Coronavirus: Austin Health Official Could Suggest City Shutdown

AUSTIN, TX — The interim health authority in Austin is poised to recommend the city shut down should substantial spikes in cases of the coronavirus continue, he said at a Wednesday news conference.

“If we don’t make significant change right now — if the situation doesn’t improve in the next week to two weeks — I’m going to have to make a recommendation to the mayor and the [Travis County] judge that we shut down," Dr. Mark Escott said. "And I don’t want to do that.”

Showing a united front — a "solidarity" against the scourge of respiratory illness on the rise, as they put it in a press release — Escott was joined by doctors from Dell Medical School, Seton Medical Center and St. David’s Emergency Care, Travis County Medical Society, and others in urging the public to rigidly adhere to safeguards meant to blunt the spread of illness. These steps include wearing protective face coverings, keeping a six-foot distance from others, practicing good hygienic practices — as the public largely did in April and May.

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Those early tactics paid dividends as the illness curve began to flatten, Escott said. But that was then, and now: "The lid is off, and we need to put it back on."

The statistics speak for themselves, as illustrated by graphs used as visual aids during Escott's presentation. Take Tuesday, for example, when Travis County reported 257 new cases in elevating the total illness count to 6,596. Included among those historical cases, 4,512 patients have recovered and 1,970 are active cases. Or consider Sunday, when a whopping 506 new cases were logged.

The average increase now is 276 new cases per day, Escott noted, and "doubling time" defined as the span it takes for cases to double is now occurring at a brisker pace than before. Should the current trend continue, he said hospitals could reach capacity levels by mid-July.

"That's a concerning trend to us," Escott said. "Today, doubling time has dropped to 18 days from 44. We have more than 6,600 cases as of today. If this trend continues, we'll have more than 13,000 cases. This is why we need to increase our seriousness. Unlike hurricanes, we have the ability to lessen this storm."

Hospital admissions are also on the rise. Whereas the city averaged eight to ten daily hospitalizations in the early part of the local contagion, Escott said admissions have risen to 40 today. "The impact is also evident on hospital systems," he added. "We've gone from about 100 hospital beds being used on June 7 to 275 in a very short period of time."

Despite the increase, Escott assured hospitals still have capacity, and are not yet overwhelmed with an influx of patients. "We're not at risk this week or next week, but we're concerned what might happen three to four weeks from now. This is why were asking everyone to take action now. if you don't need to go out, don't go out. If you on't need to congregate with people, don't do it."
Joining Escott at the news conference were:

• Dr. John Abikhaled, president of the Travis County Medical Society;
• Dr. Kirsten Nieto, Dell Children's and Dell Seton Internal Medicine and Pediatric Hospital;
• Dr. Jewel Mullen, associate dean for Health Equity at the Dell Medical School;
• Dr. Christopher Ziebell, U.S. Acute Care Solutions Southwest medical director;
• Dr. Michael Pignone, chair of the Department of Internal Medicine at Dell Medical School;
• Frances Simpson, RN, Seton Medical Center Director of Critical Care;
• Dr. Ann Buchanan, St. David's Emergency Care specialist; and
• Dr. Guadalupe (Pete) Zamora, Central Health Board of Managers.

Abikhaled likened the renewed speed of contagion to the sharing of cute cat videos. What could begin with one person sharing to ten friends could easily reach one million as subsequent groups of ten each share to ten others. "Viruses like the coronavirus work the same way," he said. "One person can infect another person, and those people can infect many more."

He echoed his colleagues' advice to revert to safe practices seen as effective tactics that have been eroded of late after residents "...got tired, got a little stir crazy and went out" after having isolated at home to ride the virus out, he said.

Nieto concurred: "The new cases we're seeing in the community is because people are congregating. Coronavirus is a bad disease. The virus puts people on ventilators for weeks, not days," she said, calling for a return to mask wearing and social distancing.

Ziebell echoed the sentiment: "Please mask when you have to leave home. Please stay home when you don't have to go somewhere else. And it can work again. Now is the time to intervene not in anther two weeks."

He referenced the feeling some have expressed such tactics violate vaunted "personal liberties" among those refusing to heed health officials' advice. "I also can understand that while you are free to do the wrong thing, you're also free to do the right thing which is to protect yourself from this disease and protect others from his disease. Masking does work. Isolation does work. All of those are things we can do and should do."

For her part, Simpson noted how supportive the community has been to those on the front lines of the coronavirus fight. She asked the public to extend further support by adhering to health officials' advice.

"There's been a tremendous outpouring from the community and support in many forms," she said. "We've had thoughtful and inspiring letters, we have a little COVID busters poster fom some kiddos they sent to us. And we ask for your continued support by social distancing and providing six feet distance, wearing your mask when you're out in public, good hand washing. We learned from New York and Seattle; we have the benefit of their experience that hey didn't have."

Buchanan, the emergency room physician at St. David's, said she the surge of new patients began in early June as people began to celebrate on Memorial Day and the beginning of the summer season.

"Right now, the situation is very fluid, and is ever changing every day. You as a community have that power to help change this curve and help decreaes the number of cases that continue in our community," she said. "Your job, and all of our jobs as part of this community, is to help each other by masking, socially distancing and hand washing. You should not leave your home if you are sick, you should not be going to gatherings and parties of large amounts of people if they are unneccessary because this is going to potentially lead to further spread."

Having said that, she joined other doctors in urging those needing emergency care to avail themselves of medical services. "People are staying home because they are sscrred to come to the emergency room, and we do not want that to happen. It is very important that people still get treated for their heart attacks, for their strokes, for accidents that happen at home. We do want to recognize that this continues to be a safe place for people to come."

Following the news conference, officials from Ascension Seton, Baylor Scott & White Health and St. David's HealthCare issued the following joint statement related to hospital capacity:

"The pandemic is an evolving situation, and we continue to monitor the increase in COVID-19 cases in our community. We currently have the capacity to treat all patients, including patients diagnosed with COVID-19, and we are able to quickly adapt to the needs of our patients and to the healthcare demands of our community.

"As previously shared by the state, Ascension Seton, Baylor Scott & White Health and St. David’s HealthCare have a total of 3,250 licensed beds available for patients in our community. However, it is important to note the number of licensed beds is different than the number of staffed beds available. Licensed beds represent the total number of beds a hospital is licensed to operate. This number is typically higher than a hospital’s staffed beds, which are those that are set up and ready for use, with the necessary staff in place to care for those patients.

"While we have the ability to surge to our number of licensed beds, it would require staffing that exceeds what we typically have available for daily operations. Given that all three of our healthcare systems are part of larger healthcare organizations, we have the ability to pull in necessary resources, including PPE and staff, should that be needed for us to surge to our full licensed capacity.

"At this time, the three healthcare systems have 2,470 staffed beds collectively, and occupancy of those staffed beds is at 71 percent. Collectively, the three healthcare systems have 483 ICU beds and occupancy of those ICU beds is currently at 70 percent.

"Our health systems are committed to providing capacity in these unusual times and collaborating closely with each other and with local and state leadership and public health experts. It is important to note that we have implemented new measures and protections in accordance with CDC guidance and recommendations by our clinical experts to provide our communities with peace of mind.

"However, if our hospitals reach a capacity where we cannot safely accommodate demand, while we will always make emergency care available, we may have to make changes, such as adjusting our staffing needs and limiting the services we are able to offer to patients. In some cases, we may transfer patients between facilities within our healthcare systems in order to provide the most appropriate care. We also support planning ahead to set up alternate care sites, and we are working with community leaders to plan for this potential need.

"The best way to decrease the spread of COVID-19 is to adhere to the guidelines put in place by local health officials. It is in the best interest of everyone throughout Central Texas to wear a mask when around people who aren’t part of your household, practice good hand hygiene and engage in social distancing."

From earlier:

AUSTIN, TX — Medical professionals will join city and county officials during a Wednesday news conference designed to update the public on rising levels of the coronavirus in the region.

The number of coronavirus cases and the seven-day moving average of new hospital admissions have risen significantly in the Austin area in particular and Texas in general since the governor launched a multi-phased reopening of the state economy on May 1. Since then, area officials have issued guidance related to best practices to the public aimed at averting illness spread — many of those coming in the form of municipal orders issued by elected officials.

To further update the public, a news conference is scheduled at 2 p.m. Participating medical professionals will provide brief updates, followed by about 30 minutes of media Q&A. Those scheduled to attend are:

• Dr. Mark Escott, Austin-Travis County, Interim Health Authority
• Dr. John Abikhaled, Travis County Medical Society, President
• Dr. Kirsten Nieto, Dell Children's and Dell Seton Internal Medicine and Pediatric Hospitalist
• Dr. Jewel Mullen, Associate Dean for Health Equity at the Dell Medical School
• Dr. Christopher Ziebell, US Acute Care Solutions Southwest Medical Director
• Dr. Michael Pignone, Chair of the Department of Internal Medicine at Dell Medical School
• Frances Simpson, RN, Seton Medical Center Director of Critical Care
• Dr. Ann Buchanan, St. David's Emergency Care Specialist
• Dr. Pete Zamora, CommUnity Care Chief Medical Officer (Spanish)

Here are the ways to access the video feed:

• LiveU signal
• Livestream feed ATXN 1: http://www.austintexas.gov/page/watch-atxn-live
• Livestream feed ATXN 3 (Spanish-language Simulcast): http://media.swagit.com/austintx/atxn3/
• Facebook: Facebook.com/AustinPublicHealth