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Local leaders warn Texas is heading down a dangerous path as coronavirus cases and hospitalizations surge in big cities

COVID-19 test samples are organized into coolers at a mobile testing site at Uhland Elementary School in Uhland on June 18, 2020. Jordan Vonderhaar for The Texas Tribune

As Texas’ coronavirus cases and hospitalizations continue to break records for a second straight week, leaders and health experts in the largest cities are warning that the state is heading down a dangerous path and hospitals could soon be overwhelmed.

Gov. Greg Abbott is expected to address the state's response to the rising cases in a press conference at 2 p.m. CST.

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Travis County and Austin-area cases dramatically increased over the weekend, surging to 6,210 on Monday, compared to about 4,991 reported on Friday.

In an open letter published on Sunday, Austin Mayor Adler called on residents to take the threat of coronavirus seriously. He said the risk of catching the virus today is three times higher than it was two weeks ago.

"The virus is here. Infections are rising. If we want the economy to reopen fully and stay open, we have to take this seriously," he wrote.

If cases continue to increase at this same pace, Adler said they will soon have to "choose between returning to sheltering at home or watching as our hospitals get overwhelmed and we suffer many preventable deaths."

"We could act now to try to change that trajectory," he said "Wear masks, socials distance, don’t be around people if you even think you might have the virus. We’ve got to do this, we’ve got to do this together, we’ve got to do this now."

Meanwhile, Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, predicted over the weekend that Houston is on the brink of a disaster based on the latest trends in increasing numbers.

"My observations if this trajectory persists: 1) Houston would become the worst affected city in the US, maybe rival what we're seeing now in Brazil 2) The masks = good 1st step but simply won't be enough 3) We would need to proceed to red alert," Hotez tweeted.

In the Houston region alone, the number of confirmed or suspected patients in intensive care unit beds has leapt 80%, from 273 on Memorial Day to 506 Saturday, according to the Southeast Texas Regional Advisory Council. The current increase in cases could exceed hospital intensive care units' capacity in two weeks in the greater Houston area, according to data gathered by the Texas Medical Center.

Last week, with Abbott's blessing, city mayors and county judges started requiring businesses mandated face masks inside where social distancing is not possible. Abbott had previously said that local leaders could not penalize individuals for refusing to wear masks, but last week he OK'd the business regulation.

According to data collected from the UT Southwestern Medical Center on Friday, Dallas-Fort Worth hospitalizations due to COVID-19 have increased by 24% compared to the week prior, experts said Monday. Because of the percentage of COVID-19 tests coming back positive, UT Southwestern’s model now predicts that new cases and hospitalizations will increase by approximately 20% over the next two weeks.

“These numbers, as you can see, in the last two weeks are trending upwards alarmingly, and they've been the highest numbers that we've ever seen in the DFW area,” said Dr. Mujeeb Basit, assistant professor of Internal Medicine/Cardiology.

“We're still relatively low [percentage] in terms of hospital capacity, we're the highest that we've ever been, but the percentage wise is all still relatively low. It's around about 10 to 15%. But with the doubling rate, that's only about three weeks of capacity if you really think about it,” he added.

He said there has been a sharp increase in the number of cases of younger people in North Texas.

“That's translating into the younger people who are requiring hospitalization and younger people who are now requiring ICU [care],” he said.

In June, those under 50 make up 50% of those hospitalized in DFW hospitals and 30% of those in critical care, according to data gathered by the center.

The medical center tracked a surge in hospitalizations two weeks after holiday weekends such as Easter and Memorial Day. Now they’re concerned by a potential surge after July 4.

“Major holidays really affected the curve quite significantly,” Basit said. “But with July 4, that is really an unknown. You could have an increase in the reproduction number quite significantly if you have big gatherings.”

Cases are also rising fast in Hays County, south of Austin, particularly in San Marcos, home to Texas State University. Until June, the county typically reported well under 20 new cases each day.

That changed about a week after the Memorial Day Weekend. On June 11, the county reported 82 new cases of the virus — "you read that right, 82," local officials emphasized in an incredulous press release. Since then, the county has reported more than 100 cases on many days, including more than 200 on Thursday. A huge share of those cases are individuals in their 20s.

"We're in a national hotspot, y'all. Be safe," warned state Rep. Erin Zwiener, a Democrat who represents the area in the Texas House. She cautioned that cases in Hays County are growing faster than those in the rest of the Austin metropolitan area.

When Abbott let businesses start reopening, he pointed to two metrics as encouraging signs: the hospitalization rate — or proportion of infected Texans who are requiring hospitalization — and the infection rate, or the ratio of positive cases to tests conducted. At the time, he said his future decisions about business reopenings would be contingent on whether the infection rate — which public health experts want below 6% — “stays flat or decreases.”

The seven-day positivity rate has surpassed 6% every day since June 2, reaching 8.8% Sunday.

That is up since May, when the averaged rate dipped to 4.3%, but down significantly from April, when it spiked to 13.9%. The number of people hospitalized with the coronavirus has also steadily increased since late May.

It’s reached record high levels for 13 of the last 14 days, with 3,711 patients hospitalized with the virus as of Monday. The number is likely an undercount as the state only tallies lab-confirmed COVID-19 cases.

Abbott has said the the state has “abundant hospital capacity” and that officials “remain laser focused” on maintaining it.

Disclosure: UT Southwestern Medical Center, Texas State University and Austin Mayor Steve Adler have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.


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