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COVID in Austin Update (June 24)

News

We’ll start today with irony. New York, New Jersey, and Connecticut will now require a 14-day quarantine for anyone coming to those states from Texas and a number of other spiking states. As you may recall, Texas imposed a quarantine on those coming from those areas earlier in the pandemic. If you were planning an escape to Atlantic City, too bad, unless the courts say these quarantines are unconstitutional.

In Texas news, Gov. Abbott is now mandating (again) COVID protocols in child care centers. These were protocols that were originally in place once they were allowed to reopen to non-essential employees, but a week or so ago, the state made them optional. Without going into great detail since I don’t want to contradict what your child care center may be doing, it includes things like no family-style meals, temperature checks, limits of people in a room, limits to who is allowed into the building, etc.

We did pull our twins out of their pre-school—they were already scheduled to move to the elementary school in August anyhow—and opt to not enroll our one-year old as we originally planned. We’re amazingly privileged that we both work from home with arrangements flexible enough to make that work. My heart goes out to everyone who must navigate child care right now and to the child care providers trying to keep the doors open. If I recall correctly, my girls’ preschool saw a 97% decline in attendance in the first couple weeks they were allowed to reopen and the Paycheck Protection Program (PPP, the federal business relief money) wasn’t meant to last this long.

In the same time, Gov. Abbott also proclaimed an amendment to his GA-26 order now allowing local officials to regulate gatherings of over 100 people, prior GA-26 only allowed local regulation of gatherings 500 or more.

Lastly for general news, UT-Austin and Texas A&M announced they will not require SAT/ACT scores for the Fall 2021 admission cycle. High school juniors that couldn’t take their exams this spring and aiming for UT can breathe a little easier (behind a mask).

Data

On the data front, I had heard some excitement regarding OpenTable. The reservations app has regularly released data of reservations that have been a fair proxy to see how many people are relatively eating out versus the same day last year. The data recently released shows a new decline—after increasing since Texas reopened—but I’m not going to give it much stock yet since Father’s Day falling on a different date every year. In another week or so, hopefully the decline is a trend.

Another source of data I’m keeping on eye on is Apple’s mobility data. They have a dashboard of difference in mobility for iPhone users since January. It had been increasing since we reopened and we’re driving 13% more than we were on January 13th.

As a reminder, any changes in behavior will have a couple weeks until we start seeing that change hit the cases, hospitalization, etc numbers. The behavioral changes can help us understand if we may be seeing greener pastures ahead.

Greener pastures, though, is not what is in front of us right now.

Texas

New cases in the State of Texas slightly beat out yesterday’s record: 5,551.

For the 13th day in a row, the State has set a hospitalization record: 4,389.

Today, the Texas Tribute reported that our positivity rate is now over 10%. The goal for positive test results is 6% or under and 10%+ was Gov. Abbott’s “alarm” level. Positivity is used as a proxy to ensure we’re testing enough. The idea is if we are testing enough people that our positivity rate is low, then we likely have a better idea of the prevalence (e.g. how many people really have it). If we are testing and getting back 10%+ positive, that implies that our testing is missing a lot of people and we are undercounting true positives and not realizing the true situation.

To say it plainly, “we test more so we are going to get more positive tests” is faulty. If that statement is true, that means we aren’t testing enough. We need to test until we stop getting so many positive results back.

While Gov. Abbott has discussed our plentiful hospital beds across the state, beds in Lubbock aren’t going to help Houston or Austin.

Harris County (Houston)

Texas Medical Center continue to sound the alarm. They’re projecting they will go into “sustainable surge” levels of hospitalizations in the next day or two and go into “unsustainable surge” in about 11 days. As of yesterday via SETRAC, Harris County had 92% of their ICU beds full. Galveston County had 99% full (they had 1 bed empty). Still a lot of regular beds, but ICUs are starting to run dry without going into a surge state. Texas Medical Center reported today they’re at 97-98% ICU occupied.

Travis County (Austin)

Medical Press Conference

Austin/Travis County held a press conference with local-area doctors about the hospitalizations. The medical institutions covered the other local counties too, so I’m skipping the other counties today. If you’re in Hays or Williamson, etc, wear a mask and stay home.

The medical professionals on-hand included the medical directors of all of the major players—Ascension/Seton; St. David’s; Baylor, Scott, and White, etc—wanted to assure everyone that if you need a hospital, they are there. If you’re having a heart attack or stroke, please come to the ER. If you’re having cold/covid symptoms, please call ahead and head to a primary care facility first if possible.

Additionally, if you have insurance and need a coronavirus test, consider a private clinic—like Austin Diagnostic Clinic—to help Austin Public Health/CommUnity Clinic (the once-public-but-now-non-profit clinic system from the county) put resources most toward those who don’t have other form of access to tests. In all cases, if you need a test, get tested somewhere.

A lot of the other details were things we have already covered here in my reports previously (the demographic changes, the Austin Convention Center field hospital plan), but Dr. Escott shared a projection chart from the UT folks (thanks to Audrey McGlinchy with KUT grabbing and posting it on Twitter):

The overall point of the conference was act like a shelter-in-place order is in place, stay home, wear a mask.

The question did come up about the report that President Trump will be pulling back on federal funding for testing soon. Dr. Escott was not aware of the report. He said that testing was absolutely essential and Travis County would continue to ensure people have access to tests—figuring out the money later.

It sounds like though Austin’s sites aren’t part of the rollback. Dallas, El Paso, and Houston would feel the pain, though.

If you follow the Washington Post, they did pick up from the press conference that fax machines are a big reason we have such a long delay between a test and knowing the result. Fax machines are still used too often in medicine, I believe, because they are relatively easy to pass HIPPA requirements. E-mail doesn’t, which is why every doctor has an online portal that usually a pain in the ass to use. Anyhow.

Latest Austin Numbers

Austin’s latest numbers continue the trend. We had 318 new cases reported with 2 additional deaths. For the second day in a row, we had 56 new hospital admissions, putting our 7-day average at 43.4.

We now have 274 COVID inpatients of which 106 are in the ICU and 42 are on ventilators.

While today’s press conference mentioned that 1500 is a reasonable count for our hospital capacity, they did not share how many non-COVID beds are used at any given moment. I presume the 1500 includes the two children’s hospitals.

I’ll close with a quote from Dr. Mark Escott, the Austin/Travis County Interim Public Health Authority, during today’s conference:

Don’t go to a bar. Now is not the time. I’d love to be in a bar myself, but now is not the time.

Dr. Mark Escott, June 24, 2020

To end, a video about mask wearing:

By Brandon Kraft

My life is an open-source book.

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