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Texas a COVID Hotspot as State Reopens

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June 17, 2020 -- Officials in Cameron County, TX, had seen cases of the coronavirus in the double digits even before the state began easing restrictions in May for restaurants, hair salons, sports-related gatherings, and other businesses and activities. But the numbers they’ve seen recently are higher.

That’s worried James Castillo, MD, the health authority of the border county. Castillo, an internist who specializes in palliative care, thinks the uptick in cases is coming from “people interacting more, getting together more, more businesses being open. The question is how do you have a balance [to keep the economy going], right? I think maybe we’re off balance.”

At a news conference Tuesday, Gov. Greg Abbott said the overall increases in reported cases around the state are mostly linked to more testing and to people in jails, nursing homes, and prisons.

He also said in some counties, the growth in cases since June 1 has come largely from people ages 30 and younger.

"We are in the middle of a short period of time where all of us have to coexist with COVID-19," Abbott said. "The reality is COVID-19 still exists in Texas."

Mark E. Escott, MD, the interim health authority for the city of Austin and Travis County, said that in Hispanic and African American communities in his area, increases in hospitalizations due to COVID-19 may be linked to people working in the service industry, which puts them at higher risk for catching the virus. The coronavirus may also spread more easily among those racial and ethnic groups because many people of color live with several family members, he said.

They may also lack access to health care and are at a higher risk for having other conditions, Escott said.

The state’s health agency reported another record-high number of reported cases of the virus Tuesday. According to data from the CDC, Texas is among states with more than 90,000 reported cases of the respiratory virus that has affected more than 2 million Americans and killed over 116,000. It ranks sixth among states with the highest number of reported cases, behind New York, New Jersey, Illinois, California, and Massachusetts.

Data collected on the site covidexitstrategy.org, run by a group of public health researchers and crisis experts, shows the infection rate is going up in the Lone Star State. It’s considered one of the states “trending poorly,” and it’s low in available ICU beds, the site shows.

Dallas Cowboys running back Ezekiel Elliott is among athletes with Texas ties who have tested positive for the virus.

Abbott said the recent increase in new infections and hospitalizations due to COVID-19 also isn’t alarming, in part, because the state has an “abundant capacity” of hospital beds to treat people who have the disease. The virus more seriously affects people with diabetes, obesity, and high blood pressure -- chronic conditions that many Texas adults have.

While the state doesn’t have a mandate about masks, Abbott also urged Texans to protect themselves and others by using masks when they’re out and about, disinfecting their hands diligently, and keeping themselves at least 6 feet from others when possible. If people follow those preventive measures recommended by the CDC, Abbott said, “jobs can be maintained without jeopardizing the health of the community.”

But his upbeat tone was tempered by comments from one of the state’s top public health officials.

John Hellerstedt, MD, the head of the Texas Department of State Health Services, said health officials and hospitals can manage the increase in cases. But he warned that “the possibility that things could flare up again and produce a resurgence of COVID that would be a stress on our system, on our health care system, is still very real.” He said people should be careful to protect themselves because most of the state’s nearly 29 million residents haven’t caught the virus and aren’t immune to it.

Abbott, who has allowed many businesses to almost reopen fully, has been at odds with local leaders who want to make certain preventive measures mandatory. The governor restricted the power of counties to do that in April.

On Tuesday, mayors of some of Texas’s most populous cities, including Dallas, Fort Worth, and El Paso, wrote Abbott to ask that he allow them to regulate the use of masks, which studies have shown may help put the brakes on the virus’s spread. “A one-size-fits-all approach is not the best option,” they argued.

Austin Mayor Steve Adler on Monday extended his city’s emergency order requiring social distancing and the wearing of masks in public until Aug. 15. He also issued new, voluntary guidelines for businesses that were allowed to open under Abbott’s earlier mandate. Those guidelines call for limiting the number of customers allowed in the business at once and for requiring social distancing among employees and customers.

Dallas County Judge Clay Jenkins has been among Abbott’s most vocal critics. On Tuesday, he issued a statement saying that the recent increases in cases could be linked to people’s reluctance to wear masks, lax social distancing, and “the governor’s decisions to accelerate opening and limit our local ability to enforce recommendations from [the] governor or medical experts.”

Escott, the interim head of public health in Austin and Travis County, said the “confusing political messages” have made many people believe that wearing masks is a sign of weakness. Wearing masks and social distancing, he said, are critical to protecting people’s health and the economy.

Castillo, the health official from Cameron County, says the governor has a tough job and there are no easy answers on how to keep people and the state’s economy healthy. But he says the governor should give counties more power to take measures that work best for them to curb the spread of the virus.

Now that many counties are doing contact tracing, Castillo says, the governor should use that data to identify businesses that may need to scale back their hours and apply better preventive measures to protect employees and customers. “We don’t need 100% safety,” he says. “We need to do everything we can to continue to slow the spread of this virus until we can get to good treatment and a vaccine.”

After all, he knows first-hand what the disease can do to people. A few months ago, he helped treat an elderly man who survived COVID-19 and now needs a walker to get around.

“Nobody wants this,” Castillo says. “It’s definitely an unpleasant illness. It’s not the flu.”

WebMD Health News Reviewed by Michael W. Smith, MD on June 17, 2020

Sources

CDC.gov.

The Lancet: “Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.”

International Journal of Nursing Studies: “A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients.”

ESPN.com: “Cowboys, Texans players test positive for coronavirus, sources say.”

TexasTribune.org: “Gov. Greg Abbott points to ‘abundant’ hospital capacity as Texas continues with business reopenings.”

TexasTribune.org: “Gov. Greg Abbott to let restaurants, movie theaters and malls open with limited capacity Friday.”

NBCDFW.com: “Gov. Abbott: Hospital Capacity ‘Abundant’ to Treat COVID-19; Mandating Masks Not the Right Approach.”

Dallasnews.com “Gov. Greg Abbott says rising Texas coronavirus cases, hospitalizations are no need to worry.”

KXAN: “Mayors of Texas’ largest cities send letter to Abbott asking for authority to regulate face coverings.”

CBSnews.com: “Texas governor says young people are driving coronavirus surge.”

News release, Dallas County, TX.

News releases, Cameron County, TX.

News releases, Office of the Texas Governor, Greg Abbott.

Texas State Department of Health Services.

Austintexas.gov: “Order No. 20200615-013 by the Mayor of the City of Austin,” TX.

Covid Exit Strategy.

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