So what exactly is going on in Texas? Does the news stack up with reality?
I keep hearing about how bad it is from people (on the other side of the country) who quite obviously have zero ties to Texas.
I can tell you about my neck of the woods, and I can tell you about the children’s hospitals around the state.
- There is a spike in cases. It is due in part to additional testing, but is demonstrably a real spike because the percentage of tests coming back positive is higher than it was a few weeks ago.
- The average age of the positive cases and of the hospitalized patients is lower than it was. This includes the ICU patients.
- The hospital capacity issue is a little complicated. There has been a high census of non-Covid ‘catch up’ work going on, due to a combination of hospitals trying to recover financially from the huge hit they’ve taken when elective procedures were suspended, and partly due to the patients who’ve been putting things off finally coming out of their caves. The lady who needed a hip replacement or the guy who needed an invasive biopsy who thought they could gut it out for a couple months have been suffering with their issues, but have been getting stuff taken care of now.
State/federal hospital rules dictate that hospitals could only reopen for elective procedures if they abide by certain safety measures, have sufficient PPE and pretty much promise they won’t ask for more later from the state, and are required to retain 15% of beds specifically for Covid only.
So now the Covid admissions are rising (but so far still not deaths) and some hospitals in the mot populous areas are getting close to filling their normal capacities. The governor has re-suspended elective procedures in those 4 biggest counties (Houston, Austin, Dallas and San Antonio). Basically those hospitals could shift to take on a lot more Covid patients if necessary, but they’re not on that footing immediately because of the high census of non-Covid elective admissions. It shouldn’t take too long to shift that footing, so my opinion is that the noise about overwhelming capacity is probably overblown. There is a lot of slack in the system.
I’ve also seen false rumors even among medical people who should be better informed and should know better. I’m on a bulletin board for pediatric pulmonology, and several people believed Texas Children’s Hospital (Texas) was “full”. The head of the PICU responded and debunked the rumor.
My own county, the hospitals have also re-suspended non-essential admissions and procedures pre-emptively, although it’s not ordered by the state government yet.
I will be surprised if there is not a rise in deaths with a wave form lagging behind this surge. But I also think the amplitude will be much lower, with nowhere near the numbers the nursing home wave incurred. But so far, the death numbers have been steady. Scroll to the bottom of the link for graphs of new cases and daily deaths.
Texas Coronavirus: 159,310 Cases and 2,437 Deaths (COVID-19 ) - Worldometer
Its clear that there are a LOT of mild cases being detected. But there are people requiring hospitalization. I think less of these cases will prove fatal due to relatively healthier people combined with better knowledge for treatment. For example, some early reports were that steroids hastened death. Later data is showing benefit from a course of dexamethasone (now recommended by the NIH if the patient is intubated or requiring supplemental oxygen). The threshold to admit someone to the hospital is probably lower, too.
The number to watch is the deaths. Surely it will go up some, but if it’s a modest rise and fall which accompanies a high number of cases, Texas areas will probably follow NYC as place where new Covid activity is very slow because so many people have already recovered.