Austin does not need to shut down yet, health leaders say

Coronavirus

The short term projections for the 7-day average of COVID-19 hospital admissions to Austin area hospitals assuming no behavior change. Model from UT COVID-19 Modeling Consortium, presented to Austin City Council July,9, 2020.

AUSTIN (KXAN) — At Thursday’s special called Austin City Council meeting, local health leaders said the data doesn’t indicate Austin needs to issue a shutdown to curb the spread of the novel coronavirus yet.

They did express serious concern about Austin’s healthcare system being overwhelmed by the virus in the near future, however.

“Austin should do more to slow the spread”

The conversation about a potential 35-day shutdown in Austin came after both a spike in local COVID-19 cases and hospitalizations as well as a presentation from UT Austin’s COVID-19 Modeling Consortium presented to local leaders last week. Her team’s modeling last week showed that a 35-day stay-home order in Austin would result in a significant decline in the number of COVID-19 hospital admissions by August or September.

Updated models from her team on Thursday indicated that even with a 35-day shut down in Austin, projections indicate children who are COVID-19 positive would be among those returning to school in Austin in the fall.

The lead researcher from that UT Austin team, Dr. Lauren Ancel Meyers, presented models with updated data before Austin City Council Thursday. Meyers’ assessment that protective measures such as wearing masks and encouragement not to go out in groups may be having some effect to help reduce transmission of COVID-19 in Austin.

The short term projections for the 7-day average of COVID-19 hospital admissions to Austin area hospitals assuming no behavior change. Model from UT COVID-19 Modeling Consortium, presented to Austin City Council July,9, 2020.

“What the data are telling us is that it looks like we may have slowed things a little bit, so we may be able to wait before we consider stay-at home measures,” Meyers told the council. She noted, however, that there is a great deal of uncertainty in the models her team is looking at.

Meyers also warned the council, “it is very possible that we may hit our lower limits for ICU capacity soon.”

The short term projections for COVID-19 hospitalizations to Austin area hospitals assuming no behavior change. Model from UT COVID-19 Modeling Consortium, presented to Austin City Council July,9, 2020.

She told the council that there have been two significant changes to in Austin’s COVID-19 modeling recently.

The first, she said, is that health leaders have learned that Austin will likely hit the 331-474 ICU bed capacity in the Austin area for COVID-19 patients faster than any other capacity limit.

Previously, she said, health leaders were more focused on the total hospital bed capacity for COVID-19 patients in the Austin area which is around 1,500 beds.

Austin Interim Health Authority Dr. Mark Escott offered some additional detail on those 331-474 ICU numbers. He explained that 331 is the number Austin hospital systems have collectively said they can manage with internal staffing and shifting folks around — not under normal staffing. Escott explained this would require non ICU doctors to be working with ICU patients.

The 474 number, would be an even greater strain, Escott said. With 474 COVID-19 patients in local ICUs, “there is a great deal of uncertainty of that staffing,” he noted, adding that presently “a lot of that staffing is going to south Texas.”

He said that Austin area hospitals are getting requests presently to receive patients from hospitals in other parts of Texas that don’t have enough room.

The second change, Meyers said, is that health leaders see evidence as of a couple of weeks ago that transmission of the novel coronavirus may be slowing down in Austin.

The short term projections for COVID-19 ICU patients in Austin area hospitals assuming no behavior change. Model from UT COVID-19 Modeling Consortium, presented to Austin City Council July,9, 2020.

Despite that evidence, Meyers still warned Austin’s council that “the COVID-19 pandemic may soon threaten the safety and integrity of Austin’s Healthcare systems.”

She told the council that to avoid “overwhelming COVID-19 healthcare demands, Austin should do more to slow the spread of the virus and expand ICU capacity.”

Austin is not going into stage 5 (yet)

Austin Public Health updated its data this week to account for a discrepancy in COVID-19 hospitalization data.

When they did so, the added hospitalization numbers took Austin past the threshold for a seven-day moving average of 70 new COVID-19 hospitalizations per day.

Escott explained to the council Thursday that Austin’s seven-day moving average is 75, where it has been for a couple of days now.

“We are hopeful that it will at least plateau and hopefully fall,” Escott said, calling the next week a “primetime” to see if there is a change in trends.

Under the COVID-19 risk-based guidelines chart Austin health leaders have been monitoring the pandemic’s regional impact by, the intent was that when Austin passed the 70 number for the seven-day moving average of hospitalizations, that leaders should discuss whether Austin needs to be elevated to Stage 5 which would involve avoiding things like dining and having workplaces open except as essential.

APH updated risk-based guidelines chart as of June 26, 2020 (APH)

“There is some reassuring information that has come over the past week which may suggest to us we don’t need to pull the trigger on that yet, but we do need to take a more cautious tone right now,” Escott told the council, signaling that Austin will not be moving to Stage 5 at this point.

Instead, Escott called for bringing Austin into a “darker shade of orange” on the chart.

“I think now is the time that we need to consider dialing things back further, not quite to red, but to really put us into that Stage 4, which is dial it back to 75% — 75% social distancing, more equivalent to Phase 1 of Governor’s reopening,” Escott advised.

“If we can dial things back to look more like Phase 1 of the Governor’s reopening, I believe it will put us in a more protective situation, that will allow us to offer more breathing room and a little bit of certainty to handle the surge that’s coming,” he continued.

Then Austin’s Health Authority made a very specific call for assistance from state leadership.

Call to the state for help

“We really have to encourage the governor to help us out here and dial things back further so we could be in a better circumstance,” Escott said. “In talking to our nurses and physicians in the hospital, they are stressed, they are tired.”

“None of us want this to be real, but it is,” Escott told the council. “None of us want to talk about dialing things down further because we know that hurts people also.  We also know if we don’t do something further, we are going to be in a situation that costs lives.”

Austin Mayor Steve Adler told the council that Travis County Judge Sam Biscoe has indicated his intent to reach out to Governor Greg Abbott, asking him to return the state back to Phase 1 of reopening.

Adler said he intends to join in on that call to return to Phase 1 and anticipates that other cities around the state will join the call as well.

“If the science and data supports it, I hope and trust that he seeing the same kind of science and data we are seeing here ourselves,” Alder said.

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