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Fully reopening Texas ‘definitely riskier’ now than summer or fall, health experts say

Mark Dent
·5 min read

Starting March 10, Texans will no longer have to wear masks in public. All businesses, from bars to bowling alleys and beyond, can open to their maximum occupancy. “It is now time to open Texas 100%,” Gov. Greg Abbott said.

But the question of timing is actually a difficult one, according to Texas public health experts from around the state. Six who spoke with the Star-Telegram agreed that, while rollbacks on COVID measures must occur eventually and Texas has seen great progress lately, Abbott may have been wise to wait a few weeks longer.

“I have mixed feelings,” said Diana Cervantes, a professor of biostatistics and epidemiology at UNT Health Science Center and a former official with Tarrant County Public Health. “There have been a lot of advances, I just wish it was done a little more incrementally and gave us a little more time to get more shots in arms. We are in a great place with three different types of vaccine, especially the one dose where you can target high-risk groups and high-risk areas. I just think if it was going into summer or definitely fall, we’d be in a better position. It’s definitely riskier at this point in time.”

There’s no doubt Texas is in a far better place than just a couple months ago. The seven-day average new case count has fallen from around 21,000 in mid-January to about 6,600. Hospitalizations were at 5,611 on March 1, having declined by more than half since January. Meanwhile, vaccinations are on the rise: As many as 216,000 Texans are now receiving a dose of vaccine per day. Some 6.5% have been fully vaccinated, including many vulnerable and elderly Texans. The share is likely to rise substantially, with Johnson and Johnson’s one-dose vaccine now available, and enough vaccine supply for 300 million Americans is expected by May.

But Texas’ share of vaccinated residents is below the U.S. average of 8% and worse than all but four other states. After falling since January, case counts have ticked upward the last few days. The numbers may also be inconsistent, given complications from the deep freeze of two weeks ago.

“It is interesting timing because I feel like one of the challenges with recent severe weather is a lot of the testing and other monitoring of the data has been a little erratic over the last week,” said Tiffany Radcliff, associate dean for research at the Texas A&M University School of Public Health. “As a researcher it’s a little hard for me to tell whether the cases are declining, stabilizing or increasing right now.”

And the numbers of cases and hospitalizations are not historically low either. Tarrant County’s ICU hospitalization occupancy rate was at 92% Tuesday. COVID hospitalizations in the Houston area were more than double their fall total. The statewide seven-day average case count of 6,000 is around where Texas was in the fall, just ahead of a surge, and now more contagious variants are spreading, particularly around Houston.

“Last October, we were thinking things were looking better and we had these large spikes again around November, December and January,” said Neale Chumbler, a professor at the University of North Texas’ College of Health and Public Services. “So that’s the challenge.”

James McDeavitt, senior vice president and dean of clinical affairs at Baylor College of Medicine, has been telling people throughout the pandemic our defense to the virus relies on a three-legged stool. One leg is vaccinations, the other is immunity picked up from contracting the disease and the third is safe practices, notably masking, social distancing and avoiding indoor crowds. The first two legs have become sturdier than ever, but now the last leg is being removed.

“The governor is trying to balance if you pull that leg out too soon you risk getting another surge of the virus,” McDeavitt said. “If you wait too long then you’re incurring harder economic problems than necessary.

“My opinion, as a careful virus watcher, is it’s probably a little early.”

In terms of gauging the positive or negative consequences of the decision, McDeavitt and others say to wait two to four weeks, maybe even six, and closely track Texas’ case counts. They will portend future hospitalization and death rates.

For Texas to be successful following Abbott’s decision, Jeff Dennis, assistant professor of public health at Texas Tech University Health Sciences Center, believes it is imperative to make adjustments as necessary based on how people are reacting and how the virus spreads. He noted that predictions and projections have been nearly impossible to make in the pandemic.

“Occasionally you’re right, but so much more often we just look back at what happened and try to explain it,” he said.

Throughout his press conference, Abbott repeated the phrase personal responsibility. He believes Texans have learned enough about how to handle the pandemic, negating the need for a government mandate on masks and occupancy. Although Abbott stressed the pandemic was not over, public health experts wonder how average people will react to the change. Chumbler worries it may create a culture “where you drop your guard, so to speak.”

And in these next few weeks, Texans will be tempted with plenty of chances to relax from recommended pandemic behavior. Spring Break and St. Patrick’s Day are around the corner. “One of the challenges here will be how will different parts of the state behave in light of this,” said Murray Coté, a professor of health policy and management at the Texas A&M University School of Public Health. “We’ve got Spring Break in like two weeks. There’s beaches and uninterrupted time to do things. I think we may see another uptick in COVID because of that.”

Coté plans to continue wearing masks, socializing outside and getting takeout when he goes to restaurants. None of the six public health experts anticipated they would make drastic changes to their routines yet.

“My own personal responsibility, having watched this very carefully, I’m going to continue to mask,” McDeavitt said. “My family is going to continue to mask. That’s the right thing to do to help and protect others.”