Texas COVID-19 outbreak could be worst yet

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More Texas hospitals are reporting a shortage of intensive care beds than at any time since the COVID-19 pandemic hit the state 18 months ago – just one sign of the crisis health is on its way to reaching its most dangerous phase to date, according to health officials. to say.

The latest wave of the virus has also caused a rise in new cases and hospitalizations for COVID-19 at an all-time high just below their January peaks, as the highly contagious delta variant tears apart the unvaccinated community at a rate of up to at eight times faster than previous strains, officials said.

“We’re entering the worst wave of numbers,” said Dr Mark Casanova, a Dallas palliative care specialist and a member of the Texas Medical Association’s COVID-19 task force. “This is the fourth round of what should have been a three-round fight. We sincerely fear that the numbers game will overwhelm us. “

Between 93% and 98% of hospitalized COVID patients, depending on the region, are not vaccinated, officials said. With just under half of Texans fully vaccinated, the state still has some 16 million people who have yet to be protected from the virus.

And they quickly fill the state’s intensive care units.

As of Monday, in Dallas County, only 16 intensive care beds were available to serve the 2.6 million county and surrounding areas. It was 12 p.m. the day before, Casanova said.

The state has asked the federal government for five mortuary trailers in anticipation of a potential spike in deaths, which are rising again after a low in July – although daily deaths are still well below what they were in previous outbreaks .

The tension is manifesting throughout the state.

Last week in San Antonio, 26 minutes passed with no ambulances available to answer 911 calls from the city’s 1.5 million residents. In Austin, paramedics are so understaffed and overworked that some ambulances have to sit idle because there is no one to operate them, said Captain Selena Xie, Austin paramedic and chief of Austin. EMS Association.

“We are seeing call volumes that are breaking our records, outside of the [February] snowstorm, ”Xie said.

In rural West Texas, a school district announced Monday that it would be closed for the next two weeks in an effort to slow the spread of the virus before it overwhelms the region’s scarce health care resources.

And on Tuesday, overwhelmed Harris County officials offered $ 100 to anyone receiving their first dose of the vaccine, a desperate attempt to avoid what a hospital CEO called “the worst flare we have ever faced. in the community “.

“The numbers for Harris Methodist and other hospital systems in this region have never grown so far, so fast,” said Dr. Esmaeil Porsa, president and CEO of Harris Health System. “I’m begging you. Do the right thing. Get vaccinated.

Intensive care beds available at pandemic low

Of the nearly 12,000 people hospitalized with COVID in Texas on Monday, more than a quarter of them are in intensive care beds across the state. At the end of last week, at least 75 hospitals in Texas reported that they did not have intensive care beds available for patients – and more than 50 additional facilities said they only had one only bed available at any time during the previous week.

Most of the shortages are in major metropolitan areas, near the Gulf Coast and in the eastern parts of the state, where vaccination rates are among the lowest in the state.

The pressure on intensive care units affects not only COVID patients, but also others who need treatment for illnesses unrelated to COVID, Casanova said.

“When the powers that be tell you you have 12 intensive care beds in Dallas County, that means you have 12 intensive care beds for traffic on I-35, 12 intensive care beds for I-35. Stroke. [victim], 12 intensive care beds for the five borderline COVID patients we currently have in the hospital, ”Casanova said. “When we say that we may find ourselves in a situation where we contemplate impossible decisions to focus our care and efforts on those who have the greatest probability of survival so that we can save as many lives as possible, this equation doesn’t isn’t just for COVID patients. It happens for all patients.

And although hospitals are not at this stage yet, Casanova said, it remains a real threat.

In the last wave of January, he said, “we got around it for about two weeks.”

Hospitalizations approaching a pandemic peak

New COVID-19 cases have reached a seven-day average of over 14,000, still below January’s peak of over 19,000. Gov. Greg Abbott became one of the most recent cases on Tuesday. But the number that worries health officials most are hospitalizations due to COVID-19, which reached 12,227 on Monday – an increase of 2,186 since last week.

If the trend continues, the state could surpass the one-day high of 14,218, set on January 11, before the end of the month.

Former Texas state health commissioner Dr David Lakey said on Tuesday he was not convinced Texas will reach that statewide number as some areas, like Austin, are starting to experience a slight slowdown in admissions.

But he also noted that hospitalizations are not increasing at the same rate across Texas and that some areas will continue to struggle even if the numbers start to slow.

In El Paso, for example, one of the most vaccinated areas in the state, the numbers remain manageable, he said – but Dallas and Houston have already reached or exceeded their January hospitalizations.

Statewide, Lakey said, “It’s going to be close.”

So far, hospitals have been able to take steps to avoid the kind of life and death decisions that occur when there are too many patients and not enough staffed beds. They have reshuffled staff, converted unused spaces into COVID units, and postponed elective surgeries.

At LBJ Hospital in Houston, tents have been erected to deal with the overflow of COVID patients, according to media reports.

At the Parkland Hospital in Dallas, authorities sometimes hold patients in the emergency department while waiting for intensive care beds to open, said Joseph Chang, chief medical officer of Parkland Health and Hospital System.

“This is becoming more and more common as COVID spreads like wildfire in the community,” Chang said in an emailed statement to the Tribune.

The hospital, which typically has a high number of patients in intensive care even in times of non-COVID, has been refusing ambulances for weeks, he said.

“We have put in place a lot of protocols to make more staff and more space available,” he said.

But with beds unavailable because they cannot be staffed and the number continues to rise, Casanova said he is concerned hospitals are reaching their breaking point.

“We have increased what we can increase,” he said. “A power strip doesn’t have many, and you’ll eventually blow it up.” And I think we’re about to blow it up – euphemistically, and literally.

Disclosure: The Texas Medical Association and Parkland Health and Hospital System were financial backers of The Texas Tribune, a nonprofit, non-partisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial support plays no role in the journalism of the Tribune. Find a full list of them here.

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