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vaccinations

Caught between a mandate and a madman

I have sympathy for the schools.

Many Texas universities — which collectively hold billions of dollars in federal contracts — are wrestling with how to navigate the Biden administration’s mandate that all federal contractors be vaccinated by Dec. 8 in a state that bans vaccine mandates.

While more public universities across the country are announcing that all employees must be vaccinated to comply with the federal requirement, several Texas public universities — all managed by Gov. Greg Abbott appointees — told The Texas Tribune they are still evaluating the executive order, which applies to new federal contracts of $250,000 or greater and awarded as of Nov. 14 or existing contracts that have been renewed as of Oct. 15.

“This is unprecedented,” said Michael LeRoy, a labor law expert at the University of Illinois College of Law. “There have been conflicts between the state and federal government, but not at this magnitude with this kind of money on the line.”

LeRoy believes the issue will be resolved in the courts because of the two conflicting issues at the center. State universities receive funding from the state and federal level but they are run by a board of regents appointed by the Texas governor.

While LeRoy said it’s unlikely the federal government will immediately terminate a grant if universities don’t comply, he said a university’s actions could impact future bids for federal grants. The federal government could begin to give notice to rescind a grant, he speculated, but that is a lengthy process. For now, universities are awaiting guidance from their own lawyers.

“… [T]he White House has been clear that noncompliance will not be excused, even in situations where state law contradicts the federal directive,” University of Houston spokesperson Shawn Lindsey told the Tribune in a statement. “It’s an extremely complicated situation that requires further analysis.”

Texas Tech University is working with its lawyers to determine if there are contracts that would trigger the vaccination requirement, school officials said in a statement. Texas Tech is also requesting guidance from the Texas attorney general’s office.

A Texas A&M University System spokesperson said they are also still evaluating the order. The A&M system has about 500 contracts with the federal government worth $2 billion, most of which are tied to the flagship university in College Station.

A statement from the University of Texas System revealed how universities are trying to appease both federal and state leaders.

“We will endeavor to comply with federal vaccine requirements for specific, covered individuals to protect these investments in our state,” spokesperson Karen Adler said in a statement. She then went on to say the system would provide exemptions for those with religious beliefs and “we will make every effort to accommodate employees’ personal situations.”

I think we can all guess what the AG’s office will say to Texas Tech, but the ritual must be observed. We’re all awaiting final guidance from OSHA, which is writing the rule that will implement that executive order. After that is when the lawsuits will fly. Not much else to say at this point, other than I do not envy any of these university officials the task they have before them.

The Lege may fail to enshrine Abbott’s max anti-vaxx order into law

One bit of good news.

Legislation intended to block any Texas entity, including hospitals and private businesses, from mandating COVID-19 vaccines for employees has stalled out in the Senate with less than two days left in the third special legislative session this year.

State Sen. Kel Seliger, R-Amarillo, said he opposes the bill, which makes entities requiring the vaccines vulnerable to discrimination lawsuits. Seliger said the legislation — added to the session agenda as a late priority by Gov. Greg Abbott — does not have the votes to pass in the upper chamber.

“At the moment it’s not too well developed,” Seliger said of Senate Bill 51, authored by state Sen. Bryan Hughes, R-Tyler, calling it “anti-business.”

“I’ve got some real reservations because I think it’s another example of big government,” Seliger said. “And we don’t do that.”

SB 51 has been on the Senate’s calendar since Thursday, but the chamber has not taken action, even as it passed other priority legislation.

The special session is scheduled to end Tuesday, and the vaccine legislation is one of only a few outstanding Abbott priorities that appears unlikely to get through the finish line.

“It’s dead,” state Sen. Juan “Chuy” Hinojosa, D-McAllen, said of SB 51.

[…]

More than two dozen medical and business advocacy groups quickly criticized SB 51, pushing back against the legislation in the days after it was introduced last week. Hughes filed the bill after Abbott asked lawmakers last week to take up this issue to ensure Texans aren’t required to get vaccinated, saying that vaccines are “safe, effective, and our best defense against the virus, but should remain voluntary and never forced.”

Abbott called for the legislation as he took executive action to ban private companies from requiring employees or customers to be vaccinated against COVID-19, which will be in effect statewide even if lawmakers don’t act. His order came four weeks after Democratic President Joe Biden announced that federal contractors must have all employees vaccinated against COVID-19 and that businesses with more than 100 employees must mandate vaccination against the virus or require regular testing.

The organizations opposing the bill, including several chambers of commerce, the Texas Association of Business, the Texas Hospital Association, the Texas Association of Manufacturers, the Texas Hotel & Lodging Association and the Texas Trucking Association, have warned lawmakers of the legislation’s risks to small businesses, workplaces that rely on federal funding and immunocompromised Texans.

The warnings were notable in a state where business interests work closely with pro-business Republicans to influence legislation.

“We’re getting tremendous amount of communications from the business community saying this is their job,” Seliger said. “They set the rules and working conditions in their places of business.”

See here and here for some background. From the jump there were stories of strong opposition from business groups, who are normally very friendly to Republicans, to this bill. Given that the session ends today, I’d say the odds that this bill dies with it are pretty good. But I don’t want to get too overconfident, because it is entirely possible that enough objectionable pieces of that bill could get filed off, and it would be at the top of the agenda for a fourth session, whether or not one is needed. So count this as a provisional win, and hope for the best from here.

SCOTx puts San Antonio ISD’s vaccine mandate on pause

Ken Paxton finally gets what he wants.

The Texas Supreme Court temporarily halted San Antonio Independent School District’s staff vaccine mandate on Thursday, a day before the deadline for all employees to get vaccinated against COVID-19.

The ruling comes two weeks after a Bexar County judge denied the state’s request for a temporary injunction to stop the staff vaccine mandate. Texas Attorney General Ken Paxton’s office appealed that decision to the 4th Court of Appeals and also requested the court temporarily block the mandate while it considers Paxton’s appeal.

The 4th Court of Appeals denied the attorney general’s request to temporarily block the vaccine mandate. Paxton then requested the Texas Supreme Court step in and halt the mandate, which it did Thursday while stating the court’s decision is not a reflection “on the merits of the state’s claims.” The appeals court still has to rule on the state’s appeal of the temporary injunction that was denied by the Bexar County judge on Oct. 1.

[…]

While the Supreme Court’s ruling means SAISD must pause its vaccine mandate, the district said in a statement that it will continue to work with health care providers to offer vaccines to any employees, students, and families who want them.

“This is especially important as we anticipate the availability of the Pfizer vaccine for 5-11-year-old children in the next month. We remain committed to believing it’s the right thing to do,” the district said in the statement. “We are extremely proud of our efforts in providing abundant access to this life-saving protocol to all of our employees and the broader SAISD community. Based on the science, we continue to feel strongly that these vaccines help us keep our staff and students as healthy as possible and in the classroom, where learning happens best, and in giving our families stability.”

See here, here, and here for the background. Next up would be a hearing in district court on the merits of the state’s request for an injunction, followed by another round of appeals. The hope remains that in this time, whether the mandate is allowed to be enforced or not, some number of SAISD employees get vaccinated who wouldn’t have done so otherwise. If that happens, it was all worth it. The Trib has more.

More on the Abbott max anti-vaxx order

Businesses will face a choice that they would rather not have to face.

Companies doing business in Texas face new and complicated challenges after Gov. Greg Abbott this week banned COVID-19 vaccine mandates for all entities in the state — including private businesses — for employees or customers.

The ramifications for businesses could begin as soon as Friday, when companies that enter into contract work with the federal government will be required to have all employees vaccinated under orders from the White House.

This conflicts with Abbott’s ban on vaccine mandates, putting the many Texas businesses that receive federal contracts in a tough position: Comply with federal law and violate Abbott’s ban, or comply with Abbott and turn down business from the federal government.

[…]

“This harms Texans directly,” Karen Vladeck, an employment lawyer in Austin, said of the new order from Abbott. “I just think it wasn’t well thought out.”

Abbott’s office did not reply to a request for comment.

On top of prohibiting any entity in Texas from requiring vaccinations, Abbott’s order also lists several expanded exemptions. Vladeck and other employment lawyers said that this adds to the vaccine dilemma facing businesses in Texas. Under Abbott’s new rule, people may opt out of a vaccine requirement for medical reasons, including if they prove they have had COVID-19 in the past, despite scientists widely agreeing that this does not protect people against contracting the virus.

“The executive order’s medical reason language is a bit strange because usually you exempt people for medical reasons if they have a severe allergic reaction to a vaccine,” said Elizabeth Sepper, a law professor at the University of Texas at Austin. Abbott’s order is “meant to cover people who don’t want to get the vaccine because they believe, quite wrongly, that they’re completely protected by already having COVID.”

Abbott’s rule also allows people to opt out of a vaccine requirement if they prove they hold a deep personal belief against getting jabbed.

Any entity that fails to comply with Abbott’s rule could receive up to a $1,000 fine.

Abbott’s Monday order is a reversal from his position in August, when the Pfizer vaccine received final approval from the U.S. Food and Drug Administration. At the time, Abbott’s spokesperson said that businesses had the option of mandating vaccination for employees and “private businesses don’t need government running their business.”

“It’s all about company choice in Texas, except now it’s come to something that they don’t like what the companies are choosing,” Vladeck said. “It puts a big burden on employers.”

See here for the background. So far, businesses that are also federal contractors, including airlines and companies like IBM, will ignore Abbott’s order, while others are awaiting the OSHA rules before making a decision. Multiple business groups, the same organizations that often turn to the state for a legislative solution to local ordinances they don’t like, harshly criticized Abbott’s order for making their lives more difficult. Harris County Attorney Christian Menefee released a statement encouraging businesses that want to be able to get their employees vaccinated to file a lawsuit against Abbott over the order. And in the end, even wingnut talk radio hosts weren’t impressed by Abbott’s order. It’s almost as if he were a weak, gutless leader.

Abbott goes max anti-vaxx

He really wants us dead.

Texas Gov. Greg Abbott on Monday issued another executive order cracking down on COVID-19 vaccine mandates — this time banning any entity in Texas, including private businesses, from requiring vaccinations for employees or customers.

Abbott also called on the Legislature to pass a law with the same effect. The Legislature is in its third special legislative session, which ends Oct. 19.

“The COVID-19 vaccine is safe, effective, & our best defense against the virus, but should always remain voluntary & never forced,” he said in a tweet announcing his latest order.

The order marks a significant reversal after Abbott previously gave private businesses the choice to mandate vaccines for workers. An Abbott spokesperson said in late August that “private businesses don’t need government running their business.”

For weeks, Abbott has been under pressure from some on his right to go further in prohibiting vaccine requirements, and one of his primary challengers, Don Huffines, celebrated the latest order.

[…]

The latest move appears to be at least partly motivated by President Joe Biden’s actions in September that require all employers with more than 100 workers to mandate vaccines for workers or test weekly for the virus. Biden also required all federal government workers and contractors to get vaccinated, leading nearly all the major airlines — including American Airlines and Southwest Airlines headquartered in Texas — to announce they’d abide by the mandate.

See here for more on his previous order, which as noted explicitly avoided including private companies. There’s no question that this is one part a toddler’s response to the Biden executive order, but also a coward’s response to the toxic ravings of his primary opponents. Abbott’s weakness and ineffectuality are just embarrassing. Whether it’s enough to get a plurality of voters to turn against him, that’s the zillion dollar question.

As noted in the story, big employers like airlines are going to comply with the Biden order, which applies to companies with at least 100 employees. The Abbott order, to whatever extent it has an effect, will affect smaller companies.

Experts agree Abbott’s order — which says even private companies in Texas cannot “compel receipt of a COVID-19 vaccine by any individual” — would likely be trumped by President Joe Biden’s requirements that federal contractors and businesses with 100 or more employees require vaccines. Major corporations based in Texas, including Southwest Airlines and American Airlines, said Tuesday they would abide by Biden’s rules over Abbott’s.

The federal rules are still in the works, but even after they’re enacted they won’t affect the majority of the state’s workforce. The big businesses affected by Biden’s rule employ 44 percent of Texas workers.

How much protection the governor’s latest order provides to those 56 percent of workers employed by the smaller companies, however, is another question. Legal experts were split on whether those fired for refusing to get a shot could start collecting unemployment, for instance. Some attorneys believe Abbott has clearly opened the door for those workers to get benefits, while others argued the order stops well short of making such a guarantee.

And the order is likely to prompt conflicting rulings from judges at various levels of the court system, as has Abbott’s effort to stop schools and local governments from enacting mask mandates. Repeatedly, the state has admitted in court that it has no plans to enforce the ban on mask requirements, saying that is up to local district attorneys.

“You have these orders coming down at various levels. I think if you’re a consumer or even an employee, you’re kind of in a tough spot if you’re choosing to not be vaccinated,” said Alfonso Kennard, Jr., a Texas-based employment attorney. “The path of least resistance would be to be vaccinated.

“At a minimum, all it does is give some entity the ability to point to something and say, ‘The governor said this, so I should be OK,’” Kennard said. “But a week from now, a judge could say it isn’t lawful.”

The Texas Workforce Commission would not say whether the order impacts unemployment claims, saying only that each is handled on a case-by-case basis with the “totality of the job separation” taken into consideration.

Kalandra Wheeler, an employment attorney based in Houston, said Abbott’s order would appear to make it easier for unvaccinated workers to argue they deserve unemployment.

“What they have to establish for you not to get benefits is that you either resigned and there was no good cause connected to the work, or that you were terminated for misconduct,” Wheeler said. “I think there’s less of an argument you’ve done those things when the governor issues a ban that says you’re not required to get the vaccine.”

Randall Erben, a law professor at the University of Texas who previously worked as Abbott’s legislative director, said he believes the order was “very carefully drafted, very thoughtfully drafted, and drafted in a way that makes it harder to challenge and more easily enforceable.” Importantly, it doesn’t mention anything about unemployment eligibility.

“The executive order doesn’t really get into that,” he said. “What it says is a private employer can’t compel an employee to get a vaccine. What an employer does after that is not addressed in the order. It’s not even really contemplated.”

If there’s one thing that is clear, it’s that this will be a busy time for the lawyers. Actually, it’s also clear that Abbott has no qualms about contradicting himself:

OK, it’s also clear that we are already living in Don Huffines’ Texas. Abbott is just blowing in the wind. If you like this and want it to continue, you know what to do. Same for if you don’t. The Chron and the Trib, in a truly brutal analysis that includes observations such as how Abbott is “so overwhelmed by politics that he’s become a Random Policy Generator, throwing out edicts that make sense only if you forget everything he said before”, have more.

The kids are all right

This is the best thing you’ll read today.

Patrick Kisindja spends his days combating vaccine hesitancy. Sometimes he calls people, other times he drives to their homes to explain the science behind the shot.

Then, in the afternoon, Kisindja drives teens to the Harris County Public Health vaccination clinic at Dick Graves Park.

The 21-year-old southwest Houston resident serves as an ambassador at the faith-based nonprofit reVision.

Founded in 2011 at St. Luke’s United Methodist Church, the organization provides mentors, case managers and community support for the city’s most disconnected youth, including refugees, those experiencing homelessness and members of the juvenile detention system.

Because of their circumstances, members of the reVision program are especially vulnerable to COVID-19. So for the past few months, the nonprofit has focused on helping them get their shots. Ambassadors like Kisindja are integral to reVision’s program, which uses peers to lead the vaccination effort for teens.

The people Kisindja spends his days informing about the coronavirus vaccine? The parents of students in the program.

Often, he visits them three or four times before they acquiesce. Many are refugees, and he often reminds them — sometimes in Swahili — that they were vaccinated against other diseases before settling in the U.S.

“It protects you,” Kisindja said. “You’re better with that. You don’t want to end up in the hospital.”

Kisindja uses every tool in his arsenal to persuade parents to sign consent forms for their children to get the shot.

“We’re doing it for the kids,” Kisindja continued. “And that’s what reVision is all about — helping kids and keeping them safe.”

There’s more, so read the rest. Patrick Kisindja has done more good for the people of Texas in the past few months than Ted Cruz would do in a dozen lifetimes. He and his friends are doing it one person at a time, though as you’ll see there were some events that greatly helped their cause. If you need numbers to be convinced:

[reVision CEO Charles Rotramel] hired four former reVision students, now in college, to serve in the program. Methodist provided their training — going in depth with how the vaccine works and also the different categories of vaccine hesitancy.

“In June, we really just turned them loose,” Rotramel said. “I didn’t know if it would work, but we felt like, let’s just go all in and see what we could do.”

Besides, he had no idea how else they would ever reopen reVision without everyone being vaccinated.

And, ultimately, Rotramel had faith.

“I had a firm belief and trust in young people that they would make the right decision,” he said.

[…]

The youth who showed up to reVision’s first clinic in July were rewarded with a full day of fun at Main Event.

Then, those kids shared their photos on social media, and everything changed.

“That broke the dam,” Rotramel said. “Then, we had a flood of kids who wanted to get vaccinated.”

Before long, the ambassadors shuttled youth to their shots almost every day. By the time school started, about 70 percent of reVision students were fully vaccinated.

“And that was our goal,” Rotramel said. “We had been so concerned about them going back to in-person school in an unvaccinated space.”

On Aug. 12, Rotramel was able to finally open the doors to the reVision community center. The only people invited inside were fully vaccinated.

“That turned another corner because everyone wanted to be in the space,” he said. “That was moving to us.”

The hallways were again full of chatter and laughter, from all age groups and in a variety of languages.

“It’s that joyful noise we really hadn’t heard,” Rotramel said.

Now, nearly 90 percent of reVision students are vaccinated.

Just fantastic. We could use a whole lot more of this. Thanks, y’all.

More proof that vaccine mandates work

In the end, most people just get the damn shots. The rest is sound and fury.

Protests, lawsuits and national media coverage surrounded Houston Methodist Hospital in June when it became the country’s first major health system to require a COVID-19 vaccine as a condition of employment.

Now, as other Houston healthcare providers begin to enforce similar mandates, the drama has faded into the background. Hospitals are not facing the same pushback, officials say, and only a small portion of employees are holding out on the vaccine.

“There is a lot of noise around (mandates), and the anti-vaxx movement has been vociferous, but this is more of an outcry from the community rather than when it comes down to the brass tacks in facilities,” said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association.

Texas Children’s Hospital and Baylor College of Medicine were the first to reach their vaccine mandate deadlines following Methodist.

Baylor required its roughly 9,000 faculty and staff members to be fully vaccinated by Sept. 15. Those who did not attest to receiving their vaccine were subject to “progressive discipline,” which includes a series of warnings that ends in firing, according to a statement. The vast majority of employees complied, while about 3 percent were granted an exemption, according to numbers provided by the school.

One employee resigned. Another five will be fired after facing warnings.

[…]

Texas Children’s Hospital also passed its first-dose deadline on Sept. 21. Its doctors are employed by Baylor and already covered by the school’s mandate. In a statement, the hospital said “a very small number of employees did not receive the vaccine and therefore chose to leave the organization.”

Texas Children’s spokesperson Natasha Barrett said the hospital could not disclose a specific number of people who left or whether any exemptions were granted.

See here, here, and here for some background. A lawsuit by the (very small number of) fired Methodist employees was dismissed, though it is being appealed. There’s growing evidence from around the country that this is what happens pretty much everywhere that there’s a vaccine mandate – lots of loud whining and complaining and threats to quit, followed by near-universal compliance. This is why I’m happy for the San Antonio ISD vaccine mandate fight to move slowly through the courts, because regardless of outcome it’s going to cause people to get the damn vaccine. And don’t anyone tell Greg Abbott, but Southwest Airlines is doing a mandate now, too. The more, the very much better.

No vax needed to see a Rockets game

No, thanks.

The Rockets will not have any entry or seating restrictions beyond those required by NBA health and safety rules this season, according to Rockets president of business operations Gretchen Sheirr. The team does provide an option for fans to purchase seats in sections with social distancing provided in a variety of areas in Toyota Center.

The NBA requires that all those within 15 feet of the court be able to show proof that they are fully vaccinated or can provide a negative test for COVID.

The Dallas Mavericks last week announced that all fans be fully vaccinated or provide a negative test, joining Chicago Bulls and Oklahoma City Thunder, along with teams in New York (the Brooklyn Nets and New York Knicks) and in San Francisco (the Golden State Warriors) where local guidelines require it.

The Rockets’ policy for Toyota Center is in line with policies for Texans games at NRG Stadium and Astros games at Minute Maid Park.

But those are at least generally held outdoors, and even if the roof is closed on those stadia there’s still a lot more open space. The Rockets play in a much more enclosed space, and while they do have some limited “socially distanced” seating available, this sure seems like a recipe for transmission. It’s also quite different from last season, when face masks were required and attendance was capped at about 20% of capacity. I don’t begrudge them wanting to have fuller crowds – they gotta make money – but if the Mavericks can require proof of vaccination or a negative test in order to attend a game, I don’t see why the Rockets can’t. You can do better than that, y’all.

The Delta surge is killing younger people

So many avoidable deaths.

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

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

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

[…]

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

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

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

[…]

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

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

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

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

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

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

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

Don’t forget your flu shot

The flu is going to be back this year. Don’t fall for it.

After a historically light flu season in 2020, experts warn an influenza resurgence is looming this fall and winter.

“I would expect a more intense influenza season, simply because we did not have a flu season last year,” said Dr. Pedro Piedra, a virologist at Baylor College of Medicine.

Flu exposure breeds a level of natural immunity, creating a cellular memory of prior infections in those it infects. The absence of influenza last year, due to widespread masking and social distancing, has left many with a weakened immune defense — a development that could spell trouble as Texans venture out in droves this fall.

The return of the familiar body aching, fever-inducing wintertime scourge could not arrive at a worse time. Hospitals are still reeling from the fourth surge of COVID-19 spurred by the highly contagious delta variant and stagnating vaccination rates.

Experts predict flu season could hit Houston by early November.

“Now is the time to start making flu vaccine appointments,” Piedra said.

This past year was a historic anomaly due to COVID restrictions and precautions, and the lack of those plus a year out from anyone getting the flu we’re likely to see a resurgence. The flu shot may not be quite as effective this year, as it will be harder to model what it needs to be, but it will still be way better than nothing. Don’t miss out.

More on the San Antonio ISD vaccination mandate litigation

I’m a little confused at this point, but I’ll cope.

Judge Mary Lou Alvarez of the 45th District Court denied the state of Texas’ request for a temporary injunction Friday, allowing the San Antonio Independent School District to continue requiring its employees to be vaccinated against the coronavirus.

Former SAISD Superintendent Pedro Martinez, who has since left the district to take a job in Chicago, issued the vaccine mandate on Aug. 16, requiring all staff members to be vaccinated by Oct. 15. SAISD board President Christina Martinez said Thursday that about 90% of SAISD staff has been vaccinated.

Alvarez’s decision came after a hearing on the state’s request for temporary relief against the vaccine mandate was delayed. Another state district judge denied the school district’s challenge on Sept. 23 that the state and Gov. Greg Abbott did not have jurisdiction to sue. SAISD then appealed that ruling, pushing back the original hearing for the state’s lawsuit; the appeal was dropped earlier this week.

After Alvarez’s ruling, the state’s legal team said they planned to appeal. A trial for the lawsuit is set for Jan. 19, 2022.

[…]

Attorney Steve Chiscano, who represented SAISD, dismissed the state’s lawsuit as a political ploy.

“We are sitting in an injunction hearing that the AG is hoping to win so he can spin off another press release on how proud he is that he beat up on this district,” Chiscano said. “It is so obvious and so clear that this is happening that I believe at the end of the day, you’ll see that what the governor is doing is not supported by any law.”

See here and here for the background. I’ve decided that we had a motion by SAISD to dismiss the lawsuit, which was denied, and then the state asked for a temporary restraining order against SAISD, which was also denied. The source of my initial confusion was the change in judges between the two, but I think that may just be how Bexar County rolls. In any event, true to form and as the story notes, Paxton – who was not present for the hearing – did indeed tweet about it and how he’s fighting for the freedom of people who want to get sick and die and take others with them. Ultimately, this judge did not buy the state’s argument that the Abbott executive order was enough on its own to prevent SAISD from responding to the pandemic in this fashion. A higher court may intervene before the hearing for an injunction, but in the meantime I sure hope that SAISD is making progress in getting shots into arms. That is what really matters. The Current has more.

COVID continues to run amuck at the schools

This is our reality.

Students in Texas public schools are facing another year upturned by COVID-19 as the highly contagious delta variant spreads, mask mandates are inconsistent and children under 12 cannot yet be vaccinated against the virus.

Less than two months into this school year, the number of reported coronavirus cases among students has surpassed the total from the entire 2020-21 school year. Schools are prohibited from taking precautions such as requiring masks, though some are fighting the governor’s order banning mask mandates. Far more students are on campus, since most districts do not have a remote learning option.

[…]

State data on school cases is incomplete and likely an undercount. TEA suppresses some districts’ case counts to protect student privacy, and not all districts report student and staff cases to the state, despite agency guidance requiring otherwise. The agency also retroactively updates its data from previous weeks as more districts report cases.

Some large districts, such as Houston and Dallas, have not consistently reported cases to the state since TEA started tracking COVID-19 data on Aug. 2 for this school year. Many districts publish a COVID-19 dashboard that shows cases, and TEA recommends families check for the latest data there.

Entire districts, including Angleton and Lumberton, have closed temporarily without reporting cases to the state. These districts don’t necessarily report their closures, either, since they are not required to do so. TEA informally tracks closures based on media and district reports, said Frank Ward, an agency spokesperson.

I don’t quite understand the embedded table that this story has about school districts with the most reported COVID cases, as the numbers they report for HISD don’t match up with the ones on the HISD site. I guess they’re showing active cases and not cumulative ones, but it doesn’t sound like that from their description. In any event, the point is there’s a lot of COVID in the schools, and the schools have few options right now to mitigate it other than defying Greg Abbott’s mask mandate ban and hoping for the best in the courts. The forthcoming EUA for the Pfizer shot for kids will help eventually, though that will take time as even pro-vaxx parents may wait a bit before giving it to their kids.. And that is our reality.

SAISD vaccine mandate update

Still in place for now, but clearly on shaky ground.

Best mugshot ever

San Antonio Independent School District can continue requiring its staff to get vaccinated against COVID-19, despite a judge ruling against the district Thursday in a case filed by the Texas attorney general.

Judge Angelica Jimenez of the 408th District Court denied SAISD’s plea on Thursday that state Attorney General Ken Paxton lacks the legal authority to enforce Gov. Greg Abbott’s Aug. 25 executive order, which banned public entities, such as school districts, from mandating COVID-19 vaccines. Steve Chiscano, the attorney representing SAISD, immediately appealed the ruling.

Appealing Jimenez’s jurisdiction ruling delayed a hearing requested by the state to stop SAISD’s vaccine mandate with a temporary restraining order. The school district and attorney general’s office will make their arguments again before the 4th Court of Appeals. Case information is due at the court Oct. 4, according to online court records. The lawyers will file briefs, and justices will make a decision at an undetermined date.

[…]

In a statement, the district said Jimenez’s ruling does not enforce Abbott’s executive order prohibiting vaccine mandates and that SAISD would continue its vaccine protocols.

“We do not believe the Governor and Attorney General have the legal authority to continue this lawsuit, and we respectfully disagree with the judge’s ruling,” the district said in the statement. “We know that following the executive order and not requiring vaccination of our employees is potentially deadly, and we will do what is necessary to protect the children and staff of the district.”

See here for the previous update. I’ve always thought that the vaccine mandate was a heavier lift than the mask mandates, so I won’t be surprised if Paxton eventually wins this one. But as long as that mandate remains in place, SAISD can move closer to a goal of maximizing the number of its employees who have been vaccinated. No matter the odds, that’s worth fighting for.

From the “ounce of prevention” department

What is that worth, again? It’s right on the tip of my tongue.

Accessing a critical COVID-19 therapy could soon be tougher in Texas as the federal government moves to ration the treatment amid the spread of new variants.

The Biden administration is taking over distribution of monoclonal antibodies, returning to the system that had been in place until vaccines became readily available and infections began to plummet this year. It also purchased 1.4 million additional doses.

Under the old system, the federal government had been doling out doses to states based on need, and states were then responsible for distributing them.

The administration had until recently been allowing hospitals and other health care centers to order directly from manufacturers, and the U.S. Health and Human Services Department would initiate a review of any individual site that ordered more than 50 doses to make sure none were hoarding.

But with the highly contagious delta variant continuing to spread nationally, demand for the treatment has soared, with concerns that it could soon outstrip supply. By last week, the vast majority of doses — 70 percent — were going to just seven Southern states where COVID cases are still high and vaccination rates are low, including Texas.

“The recent increase in the prevalence of the delta variant coupled with low vaccination rates in certain areas of the country resulted in a substantial (20-fold) increase in the ordering and utilization of (monoclonal antibodies) since mid-July,” the federal health services agency said in a statement. “Just seven states accounted for about 70 percent of our monoclonal antibody ordering. Given this reality, we must work to ensure our supply of these lifesaving therapies remains available for all states and territories, not just some.”

Under the new model — and a 50 percent bump in allocations that President Joe Biden ordered this month — Texas and Florida are still getting far more doses than other states. Texas received 23,640 doses this week, behind only Florida, which received 30,950. Georgia received the third most, 9,920.

There’s an extremely whiny quote in the story from Chip Roy, and y’all, if people like that put one tenth the effort they exert being crybabies into getting people vaccinated, we wouldn’t have these problems, because we’d have crushed COVID by now. My sense of empathy has been a major casualty of this pandemic, and I’d really like to get it back.

The COVID shot for kids is coming

Not a moment too soon.

On Monday, Pfizer released the initial trial results, showing that its vaccine is safe and effective for the 5-11 age group. The findings are a key step toward inoculating a younger population that so far has been unprotected from the virus.

“It’s good to hear the studies are paying off,” García said. “We are happy to be part of the process to help other people get more trust in the vaccine, so we can start getting back to normal as soon as possible.”

The announcement summarized results from 2,268 trial participants. The findings show that children develop an antibody response similar to the 16- to 25-year-old age group when given a lower dosage of the vaccine.

Pfizer and BioNTech, the company’s German partner, plan to include the data in a “near-term submission for Emergency Use Authorization” while safety research is ongoing. Dr. Bill Gruber, a Pfizer senior vice president, told The Associated Press that the company plans to apply for emergency use by the end of the month.

My kids are thankfully old enough to already be vaccinated, but I know a lot of people who have been eagerly awaiting this announcement. I expect there will be a surge of new vaccinations in the weeks following the emergency use grant, and while it will surely fall well short of the full total of eligible kids, it will make a decent dent in the overall vaccination rate. We’re going to need every bit of this. The 19th and Daily Kos have more.

El Paso is doing all right with Delta

Good for them, let’s hope it lasts.

While some other metro areas like Austin reported record high numbers of COVID-19 patients in their area hospitals just last month, and while statewide hospitalizations came close to eclipsing the January peak of 14,218, El Paso-area hospitals, which serve nearly a million West Texas residents, haven’t come close to their previous highs.

El Paso’s peak for COVID-19 hospitalizations was just over 1,100 in mid-November, said Wanda Helgesen, director of BorderRAC, the state’s regional advisory council for local hospitals.

On Thursday, the number of people hospitalized for COVID-19 in El Paso was 127.

In fact, the city’s daily hospitalization numbers haven’t broken 200 since March, according to the Texas Department of State Health Services. Hospitals are seeing an increase in patients, have occasionally seen their ICUs fill up and are having the same staffing problems as the rest of the state, she said, but have so far been able to handle the uptick.

Most of the pressure is related to non-COVID patients, many of whom had been waiting to get treatment for other problems, she said.

“We do have a surge of patients but not to the extent that other parts of Texas are having,” she said.

Helgesen and others say much of the credit can be attributed to the area’s high vaccination rate, widespread compliance with masking and social distancing, and a strong partnership among local community and health care leaders.

“It is amazing,” Helgesen said. “It is absolutely a credit to our community. I really think it was an all-out effort.”

The share of COVID-19 tests in El Paso that come back positive is hovering around 6%, while the statewide positivity rate is three times that at 18%.

And while COVID-19 patients, most of whom are unvaccinated, took up more than 30% of hospital capacity in some areas and more than 20% statewide last week, in El Paso they accounted for only 7% of patients in local hospitals.

For a city with one of the state’s highest per-capita COVID-19 death counts, the numbers present a rare glimmer of good news for the traumatized residents of this West Texas border city.

“Compared to the rest of Texas, we’re in heaven,” said Gabriel Ibarra-Mejia, assistant professor of public health at the University of Texas-El Paso. “That doesn’t mean we are free from COVID, but we’re doing much, much better than most of the rest of the state. The numbers don’t lie.”

Civic and health leaders say they aren’t ignoring one important fact: El Paso’s surges have been weeks behind the rest of the state throughout the pandemic, so it’s possible that the region’s own delta-fueled spike could still be ahead.

“We aren’t letting our guard down,” Helgesen said.

El Paso Mayor Oscar Leeser, who lost his mother and brother to COVID during the winter surge, said the reason the city and county have enacted recent mask mandates, in defiance of Gov. Greg Abbott’s ban on them and in spite of lower numbers, is because the potential for another surge is still real.

“We do worry and we want to make sure that we don’t have any spikes,” he said. “You always want to be proactive and you always want to be prepared.”

The story goes on to recount the huge spike in COVID cases that El Paso experienced last November, which put it in the national news. If you look at the included chart of COVID cases, which tracks El Paso and the state as a whole, the two were mostly in sync except for that giant surge in November, which came between the two big statewide surges, and now, when the statewide rate began to take off in May but El Paso’s stayed more or less where it had been. I’m sure the mask mandate and above-norm vaccination rates have helped with that, but it may also be that enough unvaccinated El Pasoans have had COVID that the overall rate of immunity is high enough to be something like herd immunity. Or maybe they’re just lucky right now, and the curve will begin to turn upward for them eventually. I very much hope that’s not the case, but I think we all know that this pandemic has been persistent and somewhat random about who gets it the worst at a given time. In the meantime, though, keep on keeping on, El Paso.

UT-Tyler/DMN: Abbott loses ground

A well-timed poll result.

Texas Gov. Greg Abbott (R) may be feeling the pressure, the latest poll from The Dallas Morning News and the University of Texas at Tyler shows.

Abbott’s approval rating has dropped to 45 percent in the aftermath of controversial legislation such as a ban on mask mandates amid the COVID-19 pandemic and a ban on most abortions after six weeks. It’s far too early to tell how things will play out in next year’s election, but two well-known potential candidates look like they could give Abbott a serious run if they do wind up entering the race.

Actor Matthew McConaughey, who has hinted that he’s entertaining the idea (though it’s unclear what party, if any, he would represent), led Abbott by nine points in a hypothetical matchup in the new poll, while former Rep. Beto O’Rourke (D-Tex.), who ran against Sen. Ted Cruz (R-Tex.) for a spot in the upper chamber and later took a shot at the Democratic presidential nomination, cut a previous 12-point head-to-head deficit against Abbott down to five in the survey. Abbott does have a more comfortable lead against Republican primary challengers, however.

The DMN story is here, and the poll data is here. I’ve covered the McConaughey matter before, and you can refer to those previous entries because the issue remains the same. For what it’s worth, the UT-Tyler poll doesn’t mention Beto’s party either, but I think we can safely assume that a decent number of poll respondents correctly identify him as a Democrat.

The headline result here is that Abbott leads Beto 42-37 in this poll after having led him 45-33 in the July poll. We will surely start to get a lot more head-to-head data now that Beto is semi-officially in the race. We do have some previous results we can look at to provide some context, so let’s do that. First, here are the approval/disapproval numbers for Joe Biden and Greg Abbott, plus the favorable/unfavorable numbers for Beto:


April

Name     App  Disapp  Neither
=============================
Biden     48      41       12  
Abbott    50      36       15
Beto      35      37       27

June

Name      App  Disapp  Neither
==============================
Biden      47      41       11
Abbott     50      36       14
Beto       31      40       29

September

Name      App  Disapp  Neither
==============================
Biden      42      50        9
Abbott     45      44       11
Beto       34      42       24

I’ve combined the strong/somewhat approve/disapprove numbers for Abbott and Biden, and the strong/somewhat favorable/unfavorable numbers for Beto; there was also a “don’t know enough” option for Beto, which I added into the “Neither” column. Biden’s approval drop is expected given the national numbers, and honestly they’re better than I might have expected given that. Abbott is doing better here than in the recent Texas Politics Project and Morning Consult polls, but the direction is the same. Again, it’s hard to say how the various factors will play into the 2022 election, so for now let’s just note that this is where we are.

Two other data points of interest. Both were asked for the first time in the September poll, so there’s nothing to compare them to from this source, but we do have some data from elsewhere. First, this poll included a “right direction/wrong direction” question for Texas, with the result being 44/54 wrong/right. Dems were 40/59 for “wrong”, Republicans were 59/39 for “right”, and indies were interestingly 33/64 for “wrong”. Make of that what you will, and compare to the recent Texas 2036 survey of people’s “right/wrong direction” attitudes.

Finally, this poll gets into mask and vaccine mandates and the bans on same:

Do you support or oppose Governor Abbott’s ban on mask mandates?


        Total    Dem  Ind  Rep
==============================
Support   44%    33%  32%  67%
Oppose    55%    66%  67%  33%

Do you support or oppose Governor Abbott’s ban on vaccine mandates?


        Total    Dem  Ind  Rep
==============================
Support   49%    37%  38%  72%
Oppose    49%    62%  60%  28%

There’s also a question about mask mandates in schools, with 50% saying masks should be required in all K-12 classrooms, 26% saying schools should be allowed to decide, and 20% saying no mandates. There’s national data showing that the public is broadly in favor of how Democrats and President Biden have responded to COVID (and also of mask and vaccine mandates) and opposed to the Republican response. This is the sort of thing that can certainly change over time, but for now, and for a nascent Beto campaign, coming in hot on a platform that strongly criticizes Abbott on this issue would seem to have some traction. Again, more polling will surely follow, but this is very much an issue to watch.

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.

Paxton sues again over SAISD’s vaccine mandate

Yes, vaccine mandate. For teachers and staff.

Best mugshot ever

For the second time in a month, Texas Attorney General Ken Paxton sued San Antonio Independent School District and Superintendent Pedro Martinez for requiring all staff to be vaccinated against COVID-19.

Martinez issued a staff vaccine mandate and mask mandate Aug. 16 for everyone inside school buildings. Three days later, Paxton sued Martinez and SAISD over both mandates, stating in the lawsuit that the superintendent and the district were “deliberately violating state law,” as a July executive order from Gov. Greg Abbott prohibits any entity that receives public funds from mandating COVID-19 vaccines that had received only emergency approval from the federal government.

But the federal Food and Drug Administration granted full approval for the Pfizer COVID-19 vaccine on Aug. 23, and the lawsuit was dropped. Two days later, Abbott issued a new executive order, banning governmental entities from requiring any COVID-19 vaccine, regardless of FDA approval status.

Paxton filed the second lawsuit against SAISD in Bexar County on Sept. 9, seeking a temporary restraining order barring the school district from mandating vaccines. In the petition, Paxton claims SAISD and Martinez are again violating state law by “flouting” the August executive order.

“The decision to openly violate state law and devote district resources to defending Superintendent Martinez’s unlawful actions is irresponsible,” Paxton said in a statement. “But if school districts decide to use their limited funding to try to get away with breaking the law, my office will oppose them and uphold the rule of law in Texas.”

See here and here for some background. My reaction when Paxton filed the first lawsuit was that he was likely to prevail, and despite the FDA approval and Biden mandate (which has been announced but not yet fully implemented), I don’t see any reason why that would change. I will of course be happy to be wrong, and if it is the case that some people have gotten vaccinated as a result of the SAISD mandate then it’s a win no matter what happens in court. The main thing to remember here is that Ken Paxton, like Greg Abbott, is objectively pro-COVID, and we need to make them pay at the ballot box for it.

Our COVID failures and our economy

Remember when the goal was to get the economy going again?

The recent surge in COVID-19 cases is not only hitting the state in terms of lives lost, but it’s taking its toll on the Texas economy. That’s according to a new report from the Perryman Group, an economic research and analysis firm in Waco.

They estimate the state’s failure to contain the disease has led to nearly 72,000 job losses. The analysis also found on average, the state loses roughly $187,000 for every employee unable to return to work because of the pandemic. That amounts to total potential losses of about $13 billion per year, the firm found.

But they argue many of these potential losses are preventable.

“What we need to do right now is do everything we can to make it safer for people to return to work. That includes masks where appropriate. That includes safety in schools so people that have issues with their children in childcare and things like that that prevent people from returning to work,” said Ray Perryman, president and CEO of the Perryman Group. “These are what we call preventable [economic] losses.”

Perryman said certain industries are being hit harder than others.

“In terms of dollar impacts, obviously a worker in a tech industry per worker has a much bigger impact than say a worker in a restaurant. But from an industry perspective, the ones being hit the hardest are the ones you’ve been hearing about since the beginning of the pandemic that deal in interpersonal relationships – retail, particularly restaurants, salons, airlines,” he said.

He says getting more people vaccinated is also key to avoid future economic losses.

The full report is here if you want to read it, and there’s video of an interview with Perryman about this at the first link. Honestly, in the context of Texas’ economy, $13 billion is pretty small, as is 72,000 jobs. Not nothing, especially if you’re in one of the more affected sectors, but not so much that you’d notice it on a graph. The point that all of this was preventable, with more aggressive vaccination promotion and distribution, and a continued reliance on masks while allowing local governments to have the discretion they need to respond as they see fit, is still true. There’s no good reason why we have to be going through what we are going through now. It was all the result of Greg Abbott’s actions.

COVID and college football

We sure these sellout crowds are a good idea?

At Virginia Tech last Friday, the packed crowd bounced to “Enter Sandman.” At the University of Wisconsin the next day, fans jumped around to “Jump Around.”

College football and its crowd traditions are back to their full glory like they were in 2019, before Covid-19 restrictions sharply limited fan attendance in 2020.

Some of the country’s biggest powerhouses — including Georgia, Alabama, Ohio State and Oklahoma, to name a few — are hosting games to full capacity on Saturday. And fans who attend these games won’t have to prove their vaccination status, won’t be required to social distance and won’t have to wear masks in their seats.

The return of college football and its unique cultures, which began in earnest last week, are a source of communal bonding for sports fans, yet they also represent a source of anxiety for others.

[…]

Both the SEC and NCAA deferred to schools to make their own decisions — based on local and state requirements — when asked what each was doing to mitigate the spread of Covid-19 at football games. Both do have Covid-19 protocols for student-athletes.

“My ask of our fans is to try to take advantage of what science has done,” Greg Sankey, SEC commissioner, said last month.

Georgia’s plan to host such a large crowd comes as the state has fully vaccinated about half of its residents 12 and older, one of the 10 lowest vaccination rates among all states, according to the Centers for Disease Control and Prevention. Athens-Clarke County, where the Bulldogs play, has a “high” rate of Covid-19 community transmission, the CDC says.

Last week marked the full opening of the college football season, and stadiums across the country were packed with fans eager to rejoin the communal sports experience.

In Georgia, the Mercedes-Benz Stadium in Atlanta hosted nearly 72,000 fans for an Alabama-Miami game on Saturday and hosted about 31,000 fans for the Louisville-Ole Miss game on Monday. At both games, the stadium roof was open and masks were required in enclosed spaces but not in open-air areas, and there were no vaccine requirements.

A number of the universities that have packed fans into seats this season require students to be vaccinated, including at large Big Ten schools Michigan (109,000 in attendance), Maryland (44,000) and Illinois (41,000).

These schools are hardly breaking new ground by holding packed games. The National Basketball Association and Major League Baseball have similarly held full capacity events this summer, and the National Football League will do so when the season begins later this week.

This story was published Saturday morning, before this week’s games were played. Those other sports aren’t a great comparison because they have smaller crowds and their gamedays aren’t all-day party affairs. The SEC and some other conferences put an emphasis on getting players and coaches vaccinated, but getting fans vaccinated is not on their agenda. I can hardly blame them, because I can imagine the pushback they’d get if they tried. There’s evidence to suggest that limited-seating football games did not help spread COVID, but we are not doing limited seating any more – these are full stadia, with 80K to 100K people in attendance. Don’t be surprised if that has a negative effect.

Hospital systems have no excuse for not mandating COVID vaccines now

So get on with it already.

Local hospitals reacted Friday to President Joseph Biden’s sweeping vaccine mandates directed at the health care workers, who make up much of the Houston workforce.

In a move that overrides Gov. Greg Abbott’s executive order barring public institutions from issuing their own COVID-19 restrictions, the administration said it would require vaccinations for employees at health care facilities that accept Medicare and Medicaid reimbursement.

Baylor College of Medicine’s dean of clinical affairs, Dr. James McDeavitt, said Thursday he supported the new measures.

“It is the right thing to do,” he said.

Still, he wished the plan had come sooner. “It is not going to help us with the current delta surge,” he added.

[…]

Five Houston hospital systems already require a vaccine. In June, Houston Methodist became the first hospital in the nation to announce it would require its staff to be fully vaccinated, a move that met months of resistance, including a lawsuit by some employees. Memorial Hermann and Baylor College of Medicine enacted their own vaccine mandates in July; St. Luke’s Health and Texas Children’s Hospital announced similar plans in August.

Thursday’s executive order will bring similar mandates to the city’s remaining health systems.

Until now, Harris Health System and UTHealth had encouraged worker vaccinations but were unable to require it under the governor’s order.

But on Friday, Harris Health System said it “fully intends to embrace the vaccine mandate” for workers at its two hospitals, 18 community health centers and 10 clinics serving the greater Houston area. The system has not yet set a date.

UT Health said it would wait for guidance from the Centers for Medicare & Medicaid Service, expected in October. It had not instituted a mandate as of Friday afternoon.

St. Joseph Medical Center and UTMB Galveston said they are still evaluating Biden’s plan.

While Kelsey-Seybold Clinic said in August it was waiting for full vaccine approval from the U.S. Food and Drug Administration before asking employees to provide proof of immunization, the clinic has not announced a mandate since the Pfizer-BioNTech vaccine gained full U.S. Food and Drug Administration approval late last month.

See here for the background. I agree that the mandate coming out now will have little to no effect on the current surge, given that it takes a few weeks to get both shots and the full effect of them, and that it will take time for these hospital systems to get their programs going. It would still be nice if some of them had more of a sense of urgency about it. This is still by far the best thing we can do for the medium to longer term, and at the very least these hospital systems should be setting a better example. Get it done already, y’all. The Trib has more.

Now that’s a vaccine mandate

Good.

President Joe Biden on Thursday imposed stringent new vaccine rules on federal workers, large employers and health care staff in a sweeping attempt to contain the latest surge of Covid-19.

The new requirements could apply to as many as 100 million Americans — close to two-thirds of the American workforce — and amount to Biden’s strongest push yet to require vaccines for much of the country.

“We’ve been patient, but our patience is wearing thin, and your refusal has cost all of us,” Biden said, his tone hardening toward Americans who still refuse to receive a vaccine despite ample evidence of their safety and full approval of one — the Pfizer-BioNTech Covid-19 vaccine — from the US Food and Drug Administration.

He said vaccinated America was growing “frustrated” with the 80 million people who have not received shots and are fueling the spread of the virus. And he acknowledged the new steps would not provide a quick fix.

“While America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact: We’re in a tough stretch and it could last for awhile,” Biden said in an early evening speech from the White House.

At the center of Biden’s new plan is directing the Labor Department to require all businesses with 100 or more employees ensure their workers are either vaccinated or tested once a week, an expansive step the President took after consultation with administration health officials and lawyers. Companies could face thousands of dollars in fines per employee if they don’t comply.

Biden also signed an executive order requiring all government employees be vaccinated against Covid-19, with no option of being regularly tested to opt out. The President signed an accompanying order directing the same standard be applied to employees of contractors who do business with the federal government.

He also said 300,000 educators in federal Head Start programs must be vaccinated and called on governors to require vaccinations for schoolteachers and staff.

And Biden announced he would require the 17 million health care workers at facilities receiving funds from Medicare and Medicaid to be fully vaccinated, expanding the mandate to hospitals, home care facilities and dialysis centers around the country.

“We have the tools to combat the virus if we come together to use those tools,” Biden said at the outset of what was billed as a major speech to tackle the latest phase of the Covid-19 pandemic.

I mean, I’d have ordered the FAA to issue a vaccine mandate for getting on an airplane as well while I was at it, but maybe that’s still to come. To the extent that this is allowed, and based on a lot of public polling, this will move the needle significantly in the vaccination rates. Still won’t get us to 100%, but it will get us a lot closer. There will be wailing and gnashing of teeth and lawsuits – you can already hear Greg Abbott caterwauling – but it is going to have an effect. (And by the way, none of this would have been necessary if it hadn’t been for the likes of Greg Abbott.)

I have no idea what the legal status is of any of this. I’ve seen a few people I trust on Twitter suggest that the President has the authority to impose this kind of rule on large businesses in the name of public safety, especially via his emergency powers, but for sure there will be a broad array of opinion on that. Most of the rest of us are at most barely aware than it’s the Occupational Safety and Health Administration (OSHA) that will be doing the work on this, or that it will take some time for the rule to be developed. But as you can see, it has already had an effect:

The more you know…The Trib and the Chron have more.

Mayor Turner orders unvaxxed city employees to get tested twice a week

So maybe get vaccinated, and avoid all the hassle.

Mayor Sylvester Turner

Unvaccinated city workers must get tested for COVID-19 twice a month and report their results to the human resources department, Mayor Sylvester Turner announced Wednesday.

Turner signed an executive order implementing the policy,which takes effect Oct 8. It will allow some exemptions for religious and medical reasons.

The plans come as the city regularly has had more than 300 active cases of the virus among its workforce, Turner said. The latest numbers showed 342 workers with the virus, including 129 police, 161 municipal and 52 fire department employees.

Those cases hamper city operations, the mayor said.

“When you have 129 police officers with COVID, they’re not able to perform their jobs. Same thing with municipal workers, and, for example, permitting, that slows things down,” Turner said. “Simply don’t want them to get sick and don’t want anybody, anybody to die.”

[…]

The policy will apply to all police, fire and municipal staff who have not been fully vaccinated. It will not apply to elected officials or appointed members to the city’s boards and commissions.

The fire, police and municipal workers unions did not respond to requests for comment on Turner’s plan.

Turner said staff will face disciplinary action if they do not comply.

“It could even cost you your job,” the mayor said.

The mayor in recent weeks had teased a policy to encourage vaccinations, saying many city workers have not gotten their shots.

Mayor Turner implemented a mask mandate for city employees in early August. As far as I know, that executive order has not been involved in any of the lawsuits over mandates and Greg Abbott’s ban on them. This is a step up from that – it’s not a vaccine mandate per se, but it’s pretty close and I doubt Greg Abbott or Ken Paxton will split hairs. (They already have a reason to be whipped into a frenzy about this.) Whether or not cities can issue vaccine mandates is on the agenda for the next special session. What I’m saying is, I don’t know how long I expect this policy to last. And that’s before we hear of the inevitable resistance from the police and firefighter unions – police unions around the country have been staunch resisters of vaccine mandates, and we know how well the Mayor and the HPFFA get along. I support what the Mayor is doing here – if anything, I’d want to see the testing be more frequent – I just doubt he’ll be able to fully implement it. I’ll be happy to be proven wrong.

We really need a mask mandate at every school district

Or we can just accept a lot more hospitalized kids. Easy choice if you ask me.

The number of Texas children hospitalized with COVID-19 hit an all-time high over the weekend, with 345 on Saturday and 307 on Sunday, the highest two-day stretch recorded during the pandemic, according to data from the Texas Department of State Health Services.

The data follows a national trend of rising pediatric COVID hospitalization rates. A study from the Centers for Disease Control and Prevention released Friday shows the highest rate of increase among teenagers and children 0-4 years old. The study also found unvaccinated adolescents were 10 times more likely to need hospitalization compared to their vaccinated peers.

Children under 12 are ineligible for any of the available COVID-19 vaccines.

School reopenings and “pandemic fatigue” are two primary reasons for the statewide increase, said Dr. Katelyn Jetelina, an epidemiologist at UTHealth School of Public Health in Dallas and author of the popular blog “Your Local Epidemiologist.”

“The more that kids interact with each other, the more this is going to transmit,” she said, adding, “We really need to step up our mask game. Parents really need to invest in good masks to wear for their school.”

She urged parents to buy N95 masks for their children and to “lead by example” with their own mask-wearing habits.

Multiple studies have shown masks help reduce COVID transmission indoors. The CDC study also recommends universal masking in schools, where cases are soaring in Texas. The state health department on Aug. 29 recorded 51,904 COVID cases among Texas students since the 2021-22 school year began.

I mean, we’re a year and a half into this pandemic. We do know all this stuff already. I get that some people are tired of doing pandemic things, but 1) if said person is not vaccinated then they can just STFU right now, as this is all their fault, and 2) as the kids say, we may be done with the pandemic but it’s not done with us.

Thankfully, HISD is doing it right.

While outbreaks have forced some districts to close schools already, Houston ISD has fared comparatively well two weeks into its school year.

By midday Friday, the state’s largest district of nearly 200,000 students had confirmed 1,085 active cases among students and staffers, according to its dashboard.

The most important mitigation strategy the district could implement is one it already has in place — ensuring people wear masks, Superintendent Millard House II said Thursday.

“As we look at the data in our schools, yes we have COVID cases,” House said during an agenda review meeting. “But if we look at the percentage of spread in our schools in comparison to the number of kids that we have, it looks — it does not look bad in comparison to some of the other schools that don’t have mandates in place.”

Health professionals agree the mask mandate may be helping HISD reduce the risk transmission inside its classrooms, even as kids younger than 12 remain ineligible to be inoculated and the delta variant continues to spread mostly unchecked in the Houston area.

“I attribute it to that,” said Dr. Quianta Moore, Huffington Fellow in child health policy at Rice University’s Baker Institute for Public Policy. “There are some schools that the parents and the community are wearing masks and they are also having low transmission.”

As I said before, I don’t want to get overconfident, but again, we know that masking helps. Given the risks, the current legal status, and the complete lack of consequences for defiance, I can’t think of any good reason for a school district to not have a mask mandate in place. We’re either trying or we’ve given up.

Special session 3.0

Yeah, we knew it was coming. Still too soon.

Gov. Greg Abbott on Tuesday announced a third special legislative session that will begin on Sept. 20 and tackle redistrictingrestrictions on transgender student athletes and the ongoing COVID-19 pandemic.

“The Texas Legislature now has the opportunity to redraw legislative and congressional districts in accordance with the new census numbers,” Abbott said in a statement. “In addition to redistricting, there are still issues remaining that are critical to building a stronger and brighter future for all Texans.”

Lawmakers, who will meet in Austin for the fourth time this year, will also be tasked with allocating $16 billion in federal COVID-19 relief funds and with deciding whether state or local governments can mandate COVID-19 vaccines. Abbott also included on his five-item agenda a bill that would ban the tethering of dogs outside with heavy chains, which he had vetoed earlier this year. Abbott asked lawmakers to address concerns he had about the specificity of the bill and “over-criminalization.”

The Legislature just wrapped its second overtime round on Thursday, delivering on major conservative priorities like an elections law that restricts how and when voters cast ballots, a ban on how teachers can talk about race and history in classroomsbillions of dollars in additional border security funding and further restricting abortion access.

But lawmakers failed to deliver on two issues pushed by the GOP base: requiring transgender student athletes to play on teams based on the gender assigned to them at or near birth, and banning COVID-19 mandates.

Abbott had asked lawmakers to ban mask mandates in schools during the second special session but lawmakers could not get that proposal over the hump. Now, Abbott is asking the Legislature to decide whether state or local governments can mandate COVID-19 vaccines.

The bills about transgender student athletes and COVID-19 mandates will likely turn up the heat on an already contentious 30-day session. Lawmakers will take up their decennial redrawing of the state’s political maps, meaning some legislators will be fighting for their political lives. (Redistricting usually takes place during the first legislative session after the census, but it was delayed this year because of setbacks spurred by the coronavirus and the Trump administration’s handling of the census data.)

Like I said, we knew it was coming. I don’t know if the lawsuit that was filed by two State Senators to stop legislative redistricting will be successful, but I have to assume there will be a ruling of some kind before this session gets underway. The continued assault on trans kids is sadly unsurprising; the lack of a fraudit item is at least temporarily hopeful. I mean look, none of us want another special session. I’m sure that wearing us all down is part of the plan. But here we are anyway. Oh, and Abbott et al will try to do a bit of cleanup on the so-called “heartbeat bill” since none of them know how to talk about the lack of a rape or incest exemption. So we have that to look forward to as well.

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.

Readin’ and writin’ and gettin’ COVID

Welcome back to school, kids.

Positive COVID-19 cases among Texas public school students rose by more than 9,000 last week, the highest number ever recorded in a seven-day period, state data shows.

As of Aug. 22, there were 14,033 reports of positive COVID cases in students across the state, according to data released by Texas Health and Human Services on Friday. The number represents a 182 percent increase from the 4,976 student cases reported through Aug. 15.

There were another 3,425 positive cases reported in school staff across the state, an increase of 712 from the previous week.

In some districts, more than half the new infections are among elementary school students, who are not eligible for any of the available vaccines.

“This school year is gonna look a whole lot different than last year,” said Dr. Katelyn Jetelina, an assistant professor of epidemiology at UTHealth School of Public Health in Dallas. “We have a whole lot more transmission now in the community and we have the delta variant.”

The cumulative number of cases in students since the 2021-2022 school year began is 20,256. The total staff cases so far this school year is 7,488.

In case you were wondering why so many parents are pissed about the fight against mask mandates. Now that all schools are open I would hope we won’t see any more big jumps like that, but we are going to see the case levels rise for now. I hope that at some point, when there’s enough data to be reasonably confident in the results, we can get a comparison of COVID rates in districts that have mandated masks versus those that have not.

On a related note:

People under 50 are being admitted to hospitals with COVID-19 in larger numbers than at any point during the pandemic as the latest surge of the coronavirus continues to tighten its grip on Texas.

According to data released by the Texas Department of State Health Services, as of Aug. 22, adults 30 to 49 now account for roughly 29% of all COVID-19 hospital admissions in Texas, up from 15% on Jan. 11 during the height of the winter surge.

The data shows that people in the 18-29 age group increased their share of admissions during that period from 5% to 7%, while the percentage of children under 18 admitted to hospitals with COVID-19 increased by 1 percentage point — an average of 46 children each day were hospitalized during the week ending Aug 22.

Meanwhile, fewer people over 70 are landing in hospitals with COVID-19. During the winter peak, about 41% of hospitalized COVID patients were over 70. As of Aug. 22, that dropped by almost half, to 23%.

The data confirmed what many doctors have been saying in recent weeks about the delta variant sending younger people into hospitals at a higher rate than earlier in the pandemic.

“We are seeing certainly younger patients hospitalized and younger patients on ventilators where we haven’t seen that before,” said Dr. Ron Cook, chief health officer at the Texas Tech University Health Sciences Center.

This variant has spread faster among unvaccinated Texans of all ages. As of last week, between 93% and 98% of hospitalizations have been unvaccinated people, depending on the area of Texas, officials said.

More than 70% of Texans over the age of 50 are fully vaccinated, compared to only about half of Texans between the ages of 16 and 49 and one-third of those ages 12-15. Children under age 12 are not eligible for vaccination.

And as the hospitals fill up with COVID patients, people who have other serious but treatable conditions are put in jeopardy. No amount of horse de-wormer is gonna fix that.

The financial incentive

At this point, whatever works.

A week after public health officials in Texas’ most populous county started handing out $100 cash cards to locals getting their first COVID-19 shot, the number of daily vaccinations has shot up to six times its previous rate, Harris County Judge Lina Hidalgo said Tuesday.

“We had an inkling that something was going right when I started my announcement [about the incentive] at noon, and by the time I was done, 30 minutes later, there was a line of cars waiting to receive the vaccine,” Hidalgo said. “We haven’t seen those lines for months.”

To accommodate and encourage the increased demand, the county will be opening an additional mass vaccination site and expanding its mobile vaccine program, Hidalgo said.

“You have to be creative, and we’re seeing the results and we’re doubling down on it,” Hidalgo said.

Harris County officials began the incentive program last Tuesday in a bid to jumpstart stalled vaccinations in Houston and surrounding areas, and to provide relief to the region’s stressed hospitals during what health officials say is the worst surge of infections the area has seen since the pandemic began last year.

For the three weeks before the program started, Hidalgo said, Harris County Public Health was administering an average of 431 first doses per day. The day the announcement was made, the number jumped to 914. The next day, 1,596 people sought the first doses from public health providers.

On Saturday, four days into the program, some 2,700 people got their first injection, Hidalgo said.

“This is an incredible achievement,” she said.

As the story notes, more vaccination sites are being opened to accommodate what I hope will be a sharp uptick in demand. The FDA approval of the Pfizer shot, and more companies telling their employees to get vaxxed may help push the numbers up as well. I honestly don’t care what the cause is, as long as it happens. And it needs to happen at a higher rate than this – even with the uptick statewide, we’re at less than 30% of the shots-per-day peak in April. Let’s get closer to that, and then we’ll really have something.

Greg Abbott remains COVID’s best friend

It’s hard to even know what to say.

Gov. Greg Abbott on Wednesday announced an executive order banning COVID-19 vaccine mandates regardless of a vaccine’s approval status with the U.S. Food and Drug Administration.

He also said he was adding the issue to the agenda for the current special session of the Texas Legislature.

The order comes two days after the FDA granted full approval to the Pfizer vaccine. That raised questions about the fate of a previous Abbott order that prohibited vaccine mandates, but only for those under emergency authorization.

Abbott’s latest order is simple, saying “no governmental entity can compel any individual to receive a COVID-19 vaccine.” The order preserves exceptions for places like nursing homes and state-supported living centers.

At the same time, Abbott asked lawmakers to consider legislation addressing whether state or local governments could issue vaccine mandates and, if so, which exemptions should apply.

“Vaccine requirements and exemptions have historically been determined by the legislature, and their involvement is particularly important to avoid a patchwork of vaccine mandates across Texas,” Abbott said in a statement.

[…]

There specifically appeared to be the fresh potential for cities, counties and school districts to require their employees to get vaccinated against COVID-19. San Antonio Independent School District had already announced mandatory employee vaccinations, prompting a lawsuit from Attorney General Ken Paxton.

District officials said Wednesday they will move forward with the mandate — despite Abbott’s latest order.

“We strongly believe that the safest path forward as a school district is for all staff to become vaccinated against COVID-19,” the district said in a statement.

See here for some background, and here for a copy of the order. As the story notes, this would prevent government entities from ordering their employees from getting COVID shots, though as you can see that’s already being challenged. Private employers are not affected by this, so if you work for one of the increasing number of them that are imposing COVID vax mandates, you’re out of luck. A bill passed during the regular session forbids businesses from requiring proof of vaccination from their customers, though that doesn’t take effect until September 1 so Harry Styles can still do what he wants.

I don’t think this is anywhere near the end of it. The same arguments being made about mask mandate bans – successfully, so far – by multiple counties and school districts is that the Disaster Act of 1975 doesn’t actually give Abbott this power. That would be equally true for vaccine mandate bans, I would think. That doesn’t mean the courts, by which I mostly mean the Supreme Court, will eventually accept that argument, just that these same entities will give it a try. The federal government will have a say as well, and let’s not forget the federal lawsuit, too. We’re also going to have an election next year, and we have the option of electing a Governor who wants to fight against the COVID virus instead of fighting for it. There’s a lot more of this story to be written. The Current and the Chron have more.

More teenagers are getting vaccinated

Good, but not enough in itself.

As a third COVID wave coincides with the back-to-school season, more Texas teenagers are getting the vaccine — but health experts say they need to see shots increase in even larger numbers to protect children from the delta variant.

Vaccinations have gone up recently among all Texas age groups, especially for those under 50, and they’ve more than doubled over the past six weeks for 12- to 17-year-olds.

In the last week of June, about 36,000 Texans under 18 got a shot — the lowest point to date — but that number shot up to 86,000 two weeks ago and remained there last week, according to new data from the state health department.

The jump is promising for public health experts, who stress that vaccines are the best way to avoid severe illness and slow the spread of the coronavirus. Still, youth vaccination rates are the lowest of all age groups in Texas, with just 49 percent of those under 18 getting at least one shot, compared to much higher rates for their elders.

“The percent of adolescents that are eligible for vaccination and have been vaccinated, certainly in Houston and in Texas, is still quite low,” said Dr. Stan Spinner, the vice president and chief medical officer for Texas Children’s Pediatrics and Texas Children’s Urgent Care in Houston. “Yes, the numbers are going up. That’s encouraging. But they’re not going up fast enough.”

About 46 percent of 12- to 15-year-olds, who have been eligible for the Pfizer vaccine since May, have received a shot. Roughly 55 percent of 16- and 17-year-olds have gotten the shot, according to the health department data.

Meanwhile, the number of pediatric COVID cases and hospitalizations has exploded — more than 500 children are currently hospitalized with the virus in Texas. Children account for about 20 percent of all positive COVID tests at Texas Medical Center, Spinner said.

“They are the major component of the population that’s vulnerable,” he said. “They have not been able to get vaccinated, and we know kids get it. We’re seeing it. It’s not a myth. We’re seeing it in larger numbers than ever.”

The increase in vaccinations is unequivocally good, I want to be clear about that. But there are still two concerns. One is that the rate of increase is not enough. About one-fourth of all Texans are under 18, which means in absolute terms between seven and eight million people. Not all of them are currently eligible for the vaccine, but at a rough guess it’s probably two to three million. Even at 100K shots a week, it’ll take us months and months to get to a sufficient level of immunization. We need to increase that 86K figure by a factor of at least five, maybe even ten.

And two, as we well know, while even the first shot conveys some extra level of protection from COVID from the get-go, it takes a month from the first shot to be really protected. We need to be doing more in the here and now to help mitigate the spread of this plague. We all know the drill – masking, avoiding indoor gatherings, social distancing – but as long as our malicious Governor and malignant Attorney General are doing everything in their power to prevent those things, we’re going to continue putting everyone in a maximal amount of jeopardy. We’ve already seen high infection rates in school districts that have been open, and several districts forced to close down in person instruction in the short term. We know what needs to be done. It’s Greg Abbott and Ken Paxton and Dan Patrick who want to stop us from doing them. We can’t let them put our kids, and ourselves, in such danger.

HISD starts its year

Good luck, kids. You too, parents.

For the second straight year, Houston ISD is set to welcome back nearly 200,000 students in the midst of a pandemic.

The similarities between last year and Monday’s reopening end there, however.

HISD entered the 2020-21 school year with COVID-19 infections and hospitalizations in Harris County on a downward slope. Nonetheless, the district began the year online and did not open its campuses until October. Nearly half its students finished the school year learning remotely even as case numbers had waned toward the end. Those who returned to campus remained masked up, socially distanced, and in some cases, behind plexiglass.

This year, the district is plunging right in, offering limited remote learning to vulnerable kids, requiring face masks but relaxing social distancing requirements while the number of COVID cases and hospitalizations are rising higher than ever, driven by the highly contagious delta variant and a lagging vaccination rate in Harris County.

Many of those cases involve young people, including some under 12 unable to be vaccinated. Eighteen percent of all the new cases in the Texas Medical Center this month have been children, President and CEO Bill McKeon said.

A look at COVID numbers in the surrounding districts, most of which have been open for less than two weeks, provides a glimpse into what the largest school district in the state could face when it opens its doors Monday.

A week and a half into the school year, Conroe ISD reported 1,487 students and 143 employees were isolated with symptomatic or test-positive COVID-19. Fort Bend ISD disclosed 536 total cases among students and staff. At Spring ISD, officials had 139 active student cases on the seventh day back.

On Friday, HISD had 157 active cases. The district finished last year with 2,037 total cases among students and another 1,600 among staff, according to state figures.

“We are really shoveling water out of the boat as we go because the cases are going up. The cases are jumping into the boat while we are shoveling them out of the boat,” HISD Superintendent Millard House II said of the region’s surge. “We are doing the best job we can, being as strategic as we can — keeping students and staff first in every decision that we make.”

It is what it is at this point. I forget where I saw it, but I came across the observation that HISD and other school districts were planning over the summer to emphasize making up for lost ground this year, and instead they’re having to deal with another form of the pandemic. The school year starts as the case rate is as high as it’s been since February, young kids still can’t be vaccinated, and the district is fighting to be able to enforce its mask mandate. I’m happy with the way Superintendent House has handled this so far, and I’m cautiously hopeful that we can get through the worst of this and be in a good place when we do. If you have schoolkids like I do, good luck and stay safe.

The approval and the mandates

As I’m sure you’ve heard by now, the FDA has given its final approval to the Pfizer vaccine for COVID-19. That should mean a lot of good things, but among them it should mean broader vaccine mandates are now in play.

The U.S. Food and Drug Administration’s full approval of the Pfizer vaccine Monday is cracking open the door for Texas cities, counties and school districts to compel their employees to get vaccinated against COVID-19 — moves previously blocked by Gov. Greg Abbott.

Abbott had banned public schools and local governments from enacting their own vaccine mandates. But the governor’s executive order specifies that the ban on mandates applies to COVID-19 vaccines that are under emergency authorization — a designation that no longer applies to the Pfizer two-dose vaccination.

Already, one major school district is pressing forward with its plan to require vaccinations for teachers and staff.

Pedro Martinez, superintendent for San Antonio Independent School District, called for mandatory employee vaccinations last week — drawing a lawsuit from Attorney General Ken Paxton, who accused the district and Martinez of breaching Abbott’s ban on vaccine mandates.

But with the FDA’s approval, San Antonio school officials are moving forward with their vaccine requirement for district employees.

In a statement, Martinez called the FDA approval “a positive step forward in the fight against COVID-19 nationwide and a step forward in helping keep schools safe for learning here at home.”

Here’s Superintendent Martinez on CNN discussing his fight against Greg Abbott over this. Most of the fights so far have been about mask mandates, but as we noted recently, San Antonio ISD has notified its employees that they must get vaccinated, which has drawn a lawsuit from Ken Paxton. Which, apparently, has been withdrawn now, as the executive order against vaccine mandates only covered “vaccines administered under an emergency use authorization”.

Here’s more from the Chron.

The Pfizer vaccine’s change in status appears to give cities, school districts and universities a way around the governor’s ban.

“Receiving a COVID-19 vaccine under an emergency use authorization is always voluntary in Texas and will never be mandated by the government, but it is strongly encouraged for those eligible to receive one,” Abbott’s most recent executive order reads.

A spokeswoman for Abbott did not immediately respond to a request for comment on Monday.

The update means San Antonio Independent School District, which was sued by the state after requiring its employees to get the shots by Oct. 15, is still moving forward with its mandate. The district had clarified late last week that it would not compel workers to get a vaccine that wasn’t fully approved by the FDA.

Attorney General Ken Paxton touted that as a win in a news release Monday, distributed less than an hour after the FDA granted full approval.

“State law could not be clearer: ‘No governmental entity can compel any individual to receive a COVID-19 vaccine administered under an emergency use authorization,’” Paxton said in the release. “But San Antonio ISD tried to play by its own set of rules. Thankfully, we stopped them.”

San Antonio school officials say the full authorization now allows the district to go ahead with its requirement that all employees get the shots by mid-October, they say. In his clarification statement last week, Superintendent Pedro Martinez had stipulated that the timeline would only change if the FDA hadn’t fully authorized the vaccine by Sept. 10.

Hey, if you want to declare victory while you’re surrendering and retreating, it’s fine by me. Just keep on surrendering and retreating, that’s all I ask.

The remaining questions are 1) What about Moderna and J&J; 2) What will other government entities do about this new ability; and 3) What about the mask mandates? In short,

1) “In May, Pfizer and BioNTech submitted their license application. Moderna began its application in June, and Johnson & Johnson said it will begin the process later this year.” As such, I’d assume the Moderna approval will come sometime in September or October, and J&J will be later than that. But most people have Pfizer or Moderna shots, so that’s the main thing.

2) My guess is they will move more slowly, but once the first domino falls I’d expect others to follow quickly. Note that this will be about mandates for local government employees, not residents. It’ll help, but it won’t apply to everyone.

3) Not the same thing, so we’re still waiting for the lawsuits to play out.

In the meantime, go tell all your vax-hesitant family, friends, neighbors, co-workers, acquaintances, and whoever else that now is the time for them to get their shots. It’s all officially approved, there’s no need to wait any longer.

The nursing home vaccination mandate

This just seems obvious to me.

President Joe Biden announced on Wednesday that he is directing all nursing homes to require their staff be vaccinated against Covid-19 in order to continue receiving Medicare and Medicaid funding.

Biden said he is directing the Department of Health and Human Services to draw up new regulations making employee vaccination a condition for nursing homes to participate in Medicare and Medicaid. The decision on nursing home staff represents a significant escalation in Biden’s campaign to get Americans vaccinated and the tools he is willing to use, marking the first time he has threatened to withhold federal funds in order to get people vaccinated.

“Now, if you visit, live or work at a nursing home, you should not be at a high risk of contracting Covid from unvaccinated employees. While I’m mindful that my authority at the federal government is limited, I’m going to continue to look for ways to keep people safe and increase vaccination rates,” the President said during a speech at the White House.

[…]

The move comes as the more transmissible Delta variant now accounts for 99% of Covid-19 cases in the United States and as data shows a link between low vaccination rates in certain nursing homes and rising coronavirus cases among residents.

The Delta variant has spurred a jump in daily new cases from a low of 319 on June 27 to nearly 2,700 on August 8, according to Centers for Medicare & Medicaid Services. Many are in facilities in areas with the lowest staff vaccination rates.

In the seven states in which less than half of nursing home staff is vaccinated, weekly cases were 7.9 times higher in the week ending August 1 than they were in the week ending June 27. Meanwhile, in states that have vaccinated a larger share of staff than average (more than 60%), cases reported in the week ending August 1 were only three times higher than cases reported in the last week of June.

The new regulations could go into effect as early as next month, but Johnson said the CMS will work with nursing homes, employees and their unions to ramp up staff vaccinations before the regulations go into effect.

About 1.3 million people are employed by the more than 15,000 nursing homes that participate in Medicare and Medicaid. Some 62% of those workers are vaccinated nationwide, according to CMS data, but the figure ranges from 44% to 88% depending on the state.

“We have seen tremendous progress with low Covid rates within the nursing home population and I think we’re seeing signs that it is starting to tip the other direction. We don’t want to go backwards,” said Jonathan Blum, CMS’ principal deputy administrator.

Blum said CMS officials are “confident we have the legal authority” to implement the new regulation, noting that the law allows CMS to take action as it relates to the health and safety of nursing home residents.

As the story notes, this came a day after Biden directed the Education Department to get involved in the mask mandate fight. You would think, given how devastating the first wave of COVID was to the residents of nursing homes, that their staffers would be highly vaccinated as well, but you would be wrong.

Nationwide, most of the elderly and vulnerable in long-term care facilities have taken the coronavirus vaccine, but many of the staff caring for them have refused it. The federal program responsible for bringing vaccines to the vast majority of nursing homes and similar settings inoculated roughly half of long-term-care workers in the nation, and in some states a much slimmer percentage, as of March 15, according to new data from the Centers for Disease Control and Prevention provided to the Center for Public Integrity.

In seven states and the District of Columbia, the program vaccinated less than a third of staff members.

Now the federal program is winding down in the coming days, leaving states and facilities to figure out how to vaccinate the remainder of workers in settings where COVID-19 has already taken a heavy toll.

Though they represent a tiny fraction of the American population, long-term-care residents made up 34% of the nation’s COVID-19 deaths as of March 4, according to the Covid Tracking Project. Low vaccination rates among staff at these facilities mean that workers continue to have greater risk of contracting COVID-19 themselves or passing the virus to their patients, including residents who can’t be inoculated for medical reasons. Low staff uptake can also complicate nursing homes’ attempt to reopen their doors to visitors like Caldwell, who are striving for some sense of normalcy.

“Going into it, we knew it was going to be a problem,” said Ruth Link-Gelles, who led the team at CDC working on the federal initiative that’s now closing up shop, the Federal Pharmacy Partnership for Long-Term Care Program.

She cited past years’ low vaccination rates among long-term-care workers for diseases such as the flu. “We were disappointed, but I don’t think anyone was shocked to see the low uptake. … There is a stubbornly large portion of the population that really doesn’t want to get vaccinated, and we have a lot of work to do generally and in this community in particular.”

Federal agencies and states have poured resources into a #GetVaccinated educational campaign, hosting listening sessions, live chats and virtual town halls for long-term-care staff to get their questions answered.

In spite of all these efforts, many workers are reluctant to take the shots because they don’t trust information about the vaccines’ safety or they don’t wish to be among the first to take them, experts said.

“There are many reasons to blame nursing homes and the federal government,” said David Grabowski, a professor of health care policy at Harvard Medical School who studies long-term care. “We knew this coming in — that this was a group that was not very trusting of leadership and frankly not very trusting of the vaccine so it was going to take some work in terms of building that trust.”

That story was from late March, so things may be better by now. According to the map embedded in this story, as of that time about 54% of the long-term care workers in Texas who have been vaccinated got their shots through this federal program. But as usual, the overall story in Texas is not great.

The number of nursing homes across the state with at least one active COVID-19 case has shot up nearly 800% in the past month — while nearly half of nursing home employees in Texas remain unvaccinated.

Nursing home residents were among the hardest hit by COVID-19 last year as the virus tore through facilities at an alarming rate. More than 400 Texas nursing home residents died during a single week in August 2020; since the pandemic began, 9,095 have died after contracting COVID-19, according to the Texas Health and Human Services Commission. As of Aug. 11, that’s 17% of the state’s COVID-19 deaths.

To slow the virus’s spread, Gov. Greg Abbott shut down nursing home visitation in March 2020, then eased those restrictions five months later for facilities that didn’t have active cases in the previous two weeks. HHSC’s current visitation guidelines for nursing homes require visitors to wear a mask at all times and limits visitation to no more than two “essential caregivers” per resident.

But after seeing infections remain relatively low in recent months, the state’s more than 1,200 nursing homes are seeing a new wave of infections as COVID-19 cases explode around the state, driven by the highly contagious delta variant:

  • The number of Texas nursing homes with active COVID-19 cases has risen by 773% in the past month, from 56 in mid-July to 489 on Aug. 11. That’s still well below the peak in January, when more than 900 facilities had at least one active case.
  • Deaths are increasing as well. From July 21 to Aug. 11, 84 nursing home residents died from COVID-19, compared to seven deaths during the four-week period before.
  • Roughly 76% of nursing home residents in Texas have been fully vaccinated, putting the state 46th nationally. The national average is 82%.

But the current surge in nursing home cases hasn’t triggered renewed restrictions by the state.

“We continually assess what actions are necessary to keep people safe in the facilities we regulate,” HHSC spokesperson Helena Wright-Jones said in a written statement.

Meanwhile, just over half — 56% — of nursing home staff have been fully vaccinated, below the national average of 59%, which puts Texas 33rd nationally for nursing home staff vaccination rates.

In other words, the usual indifference from state government and general mediocrity, which puts a whole lot of people at risk. What do the nursing homes have to say for themselves?

Kevin Warren, the president and CEO of the Texas Health Care Association, whose members include both for-profit and nonprofit long-term health care facilities, said nursing homes are hesitant to require staff to be vaccinated because they are fearful of losing employees who might look for other jobs that don’t require vaccinations.

“Right now, we have a severely stretched workforce,” Warren said. “And when we see this surge occurring again, the stress and the emotional toll it places on staff and others that are in the building, the concern is: ‘If I put this vaccine mandate on, am I potentially going to lose staff?’”

The percentage of nursing home staffers who are unvaccinated is similar to the general population, Warren added, “so let’s not set them out to the side.”

Except they’re in close contact with the most vulnerable people in the state, and not enough of them are vaccinated, either. The DMN has a whole story on that, and while I can believe it to some extent, there’s a quote from a nursing home operator whose staff is 70% vaxxed, and I cannot see how this is any less urgent than getting hospital staff vaccinated. We’ve tried the carrot, now there needs to be a stick. There’s plenty of polling data to suggest that a non-trivial number of people who are vaccine hesitant will give in and get the shot if their workplace mandates it. Let’s put that to the test.