Austin health leaders concerned about possible 2nd COVID-19 wave in June

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AUSTIN (KXAN) — During a weekly news briefing, Austin Public Health discussed the effectiveness of preventative measures taken against COVID-19 as the state reopens and the possibility of a second wave of cases in mid-to-late June.

Interim Health Authority Dr. Mark Escott, APH Director Stephanie Hayden and APH Chief Epidemiologist Janet Pichette hosted Wednesday’s press conference.

During the news conference, Escott said of the possibility of a second wave “we are concerned about that.”

Austin’s Interim Health Authority Dr. Mark Escott speaks at a city COVID-19 press conference about his concerns for a second wave of the virus in the Austin area. Screenshot from ATXN Live 2 Stream May 27, 2020.

“The UT model, other models are all suggesting that beginning mid-June and particularly toward the end of June that we may see a significant increase in the number of cases and hospitalizations,” Escott said, referencing the University of Texas’ COVID-19 Modeling Consortium which has been churning out research papers and models on COVID-19 throughout the pandemic to guide health leaders.

However, Escott clarified, just because the second wave is modeled doesn’t mean that has to be fate Austin-Travis County faces.

“These models are based on assumptions,” he said. “And part of those assumptions are that people are going to be more risk taking, and more risk taking means more cases and mean more hospitalizations and deaths.”

UT Professor of statistics and data sciences, James Scott, has been a member of the consortium working on COVID-19 modeling.

He explained, “The analogy I would draw here is that, you know, the virus is like the cards we’re dealt, and people’s behavior is how we play that hand.”

Scott added, “The virus is what it is. It has certain biological properties. It behaves this way, and that’s once it gets into your system. But in terms of spreading it, that’s how we play the hand were dealt. And right now, it’s very difficult to know what kind of hand we’re playing.”

“The models aren’t predicting the absolute future, and it’s important to remember that we as a community can change what that future looks like,” Escott said. “It is based upon our social distancing, our personal practices, our masking in public. It is up to us to keep the numbers down, it is up to us to keep businesses open, it’s not just the government that can do this for us. It is each individual, each family that has to commit to doing both things well, and if that’s the case we can change our future, we can change the weather forecast for COVID-19 and our jurisdiction.”

Escott stated at the press conference that he does believe Austin and Central Texas have “done a great job” at flattening the curve of the virus’ spread so far.

A city spokesperson later clarified in an email to KXAN, “As COVID-19 continues to evolve, it cannot be said that the first wave of the virus has ended. “

“While a second wave of the virus has been identified as a possibility, it cannot be conclusively stated that it will occur,” the spokesperson said. “Residents of Austin-Travis County are strongly encouraged to follow social distancing, face covering, and personal hygiene suggestions provided by local officials, the state, and the CDC to continue to flatten the curve and avoid a second surge of new cases.”

What the models show

UT Austin’s COVID-19 Modeling Consortium created a publication with recommendations for policy makers on how to avoid COVID-19 hospital surges and deaths while reducing economic burdens on the public. The text on the document indicates it was presented to Austin and Travis County leaders on May 18 though the document itself is dated May 22.

While the researchers calculated that Austin’s shelter-in-place order reduced COVID-19 spread in the area by 75%, their models estimate that reproduction of the virus has been steadily increasing since May 1.

The reproduction number is how many people one patient infects.

A projection from the UT Modeling Consortium tracking COVID-19 transmission by monitoring daily, new COVID-19 hospital admissions in Austin and projecting an increase in reproduction of the virus in the Austin area in June. Image Courtesy UT Modeling Consortium Document dated May 22, 2020.

“One means we would expect cases and hospitalizations and deaths to stay relatively constant over time. Less than one means we expect them to go down. Higher than one is the danger zone,” said Scott. “That’s when we expect cases to grow exponentially.”

He said the reproduction number got down to less than one in April, but after May 1, when the governor eased stay home restrictions and more people resumed interacting with one another, that number is back to up one.

According to Scott, when stricter stay at home orders were in place, significantly fewer people went to parks. If the number of people we saw at parks in February is considered 100 percent, in April, that number dipped to as low as 30%.

Scott said, now, we’re seeing about half of normal use at 55%. Increased interactions mean more opportunities for the virus to spread.

The recent projections suggest that Austin will experience a hospital surge from COVID-19 starting in June that will exceed hospital capacity this summer “unless stricter measures are enacted.”

One scenario the researchers modeled for assumed: that COVID-19 transmission rebounds by 50% after May 1 economic reopening measures implemented by the state, that high-risk populations are ‘strictly cocooned’, and that intervention policies are reducing transmission by more than 60% compared to how the virus was reproducing prior to the stay-home orders.

In this scenario, their models predict that this second wave will peak in late summer to early fall of 2020 and that this wave will overwhelm local hospital capacity starting around June.

Projected COVID-19 hospital surge in Austin assuming that
transmission rebounds by 50% following the May 1, 2020 reopening
and high risk populations remain ‘strictly cocooned’. This assumes that
intervention policies continue to reduce transmission by over 60%
relative to the baseline reproduction number observed in early March
before stay-home orders began. Image Courtesy UT COVID-19 Pandemic modeling document dated May 22, 2020.

The researchers also looked at what would keep us under hospital capacity.

One scenario assumes the city has two choices.

The first choice is ‘relaxed’ social distancing in which transmission is elevated by 50%.

The second choice is stay-home.

In that case, we could see four lockdowns between now and spring 2021, but the hospitals wouldn’t be overwhelmed.

COVID-19 risk chart (Picture: APH)

A third scenario assumes the city uses its risk-based guidelines to guide people’s behavior depending on the situation.

The researchers said, “The key is to move between stages to control spread proactively, so that we don’t ultimately need to return to stay-home measures.”

In that case, there could be one lockdown, and the hospitalization rate would stay below the capacity.

The researchers say that new, daily confirmed COVID-19 admissions from Austin area hospitals are an important measure that will help local leaders prevent future hospital surges or excess deaths. Additionally, the researchers call for other regions to use the same approach of sharing new daily confirmed hospital admissions as well as regional hospital capacity.

The UT Modeling Consortium has a regularly updated model regarding the daily death rates of COVID-19 cases throughout the country. As of Wednesday at noon, that model projects that there is a 99% chance that the daily COVID-19 death rate in the U.S. is declining and a 91% chance that the daily COVID-19 death rate in Texas and in Austin is declining.

Navigating reopening and a possible surge

One concern brought up during the news briefing was a drop in preventative measures at public places such as bars and restaurants now that the state is beginning to reopen.

“Anecdotally, we have heard reports. I’ve certainly seen a decrease in the social distancing and mask-wearing at places where I have been, and it’s important for the community to understand,” Escott said. “And they’re very confused because we are in an election year, and I think in many circumstances the public’s being told ‘You have to choose public health or the economy — those are the only two choices,’ and that’s simply not true.”

“We are looking for the sweet spot in the middle that optimizes public health and the economy and that means that when we go out we should do things safely. We should wear a mask, we should social distance, we should continue those personal hygiene practices because if we can do those together we can optimize the benefits of public health and the benefits to our economy if we don’t act responsibly we risk failing at both things,” Escott said.

Another concern raised during the new briefing was the possibility of small clusters of COVID-19 cases popping up in certain types of professions that work in close proximity.

“As we begin to reopen, we are beginning to see different kinds of clusters now that people are going back to work. Construction has been one area that has been challenging for us to narrow down where people may be, because, as an example you may have the general contractor who has several subcontractors,” Pichette explained.

“So, again, we are trying to work and develop an initiative that we can provide some targeted outreach to those areas,” Pichette said. “There has been some reluctance for people to actually come in and take advantage of those testing because if they are identified as positive then maybe they will be out of work for a period of time because they are under a control order and need to self-isolate for a 14-day period. Again, this is an area we are continuing to look at. Construction is a big area but we are seeing clusters within food service areas and other industries as well.”

In a city memo on May 22, Hayden said she submitted a COVID-19 testing plan to U.S. Secretary for Health and Human Services. It describes how Austin-Travis County will increase and conduct COVID-19 testing through the end of the year.

Escott also announced an additional news conference for Thursday to to discuss measures that may need to be taken to not overwhelm the health care system in case a second wave of COVID-19 cases does hit in mid-to-late June.

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