COVID-19 CODE RED: Austin Moves Into Crisis Mode

As was sadly anticipated, Austin and Travis County are hurtling toward what had been the worst-case scenario for the rampaging COVID-19 pandemic. On Wednesday, as the Chronicle went to press, Austin Public Health leaders huddled with local health care experts and stakeholders and the modeling team from UT-Austin to determine whether to move into Stage 5, or the red zone, of APH's risk-based guidelines for COVID-19 response. Most likely, the answer by the time you read this will be yes – and the best thing for you to do, whenever possible, is to stay home.

The rate of community spread of the novel coronavirus would – and in APH's opinion still should – lead us to return to sheltering in place, as was mandated in March and April, before being overturned by Gov. Greg Abbott's "Open Texas" plan. (If you've forgotten the "stay home, work safe" orders, we made a handy infographic you can find online.) "We are in a very dangerous situation in Texas. We simply must be careful because we are at the verge of a real crisis," Austin Interim Health Authority Dr. Mark Escott told reporters and the public at APH's regular Wednesday news briefing. "Now is the time to act. Now is the time to protect yourselves, your family, and your community by staying home."

As the miscalculations of the state's GOP leaders and their vocal liberty-luvin' constituents – following the beyond-inept and chaos-spawning "lead" of the White House – have become horrifyingly evident, the onus on dialing back the state's reopening, or allowing cities and counties to do so locally, is back on Abbott. At press time, Austin Mayor Steve Adler, Travis County Judge Sam Biscoe, and their counterparts in other Texas metros have required people to wear masks in public (and businesses to require the same on their premises) and limited gatherings outside the home to 10 people or fewer. (They can waive the latter restriction if they want, on a case-by-case basis; neither Adler nor Biscoe has.) There may be further steps that can be taken to stop COVID spread within the authority still available to local leaders under current executive orders; the City Council is expected to discuss this and other COVID issues at a special called meeting today (Thursday, July 9).

To do heavier lifting – close nonessential businesses, make people stay home, prohibit gatherings of any size – would require Abbott to make a very public reversal on not just his specific orders but his whole approach to the virus. Is that simply out of the question? "My hope is that this would be a dialogue with the state," Escott said Wednesday, adding that "Gov. Abbott has been very reasonable in listening to the data ... He doesn't want to see people needlessly die." Escott, unlike most of the local politicos now at odds with Abbott, identifies as a Republican, and he expresses sympathy with the desire to keep the economy moving. "None of us wants to make the recommendation to go back to sheltering in place," he said. "We want to find a balance, so we're pleading with people today to dial things down on their own, to do things in a more protective way."

An economic shutdown would be bad, but a collapse of the Austin metro area's health care infrastructure would be worse, and it's that outcome – that is to say, a lot of needless deaths – that the local COVID response has been designed to avoid. While APH's emphasis on a single metric – the number of new hospital admissions for COVID-19 each day, expressed as a seven-day rolling average – has helped sharpen public health messaging, it's not actually the only factor that determines what stage we're in, which is itself only a rough proxy for the capacity and resiliency of the health care system. The admissions metric itself proved to be too low this week, as APH was able to match positive test results – which are once again lagging way behind, taking 10 days or more to be reported – with previously logged hospitalizations.

That said, all the metrics are quite bad – the number of new cases, ICU and ventilator usage, the positivity rate of new tests, and the grievous disparities between demographic groups – so trying to keep up with the variables on the COVID-19 dashboards is not really necessary. Just stay home, and assume you and your loved ones are contagious unless you absolutely know otherwise. As Escott put it on Wednesday, "It's COVID-19 season in Texas."