Democratic officials angry at Texas Gov. Greg Abbott’s handling of surging coronavirus numbers in the state this week had one lackluster place to voice their frustrations about the rapidly escalating public health crisis killing their constituents: a Zoom press conference.
“While some states followed the advice of public health experts, Texas did not,” Dallas-area State Rep. Toni Rose said from a webcam on Wednesday, a photograph of the Texas Capitol superimposed behind her.
It was certainly not the first time Democrats in the state had inveighed against a pandemic approach criticized by some as too reckless, and followed months of power struggles between local and state leaders in Texas over lockdowns, masks, and more.
But the politics of the COVID-19 situation in the state—Democrats yelling into the void, at least until Gov. Greg Abbott ordered mask use in hot zones across the state Thursday—had already given way to hard numbers, not just of cases, but also of hospitalizations, with the state’s medical system suddenly under pressure that seemed unthinkable even a few weeks ago.
“If rates [of infection] continue to increase 50 percent week over week, you can only do that for so long,” said Dr. David Lakey, vice chancellor for health affairs and chief medical officer at the University of Texas system and a member of the Texas Medical Association COVID-19 Task Force.
He added that chief medical officers across the state, at least this week, are “really busy, but they’re managing it.” The fear, he explained, is what next week, or the week after, will look like. And while beds, ventilators, and ICU rooms are holding up overall so far, “they’re starting to see some challenges in staff,” like respiratory therapists and nurses. As those challenges rise with the climbing hospitalizations, staffers have gotten sick or been forced to quarantine after exposures.
And the numbers are getting more ominous.
Texas broke another record for daily new cases on Tuesday, at 8,076 infections, according to state data. The previous record, on Monday, was 6,975. Days earlier, the record was 5,996. On June 16, the state broke the 4,000-mark for the first time.
As Democratic State Rep. Trey Martinez Fischer, who represents San Antonio, said during the press conference, Gov. Greg Abbott “gambled” with Texas lives with an aggressive reopening, and “we have lost.”
After a slew of mayors and judges tried to drag their feet on the governor’s swift reopening plan earlier this spring, the state’s attorney general sent letters to leaders in Dallas, Austin, and San Antonio warning that rules stricter than the state’s might be met with legal action. As the surges worsened across the state, though, Abbott gave his tacit consent for local officials to impose masking requirements on businesses, and urged individual Texans to mask up.
This week, Abbott went much further, shutting down bars statewide and suspending elective medical procedures in eight counties. Bar owners who previously said they supported Abbott’s reopening turned against the governor, with some protesting in front of the state Capitol holding signs that read “Bar Lives Matter.” And on Thursday, Abbott made a remarkable turnaround, ordering residents to wear face masks in all counties with at least 20 COVID-19 cases, and empowering local authorities to break up gatherings of more than 10 people.
But conversations with health experts and medical professionals in the state suggested the emerging crisis at medical facilities in Texas was already deeply advanced.
Texas Medical Center, the world’s largest medical complex, indicated last Thursday that its base intensive care capacity hit 100 percent and that it was “on pace to exceed an ‘unsustainable surge capacity’ of intensive care beds by July 6,” The Houston Chronicle reported this week. Last week, the Texas Children’s Hospital in Houston began admitting adult patients because of the surge, according to the paper. Internal communications at Houston hospitals revealed a lack of space and therapeutic drugs as the region’s medical facilities worked to treat more than 3,000 COVID-19 patients, including about 800 in intensive care, NBC News and Propublica reported Wednesday.
Meanwhile, as of Tuesday, about 75 percent of Tarrant County’s intensive care unit beds were occupied, The Fort Worth Star-Telegram first reported.
At recent hospitalization growth rates, facilities in Tarrant and Dallas counties could reach their surge capacities in as few as four weeks, according to Rajesh Nandy, an associate professor of biostatistics and epidemiology in the University of North Texas’s School of Public Health.
“The simplest way to look at is this: Let’s say the trend doesn’t change, and hospital capacity stays the same as it is currently. Under those assumptions, it would be two to three weeks before they’re operating at max capacity,” Nandy, whose team has studied local and national COVID-19 data since the pandemic began, told The Daily Beast on Wednesday. “It probably would be three to four weeks when we’d be overloaded even with surge capacities. At that point, we’d have to consider creating new facilities at convention centers.”
Despite those warnings, Dallas-area hospitals have repeatedly said they don’t need to prepare a pop-up facility at a nearby convention center, with the chair of the Texas Medical Associations’ board of trustees telling the newspaper that there are “a number of safety valves that could be pushed.”
Still, said Nandy: “Our health-care system will be overwhelmed if it continues like this.”
And ragged, frustrated medical providers all over the state have said they’re anxious about the days to come.
“We are in an entirely different place now than what we were just four weeks ago,” said Dr. Pritesh Gandhi, an Austin-based primary care doctor and the associate chief medical officer at People’s Community Clinic, which serves uninsured and underinsured Central Texans. “In the last few days, our clinic has seen three or four times as many patients for drive-through testing than we had weeks ago, and it’s reflective of massive community spread.”
Gandhi, a Democratic candidate for Texas’ 10th Congressional District, called the medical community’s efforts to provide care for Texans during the past month of surges “extraordinarily challenging” and said it has been “complicated by failures at both the federal and state level.”
“We’re testing more, having more positives, having more symptomatic patients, doing more drive-through testing,” Gandhi told The Daily Beast on Wednesday. “Staff are getting sick, just like anywhere else.”
Gandhi, and the group of Democratic state representatives who held the press conference, decried an undercurrent of “science denialism” and “hostility towards public health” perhaps best embodied by an interview Lt. Gov. Dan Patrick gave to Fox News hours earlier. He said Dr. Anthony Fauci, the top infectious disease expert in the country—and the face of the federal response to the pandemic—was “wrong every time on every issue.”
“He doesn’t know what he’s talking about!” Patrick told Fox News on Tuesday evening. “I don’t need his advice anymore.”
Dr. Lakey—a former commissioner of the Texas Department of State Health Services who was appointed by former Texas Gov. Rick Perry—was more forgiving of Abbott than others in the state. He said he doesn’t envy those, like the governor, who’ve had to navigate the middle ground between complete statewide shutdowns and complete light-switch openings.
“It’s a very fraught time in public health,” said Lakey. “No one has a crystal ball. There’s no perfect plan.”
“You make your plan, and then you have to be ready to adjust your plan,” said Lakey. “That’s not a sign of failure, it’s a sign that you’re looking at the data and trying to make the best decision.”
But both Rose and Rep. Donna Howard, who represents Austin, said their constituents would likely benefit from a second statewide shutdown, and that Abbott’s decisions had been deeply damaging. Martinez-Fischer emphasized that stay-at-home orders were a tool that should never have been taken out of local hands.
“We know that it worked before,” said Howard. “That contained the spread before. We have to do what we have to do here, and unfortunately shutting down may be our only option.”
Whether or not that’s true, it remains unclear if Abbott would do it, as he’s said “closing down Texas again will always be the last option.”
Then again, many public health experts question whether it would be necessary.
As Lakey noted: It’s no longer March. Those trying to battle the crisis in Texas have the benefit of months of nationwide observation, studies about intubation, clinical trials, and promising therapeutic treatments like Remdesivir. And the mask order could help turn the tide.
“We have learned from that experience and are bringing those lessons to the response,” said Lakey.
Still, he and others point to the myriad unknowns in the coming days, from July 4 weekend celebrations to college students possibly returning to campuses in just a few weeks.
As Gandhi said on Wednesday, “We’re angry and we’re exhausted because of the incompetence.”
“It didn’t have to be like this.”