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June 30, 2020

Coronavirus is surging in Texas. Here's how hospitals are responding.

Daily Briefing

    Texas Gov. Greg Abbott (R) on Sunday said the new coronavirus has taken a "very swift and a very dangerous turn" in Texas, as the rate of positive coronavirus tests rose to 13% in the past month—the highest since April—and Texas hospitals are seeing a surge of new coronavirus patients.

    Tracking a surge

    In response to the surge, Abbott has suspended the state's reopening plans, closed down bars, and rolled restaurant capacity back to 50%. Further, he last week banned elective surgeries in four counties in an effort to make more hospital beds available.

    Overall, according to the Dallas Morning News, Texas in the past week has reported nearly 36,000 new cases, representing 25% of Texas' total reported cases since the epidemic hit the state in March. In the past week, more than 5,500 individuals have been hospitalized with Covid-19, the disease caused by the new coronavirus.

    On Sunday, Houston Methodist Hospital reported almost 400 patients with the new coronavirus, with about another 150 being tested for it, the Times reports. In comparison, according to the New York Times, during the state's previous surge of coronavirus patients in April, Houston Methodist saw, at most, just over 200 patients with the virus.

    Last Thursday, the Texas Medical Center—which includes Houston Methodist—reported that its base intensive care capacity had hit 100% for the first time during the new coronavirus epidemic, with 28% of those beds being occupied by coronavirus patients. Houston Methodist CEO Marc Boom later clarified that TMC still had room to expand its ICU capacity, as an additional 373 beds can be converted to ICU beds.

    How hospitals are coping

    As cases increase, Houston Methodist has prepared for an influx of coronavirus patients by hiring traveling nurses, offering bonuses to staff who take extra shifts, and bringing in new laboratory equipment to process thousands more coronavirus tests a day. The hospital also moved beds and mobile computers into a previously shuttered 34-bed unit, which will be used for patients with the new coronavirus and to ensure the hospital has sufficient capacity to treat non-coronavirus patients safely.

    The majority of coronavirus patients at Houston Methodist have been placed in medical wards rather than ICUs, the Times reports, and the average length of stay for such patients is about a day and half shorter than it was back in April and May. According to hospital leaders, that could be due to the hospital's improvement in treating coronavirus patients—but it could also be due to an influx of younger, healthier patients with the virus.

    Tritico Saranathan, a charge nurse in one of the hospital's virus wards, said, "We're seeing a lot of people in their 30s—they're out there partying and not wearing masks," she said. She added, "What I'm seeing is that … the younger ones are pretty sick. They're struggling a lot with respiratory issues. They're having a hard time breathing, just feeling like death."

    Meanwhile, Texas Children's Hospital is opening a unit to care for adult patients with the virus, the Times reports.

    Comments from public health experts

    Thomas Tsai, a physician at the Harvard T. H. Chan School of Public Health, called for mandatory mask-wearing in Texas and said additional closures may be necessary to stem the tide of cases. "Now is not the time for half-measures," Tsai said, adding, "This is the moment to take action … We've seen this play out before and there is no need to condemn ourselves to repeat history."

    David Rubin—a physician at Children's Hospital of Philadelphia, who leads a team that has been tracking the spread of the new coronavirus throughout the United States—said Dallas is poised to follow Houston's experience. "Dallas need only look down the road to see that this could be [them]," he said.

    Rubin continued, "A bold move would be to shut it down, go to universal masking, let the hospitals recover, and let things settle down," he said. "Recommendations that people 'should' or 'might consider'—that kind of language is insufficient for the challenge in front of us" (Fink, New York Times, 6/28; Morris/Despart, Houston Chronicle, 6/28; Hacker et. al., Dallas Morning News, 6/28).

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