COVID-19 hospitalizations in Texas level off just below the pandemic’s winter peak

Nurse practitioner Cheryl Shovan inputs patients data in the halls of the COVID-19 care unit at Titus Regional Medical Center in Mount Pleasant on Aug. 19, 2021. The hospital is short of at least 20 nurses needed to handle the surge of COVID-19 cases in the Titus County area.
Nurse practitioner Cheryl Shovan inputs patients data in the halls of the COVID-19 care unit at Titus Regional Medical Center in Mount Pleasant on Aug. 19, 2021. The hospital is short of at least 20 nurses needed to handle the surge of COVID-19 cases in the Titus County area.

With at least 13,790 COVID-19 patients, most of them unvaccinated, hospitalized in Texas on Thursday, the state marked a week hovering at just below the record set in January for hospitalizations during the pandemic, according to numbers released by the Texas Department of State Health Services.

The state’s previous pandemic peak of 14,218 hospitalized COVID-19 patients was reported Jan. 11 during the deadliest wave of infections the state had seen since the virus was first reported in Texas in March 2020.

During the current summer surge, the largest number of COVID-19 patients in Texas hospitals has been 13,932 on Aug. 25. But with just a couple hundred fewer patients statewide than the record — and a much more exhausted and depleted workforce than they had over the winter — hospitals have been operating at or above capacity for weeks.

The surge has put unprecedented pressure on the state’s health care system as the delta variant spreads largely uncontrolled at a rate up to eight times faster than previous versions of the virus. Medical professionals say the situation could have been prevented with wider acceptance of the vaccine.

In recent weeks, the state has already seen a record number of hospitals reporting that they had run out of staffed ICU beds available for new patients. Particular pressure is being felt by large metropolitan systems that have put elective surgeries on hold and report having to turn away ambulances due to overflowing emergency and intensive care departments.

Much of the problem, hospital officials say, is a severe shortage of nurses and other staff to take care of patients after large numbers of health workers quit or retired due to COVID-related during the pandemic. Health care workers who remain are expensive and in high demand.

During the winter surge, state health and emergency management leaders sent tens of thousands of relief nurses from across the state and nation to relieve the pressure on overwhelmed hospitals.

After vaccinations were made widely available in the spring and hospitalizations dropped, the state-supported nurse program ended in May. But vaccinations began to slow around that time as well, when just about a quarter of Texans had gotten injections.

That opened the door for the delta variant to spread more quickly starting around June; hospitalizations started surging later that month.

Experts say the best way to flatten the curve is to ramp up social distancing, mask-wearing and hand-washing, proven methods for stopping COVID-19's spread, while the state works to get more of Texas’ 29 million residents vaccinated.

But Republican Gov. Greg Abbott has stood fast against any state or local mandates that proponents say would push Texas toward more vaccinations and slower community spread.

A strong opponent of lockdowns in the wake of widespread Republican criticism of his pandemic-era rules last summer, Abbott dropped statewide business capacity restrictions and mask mandates in March.

Through a series of executive orders and legislation, Abbott and Texas lawmakers also banned Texas businesses from requiring customers to show proof of vaccination, local governments and school districts from requiring masks and public sector employers from requiring their workers to be vaccinated.

Those bans remain in legal limbo as they move through the courts.

Last week, Abbott issued an executive order saying that his bans would remain in place even after the U.S. Food and Drug Administration gave Pfizer's vaccine full approval for people ages 16 and up on Monday. Abbott's previous orders had applied only to vaccines that had only emergency use authorization.

Meanwhile, most Texas school districts have started classes almost entirely in person, many with mask requirements in place in defiance of Abbott’s stance against them, in an effort to stop the quickening spread of the delta variant among Texas children.

Just under 48% of Texans have been fully vaccinated, which experts say protects them from serious illness, hospitalization and death.

Those who aren’t vaccinated constitute upward of 90% of the hospitalized patients, officials report. Cities, counties, universities and private companies are offering incentives for vaccinations, and the state has reported a small upswing in the number of daily shots being given in recent weeks.

But while that number begins to climb from its low point late July, officials are seeking to solve the hospital staffing problem.

So far, the state has paid to hire more than 8,000 contract health care workers for Texas hospitals that are under the most pressure, many of which have already seen admission rates close to or higher than they were seeing in January — when they had more staff to take care of those patients.

The state-funded relief nurses have been arriving at hospitals for the last few weeks. Meanwhile, some counties are considering using or have already agreed to tap federal stimulus money to add more workers to further handle the crush of patients.

More Texas doctors are also turning to monoclonal antibody therapies for COVID-19 patients who qualify, saying that the treatment gives them a better chance of staying out of the hospital and could lower statewide hospitalization rates until more people become vaccinated.

Mandi Cai contributed to this report.

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