Memorial Hermann Southeast employees are greeted by dozens of people honking their horns and flashing their lights in appreciation of their work during the COVID-19 pandemic on April 10, 2020. Annie Mulligan for The Texas Tribune
Public health experts have mixed reviews for Gov. Greg Abbott’s recent directive allowing businesses to partially reopen this week as the state continues to fend off the new coronavirus.
Many praised Abbott for taking a phased approach to reopening as opposed to allowing everything to open all at once, though some said his timeline started too soon and is moving too fast. They cautioned that the state still needs to ramp up its testing and contact tracing abilities. And they warned that officials should be prepared to pause during the first phase of reopening — or even revert back to a stay-at-home order — should the data show a surge is likely.
“We’ve been stable for a while with the number of cases. We haven’t exceeded hospital capacity. He’s trying to give a jumpstart to the economy, being very cautious about it,” said Luis Ostrosky-Zeichner, a professor of infectious diseases and epidemiology at UT Health. “It’s kind of a measured way he did it.”
Abbott said Monday that restaurants, movie theaters and malls may open at 25% capacity in most of the state starting Friday, though some have said they will not. If that partial opening proceeds without a major “flare-up” of the virus, Abbott said, broader openings may take place starting May 18 — or even sooner, he suggested in a later interview with a Houston television station.
Diana Cervantes, director of the epidemiology program at the University of North Texas Health Science Center, said Monday’s announcement came too soon — and did not give businesses enough time to prepare precautionary measures before opening Friday.
“That’s a concern,” she said.
Health leaders in some Texas cities said it was too soon to relax social distancing precautions that have helped keep the coronavirus outbreak manageable in Texas. Abbott moved toward reopening about 10 days sooner than health leaders in Houston had hoped for, according to the Houston Chronicle. The governor said his order supersedes any local restrictions.
“This is too soon for us,” Mark Escott, Austin’s interim health authority, said Tuesday during a city council meeting. “As we’re still preparing contact tracing, ramping up testing, working to protect vulnerable populations, now is not the time to flip on the light switch.”
At the same meeting, Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin, shared a model she created showing that Austin could surge past its hospital capacity as soon as this summer if social distancing regulations are eased indefinitely.
In Dallas County, which marked its deadliest day on Tuesday, Health and Human Services Director Philip Huang said some area hospitals have seen increases in COVID-19 populations.
“These are the trends we’re worried about even before the governor’s order,” he said, standing in front of a screen that read “Stay Home, Stay Safe.” As businesses reopen, he said, it is all the more important that Dallas continue to socially distance, wear masks and “make smart choices.”
Health experts said Abbott must be careful in determining whether it’s safe to continue to expand business openings in coming weeks. The success of the economic reopening depends on increasing the state’s capacity for testing and contact tracing.
Moving forward to the second phase of reopening — when certain businesses could serve customers at 50% capacity — depends on the outcome of the first stage. Abbott said it is “only logical” that the restrictions he’s easing this week will cause an increase in the number of positive coronavirus cases. That alone will not be “decisive,” he said.
The governor and his advisers will look closely at hospitalization rates and death rates to decide whether it is safe to move on to phase two. But Abbott’s plan, outlined in a 65-page booklet, does not offer specific figures or thresholds.
Ostrosky-Zeichner said “any sort of uptick in cases would be worrisome to me.”
Experts also said they’d look at hospital capacity to determine whether it is safe to proceed to a more open phase. They said it will also be important that the state see the share of those testing positive for the virus stay flat or decrease.
“If this unfolds in a way we don’t like, like all of a sudden we see a spike in cases, we all must be prepared to step right back into losing those easements of restrictions — we might have to shelter in place again,” said Rodney Rohde, a virologist and epidemiologist at Texas State University.
Like several other experts, Rebecca Fischer, an infectious disease epidemiologist at Texas A&M University School of Public Health, praised the phased approach to reopening, but cautioned that the timeframe Abbott has laid out may prove too quick. Since it can take up to two weeks for individuals to develop symptoms, then even longer to get tested and receive results, any bad outcomes from the first phase of reopening may not show up in time to caution against beginning phase two, she said.
“That time frame would really be more appropriate at four weeks,” Fischer said. But “nobody’s going to want to hear that.”
Texas has administered nearly 315,000 tests for the coronavirus, but the state still ranks toward the very bottom nationwide. Abbott’s plan identifies a goal of 30,000 coronavirus tests per day — a figure some experts say is too low.
Currently, about 1,150 people are working to track down each person and place that a COVID-19 patient may have put at risk. State officials are working to ramp up capacity for contact tracing with a goal of mobilizing 4,000 workers by mid-May. Some policymakers have called for a much larger workforce.
“You really want to track down: Where is the virus in the community, where is it going? And you really want to create dead ends out of every person,” Fischer said. “The contact tracing definitely needs to be ramped up, and it can’t be ramped up without a workforce.”
Experts emphasized there is much they don’t know about the virus, and that any economic reopening will have to happen in a trial-and-error framework. Above all, they said, Texas’ health will depend on how carefully individuals hew to social distancing protocols. And state leaders must be prepared to change course if the data indicate economic easements are bringing major adverse health outcomes.
“Viruses are gonna virus. They really don’t care what mankind does. They don’t read the books, they don’t follow the rules,” Rohde said. “And I can’t tell you how many times, myself included, that a microbe makes you look silly later.”
Edgar Walters contributed reporting.