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With shutdown success evaporated, model suggests mid-July peak for COVID-19 in Houston - Houston Chronicle

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A surge in COVID-19 cases since Memorial Day could set the Houston area on track for a peak of 2,000 daily hospitalizations by mid-July, according to a model from a Baylor College of Medicine epidemiologist.

The region’s intensive care units would be overwhelmed by that number of patients, a nearly 50 percent increase from current levels, though thousands of general hospital beds remain available, said Dr. Chris Amos.

City of Houston Health Authority Dr. David Persse said several area hospitals already are at or over capacity and warned that shifting patients to facilities in other cities, a common practice in natural disasters, may no longer be possible.

“The difference this time is the hurricane, if you will, is infecting the entire state,” Persse said.

With government restrictions on business and travel removed, the epidemiologist and hospital executives from the Texas Medical Center said the only hope for the Houston area to avoid that outcome is for residents to practice social distancing, wear masks and avoid unnecessary contact with others.

Too many residents, they said, appear to have mistaken the end of Harris County’s stay-at-home order as a cue to resume normal life, while the virus poses a greater threat today than it did May 1.

“The alarming situation could be that we have rampant COVID spreading throughout our society,” Houston Methodist CEO Dr. Marc Boom said. “If we don’t take control, it takes control for us.”

Elected officials and their public health experts are grappling with the idea that Harris County may have squandered much of this spring’s success in slowing the growth of the virus during the six-week stay-home period.

The shutdown dealt severe damage to the economy, including half a million lost jobs. Since Gov. Greg Abbott began reopening the state in May, however, the Houston area has set new records for cases and hospitalizations.

“All of the good work that we did, shutting down, closing conferences and conventions … we’re wiping away the success that we collectively achieved, and the sacrifices that people made in March, April and in May,” Houston Mayor Sylvester Turner said.

The mayor lamented that local officials have had little authority to issue restrictions since Abbott has implemented his phased reopening plan, and urged residents, at a minimum, to follow County Judge Lina Hidalgo’s mask order, which went into effect Monday. The order mandates that Harris County businesses require their customers to wear face coverings.

Abbott defended his strategy during a news conference in Austin, saying it achieved its primary goal of preventing hospitals from being overrun. He said the rate of new cases across the state was unacceptable, however.

The state reported 3,280 new cases Monday, bringing Texas’ total to 114,881.

The 25-county region anchored by Houston set a new record for COVID hospitalizations for the ninth time in 11 days Sunday, with 1,847 patients. ICU usage crept up to 89 percent, and the Texas Medical Center warned its system could exhaust base intensive care capacity within two weeks. More than 10,000 general and ICU beds remain available in the region.

While the number of daily COVID tests has remained constant, the rate of positive results has tripled to 9 percent in recent weeks, another troubling trend, Persse said.

Without any signs that those numbers will slow, Memorial Hermann Executive Vice President Dr. Jim McCarthy said he will keep anticipating a deluge of cases in his hospitals.

“They’re going to continue to fill us up,” McCarthy said. “We have not flattened into that steady state of growth.”

Should the current new case and hospitalization rates continue, physicians warn, the region’s outlook is grim. Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor, said Sunday that Houston could become the worst affected area in the country if the trajectory persists.

Boom added that Houston residents could face a shutdown of sorts even though businesses are allowed to remain open. Many companies, including restaurants, bars and retailers, may shutter again as their employees fall ill, he said, and measures like Harris County’s new mask rules simply are not enough to contain the spread of the virus.

Fifteen Houston restaurants over the weekend announced temporary closures due to an employee testing positive or fear of spreading the virus among patrons.

Amos’ model combines current case trajectories with projections of recovery rates to determine when the area could see a downturn. He said the model offers Houston residents, much like Ebenezer Scrooge, a chance to see what may happen while retaining the ability to change the outcome.

“Now is the time where people can change their behaviors,” Amos said. “It’s sort of like Christmas future. It doesn’t have to be this way.”

The increase in cases is not attributable to a single factor, Harris County Public Health Executive Director Umair Shah said. Each family picnic, crowded bar, public protest and graduation ceremony creates a “layering effect” where the virus spreads invisibly, often not creating symptoms in patients for a week or more.

The march and rally in memory of George Floyd on June 2, which drew more than 60,000 people to downtown Houston, is likely one of many drivers of the jump in cases, Shah said.

Shah said state leaders have not appeared to reassess whether Texas has reopened too quickly.

“As restaurants went from 25 to 50 to 75 percent (capacity), we started to see increases in cases,” Shah said. “From a public health standpoint, you would have thought some of those areas would have been pulled back.”

The worsening trends have helped Harris County meet four of the five criteria set by the health department’s threat level system that would call for a return to stay-at-home rules. Since Hidalgo lacks the authority to issue new restrictions, Shah said residents must decide whether to heed the increasingly desperate requests of health officials.

“It’s up to all of us as a community to decide which direction we’re going to go,” he said.

zach.despart@chron.com

samatha.ketterer@chron.com

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