One hundred thirteen Kerr County residents were among the 168,062 coronavirus infections reported in Texas since the start of the pandemic, according to the latest information released from the state and city of Kerrville on Wednesday afternoon.

As of Wednesday afternoon, active COVID-19 infections numbered 64, 35 had recovered, and three people were hospitalized with infections at Peterson Regional Medical Center, according to city and county press releases. Since the pandemic began, two people had died, the latest on June 30.

Since the state health department is experiencing "a significant backlog in its tracking and investigation process," more locals may have recovered, and there may be fewer active infections, according to the city. 

Statewide active COVID-19 cases totaled approximately 78,025, according to the Texas Department of State Health Services, and 244 Texas counties had reported coronavirus infections. At least 2,481 people had died from the disease in Texas and 2,174,548 had been tested. An estimated 87,556 people had recovered from the disease in Texas.

Nationwide, 729,994 people have recovered from the disease, 2,686,587 have been infected and 128,062 have died since the pandemic began, according to Johns Hopkins University. In the U.S., 32,827,359 had been tested for the virus. 

Worldwide, at least 10,719,286 had been infected since the pandemic began, 516,786 had died, and 5,504,493 had recovered, according to the university. 

Top 10 Texas counties for confirmed infections since pandemic started

Harris County


Dallas County


Tarrant County


Bexar County


Travis County


El Paso County


Hidalgo County


Fort Bend County


Galveston County


Collin County


Infections in nearby counties since the pandemic began



























More than 300 children in Texas day cares have caught COVID-19, and the numbers are rising

Although COVID-19 transmission rates nationwide among children have appeared to remain relatively low, more than 300 children at Texas child care centers have tested positive, and the numbers are rising quickly.

As of Tuesday, there were 950 reported positive cases of COVID-19 — 307 children and 643 staff members — at 668 child care locations. Statewide, 12,207 licensed child care operations are open, and total reported coronavirus cases have risen from 59 cases in mid-May and 576 on June 23.

The rise comes as experts and health officials appear to diverge on how risky it is for children to gather in group settings like day care and school classrooms. The American Academy of Pediatrics is recommending that students be “physically present” in schools, saying that the educational advantages outweigh health risks. The academy says it thinks 3 feet of social distancing is sufficient for classrooms and stated that "the relative impact of physical distancing among children is likely small based on current evidence and certainly difficult to implement."

But guidelines from the U.S. Centers for Disease Control and Prevention recommend that day care center providers consider a minimum of 6 feet of social distancing and dismiss students and most staff for two to five days if they have a confirmed coronavirus case so public health authorities can assess the situation.

About 1.1 million Texas children were in state-licensed and registered home day care centers before COVID-19 struck. Several child care centers have closed during the pandemic, with others reporting a drop in the number of children attending.

A University of Vermont study has found that children contract COVID-19 "far less frequently" than adults and found it less likely to be spread among children. It concluded that “transmission in schools may be less important in community transmission than initially feared.”

The American Academy of Pediatrics, which is set to publish the study in its journal, reiterated this in its guidance for reopening schools, stating that unlike the flu, children do not seem to amplify the outbreak of COVID-19. Other experts have echoed these findings as well.

On Thursday, Texas published a new set of emergency rules for child care centers, reinstating safety mandates that had been repealed in mid-June. These include requiring child care centers to check temperatures of staff and students daily, having parents drop students off outside, and not serving family-style meals.

“Providers are required to follow state Minimum Standards to ensure the health and safety of children in care,” Texas Health and Human Services Commission spokesperson Danielle Pestrikoff said in an email. “HHSC has enacted emergency rules and they require operations to implement screening procedures that align with the CDC’s most recent guidance. We continue to advise child care operations to follow the guidance of the CDC and those laid out in Governor Abbott’s Open Texas Checklist.”

Texas Lt. Gov. Dan Patrick says Dr. Anthony Fauci “doesn’t know what he’s talking about”

Despite Texas’ surge of new COVID-19 cases and hospitalizations, Lt. Gov. Dan Patrick said Tuesday evening that he doesn’t need the advice of the nation’s top infectious disease doctor, Anthony Fauci.

“Fauci said today he’s concerned about states like Texas that ‘skipped over’ certain things. He doesn’t know what he’s talking about,” Patrick told Fox News host Laura Ingraham in an interview. “We haven’t skipped over anything. The only thing I’m skipping over is listening to him.”

Patrick also said Fauci has “been wrong every time on every issue.” While he initially did not elaborate on specifics, the lieutenant governor pointed Wednesday afternoon to an example from January when Fauci told Newsmax that the coronavirus was “not a major threat.” (According to Politifact, Fauci did say that twice in late January, when there were a handful of reported COVID-19 cases in the country, and that Americans should not fret. But both times, Fauci added that the situation could change.)

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Since Fauci’s initial remarks, however, case numbers have risen nationally. And during a U.S. Senate hearing Tuesday, Fauci said the nation is going in the “wrong direction” with coronavirus cases.

“It could get very bad,” Fauci said, warning that new cases “could go up to 100,000 a day” if people continue to defy advice on social distancing and face masks. He said states like Arizona, California, Florida and Texas have had to roll back reopening plans as cases in those states climb, noting that half of the new cases nationwide have been reported in those states.

The sharp increase in new infections and hospitalizations rates, he said, has also jeopardized reopening plans throughout the country.

“We’ve got to make sure that when states start to try and open again, they need to follow the guidelines that have been very carefully laid out, with regard to checkpoints,” Fauci said. “What we’ve seen in several states are different iterations of that, perhaps maybe in some going too quickly and skipping over some of the checkpoints.”

The White House has outlined those checkpoints; before proceeding with a phased economic comeback, states are encouraged to satisfy criteria related to case numbers, testing and hospital capacity.

Fauci is not the only expert sounding the alarm on case numbers in Texas. Earlier this week, Dr. Deborah Birx, the coordinator of the White House coronavirus task force, included Austin in a group of metro areas she categorized as “concerning” given the city’s positivity rate over the past seven days.

Last week, Gov. Greg Abbott shut down bars across the state for a second time as part of a series of moves to contain a coronavirus spike in Texas. He also scaled back restaurant occupancy to 50%, shut down rafting and tubing businesses, and banned outdoor gatherings of over 100 people unless approved by local officials.

On Tuesday, Patrick said closing bars was “the right decision.”

“In my view, the worst thing we can do is to lock down Texas again. That’s not what Gov. Abbott wants. That’s not what I want,” he said. “But we need help from the young people out there to help bring these number of cases down and free up hospital beds.”

Patrick sparked a firestorm for saying in an earlier Fox News appearance he would rather perish from the new coronavirus than see the economy destroyed for his grandchildren by overreaction to the disease.

“No one reached out to me and said, ‘As a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that all America loves for your children and grandchildren?’ And if that’s the exchange, I’m all in,” he said in March.

Statewide, more than 6,500 patients in Texas were hospitalized with the coronavirus Tuesday, a record-breaking number and a figure that has gone up nearly every day since June 1. According to data from the Texas Department of State Health Services, there were 1,405 available staffed intensive care unit beds statewide and 13,711 available hospital beds, but with regional disparities.

The increase in infections here came as the local leaders have pleaded with Abbott to allow them to issue stay-at-home orders or mandate face coverings. “We are having an experiment, a gamble, in the hopes that we can be the first community that suddenly flattens the curve without a stay-at-home order,” said Harris County Judge Lina Hidalgo, who represents parts of Houston, one of the country’s fastest-growing coronavirus hot spots.

In his Tuesday interview, Patrick told Ingraham that the state will make further decisions based on listening to “a lot of science” and “a lot of doctors.” Then, he said, “Gov. Abbott and myself and other state leaders will make the decision. No thank you, Dr. Fauci.”

Later Wednesday, Patrick doubled down on his criticism of the infectious disease expert, saying in a statement that it’s “notable that Dr. Fauci did not criticize Andrew Cuomo’s deadly decisions in New York or California’s strategy, whose months long draconian lock down has had no impact on case numbers there.”

In a statement, Abhi Rahman, a spokesperson for the Texas Democratic Party, condemned Patrick’s remarks.

“Last night, Dan Patrick confirmed what we already knew: he and the rest of Texas’ GOP leadership are ignoring the advice of Dr. Fauci and public health experts. Their abysmal failure of leadership is costing Texans their lives,” he said.

High school coaches’ convention will draw thousands to San Antonio as pandemic rages across Texas

Later this month, thousands of people from across Texas are expected to gather in San Antonio for the state’s premier annual high school coaching convention.

Over the course of three days, coaches and athletics professionals in the Texas High School Coaches Association will participate in educational sessions, learn about student health and safety, network, mingle and attend an awards banquet. Masks won’t be required, according to the association’s rules.

“While risk remains low at this time, we cannot ensure a virus-free environment. THSCA will be a handshake free meeting. We recommend the THSCA elbow tap,” the association posted June 10 in its health guidelines for the convention.

Next week, about 500 people are expected to gather for a different coaches’ convention in Arlington. Meanwhile, the Texas Republican Party is mulling this week whether it will move forward with its 6,000-person convention in Houston.

As Texas weathers rapidly increasing coronavirus cases and a worrisome level of hospitalizations, conventions are largely allowed to go on as planned. Gov. Greg Abbott has shut down bars and banned nonessential hospital procedures in some counties. He’s allowed local governments to limit outdoor gatherings to no more than 100 people. But there is no statewide prohibition stopping thousands of people from attending indoor gatherings in Texas’ COVID-19 hot spots.

San Antonio is in Bexar County, which has the fourth-highest number of coronavirus cases and deaths in the state. The THSCA’s 2019 convention drew more than 13,000 attendees from across the state, according to the group’s website.

This year, the THSCA projects that the conference — scheduled for July 19 to 21 at the Henry B. González Convention Center — will draw 5,000 attendees, said Wanda Williams, the center’s operations manager.

“After these past few difficult months, it’s exciting to open our doors again to welcome the association to a safe, comfortable destination,” Casandra Matej, the president and CEO of Visit San Antonio — which partners with the THSCA — wrote in a June 8 press release. “San Antonio is open for business again, and together we’ll play a winning role in Texas’ economic recovery.”

On Wednesday, Matej acknowledged the gravity of the situation and said officials were taking health precautions seriously.

“The pandemic situation continues to evolve and so does San Antonio and its businesses,” she said in an email. “San Antonio is known to Texans as a safe and comfortable destination and we are all doing everything possible to keep it so. ... This meeting, similar to other meetings and events across the state, are under a watchful eye of the industry and public to ensure we all can deliver on a safe path forward for in-person events. It’s a great responsibility and one no one is taking lightly.”

This week, the city of San Antonio announced it is prohibiting indoor gatherings of more than 100 people, effective at noon Thursday for an indefinite period of time. But the order does not apply to trade associations leasing convention center space, said Jeff Coyle, the city’s director of government and public affairs.

“Regardless, the City owns the convention center, and we will be requiring daily temperature checks and symptom screening upon entry to the facility, and we will require the wearing of facial coverings where social distancing is not feasible,” Coyle wrote in an email Wednesday.

Masks are not mandated throughout the convention, but they are encouraged, according to the association’s rules. But Williams said employees and guests will be required to wear them in situations where “social distancing cannot be maintained.”

“The Convention Center will implement physical distancing protocols and requires the use of masks where six feet of distance between people cannot be maintained,” Williams said in an email. “In addition, the facility is equipped with hand sanitizer stations and signage to remind patrons of keeping a safe distance from others.”

Guests will be screened upon entrance and have their temperatures taken, and paramedics will be standing by to assist.

The Texas High School Coaches Association did not respond to a request for comment.

Both of the coaches’ conventions planned for this month will offer a virtual program for participants who cannot make it to the in-person meetings.

The Texas Girls Coaches Association’s in-person convention — scheduled for July 6 to 9 — is expected to draw 500 attendees, where activities will be split between the Arlington Convention Center and the neighboring Sheraton Arlington Hotel, according to Susan Schrock, a spokesperson for the city of Arlington, which is in Tarrant County.

Tarrant County has the third-highest number of coronavirus cases and deaths in the state. Last week, county officials issued an order mandating face masks at all businesses and outdoor gatherings of more than 100 people. Schrock said the convention center will require masks regardless.

“The convention center is operating under county and state guidelines, which currently means that conventions are limited to 50% of the occupancy for each space that they use,” Schrock said. “We’ve got sanitizing stations, and those who enter the convention center will wear a mask.”

Tarrant County officials declined to comment on the convention and deferred to city of Arlington officials on the matter.

Schrock added that visitors will be required to wear masks in the Arlington Convention Center “except for in instances where they can safely socially distance.”

Sam Tipton, TGCA’s executive director, wrote in an email that the in-person clinic will abide by all Tarrant County and city of Arlington regulations.

“It has now been mandated you wear a face covering in all buildings and businesses in Tarrant County,” the TGCA’s website read as of Monday morning, an update from the previous week when the website said face coverings were “not a requirement, at this time.”

The TGCA’s website also informs attendees that they will be required to sign a form acknowledging the risks of exposure to the coronavirus.

“We will not skirt any of the rules,” Tipton said.

Medical experts have discouraged large indoor gatherings as the pandemic worsens in the Lone Star State.

Dr. Luis Ostrosky, a professor of infectious diseases at the University of Texas McGovern Medical School, did not comment on the coaches’ conventions, but he said he generally thinks large indoor gatherings are not advisable at this time.

“I've always thought we could do indoor gatherings, if we follow the rules and community incidence is low,” Ostrosky said. “Obviously, at this time, we're not meeting those conditions. There's very high community incidence.”

The Texas Republican Party this week said its board will decide Thursday whether there will be changes to plans for its in-person convention, which is scheduled for July 16-18 in Houston and does not have a mask mandate. The Texas Tribune reported earlier this week that the Texas Medical Association is one of the convention’s sponsors, prompting the organization to criticize the in-person convention and call for its cancellation.

Disclosure: The Texas Medical Association has been financial a supporter 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.

Texas won’t specify where hospital beds are available as coronavirus cases hit record highs

As Texas sets records for new COVID-19 cases and hospitalizations day after day, the state’s hospital capacity — one of the key metrics that Gov. Greg Abbott cited as he allowed businesses to reopen — has become the focus of increased attention and concern.

But the state isn’t releasing the information it collects about how many beds individual hospitals have available. And only a fraction of the state’s hospitals, cities and counties are providing that information to the public on their own.

The Texas Department of State Health Services has that data at its disposal. Hospitals across the state have been sending daily reports on how many available regular and intensive care unit beds they have, as well as the number of available ventilators, to regional health authorities, which send the information to the state. The agency then publicly releases that data for the state as a whole and for the state’s 22 trauma service regions.

Data for individual hospitals or counties is not made public “because hospitals within trauma service areas coordinate to ensure their communities have necessary care, and because people often cross county lines to get hospital care,” said Chris Van Deusen, a DSHS spokesperson.

Hospital officials in Houston and other parts of the state recently warned that hospitals could get overwhelmed if the number of infections keeps climbing. Statewide, 6,904 patients in Texas were hospitalized with COVID-19 on Wednesday — a figure that has been going up nearly every day since June 1.

On June 25, Abbott reinstated a ban on elective surgeries in four counties that are seeing rapid increases in coronavirus cases, saying he remains focused on maintaining sufficient hospital capacity; three days earlier, he told Texans that hospital capacity was “abundant.” The governor expanded the ban to four more counties in South Texas on Tuesday.

According to data from DSHS, the state had 1,322 available intensive care unit beds and close to 13,000 available hospital beds Wednesday. But there are important regional disparities. The Northeast Texas Regional Advisory Council reported Wednesday that 43% of its hospital beds are in use with 92 ICU beds available, while the East Texas Gulf Coast Regional Advisory Council, which includes nine counties and more than 1.3 million people, is 83% full with only 10 open ICU beds.

Some of the regional advisory councils provide county-level breakdowns of available hospital beds within their boundaries, including the Southeast Texas Regional Advisory Council, which includes Houston.

Many local government and health authorities have opted not to make hospital capacity information public.

“Publicly, we do not share which hospitals are at capacity, because there is constant shifting and we want the hospitals to have the freedom to move resources as needed,” Mark Escott, Austin's interim public health authority, said in an email.

Dallas County provides daily briefs that include hospitalizations, ICU admissions and emergency room visits — but doesn’t include available hospital capacity — saying local health experts use these key indicators to determine the COVID-19 risk level and the appropriate response.

The Texas Medical Center in Houston, which includes 21 hospitals, used to update daily a set of “early warnings,” including its base intensive care capacity. On June 24, TMC leaders issued a statement warning that patients with COVID-19 were being admitted at an “alarming rate.” The next day, the medical center reported it had reached 100% of ICU base capacity — and then stopped updating that information for almost three days.

During a joint news conference June 25, Houston Methodist CEO Dr. Marc Boom said officials were concerned that the level of alarm was “unwarranted.”

The Houston Chronicle reported that Abbott had expressed displeasure to hospital executives about headlines related to ICU capacity, but Abbott spokesman John Wittman said any insinuation that the governor suggested the executives publish less data is false.

“We were getting panicked calls from elected officials and members of the media saying, ‘You all are out of ICU beds, what are we going to do?’” David Callender, president and CEO of the Memorial Hermann Hospital, told KHOU-TV. “We were not doing a very good job with our slides and portraying how we manage our capacity.”

The slides that the medical center posts on its website have been changed to put emphasis on its available surge capacity.

But the sudden change in data reporting brought criticism from Harris County Judge Lina Hidalgo.

“The timing is suspect. I find it very very problematic,” Hidalgo said in a new conference Monday. She said that her team uses this data to help develop its projections and that the county’s message urging residents to stay home can be “diluted” by this sudden change.

Although the hospital capacity data is available to state and county officials, some local agencies say they are in the dark about capacity at their own hospitals.

The Austin Public Health Department, which organizes COVID-19 response locally, does not “yet have a data feed from all of the hospitals in the [area] to accurately determine daily occupancy and capacity,” a spokesperson said.

Last week, Sarah Eckhardt, the former Travis County judge serving as an adviser to interim County Judge Sam Biscoe, said she was having trouble obtaining information about capacity at local private hospitals. On Tuesday, she said that the county has since received all the information it needs to plan its response to the recent surge in COVID-19 hospitalizations, which reached 369 in Travis County on Tuesday, including 132 people in ICU.

Travis County has a 22.9% positivity rate, a figure “substantially higher than most of the country,” Escott said in a news conference Wednesday. The positivity rate is the ratio of positive cases to the number of tests conducted, and it can vary depending on who is being tested, health experts say. Public testing in the county is being rationed to only people with symptoms.

“I think that it's pretty plain that if the chief executives of the county and the city are having a hard time getting information about the occupancy levels in the hospitals, then how would you expect the regular individual to know?” Eckhardt said.

Vanilla Ice to perform Fourth of July weekend concert near Austin as coronavirus cases surge

As coronavirus cases continue to surge in Texas, one venue outside Austin says it still plans to host an in-person concert Friday with rapper Vanilla Ice.

But while news of the show has sparked concerns about social distancing, the concert venue's organizer told The Texas Tribune that only 84 tickets had been sold as of Wednesday night. Barret Brannam, owner of Emerald Point Bar & Grill on Lake Travis, said that contrary to reports suggesting that the number of fans at Friday's show will be roughly 2,500, the maximum occupancy for the event has been set to 450 people.

"We're not trying to buck the system — we're going within the guidelines we've been given," Brannam said. "Music is part of Emerald Point — and it will always be part of us going forward."

An event promoter told the Austin Chronicle, which first reported the plans for the concert, that Emerald Point is officially categorized as a restaurant because at least 51% of its sales are food. That would mean it can operate at 50% capacity under Gov. Greg Abbott's latest executive order aiming to slow the spread of the coronavirus. Under that order, bars were forced to close their doors, but restaurants can still operate at half their capacity. Local officials have the power under his order to cancel public outdoor events with more than 100 people.

Despite the paltry ticket sales so far, Brannam said that additional people may watch the show from their boats while on the lake.

He also stressed the safety precautions the venue has been taking for months and plans to implement Friday, such as taking attendees' temperatures at the entrance and requesting that they practice social distancing and wear masks. Brannam said his venue was not requiring people to wear masks because "I'm not their mom and dad, [and] I can't make them do it."

"We reduced the capacity to 450 people because that's what we thought we could space with tables," he said, stressing that the venue has followed Abbott's guidelines since the pandemic hit the state. "It's really not as gross as people are making it out to be."

On Wednesday, state health officials reported the highest number of coronavirus cases yet with 8,000 new cases. That figure more than doubled what the state's case count was roughly two weeks ago.

Brannam said 20 employees at the venue who were tested last week for the virus had negative results. He said people "can live life in a way that protects yourself" and that while the venue is enforcing social distancing measures "the best we can ... at the end of the day, there's still in this country something called personal responsibility."

"[Vanilla Ice] has already been paid," he said. "If I cancel the show ... I'm just flushing money down the toilet. ... If only a couple hundred people come out, at least those people got to see a cool show."

Internal messages reveal crisis at Houston hospitals as coronavirus cases surge

HOUSTON — At Lyndon B. Johnson Hospital on Sunday, the medical staff ran out of both space for new coronavirus patients and a key drug needed to treat them. With no open beds at the public hospital, a dozen COVID-19 patients who were in need of intensive care were stuck in the emergency room, awaiting transfers to other Houston area hospitals, according to a note sent to the staff and shared with reporters.

A day later, the top physician executive at the Houston Methodist hospital system wrote to staff members warning that its coronavirus caseload was surging: “It has become necessary to consider delaying more surgical services to create further capacity for COVID-19 patients,” Dr. Robert Phillips said in the note, an abrupt turn from three days earlier, when the hospital system sent a note to thousands of patients, inviting them to keep their surgical appointments.

And at The University of Texas MD Anderson Cancer Center, staff members were alerted recently that the hospital would soon begin taking in cancer patients with COVID-19 from the city’s overburdened public hospital system, a highly unusual move for the specialty hospital.

These internal messages highlight the growing strain that the coronavirus crisis is putting on hospital systems in the Houston region, where the number of patients hospitalized with COVID-19 has nearly quadrupled since Memorial Day. As of Tuesday, more than 3,000 people were hospitalized for the coronavirus in the region, including nearly 800 in intensive care.

“To tell you the truth, what worries me is not this week, where we’re still kind of handling it,” said Roberta Schwartz, Houston Methodist’s chief innovation officer, who’s been helping lead the system’s efforts to expand beds for COVID-19 patents. “I’m really worried about next week.”

What’s happening in Houston draws eerie parallels to New York City in late March, when every day brought steep increases in the number of patients seeking care at overburdened hospitals — though, so far, with far fewer deaths. But as coronavirus cases surge in Texas, state officials here have not reimplemented the same lockdown measures that experts say helped bring New York’s outbreak under control, raising concern among public health officials that Houston won’t be able to flatten the curve.

“The time to act and time to be alarmed is not when you’ve hit capacity, but it’s much earlier when you start to see hospitalizations increase at a very fast rate,” said Lauren Ancel Meyers, a professor of integrative biology who leads the University of Texas at Austin COVID-19 Modeling Consortium. “It is definitely time to take some kind of action. It is time to be alarmed.”

Even as new cases and hospitalizations soar, the number of daily deaths in Texas has remained relatively low. On Tuesday, the state reported nearly 7,000 new cases, a record, but only 21 new deaths. All told, New York state has reported nearly 25,000 confirmed deaths from COVID-19. Texas has recorded fewer than 2,500, including 378 in Harris County, which includes Houston.

But experts caution that rising hospitalizations today will likely result in a spike in deaths in the coming weeks, and those who require ICU care for COVID-19 but recover often leave the hospital with lasting health problems.

Meyers and others said that while hospitals across the United States generally are more prepared than they were in March and April — personal protective equipment is more plentiful, advances in therapeutics have helped patients and ventilators aren’t in short supply — the lack of government measures to slow the spread in Texas and other states puts them at a disadvantage.

Texas was one of the first states in the nation to ease social distancing mandates, beginning two months ago when daily coronavirus cases remained relatively low compared with some states. Restaurants reopened first, with gradually loosening capacity restrictions; bars, hair salons, bowling alleys and other businesses soon followed. In Houston, where Gov. Greg Abbott had until recently blocked local officials from issuing public mask requirements, it was common to see the majority of people shopping at neighborhood supermarkets or big-box hardware stores with no face coverings.

But to date, Abbott has resisted a return to the lockdown, other than an order last week closing bars and further limiting the capacity at restaurants. This week, after the top elected leader in Dallas County asked for the authority to issue a new stay-at-home order locally, Abbott dismissed the idea, saying the official was asking to “force poverty” on people.

“Closing down Texas again will always be the last option,” the governor said last week, emphasizing his commitment to protecting the state’s economy.

Experts noted that it can take two weeks or longer for social distancing measures to lead to decreases in cases and hospitalizations.

“The hospitalizations you see today, they’re not just going to linearly increase in the next two weeks,” said Dr. Clay Johnston, dean of the Dell Medical School at the University of Texas at Austin. “They’re going to accelerate. When you overwhelm the hospitals, you’re in big trouble. That to me is the impossible task that the governor faces. It’s like steering a giant tanker through a tiny strait without any maps.”

Although hospital executives in Houston stress that they have the ability to add additional intensive care beds in the region to meet the growing demand — for a few more weeks, at least — the strain on hospitals is already being felt in other ways.

Houston Fire Chief Samuel Peña said his paramedics sometimes have to wait for more than an hour while emergency room workers scramble to find beds and staffers to care for patients brought in by ambulance — a bottleneck that’s tying up emergency medical service resources and slowing emergency response times across the region.

Part of the problem, Peña said, is that when his crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it. That’s a problem that’s likely to deepen as a growing number of medical workers have been testing positive for the virus, according to internal hospital reports. Just as New York hospitals did four months ago, some Houston hospitals have posted on traveling nurse websites seeking nurses for “crisis response jobs.”

“If they don’t have the nursing staff, then you can’t place the patient,” Peña said. “Then our crews have to sit with the patient in the ER until something comes open. It has a huge domino effect.”

The crisis in Houston has accelerated rapidly in recent weeks, at times resulting in muddled messaging from both hospital leaders and public officials.

On June 24, several hospital executives affiliated with the Texas Medical Center — a sprawling medical campus that’s home to most of Houston’s major hospital systems — issued a statement warning that COVID-19 hospitalizations were growing at an “alarming rate” and could soon put an unsustainable strain on hospital resources.

But the following day, after Abbott issued an executive order directing hospitals to limit elective surgeries — a measure intended to preserve hospital capacity but one that also hurts hospital revenues — the CEOs of four hospitals in the medical center abruptly dialed back their earlier warnings at a hastily organized news conference. They said they hadn’t meant to alarm the public. The hospitals still had room to add ICU beds, they said, both to treat COVID-19 and to continue caring for other patients.

“I think the Texas Medical Center’s purpose was to really urge people to do the right things in the community, and do so by talking about capacity, but really ended up unintentionally sounding an alarm bell too loudly,” Dr. Marc Boom, president and CEO of Houston Methodist, which is part of the Texas Medical Center, said at the news conference. “We clearly do have capacity.”

The shifting messages upset Harris County Judge Lina Hidalgo, the county’s top elected official. She vented her frustrations Monday during a virtual news conference from her home, where she’s on self-quarantine after a member of her staff tested positive for the coronavirus. Hidalgo said the “diluted” messaging from some hospital leaders “weakens our community’s ability” to stop the virus.

“The goal is not to have doctors and nurses that we’re bringing in from out of town,” Hidalgo said. “The goal is not to have basic general population beds that we need for dialysis and heart attacks and strokes and pregnant women who need to give birth turned into ICU beds. The goal is not to see how much room we can make for people to go and be there and die in a hospital bed. That is not the point of any of this.”

In an interview Tuesday, Boom said he didn’t intend to suggest that there wasn’t reason to be deeply concerned about the number of COVID-19 patients filling hospital wards. He said he and other executives were trying to thread the needle between sounding the alarm about the growing but still manageable strain on hospital resources, while trying to reassure people who might need to come to the hospital for other ailments.

“Honestly, in a way, it’s backfired, and I’m very sorry for that because what has happened has actually been the exact opposite of what we were trying to accomplish,” he said of his attempt to clarify the earlier warning about hospital capacity. “I never wanted to confuse the public. The message really was, ‘Hey guys, we don’t want panic, because when people panic, bad things happen.’”

Hospitals in Houston and elsewhere in the country temporarily halted outpatient visits and elective surgeries in March and April as the coronavirus pandemic took hold on the East Coast — a move that not only hurt hospital revenues, Boom said, but also forced many patients to delay critical procedures, including heart surgeries.

Boom and other hospital leaders said the earlier restrictions also led some patients to avoid going to the hospital after suffering symptoms of heart attacks or strokes, leading to potentially deadly delays in care.

Vivian Ho, an economics professor at Rice University, said hospitals want to protect their fiscal health and the health of patients, both those with COVID-19 and those with other conditions, while also preventing themselves from becoming overwhelmed down the line.

Elective surgeries deliver a far better financial return than ICU wards full of patients with COVID-19.

“They would prefer to tell the public that this is extremely dangerous,” she said, “but they can’t, in part, because they have to keep performing these elective surgeries, and for the most part, that is safe.”

Not all hospitals are equally equipped to respond to a surge in COVID-19 demand, accompanied by a loss of more profitable business, Ho said. Hospital systems like Houston Methodist have “the financial resources to sort of convert anything into an ICU just because they have more money, more cash on hand,” she said.

Houston’s public hospitals, Ben Taub and Lyndon B. Johnson, don’t have those same resources.

“The problem is that, of course, there are going to be more patients who are going to be going to Ben Taub” because the virus is disproportionately affecting Black and Latino people in low-income communities, and Ben Taub is traditionally the safety net for those without health insurance, Ho said. “I don’t know to what extent they are able to send patients to the other hospitals.”

Harris Health System officials said that capacity limits at both of its public hospitals have forced doctors to transfer coronavirus patients elsewhere, including sending some to hospitals in nearby cities.

The Sunday note to the staff at Lyndon B. Johnson said that the hospital had reached maximum occupancy in its COVID-19 units. That day, nearly 50% of the patients tested for the virus had it, more than double the rate from a week before. The hospital had run out of remdesivir, an antiviral drug that’s shown some effectiveness in treating COVID-19. And for now, all elective surgeries were being canceled to preserve bed and staffing capacity.

There appeared to be no letup in sight; the note to the staff warned that Monday would likely be worse.

“Sunday,” it said, “is typically a lower volume day.”

Texas sales tax revenue declined 6.5% versus last June as state reopened for business

Texas collected $2.67 billion in state sales tax revenue in June — a 6.5% drop compared to what the state brought in the same month last year, Comptroller Glenn Hegar said Wednesday.

June’s sales tax revenue, which mainly reflects purchases made in May, suggests that the state’s phased reopening and relaxing of social distancing measures over the past month led to some increases in economic activity. That phased reopening, spearheaded by Gov. Greg Abbott, marked one of the earliest and quickest reopenings in the country, allowing almost all businesses to operate with at least 50% occupancy by the beginning of June.

Still, Hegar said, sales tax revenue totaled over April, May and June was down 9.7% compared to the same period a year ago.

While collections from restaurants were depressed, Hegar said that take-out and delivery sales, along with online purchases, helped buoy revenue in the restaurant and retail sectors.

“Retail trade receipts rose significantly, buoyed by increased online shopping and building material purchases, as business premises were modified for COVID-19 precautions,” he said in a statement. “Retail sales likely also were boosted by increased alcoholic beverage sales at package, grocery and convenience stores. That’s because this category of spending shifted from restaurant and bar on-premise consumption, subject to mixed beverage taxes, to purchases for at-home consumption subject to sales tax.”

Hegar said that the latest collection, down from nearly $2.9 billion in June 2019, "was driven principally by steep drops" in the oil and gas sectors of the state's economy. Collections from construction and amusement service sectors, he said, "were also sharply down."

The state’s single largest source of funding may see further declines in the coming months after a recent surge in coronavirus cases led to the governor last week ordering bars to shutter again and restaurants to reduce to 50% occupancy, among other things. Before that, bars had been allowed to operate at 50% capacity and restaurants at 75% capacity.

Later this month, Hegar is expected to announce his revised revenue estimate for the current state budget, which ends in August 2021. That figure, which Hegar has already said will be revised downward by billions of dollars, will give state lawmakers perhaps their best picture yet of how much money the Legislature will have to work with when it reconvenes in January.

State leaders have already moved to offset at least a portion of the state’s losses from the pandemic and, to a lesser extent, the recent crash in oil and gas prices. In May, Abbott, Lt. Gov. Dan Patrick and House Speaker Dennis Bonnen asked certain state agencies and higher education institutions to submit plans to trim their budgets by 5%. Those plans were due June 15. The Big Three, which excluded agencies and programs from the directive that make up a majority of the state’s general revenue funding, also said that additional cuts could happen as the economic forecast continues to firm up.

Meanwhile, some economists have signaled that Texans can expect an “uneven recovery” on the heels of Abbott’s announcement last week to again shut down parts of the economy and until the coronavirus stops spreading in large numbers.

“Unless [COVID-19] is under control, it is very hard for people to feel the confidence to go out and spend,” Venkatesh Shankar, director of research at the center for retailing studies at Texas A&M University, said in an interview. “[At] the end of the day, the sales are not moving rapidly. In June, everybody jumped back, perhaps, too quickly.”

Austin City Limits music festival canceled for 2020 because of coronavirus

The Austin City Limits Music Festival, set to take place this fall was canceled Wednesday because of ongoing concern over the spread of the coronavirus, festival organizers said in an email Wednesday.

ACL is one of the largest outdoor music events in Texas and a major economic driver for the city. Last year, about 75,000 people attended each day of the two-weekend event, bringing attendance to at least 400,000, according to the Austin Monitor. The 2019 headliners included Cardi B, Guns N' Roses, Childish Gambino and The Cure. The lineup for 2020 had not yet been announced.

In 2019 the festival contributed $291 million to the city's economy and created or sustained at least 1,500 jobs across bars and restaurants, hotels and transportation, according to the Austin City Limits Music Festival 2019 Economic Impact Report.

"We would have loved to put on another memorable show this year, however, with the uncertainty surrounding the current situation in Texas, this decision is the only responsible solution," organizers said. "The health and safety of our fans, artists, partners, staff and the entire Austin community remains our highest priority.

The festival is scheduled to resume in October 2021 to commemorate the event's 20th anniversary. Those who already purchased tickets to the 2020 event have the option to lock in tickets for next year at the same price or get a refund.

"Few events are rooted in – & embody - the soul of this city like @aclfestival & their hard decision for the greater good is applauded," Austin Mayor Steve Adler said in a tweet. "While the show won’t go on this year, there are many ways to support local musicians while we all look forward to the 20th Anniversary next year."

This is the latest of a number of high profile cancellations in Texas related to the pandemic, including the popular South by Southwest festival that was canceled in March by Adler about a week out from when it was set to begin.

The cancellation from the city of Austin initially caused some tension with festival organizers and the hospitality industry who worried Adler was being overly cautious. When the cancellation was announced Texas had at least 17 confirmed cases of the virus — all were people who were exposed overseas and the virus had not begun to spread widely in the community. It was the event's first cancellation in its 34-year history.

Last year, SXSW had an estimated $356 million financial impact, about $200 million of that is related to spending by attendees, the Statesman reported. The economic activity from SXSW makes up about 4% of Travis County's annual hospitality earnings.

Critics slam changes in ICU capacity reporting in Houston

HOUSTON (AP) — A change in how Houston area hospitals report intensive care unit capacity during the coronavirus pandemic has drawn criticism from the top two locally elected officials who are questioning if the medical facilities are being fully transparent.

But officials within the Texas Medical Center, a sprawling medical complex made up of Houston’s major hospitals, say the change was done to provide more accurate information and reassure the public that it was not running out of ICU beds.

As coronavirus cases and hospitalizations have continued to rise in Houston, the Texas Medical Center has been providing a daily pandemic-related update on its website, including charts on ICU capacity, when base ICU capacity could be exceeded, when sustainable surge capacity could be exceeded and other metrics from its local member hospitals.

Last week, the medical center reported that its normal ICU capacity was at 100% and warned that “ICU capacity is becoming increasingly stretched.”

Hospital leaders later held a news conference in an effort to tamp down public alarm.

Adding to the public concern, the medical center then took its charts offline for several days and when they reappeared, references to sustainable and unsustainable surge capacity and when those could be exceeded were replaced with discussion of different phases of intensive care. Many of the bright yellow and red colors used to highlight concern and warnings in some of the old charts were replaced with shades of blue.

Dr. James McDeavitt is senior vice president and dean of clinical affairs at Baylor College of Medicine, which is one of the member institutions within the medical center. He said the way the data was presented didn't provide a complete picture of ICU capacity.

“Not to minimize the fact that we’re getting stressed at hospitals, but that was the wrong message for people to take away. I think that was the underlying concern because we had plenty of capacity,” McDeavitt said Wednesday.

The hospitals in the medical center have reached their phase one ICU capacity, which is 1,330 beds. But McDeavitt said there are two other phases that could add nearly 900 more ICU beds.

“There are plenty of levers now to help manage that capacity before we risk tipping over into” the most serious phase, McDeavitt said.

In Harris County, where Houston is located, the number of people hospitalized in ICU beds with COVID-19 has increased by more than 52% since May 26.

Texas’ case levels continued to skyrocket Wednesday as the state soared past 8,000 new confirmed infections in a single day for the first time. It was also the second deadliest day of the outbreak with 57 new deaths reported, bringing the total confirmed death toll to at least 2,481.

Nearly 7,000 people with COVID-19 are now hospitalized, meaning that Texas is starting July with nearly four times as many patients in hospital beds as on June 1.

Harris County Judge Lina Hidalgo said she was alarmed by the changes to how the information on ICU capacity in the Houston area was now being presented.

“The timing is suspect. I find it very, very problematic,” said Hidalgo, the top elected official in the county.

Houston Mayor Sylvester Turner said the change raised questions and he asked the medical center to go back to its original reporting.

“We need to be very truthful and be upfront and not try to camouflage the severity of this virus,” Turner said.

But William McKeon, president and CEO of the Texas Medical Center, said the data is constantly being refined as medical professionals learn more about the virus.

“There’s nothing sinister here,” McKeon told KTRK-TV.

Questions have also been raised about whether the hospitals will have enough staffing if additional ICU beds are needed.

McDeavitt said hospitals at the medical center have developed training programs and have hired additional staff to ensure that patients have qualified nurses and doctors taking care of them.

Health district reports 31 new COVID-19 cases, three new deaths

The Angelina County & Cities Health District reported an additional 31 cases of COVID-19, bringing the total in Angelina County — including the Rufus H. Duncan Geriatric Facility prison unit in Diboll — to 820.

The health district is reporting 507 positive tests with 225 estimated recoveries and nine deaths. The Southeast Texas Regional Advisory Council is reporting 13 confirmed cases in general isolation with two in the Intensive Care Unit. They also suspect two people to be in general isolation.

The Duncan Unit is reporting 270 offender cases and 43 employee cases, according to information from the Texas Department of Criminal Justice. Of the offender cases, 81 are active and 189 are recovered. Of the employee cases, 28 are active while 15 have recovered.

The Duncan Unit is reporting eight coronavirus-related deaths as of Monday. There are 205 offenders on medical restriction and 98 in medical isolation.

Three more people have died from complications related to COVID-19 in Angelina County, bringing the county’s total number of deaths to nine, according to the health district.

The individuals had been hospitalized and died from complications associated with the disease, according to an email from health district administrator Sharon Shaw. The three who died were 53, 60 and 63 years old.

“Our sincere condolences are extended to the families, friends and loved ones,” the email states. “Please continue to be diligent in following the (Centers for Disease Control and Prevention) recommendations for social distancing, wearing a mask when around anyone not in your immediate household, monitor your health at all times and do not go to work or other places when feeling ill.”

As of Saturday, Nacogdoches County reported an additional 16 new cases, bringing the total cases to 375, with 288 estimated recoveries and 24 deaths.

The health district also reported 121 positive tests in Polk County with 42 estimated recoveries and 105 positive tests with 34 recoveries and seven deaths in San Augustine County.

As of Tuesday evening, the state was reporting 159,986 cases, 2,424 fatalities and an estimated 84,818 recoveries leaving 72,744 estimated active cases.

Lake Jackson nursing home employees test positive for COVID-19

Two-fifths of Wednesday's 70 newly-announced COVID-19 cases are from Pearland, but a nursing home resident and employees in Clute and Lake Jackson also contributed to the number.

Three employees of Carriage Inn in Lake Jackson, which had yet to report any COVID-19 cases before Wednesday, tested positive for the virus, County Judge Matt Sebesta said. He did not report any Carriage Inn residents to have tested positive.

A resident of Creekside Village Healthcare in Clute and a resident of Tuscany Village in Pearland also were announced to have tested positive Wednesday, Sebesta said.

A Texas Department of Criminal Justice employee is also included in Wednesday's count, he said.

Of the 70 new cases, 28 are in Pearland residents, according to county data. The Pearland residents range in age from 10 to older than 80 years old, the data shows.

In Alvin, a man in his 60s and a man in his 70s tested positive for the virus, according to county data. A man and a woman in their 30s tested positive for the virus in Freeport, as well as a man and a woman of the same age range in Iowa Colony. One man from Jones Creek in his 40s tested positive for the virus, according to county data.

Seven confirmed cases were reported in Angleton, including people ranging from the ages of 10 and over 80 years old.

Six confirmed cases were reported in Clute, including men and women ranging from the ages of younger than 10 to 49.

Lake Jackson reported 10 new cases, including children younger than 10 to and a man older than 80. Two of those cases were probable, according to county data, meaning they are in people who are symptomatic and connected to a confirmed case of COVID-19, usually by living in the same household.

Three confirmed cases and one probable case was reported from Manvel, ranging from the ages of 10 to 59 years old.

Wednesday’s case count included 54 recoveries and 998 recoveries overall. There are 850 active, 17 are deceased and 38 are probable. There have been 1,903 cases reported by the county since the start of the pandemic.

The Texas Tribune, The Associated Press
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