COVID-19

With COVID-19 Cases Surging In Texas, What’s Next?

Positive cases, hospitalizations and deaths are on the rise. Texas A&M infectious disease experts discuss the direction of the pandemic.
By Caitlin Clark, Texas A&M University Division of Marketing & Communications July 14, 2020

man wearing masks and gloves writes on a clipboard in front of a line of people
A community outreach specialist collects patient information as they wait in line at a walk-up COVID-19 testing site in on June 27 in Dallas. Texas is facing a surge of new cases of COVID-19.

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At the end of a record-setting week for new coronavirus deaths and hospitalizations in Texas, Gov. Greg Abbott suggested that “the worst is yet to come.”

The governor said the new statewide mask mandate “was our last best effort to slow down the spread of COVID-19.” The next step, he told a reporter for KLBK-TV in Lubbock, “would have to be a lockdown.”

“I hope this is a signal to everybody that we cannot be complacent, we cannot afford to shut down our economy – I don’t think that’s the right answer – but we need to have everyone be compliant with the basics in infection controls so we don’t have to take more drastic measures,” said Dr. Gerald Parker, associate dean for Global One Health at Texas A&M University.

Parker, an infectious disease expert who also serves as director of the Bush School of Government and Public Service’s biosecurity and pandemic policy program, has said an increase in cases was to be expected as people began to return to restaurants, bars and retailers under the state’s phased reopening plan. Now, Parker said, “I must admit that I’m more concerned than I was two weeks ago with the uptick in cases we are seeing, and the rapid slope of that uptick is what’s concerning.”

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Texas has reported 3,235 COVID-19 fatalities as of Monday. Another 10,405 confirmed COVID-19 patients are currently in Texas hospitals – according to state data, 984 ICU beds remain available. More than 2.8 million people have been tested for COVID-19, according to the Texas Department of State Health Services, with 264,313 testing positive.

“The outlook for the COVID-19 pandemic as it’s specifically affecting Texas is pretty dire right now, but that doesn’t mean to say that we can’t turn that around,” said Rebecca Fischer, professor of epidemiology and biostatistics at the Texas A&M School of Public Health. “I think in particular the increasing number of cases, and the number of deaths as well over recent weeks, along with the growing number of people whose illness drives them to hospitalization, really emphasize the magnitude and drives home the reality of the pandemic and manifest the power this pandemic has had in our lives.”

The situation wasn’t always so grim – Texas had low case counts for a state of its size toward the beginning of the pandemic, and the trajectory of confirmed cases had seemed to level off, Fischer said. The state’s measures to restrict the movement of Texans to reduce community spread were working, she said. The response wasn’t perfect, and didn’t prevent the pandemic from moving forward, but the amount of cases was manageable enough for hospitals to treat and triage patients as needed.

view through foliage of masked medical professionals moving a patient in a hospital bed through a parking lot
Members of the medical staff move a bed to transfer a patient to another room outside of the COVID-19 intensive care unit at the United Memorial Medical Center on July 2 in Houston. COVID-19 cases and hospitalizations have spiked since Texas reopened, pushing intensive-care wards to full capacity and sparking concerns about a surge in fatalities as the virus spreads.

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However, Fischer also admits that while it was an effective initial reaction, remaining in a state of shutdown was not a long term solution.

What happened next was a “perfect storm of events” leading to a surge in cases. Fischer said the reopening of bars, social events over Memorial Day weekend and lower perceived risk in the community were all likely factors that made Texas a hotspot for the virus.

Complacency and a stream of often-contradictory information also hasn’t helped, said School of Public Health Dean Shawn Gibbs.

Gibbs, who’s studied the disruption of highly infectious diseases for 20 years, said while public health messaging has largely stayed the same, the public has been given nationally and regionally inconsistent messages about social distancing, the importance of wearing face coverings, reducing interactions with others and the severity of the virus.

“Unfortunately, what we’ve seen is public health precautions have now been turned into political issues,” Gibbs said.

The demographics of people infected are also changing. Fischer said younger Texans are testing positive for the novel coronavirus at higher rates, with that age group including adolescents, teens and people in their 20s. Those who have co-morbidities or are immunosuppressed are still getting sick, she said, but the virus is now affecting more and more young people who returned to social gatherings, allowing the virus to spread more widely among communities.

The growing percentage of positive test results among those delivered is also a concern, Fischer said. Epidemiologists are worried about underreporting and cases that have gone untested.

aerial view of cars lined up in parking lot
An aerial view fas residents wait in line for the drive-thru COVID-19 testing center at the Ellis Davis Field House on July 2 in Dallas.

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Experts are watching the state’s positivity rate – the percentage of positive cases to the total number of tests conducted. Fischer said several target numbers have been suggested, with a rate of about 3 or 4 percent proposed. That would mean that enough tests are being administered that roughly 97 percent of people screened are negative for the virus.

“That’s the goal, that testing is widespread enough that the vast majority of people that we are screening are testing negative, and the disease has been suppressed at that level in the community,” Fischer said.

The experts point to simple measures that need to be taken to curb further spread.

“This is really going to require a kind of collective sense of social and personal responsibility and accountability,” Fischer said. “This is a disease that we don’t have a vaccine for yet, there’s no widespread, blanket treatment, and the best options we have include preventing the spread, which happens through our own responsible behaviors. We all know what they are at this point… we know what to do, and it truly does boil down to individual behaviors and a sense of responsibility.”

Gibbs said it’s an act of selfless service to practice social distancing and wear a face covering to prevent potentially spreading the virus to others.

“It’s really being able to get people to change behaviors so that they don’t put themselves and others at risk, and I think that’s one of the things we’re seeing over and over again, is people who thought they were invincible or thought they were not at risk of being infected,” he said.

As experts learn more about the coronavirus, Gibbs said, public health officials and government leaders will need to be flexible and able to quickly make adjustments to response plans based on available information.

Echoing Dr. Anthony Fauci, who gave an urgent message to lawmakers last month that the U.S. could see new cases of COVID-19 rise to the level of 100,000 a day, Parker said, “We are not on the path we need to be on.”

“Whether it turns into a dangerous path, I don’t know, but what I do know is that this pandemic is far from over,” Parker said. “This is going to go on, even if we have a vaccine… we’re in the second or third inning of a baseball game that may go extra innings.”

Video by Mark Guerrero and Sam Craft, Texas A&M University Division of Marketing & Communications

 

Media contact: Caitlin Clark, caitlinclark@tamu.edu

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