Coronavirus: Austin, Travis County Implement Medical 'Surge Plan'

AUSTIN, TX — A network of emergency backup medical facilities is being implelented in the event regular services are overwhelmed by further increease of coronavirus cases, officials said on Wednesday.

The so-called "Surge Plan," designed to address additional patient care needs resulting in hospital over-capacity is predicated on updated models from the lab of Lauren Ancel-Meyers at the University of Texas at Austin projecting a likely surge in infections. Given the projections, the health authority has put a plan in place to set up Alternative Care Sites to handle high demands on the system.

“We hope that this surge plan is not necessary, but we are preparing for the worst,” Dr. Mark Escott, Interim Austin-Travis County Health Authority, said in a prepared stateement. “We must continue to stay home and practice physical distancing. The future of our healthcare system is up to our daily individual behavior, and it is going to take all of us to fight this virus.”

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Escott explained that under the Surge Plan, once traditional hospitals have run out of bed spaces, patients would be transferred to Type II Alternative Care Sites (ACS) and receive a range of hospital-level care in buildings that were previously purposed for patient care such as former clinics or medical facilities. If Type II ACS exceeds capacity, patients would be taken to Type I ACS facilities, which are similar to combat surgical hospitals or large wards, he added.

Officials are in the process of identifying specific sites for both types of ACS facilities in Austin-Travis County that will meet the community’s needs, the health authority noted.

Escott said the current hospital bed count for Austin-Travis County is approximately 4,300 on an average day. However, this number will continuously change depending on additional capacity coming online, he added, noting that hospitals are currently operating at about 50 percent capacity.

Escott outlined other aspects of the Surge Plan:

• Isolation Facilities and Protective Lodging Facilities (ProLodges) have also been established. Isolation Facilities are locations that are being used to house patients who do not need medical care but do not have anywhere to safely be isolated from the public (e.g. are unable to adequately isolate from a family member’s home). ProLodges are protective lodging for vulnerable communities.
• To ensure those on the frontlines of the COVID-19 outbreak are properly informed, Austin Public Health (APH) has been providing regular updates to more than 4,000 physicians through the Travis County Medical Society (TCMS). There are also daily conference calls with the hospital networks, where providers detail current cases, system status and review current measures being planned and taken. Additionally, doctors have access to a dedicated phone line to reach APH directly.
• A dedicated section for health care providers on the www.AustinTexas.gov/COVID19 website has been updated to include surge plans for the area, information about the Austin-Travis County Emergency Operations Center (EOC) and the different task forces to support medical and social service community needs.
• Health care providers can also access guidance on COVID-19 testing and personal protective equipment. APH, the City of Austin and Travis County -- as a whole -- are prepared to maintain emergency operations for many months to ensure our community remains safe and educated during this unprecedented time.

During a 2 p.m. press conference detailing the plan, Escott gave updates on the latest Travis County illness count as of Wednesday: 554 case with 77 patients hospitalized and 28 on ventilators. While Escott did not mention it at the press conference, the number of fatalities from the respiratory illness is seven as recorded on a specially built Austin Public Health dashboard meant to apprise the public of the scope of illness spread.

Escott was joined by Austin Mayor Steve Adler and Travis County Judge Sarah Eckhardt at the pres conference providing updates.

Amid the grim news of the growing reach of illness and the projected increases, Eckhardt offered some encouraging news in conveying physical distancing has been reduced countywide by 64 percent as a growing number of residents adhere to stay-at-home directives. "That is really profound, and it goes to the heart of who we are as a county," the judge said. "Let's stay on the course," she added. "We are saving lives."

In was likely was a way to lead by example, both Eckhardt and Adler wore protective fabric face coverings during the press conference — a new feature to their regular televised updates — before removing them to speak at the lectern in addressing their audience. Escott opted not to wear a protective face covering during the press conference.

For his part, Adler went into the rouch calculus of the UT-Austin study showing projections of illness spread in the coming months. While thanking the governor for having recently issued a statewide stay-at-home order — a move that lagged behind similar action by his counterparts elsewhere and came after Austin-Travis County already had implemented the shelter-in-place move — the mayor took issue with the governor's jump-starting of the construction industry he deemed "essential activity."

The governor's subsequent, state-wide order superseded guidelines first implemented by the city and county. As a result, Austin and Travis County officials were forced to clarify their original orders to reflect statewide uniformity. One element of the governor's version that worries the mayor is the re-starting of construction — an activity that had been halted under the city and county guidelines before the governor trumped them with his own statewide directive. Abbott also deemed religious services as "essential, sparking concern over potential illness spread locally.

Pointing to a portion of the UT-Austin study, Adler said hospitalizations due to COVID-19 infection would increase three-fold if 100 percent of construction activity were allowed to resume per the governor's order. Adler said he and Eckhardt will soon be meeting with construction industry representatives to ensure safety and adherence to physical distancing guidelines at work sites.

"We're going to make sure we're doing this well and include elements to our orders 2.0," Adler said, referring to the local guidelines the required clarification after the governor's subsequent, superseding statewide policies. "We can't enforce this or police this everywhere. It's going to take all of us to cumulatively get this done. I believe in this community; I belive in the people that live here."

In a personal note, Escott referenced the dismay felt by many in not being able to attend church service on Easter — the most important religious observance on the Christian calendar — amid the growing threat of illness. The doctor noted he and his family recently "attended" church in virtual setting from the comfort of the family couch. Religious leaders have largely advised parishioners to stay at home too, offering special dispensations in a time of pandemic — despite the governor's tacit invitation to return to the "essential" activity of church attendance.

"This is Holy Week for a lot of us," Escott said. "People want to be in church, people want to be with their families, but now is not the time for that," he added, referencing the "devastation" that has visited households when family members become infected across generations in defying social distancing guidelines.

"Easter Sunday is going to be very different than it normally is," Escott acknowledged. "But it's dangerous to go to church at this time. If we all work together, we can have many more celebrations once again."