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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’s hospitals are still busy

Interesting.

While local hospital leaders aren’t sounding the alarm about capacity concerns, we heard a similar story from leaders at St. Luke’s and Houston Methodist: hospital beds and emergency rooms are regularly filling up as both health systems continue to manage coronavirus patients on top of all the folks finally heading to the hospital for care they may have delayed due to the pandemic, all while the number of patients coming into local emergency rooms is already hitting pre-COVID levels.

Roberta Schwartz, Executive VP of Houston Methodist Hospital in the Texas Medical Center, told the Press that it wasn’t surprising to hear that the Houston Methodist ER in Sugar Land was recently so busy it had to turn away ambulances temporarily.

“The emergency rooms and the hospitals are very full,” Schwartz said.

When we asked Dr. Brad Lembcke — Chief Medical Officer at St. Luke’s — about the current status of his hospital system’s bed count and ER capacity, he said “We’re full, I guess is probably the two-second version.”

[…]

Lots of Schwartz’s colleagues around the country have told her their hospitals are seeing lower numbers of emergency room visits than they did before COVID. “That is not the case at Houston Methodist,” Schwartz said, “and seems not to be the case in Houston.”

St. Luke’s is also seeing a similar trend of ERs packed with more patients than in other parts of the United States, Lembcke said. While “a lot of places report only recovering to about 80 percent of what their prior volumes were,” he said, St. Luke’s main downtown hospital is now seeing ER numbers that have “just about reached the pre-COVID states.”

Even though coronavirus hospitalizations have fallen after the winter surge, local hospitals continue to deal with steady numbers of COVID-19 patients. At Houston Methodist, the number of coronavirus hospitalizations has plateaued in recent weeks, and at a level higher than where that patient count leveled-off at after the first two surges in the spring and summer of 2020.

Schwartz said that after the first surge last spring, coronavirus hospitalizations at Houston Methodist fell to around 50. Following the summer surge, they averaged “about 100 COVID patients on a daily basis.”

“When we came down from this latest surge in December and January, we’re settling in at about 180 to 200,” Schwartz said.

“If you had a normal load of patients, and you add on 200, that would put some stressors to the system, and I think that you’re seeing that across Houston. And this comment on saturation is not just us, it’s lots of hospitals,” she said.

Lembcke said that St. Luke’s average number of coronavirus hospitalizations these days is “maybe a little higher” than what they saw right after the summer surge. “But it’s more consistent. It’s been pretty stable over the last month or so.”

When asked about why Houston’s hospitals are still so full, Schwartz said she and her colleagues have a few educated guesses.

“We do know for sure — 100 percent, this is documented in many papers — that people have delayed their care in many cases, and are coming in with later stage illnesses,” many of whom whose conditions got bad enough that they needed emergency care, Schwartz said. Some of those patients “were people who said ‘I don’t want to get COVID from going to the hospital or to the doctor.’ We know that.”

They note also that a lot of nurses have retired or left the industry due to burnout from the previous high volume of COVID cases, and that they are seeing a lot more younger patients with serious COVID issues, as is “needing a lung transplant”-level of seriousness. I certainly hope we’ll get back on a downward trajectory as more people get vaccinated, but this is a reminder both that we really need to get as many people vaxxed as we can, and that even as the overall numbers have dropped we’re still not out of the red yet.

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.

We’ve got all kinds

Not the kind of distinction you want.

Houston is the nation’s first city to record every major variant of the novel coronavirus — many of which are more contagious than the original strain.

“The numbers of the major variants we have identified in our large sequencing study are disquieting,” said Dr. James Musser, who leads the team of experts at Houston Methodist Hospital behind the new finding. “The genome data indicate that these important variants are now geographically widely distributed in the Houston metropolitan region.”

It comes barely a week after the ever-evolving virus’ death toll in the United States passed the half-million mark, a grim figure that Musser and other experts believe will continue to increase unless Americans double-down on social distancing, masks and vaccination efforts.

Since the virus was first detected in the Houston region nearly a year ago, Musser’s team has sequenced more than 20,000 genomes of COVID-19. The most recent batch of roughly 3,000 genomes sequenced from patients who had tested positive for COVID-19 included variants from the United Kingdom, South Africa and Brazil.

Experts are still researching the new strains and the effectiveness of the Moderna and Pfizer vaccines. But there’s no reason to panic, said Dr. Wesley Long, a Methodist infectious disease expert who assisted with the study.

There is evidence that the Brazilian strain is more contagious and can infect those who have received the Pfizer or Moderna vaccines, Musser said.

But Long said the variations in vaccine effectiveness are minor and don’t detract from the overall goal of vaccines: to prevent severe illness, hospitalization or death.

“It doesn’t mean that (current vaccines) are useless,” he said. “That doesn’t mean that (the new strains) go through walls or defeat masks or that they change the way they are transmitted. All of the rules that we’ve used against COVID still apply.”

His advice: Continue to social distance and wear masks and get vaccinated as soon as possible — regardless of which brand is available.

Go tell that to Greg Abbott. He won’t listen, but at least you can say you tried.

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.

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.

“On the cusp” of another COVID surge

The numbers are already trending up. You know what that means.

Cases of COVID-19 in parts of Texas surged to near catastrophic levels this summer as some hospitals were forced to put beds in hallways, intensive care units exceeded capacity and health officials struggled to stem the tide of the virus.

After peaking in late July and August, cases fell and leveled off in September, and the state’s seven-day positivity rate — or the proportion of positive tests — reached its lowest point since early June.

But health officials are now eyeing a worrying trend: New infections are rising again, and the number of patients hospitalized with COVID-19 is also ticking upward. The state reported 2,273 new cases Monday, and the seven-day average was up by 862 from the previous week. On Monday, at least 4,319 patients were hospitalized with COVID-19, far below the more than 10,000 in July, but that number has steadily risen during the last month.

“I’m no longer pondering if we’re going to see a surge,” said Dr. James McDeavitt, dean of clinical affairs at the Baylor College of Medicine. “We’re already seeing it.”

Eight months since Texas recorded its first case, experts say the state is more prepared to handle another wave, but they fear that if the state fails to control the outbreak, it could quickly spiral out of control.

“The question is whether it’ll be a modest surge, or something like we saw in July, or worse,” McDeavitt said.

[…]

At Houston Methodist, one of the region’s largest health care systems, medical staff were stretched thin this summer, said President Marc Boom. At its peak in July, the system’s staff treated nearly 850 patients with COVID-19 each day. Since then, Boom said, the medical community’s understanding of the virus has evolved, along with how to treat the disease.

Remdesivir, an antiviral medication, has shown promising results in minimizing the severity of illness, especially when administered shortly after symptoms develop. Houston Medical was the first hospital to use convalescent plasma, a therapy in which antibody-rich blood from people who have recovered from COVID-19 is administered to ill patients, Boom said.

“We’ve had tons of experience gained, better outcomes, shorter lengths of stay,” Boom said. “But this is still a serious illness.”

While health authorities are better equipped to deal with new spikes, including an adequate supply of protective gear and sizable quantities of drugs like Remdesivir, a fall surge could still be equally as taxing on hospitals, said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association. As colder weather forces people inside and families gather for the holiday season, the chances for transmission increase, she said.

“We certainly have been tested, and we know the beast that it is, and have shown that we were able to make it through those first two spikes,” Kroll said. “But we don’t want to test the limit by putting patients into hospitals.”

See here for the previous update. It’s getting bad all around the country, too. Just a reminder, the July surge was bad, and it took Greg Abbott way too long to react to it. In the meantime, various assholes have decided that it’s a good use of their time to sue everyone in sight to limit the government’s ability to respond to COVID-19. I have one small bit of local optimism in that Harris County has not backed down from being at the top threat level even as the numbers were improving. Our numbers are also trending up, but they’re not as bad as other places. Yet, anyway.

“The trends are going in the wrong direction,” said William McKeon, president of the Texas Medical Center. “You hate to see the sacrifices we made and the successes we achieved lost because people let their guard down.”

Dr. Marc Boom, president of Houston Methodist, said, “We’ve definitely turned the wrong corner. The numbers aren’t growing in an out-of-control fashion, but there’s no doubt we’re in a significant growth trend that we need to stop before the holiday season.”

[…]

The Houston numbers are well below those in other parts of the country, particularly the Midwest and the West. As of Monday, 16 states had added more COVID-19 cases the past week than in any other seven-day period.

The surge is even greater in Europe. There the total of new cases in the five most-affected countries — France, the United Kingdom, Russia, Spain and the Netherlands — was nearly 42 percent greater than the U.S. increase a week ago.

Nor does Houston’s increase compare to the Panhandle and El Paso. El Paso health officials Monday reported their highest number of COVID-19 hospitalizations since the pandemic began — 449 in one day — and said just seven of the city’s ICU beds were unoccupied.

Still, increases in Houston area’s key metrics since early October are cause for concern, said local health officials. Those provided by the Texas Medical Center include:

• The rolling average of 497 COVID-19 cases reported the week ending Sunday represents a 33 percent increase from late September, when the number was 373. It increased gradually the weeks in between.

• The number of COVID-19 patients admitted to TMC hospitals exceeded 100 last week, up from the 80s the previous week and 70s the week before that.

• The TMC COVID-19 test positivity rate, 3.4 percent early in October, has been at 3.9 percent the past week, an 8 percent increase.

• The so-called R(t), or reproduction rate, the rate at which the virus is spreading, did drop to 0.99 Tuesday, but that remains a 55 percent increase over the Sept. 29 rate of 0.64, when the spread was decreasing. The rate last week hit 1.14, which means the virus’ spread was increasing.

“We’re in a yellow zone, not a red zone”, is how one doctor put it. “COVID fatigue”, they say this is. I get that, but you can see what happens when we start to take this less seriously. Until there’s a widely available vaccine, wear your damn mask, stay out of crowded indoor spaces, maintain social distancing, and hope for the best. At least our mild winter weather means we can largely stay outside. It could be worse.

No smokers need apply

Boy, is this a big can of worms.

Methodist Hospital System in Houston this month announcedit will implement a tobacco-free hiring policy on Jan. 1, joining the Texas Medical Center and Memorial Hermann Healthcare System, which have had similar policies since last year and 2010, respectively.

The policies are straightforward. Applicants who smoke or chew tobacco will not be hired. Existing employees are exempt.

A growing number of hospitals and health care institutions have adopted the policies to promote wellness, improve productivity and rein in rising health care costs, but critics say they discriminate and could lead to punitive actions against other personal habits and vices.

“We think this is an invasion of privacy and really overreaching,” said DottyGriffith, public education director for the American Civil Liberties Union in Texas. “At what point do you give up your rights and autonomy? Will they not employ those who ride motorcycles and drink alcohol?”

Dr. Marc Boom, president and CEO of Methodist Hospital System, said the policy is about company employees modeling healthy behaviors. More than 13,000 people work at the system’s five hospitals.

“This is part of a journey of wellness and making this a great place to work,” Boom said. “Employees work here to take of care patients. We can only do that if we’re leading by example.”

Methodist’s online application will warn job seekers that it is a tobacco-free employer and that urine tests will be used to detect nicotine. A job offer will be rescinded if an applicant’s results are positive. Free smoking cessation classes will be offered, giving applicants an opportunity to reapply if they have been smoke-free for 90 days.

On the one hand, it makes perfect sense for a hospital system to practice what it preaches. There’s a lot to be said for leading by example. And, though it isn’t specifically mentioned in the story, having an entirely non-smoking workforce would be great for Methodist’s bottom line, since it would reduce their own health care costs. Therein lies the rub, of course, because if having a non-smoking workforce is good for the company, then so is having a non-overweight workforce, and who knows what else. Employers have enough power over their employees already, thanks very much. Be that as it may, I have a strong feeling this will ultimately be settled in a courtroom, after someone files suit for discrimination. What do you think?