaccine requirement to the Nuremberg Code, a set of medical ethics standards created at the end of World War II following medical experiments by the Nazis on German citizens.

U.S. District Judge Lynn Hughes heavily criticized the comparison in a decision Saturday.

“Equating the injection requirement to medical experimentation in concentration camps is reprehensible,” Hughes said. “Nazi doctors conducted medical experiments on victims that caused pain, mutilation, permanent disability, and in many cases, death.”

Houston Methodist is one of the first hospitals in the nation to require employees to be vaccinated. The hospital system allows employees to opt out of the vaccine requirement if they provide a medical or religious exemption.

[…]

Jennifer Bridges, a Houston Methodist Baytown nurse who originally circulated a petition in April asking the hospital’s executives to reconsider the policy, said the plaintiffs plan to appeal.

“This will go all the way,” Bridges said. “This is only the beginning.”

Occupational Safety and Health Administration officials issued guidance on Thursday outlining new COVID-19 precautions and procedures to prevent the spread of the virus in health care workplaces. Under the new rule, health care employers must provide paid time off for workers to receive COVID-19 vaccinations and recover from the side effects. Federal regulators in May issued guidance allowing employers to require proof of vaccination as a condition of employment.

Hughes wrote in the dismissal order that the vaccinate mandate “was not coercion.”

“Methodist is trying to do their business of saving lives without giving them the COVID-19 virus,” the judge wrote. “It is a choice made to keep staff, patients and their families safer.”

He also denied a request for a temporary restraining order to block the hospital from suspending the 178 employees who have not received a shot.

See here for some background – the policy was announced in late April, the lawsuit was filed shortly afterwards. As of the last day before the suspensions, all but 178 employees out of 25,000 had been vaccinated, and 27 of those 171 had since received a first shot. The nurse who has acted as the spokesperson for the holdout employees has insisted this isn’t about vaccine skepticism but about not wanting to rush things and so on, but as the Chron editorial board noted over the weekend, her rhetoric has veered more into conspiracy theory land as this has progressed. Plus, there’s the whole “hiring Jared Woodfill as their attorney” thing, which is something you never do if you want to be taken seriously. Anyway, my guess is that they will get no joy from the appeals courts, who I suspect will be more pro-employer than pro-not-getting-vaccinated, but we’ll see. The Press has more.

Will Methodist fire its unvaccinated workers?

In two weeks, if they haven’t gotten vaccinated, the answer is Yes.

Dozens of cheering supporters gathered outside the Houston Methodist Baytown campus Monday evening as several medical workers who refused to get a COVID-19 vaccine ended their last shifts working for the hospital system.

The act of protest was aimed at what workers said was the hospital’s decision to suspend employees for two weeks without pay and then fire them for failing to immunize themselves.

Jennifer Bridges, a nurse who effectively lost her job at the Baytown facility for deciding not to be inoculated, said the goal was to stage a walkout but that did not go as planned. Participating employees who refused the vaccine’s first dose were told not to gather or linger on the hospital grounds after ending their shift, she said.

“The hospital wouldn’t let us do it,” Bridges said.

She got out of work early, emptied her locker and gathered with others on a grassy medium near the ambulance entrance to the hospital. Bridges fished a paper out of a backpack — a suspension report — that she had been asked to sign. She refused, she continued.

About 117 employees in May filed a class action lawsuit against the health system for requiring its workers to be vaccinated against COVID-19. Bridges said the plaintiffs in the suit are a mix of those who want more trial data to emerge on the long-term effects of the vaccine before taking it, and those who simply don’t want any shots.

Sorry, I’m with Methodist on this. I cannot see any reason why health care workers – who by the way were already required to get a flu shot every year – should be able to opt out of this. If the concern is that we still don’t know enough about the potential negative effects of the vaccines, which at this point have emergency authorization from the FDA and not full clearance yet, all I can say is that over 300 million doses have been administered so far, with basically zero serious negative effects. There’s no way that the risk analysis comes out more favorably for not being vaccinated. Hiring Jared Woodfill as your attorney for that class action lawsuit doesn’t say much for one’s commitment to science, either.

In the end, it’s a pretty small number of employees who are affected.

While nearly 25,000 Houston Methodist workers are now vaccinated against COVID-19, 178 employees are now suspended without pay for not receiving a shot.

In a Tuesday memo to hospital staff, Houston Methodist CEO Marc Boom said 27 of the 178 workers who have not been fully vaccinated have received at least one dose of the vaccine. If they comply, they will not face termination.

“I wish the number could be zero, but unfortunately, a small number of individuals have decided not to put their patients first,” Boom said.

More than 600 employees were granted deferrals or exemptions for medical or religious reasons, the hospital said.

The hospital will have a final number of employees fired for not complying with the vaccine mandate in two weeks. Houston Methodist also requires its workers to get an annual flu shot.

That’s 0.7% of the Methodist workforce that was affected, and some of them have already decided it wasn’t worth getting fired over. Good for them. All of these folks did have a choice, and they made it. That there are consequences is just how life is sometimes. Erica Greider and the Press have more.

Houston Methodist tells its employees to get vaxxed or else

I’m okay with this.

Four out of five Houston Methodist employees are vaccinated against COVID-19. The sliver who are not will be suspended or fired if they refuse the shot, according to company policy.

The hospital required managers to be vaccinated by April 15 and all other employees — about 26,000 workers in total — by June 7, said Stefanie Asin, a Houston Methodist spokesperson.

With 84 percent of the staff vaccinated, the hospital is close to herd immunity, CEO Marc Boom wrote in a letter to employees this month.

“As health care workers we’ve taken a sacred oath to do everything possible to keep our patients safe and healthy — this includes getting vaccinated,” Boom wrote.

A little more than 4,100 employees have not received at least a first dose of the COVID-19 vaccine. The hospital does not know yet how many employees potentially will be suspended or terminated because of the mandatory vaccination policy.

Since 2009, a hospital policy has mandated its workers receive the flu vaccine each year, unless they have a medical or religious objection qualifying them for exemption.

[…]

Several nursing homes in Houston are requiring COVID-19 vaccinations of their workers, while other hospitals in the Texas Medical Center have not yet followed suit.

“UTMB is not mandating vaccination,” said Christopher Smith Gonzalez, senior communication specialist for the hospital. “But, in view of the high contagiousness of the some of the SARS-CoV-2 variants, UTMB has implemented enhanced respiratory precautions for all unvaccinated individuals caring for or evaluating patients for COVID.”

While 80 percent of Texas Children’s Hospital employees are vaccinated against COVID-19, the hospital does not require inoculation. St. Luke’s Health has vaccinated “thousands of our staff,” vaccinations are not mandatory, according to the health system.

But some are considering it to cut back on health hazards for employees and patients.

“As a provider of health care services, Baylor College of Medicine currently requires vaccination for employees for a variety of infectious diseases,” said Dr. James McDeavitt, senior vice president of Baylor College of Medicine. “For example, flu vaccination for employees has been mandatory for several years. With appropriately defined exemptions (medical contraindications, religious beliefs), we support mandatory vaccination for COVID-19. We do not yet have this requirement in place, but it is under active consideration.”

Memorial Hermann will make COVID-19 vaccines mandatory after it relaxes some of its COVID-19 protocols, such as mask-wearing and social distancing. However, it has not set a deadline for employees to receive the vaccine, said Drew Munhausen, a Memorial Hermann spokesperson.

This all makes sense to me. They’re health care workers, which not only makes them at high risk for catching COVID, it means they’re in very close contact with a lot of extremely vulnerable people as well. The story notes a recent incident in a Kentucky nursing home, where an unvaxxed worker was the cause of an outbreak. While most of the residents, who had been vaccinated, had only mild symptoms, one of them died. None of that should have happened. State law requires that health care facilities have a policy about vaccinations, but doesn’t require that they mandate them; federal law allows employers to require vaccinations, but also doesn’t mandate it. I for sure would want to know that the doctor or nurse or physician’s assistant who is giving me medical assistance, as well as all of the support staff, have been vaccinated for COVID. I understand that some of the employees may be hesitant about the vaccine, and I have some sympathy for them, but only so much.

There is also this:

Houston Methodist was one of several companies to offer incentives for its workers to get a COVID-19 vaccine. The hospital is granting $500 bonuses to anyone who worked during the pandemic and received the vaccine.

“Already we’re seeing positive results as the number of employee infections has dropped inversely with the number of employees receiving the vaccine,” Boom wrote.

Paying people to get vaxxed has its merits. One of the hesitant Methodist employees from the story says that some of her fellow hesitators are thinking about getting the shots to keep their jobs. Clearly, incentives work. Maybe that’s a lesson for us for the broader issue.

Scooters banned from sidewalks

Fine by me.

Houston has scuttled scooter rentals along city sidewalks, and kicked riders of the two-wheel transports in busy areas into the street.

City Council on Wednesday approved changes to Houston’s codes outlawing any rental activity that impedes public sidewalks or blocks a city-controlled parking spot, a move aimed at eliminating businesses that use temporary trailers and the public walkway to offer rental scooters. The businesses have grown in popularity, but critics complain they block sidewalks and encourage novice riders to rocket along crowded sidewalks.

“They ride them recklessly, they don’t have helmets on,” District G Councilman Greg Travis said. “It is a disaster.”

In addition to banning scooter rental companies, the council revised existing rules to outlaw scooter use on sidewalks in a business district, effectively moving them off walkways in downtown, Uptown and the Texas Medical Center.

Scooter rental companies earlier this month complained they are being singled out for offering a popular activity where customers want them. Forcing them them onto private property, such as parking lots, or to permanent locations limits where people can find and use the rentals, the owners say.

[…]

Though they approved the measure, council members said shifting the scooters to the streets comes with its own challenges. Pedestrians will not have to share space with the motorized two-wheelers but scooter users now must contend with vehicle traffic.

The scooter rules are identical to those for bicycles, which also are banned from sidewalks in business districts.

Despite the need to ensure safety, some observers lamented the council’s actions limited mobility but did not improve the on-street conditions that make some of those interactions calamitous.

“A truly pro-business city might see this as not just an opportunity but a duty to build safe rights-of-way on our downtown streets so people can get around efficiently, and to create an environment that supports entrepreneurship,” said Joe Cutrufo, executive director of the advocacy group BikeHouston.

District I Councilman Robert Gallegos said he will discuss additional safety needs in an upcoming Quality of Life Committee meeting, “so we can do what we can to keep (scooter users) safe, as well.”

Advocates said those discussions should include the addition of amenities, including dedicated bikes lanes similar to those along Lamar, Austin and Gray in downtown and Hardy and Elysian north of the central business district.

See here for the background. No question, these things do not belong on sidewalks, for the same reason that bicycles don’t – they’re a hazard for pedestrians. As noted before, the “leave your scooter on the sidewalk when you’re done with it” method for returning them is an extra hazard for people with disabilities. This was the right call.

I do think there should be a place for electric scooters in the overall transportation ecology in Houston. As with B-Cycle, the scooters can be an alternative to driving for people who need to take a short-but-not-short-enough-to-walk trip in the cited locations – downtown, Uptown, the Medical Center. It’s a question of doing it safely. I’ve ridden B-Cycle bikes downtown, and I generally felt fine riding in the right-hand lane on the one-way downtown streets. For the most part, the right lane is for buses and right turns only anyway, so you’re generally not being trailed by a car that’s dying to pass you. There are more bike lanes downtown now as well, and I too would like to see more of them. I think scooters and scooter riders will be fine doing this. Maybe it’s not as great an idea for entertainment purposes, but that’s the way it goes.

Vaccine progress

Good news.

Texas will surpass more than 7 million COVID-19 vaccination doses administered today, top public health officials told the Texas Senate as Gov. Greg Abbott lifted all capacity limits for businesses and ended government-imposed mask mandates in the state.

At the same time, the health officials also offered a strong defense of the previous mask mandates, saying they reduced the chance of asymptomatic people spreading the virus and resulted in a record low year for influenza in Texas.

The speed with which vaccinations are being distributed is one of the keys to Abbott’s new order removing all mask mandates and allowing all businesses to re-open to 100 percent of their occupancy. Still, Texas has one of the lowest vaccination rates in the country, with 15.8 percent of residents having received at least one shot.

“We have come a long way in a very short period of time,” said Imelda Garcia, a top official with the Department of State Health Services, as she testified before a committee in the Texas Senate on Wednesday morning.

Garcia reminded lawmakers that Texas didn’t get its first vaccine shipments until Dec. 14. She lauded vaccine providers around the state for stepping up to administer so many shots in such a small window.

“They have been busting their butts in order to get shots in arms as fast as they physically and possibly can,” Garcia said.

Harris County alone topped 1 million doses on Tuesday.

Because the majority of vaccines in Texas require two doses, the number of people fully vaccinated is just over 2 million statewide.

Yes, there has been a lot of great work done, and everyone involved should be praised and thanked for it. There have been plenty of obstacles to overcome, that’s for sure. Because I’m a numbers nerd, I feel like I have to say something about the totals and percentages cited in this story, because as is they’re making me twitch. Seven million people would represent about 23% of the total state population. Given that the vaccines are only being given to those 16 and up, that makes the denominator in that fraction smaller, and thus would make the percentage higher. The only way this works if that total of “seven million doses administered” counts all shots given, both first and second. That would put the number of people that have had at least one shot at almost five million, which is closer to that 15.8% (it’s now higher on that NYT page, as it updates in real time). I’m just a little annoyed that I had to think it through like this to make sense of it all.

Not so good news.

The Texas Medical Center, in partnership with the city, is now administering 232,000 COVID-19 vaccine doses per week, and experts expect that number to ramp up as more vaccines are shipped to the state.

While vaccination rates are increasing and COVID-19 cases are trending downward again, medical officials said the public shouldn’t get too comfortable. Texas Medical Center leaders said there is currently no strong correlation between vaccination and hospitalization rates.

Experts are anxious that there could be another surge as students go on spring break this month. There’s more virus in Houston, and it’s spreading faster as more infectious variants circulate in the area.

“We’re not seeing the rapid decline we want to see,” Bill McKeon, president of the Texas Medical Center, said at a Wednesday webinar on the state of COVID-19 in Houston.

Part of the reason for this is that it takes time for the vaccine to take full effect – this is true of both the one-shot J&J vaccine and the two-dose Pfizer and Moderna vaccines – and it is eminently possible to continue to carry the disease after getting your shots. You will be much less likely to get sick, but you can pass it on to others, who may not be so lucky. This is why everyone who cares about keeping people alive and healthy are continuing to urge everyone to wear masks and maintain social distancing. We are approaching a point where those things will not be vital, but we are not there yet.

Good news for some, just news for others.

Texans ages 50 and older will be eligible for the COVID-19 vaccine starting March 15, state health officials announced Wednesday.

“We’ve seen a remarkable decrease in the number of hospitalizations and deaths since people 65 and older started becoming fully vaccinated in January,” said Imelda Garcia, the chair of the state’s Expert Vaccine Allocation Panel. “Expanding to ages 50 to 64 will continue the state’s priorities of protecting those at the greatest risk of severe outcomes and preserving the state’s health care system.”

Currently, the state is vaccinating members of priority groups 1A and 1B, which include health care workers, Texans 65 and older, and anyone over age 15 who has a pre-existing condition. Last week, state officials also made educators and child care employees eligible for a dose.

Those 50 and older will be included in priority group 1C. More than 93 percent of Texans who have died from the virus have been at least 50 years old, health officials said in a press release.

One can certainly argue that some other folks should have been next in line, but this is where we are. On the plus side, thanks to President Biden, everyone will be eligible for the shot in a few weeks. Until then, get yourself signed up at your first opportunity. And keep that mask on until someone other than Greg Abbott tells you to take it off. The Trib has more.

More COVID restrictions are about to happen in Harris County

Blame Greg Abbott and the virus, in whatever order you prefer.

Houston and its surrounding communities on Tuesday became the latest region to require new emergency restrictions after seven straight days of ballooning coronavirus hospitalizations.

The rollback, mandated under Gov. Greg Abbott’s emergency protocols, includes restaurants dropping to 50 percent occupancy from 75 percent, and bars that have not reclassified as restaurants closing immediately. The restrictions remain in place until the region drops below 15 percent COVID-19 hospitalizations for seven straight days.

As of Monday, the latest day of available data, the Houston region was at 19.9 percent, up from just over 13 percent a week earlier. Infections and hospitalizations have been rising steadily in recent weeks, following spikes in other parts of the state and amid holiday gatherings.

All but four of the state’s 22 hospital regions were over 15 percent as of Monday.

Texas Medical Center Hospitals in Houston announced earlier Tuesday that they were putting a hold on certain elective surgeries to save resources for coronavirus patients. Under the governor’s protocols, hospitals are required to postpone elective surgeries that would deplete COVID-19 resources.

“The best thing we can do is take this threshold as a wakeup call,” Harris County Judge Lina Hidalgo said in a news conference Tuesday afternoon. “This is the time to take this for the red alert that it is. We are only going to get through this if we are able to quickly stem the tide of hospitalizations.”

More here.

The rollback comes as Texas Medical Center hospitals already had begun deferring certain elective procedures or readying such a managed reduction strategy, the same one they deployed during the summer when patient censuses spiked. The reduction is not the wholesale delay of elective procedures all Texas hospitals invoked in the spring.

Hospital leaders said Tuesday their systems will continue some elective procedures but suspend those non-urgent cases whose demands on staff and space detract from resources better used to treat COVID-19 patients. Procedures such as mammography and colonoscopy will continue because they don’t tax needed hospital resources, for instance, but some procedures like heart catheterizations might be better delayed.

[…]

The surge of COVID-19 hospitalizations has been relentless. The number of admitted COVID-19 patients in the Houston region has increased for 13 straight weeks, and the 25-county area anchored by Harris County had more than 3,100 hospitalizations on Monday, the highest since July, the peak of the first wave in Texas.

Houston Methodist was just short of 700 COVID-19 patients on Monday. Methodist CEO Dr. Marc Boom emailed employees that if this trend holds the system will surpass its peak July numbers in a matter of days.

“This may well be among the most challenging few weeks we’ve experienced during this pandemic,” Boom wrote in the email to employees Monday. “Together, we will get through this, but it will be difficult.”

Dr. James McCarthy, chief physician executive at Memorial Hermann, said his system exceeded 800 patients and should eclipse July numbers by the third week in January. The system’s number of patients has increased three-fold over the last month, he said.

[…]

The COVID-19 positive test rate statewide is now at 20.53 percent. Methodist’s is nearly 32 percent.

Porsa said said Harris Health is about to enter Phase 3 of its surge plans, which involves closing some of its clinics in order to deploy its nurses and other staff at Ben Taub and Lyndon B. Johnson hospitals, both of which are near capacity. He said the leadership is currently determining which clinics to start with.

Hospital officials said they are encouraged that ICUs aren’t being overloaded with COVID-19. They said their staffs have gotten much better, thanks to better treatment options and nine months of experience with the disease, at getting patients discharged faster now compared to early summer.

But with the Houston area now averaging more than 3,300 new COVID-19 cases a day — compared to roughly 2,330 such cases at the pandemic’s height in July — it appears the peak won’t come before late January or February, hospital officials said. They also worry a more contagious strain — not yet identified in Houston but maybe already here — poses an even greater threat ahead.

“January and February are shaping up to be our darkest days, given these record numbers,” said William McKeon, CEO of the TMC. “Hospitals lag behind in feeling the effects of increases in cases so expect the numbers to keep going in the wrong direction before things get better.”

We’re already passing the levels we had seen at the worst of it in July, and we’re probably a few weeks out from hitting the peak this time around. Remember all this next year, when it’s time to vote for our state government.

A new high in hospitalizations

This is fine.

The Texas Department of State Health Services reported Monday a pandemic high 11,351 hospitalizations from COVID-19.

This surpasses the previous all-time high of 10,893, which occurred on July 22.

The record comes in the midst of a holiday season public health experts worry could exacerbate the already rapidly spreading virus and following an increase in cases weeks after Thanksgiving.

This hospital data does not account for people who are hospitalized but have not gotten a positive test, and DSHS says some hospitals may be missing from the daily counts. As of Monday, the state is also reporting 49 deaths from COVID-19, a lagging indicator of the extent of transmission rates, and more than 12,800 new confirmed COVID-19 cases. Reported cases may have appeared lower the last few days because some local health departments did not report data to the state over the holiday week.

Earlier this month, Texas’ ICU capacity was already the lowest since the start of the pandemic, leaving health care experts worried hospitals could be pushed to the brink as coronavirus cases continue to climb. Across the state, COVID-19 patients occupy 17.8% of the state’s hospital beds, and only 745 staffed ICU beds are still available.

At a press conference Monday, Mark Escott, Austin’s interim medical director and health authority, said that this week alone, “ICU utilization” is up 62% in Travis County and that hospital beds could become scarce in a matter of weeks.

“Our projections forward into the new year continue to look worse and worse day after day,” Escott said. “I think right now it appears we’re going to enter 2021 in a state of emergency.”

This is fine:

This is fine:

Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, said he anticipated a major fall surge amid a wave of new infections in West Texas and the Panhandle.

Those areas are among the hardest hit in the country, he said.

“Up in Midland and places like that, it’s still a really tough area,” he said, adding, “In terms of surges, I’m maybe a little less worried about the Texas Medical Center. But in other parts of the state, it’s going to be a real concern.”

There are 745 ICU beds available across the state, according to data from the Department of State Health Services, the lowest number available since the pandemic’s surge during the summer. Among 63,679 staffed hospital beds, 13,416 are available statewide.

Further, 15 of the state’s Trauma Service Areas are reporting that more than 15 percent of their total hospital capacity is taken up by COVID-19 patients, crossing the threshold for what the state considers “high hospitalizations.”

At the Texas Medical Center, the weekly average of new COVID patients has more than doubled since early November, from 104 to 248. Medical center data from Sunday shows 1,594 total COVID patients and another 404 in the ICU. There are 1,298 total occupied ICU beds with hundreds more available, the data shows.

“The medical center has gotten a lot of heft, in terms of being able to accommodate COVID patients,” Hotez said.

[…]

The sporadic use of masks has contributed to the surge, said Hotez, adding that he doesn’t anticipate the number of statewide hospitalizations decreasing anytime soon. He noted that the number of beds is less of a concern than the number of trained staff available.

Hotez said he did not know how much Christmas gatherings would impact the number of infections. But he warned people that New Year’s celebrations would be the “best party the COVID virus can hope to have.”

“I would just say any kind of New Year’s celebration is fraught with risk ,” he said. “Because when you have this high level of transmission going on in the state, anytime you bring four or five people together, there’s a good likelihood they’re going to have COVID.”

I’m really scared for what the next few weeks may bring. Wear your mask, practice social distancing, avoid indoor gatherings, and try to survive until you can get vaccinated.

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.

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

In the state as a whole.

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

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

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

[…]

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

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

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

And here in the Houston area.

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

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

The latest numbers from Wednesday’s report:

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

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

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

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

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

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

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

How it’s going at the hospitals

In a word, it’s bad.

At Lyndon B. Johnson Hospital on Sunday, the medical staff ran out of both space for new coronavirus patients and a key drug needed to treat them. With no open beds at the public hospital, a dozen COVID-19 patients who were in need of intensive care were stuck in the emergency room, awaiting transfers to other Houston area hospitals, according to a note sent to the staff and shared with reporters.

A day later, the top physician executive at the Houston Methodist hospital system wrote to staff members warning that its coronavirus caseload was surging: “It has become necessary to consider delaying more surgical services to create further capacity for COVID-19 patients,” Dr. Robert Phillips said in the note, an abrupt turn from three days earlier, when the hospital system sent a note to thousands of patients, inviting them to keep their surgical appointments.

And at The University of Texas MD Anderson Cancer Center, staff members were alerted recently that the hospital would soon begin taking in cancer patients with COVID-19 from the city’s overburdened public hospital system, a highly unusual move for the specialty hospital.

These internal messages highlight the growing strain that the coronavirus crisis is putting on hospital systems in the Houston region, where the number of patients hospitalized with COVID-19 has nearly quadrupled since Memorial Day. As of Tuesday, more than 3,000 people were hospitalized for the coronavirus in the region, including nearly 800 in intensive care.

“To tell you the truth, what worries me is not this week, where we’re still kind of handling it,” said Roberta Schwartz, Houston Methodist’s chief innovation officer, who’s been helping lead the system’s efforts to expand beds for COVID-19 patents. “I’m really worried about next week.”

What’s happening in Houston draws eerie parallels to New York City in late March, when every day brought steep increases in the number of patients seeking care at overburdened hospitals — though, so far, with far fewer deaths. But as coronavirus cases surge in Texas, state officials here have not reimplemented the same lockdown measures that experts say helped bring New York’s outbreak under control, raising concern among public health officials that Houston won’t be able to flatten the curve.

“The time to act and time to be alarmed is not when you’ve hit capacity, but it’s much earlier when you start to see hospitalizations increase at a very fast rate,” said Lauren Ancel Meyers, a professor of integrative biology who leads the University of Texas at Austin COVID-19 Modeling Consortium. “It is definitely time to take some kind of action. It is time to be alarmed.”

[…]

Although hospital executives in Houston stress that they have the ability to add additional intensive care beds in the region to meet the growing demand — for a few more weeks, at least — the strain on hospitals is already being felt in other ways.

Houston Fire Chief Samuel Peña said his paramedics sometimes have to wait for more than an hour while emergency room workers scramble to find beds and staffers to care for patients brought in by ambulance — a bottleneck that’s tying up emergency medical service resources and slowing emergency response times across the region.

Part of the problem, Peña said, is that when his crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it. That’s a problem that’s likely to deepen as a growing number of medical workers have been testing positive for the virus, according to internal hospital reports. Just as New York hospitals did four months ago, some Houston hospitals have posted on traveling nurse websites seeking nurses for “crisis response jobs.”

“If they don’t have the nursing staff, then you can’t place the patient,” Peña said. “Then our crews have to sit with the patient in the ER until something comes open. It has a huge domino effect.”

There’s more, so read the rest. If you’re thinking that the death rate is low and that that’s a small blessing, that is true, but it’s also a bit illusory. For one thing, the sheer number of deaths will increase as the infection rate rises, not all deaths for which COVID-19 is a factor are recorded as COVID-19 deaths, and it is already the case that people are avoiding going to the hospital now for other reasons because of COVID-19, and that some of them will also die as a result. The official death count numbers have always been underestimated, and there’s no good way to spin it. Even if we were to go into total lockdown right now, we won’t begin to see the positive effects of that for another two weeks. We really need masking and better social distancing to have an effect or it’s going to get much worse. Oh, and the Texas Medical Center is above 100% ICU capacity. So we’ve got that going for us.

And as you ponder all that, ponder also this.

Despite Texas’ surge of new COVID-19 cases and hospitalizations, Lt. Gov. Dan Patrick said Tuesday evening that he doesn’t need the advice of the nation’s top infectious disease doctor, Anthony Fauci.

“Fauci said today he’s concerned about states like Texas that ‘skipped over’ certain things. He doesn’t know what he’s talking about,” Patrick told Fox News host Laura Ingraham in an interview. “We haven’t skipped over anything. The only thing I’m skipping over is listening to him.”

Patrick also said Fauci has “been wrong every time on every issue,” but did not elaborate on specifics.

Dan Patrick does not care if you live or die. You and everyone you know mean nothing to him.

Have we gone from “concerned” to “alarmed” yet?

We’re getting there.

With cases of the coronavirus surging to record levels in Texas, Gov. Greg Abbott recommended Tuesday that Texans stay home as much as possible and for the first time moved to allow the tightening of two kinds of restrictions that had been eased under his reopening plan.

“We want to make sure that everyone reinforces the best safe practices of wearing a mask, hand sanitization, maintaining safe distance, but importantly, because the spread is so rampant right now, there’s never a reason for you to have to leave your home,” Abbott said during an early-afternoon interview with KBTX-TV in Bryan. “Unless you do need to go out, the safest place for you is at your home.”

Within hours, Abbott made two announcements to alter the reopening process. He scaled back a previous statewide order and gave local officials the ability to place restrictions on outdoor gatherings of over 100 people, a threshold he originally set at 500 people. And Abbott said the state would enact mandatory health standards for child care centers after prior rules became voluntary earlier this month.

The moves came a day after Abbott said at a news conference that the coronavirus was spreading at an “unacceptable rate” but did not offer any new policies to stem the virus’ spread. Instead, he reiterated long-established guidelines such as social distancing and pointed out that the state was increasingly cracking down on businesses that allow large crowds. At the news conference, Abbott also encouraged Texans to stay home, albeit in less explicit terms than he did in the KBTX interview.

The Monday news conference marked a newly urgent tone by Abbott, which he continued into Tuesday. During TV interviews in the noon hour, he made the somewhat unusual move of getting ahead of the state’s daily announcement of new coronavirus cases, bracing audiences for a new record high exceeding 5,000 — a big increase over the last peak of 4,430 on Saturday.

Before sharing the new record figure with KBTX, Abbott said he was trying to “make sure people around the state really comprehend the magnitude of the challenge we’re dealing with.”

By the end of the afternoon, the state Department of State Health Services had reported the precise number: 5,489 new cases.

At the same time, two metrics that Abbott has prioritized — hospitalization levels and positivity rate — continued to trend in the wrong direction. Hospitalizations reached 4,092, marking the 12th straight day of a new peak. The positivity rate — or the ratio of cases to tests, presented by the state as a seven-day average — reached 9.76%, back to the level it was at in mid-April.

It’s bad, y’all.

The Texas Medical Center’s intensive care capacity could be exceeded as soon as Thursday because of the surge in COVID-19 patients, the hospital system projects.

A TMC model also predicts ICU surge capacity — extra, temporary beds and equipment used in emergencies — could be exceeded as soon as July 6 if the steep rate of new COVID hospitalizations continues, the most aggressive modeling to date.

Eleven leaders of the system’s member hospitals and medical schools said in a joint statement that COVID-related admissions were increasing at an “alarming rate,” stretching the capacity of ICU units. Texas Children’s Hospital this week began admitting adult patients to handle the surge.

“If this trend continues, our hospital system capacity will become overwhelmed, leading us to make difficult choices of delaying much-needed non-COVID care to accommodate a greater number of COVID patients,” the group wrote.

The leaders urged residents to stay home when possible, practice social distancing and wear masks.

Stay home.

Houston employers ought to send workers back home from the office if possible due to spiking coronavirus cases in the region, the region’s leading business group said Wednesday.

Bob Harvey, the president and CEO of the Greater Houston Partnership, said in a statement that Houston COVID-19 cases are reaching a “critical point” and that employers need to do their part in helping to curb what he called an “alarming trajectory.”

“We encourage employers to strongly consider returning to a work-from-home model,” Harvey said. “To keep our Houston economy moving forward, we must all do our part.”

On Tuesday, Gov. Greg Abbott asked Texans to voluntarily stay home if possible.

We’re basically back where we were in March and April, with county governments still trying to figure out what to do without clear direction from the state and a complete abdication of responsibility from the White House. The Texas Restaurant Association is calling for a statewide face mask mandate, a thing that is very much necessary now but could have done so much more good a month ago when we were in this mad stupid rush to reopen everything. Imagine if we could have been able to reopen without thousands of people getting sick every day? Too bad, that’s not how it went. What we’re doing now – and what we’re still not doing because Greg Abbott still isn’t doing it – is definitely too late. If we’re very lucky, maybe it won’t be too little. The Chron has more.

UPDATE: Oh, the irony.

Visitors from Texas will soon have to quarantine for 14 days if they travel to New York, New Jersey, or Connecticut, according to the three states’ governors, who also took aim at Texas’ handling of the coronavirus outbreak on Wednesday.

The move comes as coronavirus cases and hospitalizations hit record highs in Texas, surpassing 5,000 new cases in a single day on Tuesday and making the state one of the country’s coronavirus hotspots.

Gov. Andrew Cuomo of New York, Gov. Phil Murphy of New Jersey, and Gov. Ned Lamont of Connecticut, all Democrats, held a joint press conference Wednesday to announce the policy, which will affect nine states whose infection rates have met thresholds indicating “significant community spread,” including Texas, Arizona, and Florida, according to reports.

“We need to do things right inside the four walls in our respective states,” Murphy told reporters.

The restriction on Texas travelers marks a notable shift in which states are being flagged nationwide for the most alarming increases of coronavirus cases. Earlier in the pandemic, Texas touted comparatively low hospitalization rates and was pointing the finger at other states where the virus was raging.

In late March, Texas imposed a 14-day quarantine on travelers from New York, New Jersey, Connecticut, Washington, and California – some of the early coronavirus hotspots. The state also mandated quarantines for those driving or flying to Texas from neighboring Louisiana as well as flying from Miami, Atlanta, Detroit, and Chicago. Those orders have since been lifted.

Abbott did not respond to a request for a comment for this story, but that’s all right. We know what he’d have said: He’s “concerned, but not alarmed”. You’re welcome.

Whistling past the ICU

Clap louder!

Gov. Greg Abbott and top Texas health officials on Tuesday responded to growing alarm over hospitals now swelling with coronavirus patients, assuring there is still plenty of space available even as some facilities have neared or surpassed capacity.

Speaking on yet another day of record high hospitalizations from the pandemic, Abbott said he is confident the state can continue reopening while controlling the spread of new infections.

“As we begin to open up Texas and Texans return to their jobs, we remain laser-focused on maintaining abundant hospital capacity,” said Abbott, a Republican. “The best way to contain the spread of this virus is by all Texans working together and following simple safety precautions.”

On Tuesday, the Department of State Health Services reported just over 2,500 COVID-19 patients in Texas hospitals, the highest single-day total since the pandemic began and nearly 67 percent more than on Memorial Day in late May. State and local leaders have pointed to the holiday weekend as one likely cause for the increase.

Statewide, there are still thousands of hospital beds and ventilators available. But in some of the largest cities, including San Antonio and Houston, the surge is pushing new limits. In Harris County, some hospitals said late last week that their intensive care units were near or above capacity.

Bill McKeon, CEO of the Texas Medical Center, said their number of COVID-19 patients has nearly doubled from its previous peak in late April. Many of the patients admitted now are younger and generally healthier, but are still susceptible to serious illness or death from the disease.

“If it continues to grow at this rate, we’re going to be in real trouble,” McKeon said of the admissions. He added that while it may not be feasible to reimpose lockdowns or other restrictions, state leaders should consider slowing the reopening if the uptick continues.

The official death count is past 2,000 now, though everyone knows that’s an undercount. On a per capita basis that’s still pretty low, but we’re doing our best to catch up. The idea that we’re “controlling the spread” in any fashion is laughable, except there’s nothing funny about what’s happening. And then we get this:

Abbott remained unwilling Tuesday to allow local officials to enforce their own mask ordinances, even as he acknowledged that many Texans are not wearing them. He instead accused Democratic county judges of not having done enough to punish businesses that fail to comply with other protocols, such as limits on public gatherings.

While they have the authority, Abbott said, many “haven’t lifted a finger.”

Hey, remember when Greg Abbott cravenly flip-flopped on consequences for not following his own executive orders? Good times, good times. What would you like the county judges to use, harsh language? Let’s not forget who’s in charge here.

But local officials are still trying, at least:

The mayors of nine of Texas’ biggest cities urged Gov. Greg Abbott in a letter Tuesday to grant them the “authority to set rules and regulations” mandating face masks during the coronavirus pandemic.

As COVID-19 cases and hospitalizations continue to climb in Texas, an executive order from Abbott bans local governments from imposing fines or criminal penalties on people who don’t wear masks in public. The mayors wrote that many people in their cities continue to refuse to wear face masks and that “a one-size-fits-all approach is not the best option” when it comes to regulating the issue.

The letter is signed by Houston Mayor Sylvester Turner, San Antonio Mayor Ron Nirenberg, Austin Mayor Steve Adler, Dallas Mayor Eric Johnson, Fort Worth Mayor Betsy Price, El Paso Mayor Dee Margo, Arlington Mayor Jeff Williams, Plano Mayor Harry LaRosiliere and Grand Prairie Mayor Ron Jensen.

The letter asks Abbott to consider allowing each city’s local officials to decide whether to require the use of a face covering in order to prevent the spread of the virus.

Mayor Turner’s press release is here, and a copy of the letter sent to Abbott is here. There was no response as of Tuesday afternoon.

Finally, let’s not forget that even as businesses may want to reopen, coronavirus may not let them. It’s almost as if an unchecked pandemic is a hindrance to having your economy run at full capacity. But don’t worry, Greg Abbott has everything under control. Now keep clapping!

Are we near the peak yet?

We sure hope so, but it’s still a little soon to tell.

After weeks of grim, ever-worsening statistics, Houston medical and public health leaders say the area has begun to flatten the COVID-19 curve, the rate at which the disease is spreading through the community.

The start of such flattening, seen in testing and hospitalization data, represents the turning of a significant corner for an area that has been shut down for more than a month to curb the spread of the novel coronavirus, which causes COVID-19. The virus has infected more than 2 million people globally and killed more than 33,000 in the U.S.

“We haven’t peaked yet, but we’re seeing very encouraging signs that the curve is flattening,” said Dr. Marc Boom, president of Houston Methodist. “The number of people testing positive has slowed and hospitalizations have also leveled off.”

Dr. Paul Klotman, president of Baylor College of Medicine, added that the trend is “definitely positive — we’re getting closer to the peak.” But he noted that “the peak is not a good place to be. The only safe place is when we’re going toward the valley.”

Texas Medical Center leaders told Mayor Sylvester Turner this week that the rate of the virus’s spread, exponential early, has definitely slowed. But they were quick to warn again complacency and stressed that now, more than ever, people need to keep aggressively practicing social distancing.

[…]

Despite the measures, the Houston area’s COVID-19 numbers continued to spike — expected, experts said, because of the virus’s incubation time of two to 14 days, the sometimes slow disease progression, the lack of access to testing and the often lengthy delays in lab results.

But in recent days, public health officials said, the signs such measures are working have become evident.

According to new research by two Harvard scientists and a Baylor doctor, for instance, the rate at which the virus is spreading dropped from nearly 30 percent a week and a half ago to almost 5 percent as of Wednesday. That means the time it takes to double the size of the outbreak has gone from every three days to 20 days now.

“It’s too early to really tell — the next week or two will be crucial — but Houston’s social distancing appears to be doing enormous good,” said Dr. Mark Siedner, a Harvard professor of medicine and infectious disease specialist at Massachusetts General Hospital. “The trend over the last week is really positive.”

The next two weeks are when a number of models project Houston’s cases will peak.

“The peak is not a good place to be”, and “The next two weeks are when a number of models project Houston’s cases will peak” are the quotes you should keep in mind when you hear people talk about “reopening the economy” and things like that. Two weeks from now is when the current stay-at-home order for Harris County expires. That order will certainly be extended, and if we’re lucky then by then we will be seeing the numbers decline. But we’re not there quite yet. Keep doing what you’re doing, we will get there.