Peterson Health reported three new coronavirus infections on Monday afternoon, bringing Kerr County’s total cases to 398, although at least 366 patients have recovered.

“Over the last few weeks, we are grateful to see lower numbers in reporting positive cases,” said Pam Burton, infection preventionist for Peterson Health

Burton said there are three patients hospitalized at Peterson Regional Medical Center with COVID-19, and the pandemic death toll for Kerr County remains at six.

Peterson Health’s outreach clinic continues to offer COVID-19 testing for people experiencing systems. Testing is available from 7 a.m. to 7 p.m. weekdays and 8 a.m. to 4 p.m. weekends, she said. 

She also noted that the hospital still has a no-visitation policy in effect through Sept. 29, with some exceptions. 

Williams “Dub” Thomas, county emergency management coordinator, appeared before county commissioners during their Monday meeting and gave what he characterized as encouraging news.

“Last week was actually a pretty good week for us — pretty slow,” Thomas said. “We only added 16 new cases to the total. … We had been adding 10, 20 a day; now we’re just down to 16 for one week.” 

Thomas said most infections have occured in the age group of 20 to 60, but there’s another trend forming.

“I’m starting to see an older age group — 75 to 79 and 80-plus starting to creep up just a little bit,” Thomas said. 

Texas totals

As of Aug. 4, the latest information available, statewide active COVID-19 cases totaled approximately 133,584, according to the Texas Department of State Health Services, and 250 Texas counties had reported coronavirus infections. Fatalities from the disease totaled 8,490 and 4,073,661 had been tested in Texas. An estimated 349,833 people had recovered from the disease in Texas. Since the start of the pandemic, 490,817 infections had been reported in Texas. A total of 4,455 new cases and 31 deaths were reported on Aug. 10. 

National totals

Nationwide, 1,670,755 people have recovered from the disease, 5,095,163 have been infected and 163,505 have died since the pandemic began, according to Johns Hopkins University. In the U.S., 62,513,174 had been tested for the virus.

Worldwide

Worldwide, at least 20,119,511 people had been infected since the pandemic began, 737,126 had died, and 12,370,465 had recovered, according to the university. 

Top 10 Texas counties for confirmed infections since pandemic started

Harris County

85,757

Dallas County

54,674

Bexar County

35,205

Tarrant County

32,177

Travis County

22,724

Hidalgo County

19,741

Cameron County

16,590

El Paso County

16,396

Nueces County

11,226

Fort Bend County

9,533

Restaurants, bars and breweries scramble to reinvent themselves to get around Gov. Greg Abbott's bar shutdown

Hundreds of Texas bars and restaurants are scrambling to change how they operate, maneuvering through loopholes that will allow them to reopen after being closed by Gov. Greg Abbott’s latest shutdown targeting bars.

Abbott has shut bars down twice since the coronavirus pandemic emerged in Texas. The first time bars were swept up in a total lockdown of statewide businesses. But the second time, on June 26, Abbott singled bars out while allowing virtually every other kind of business in Texas to stay open.

But other operations such as restaurants that sell a lot of booze, wineries and breweries were ensnared in the same order and also forced to close because alcohol sales exceeded 51% of total revenue, meaning they were classified as bars.

“Generally everyone has a common sense understanding: ‘What is a bar? And what is a restaurant?’ I think that 51% rule is so broad that it actually picks up or encompasses businesses that we would normally think of as really being restaurants,” said State Rep. John Wray, R-Waxahachie, one of more than 65 lawmakers who signed a letter asking Abbott to update his order’s definition of a restaurant.

Wray gave the example of a burger restaurant, where a patron might buy a burger and two beers. Oftentimes, the beer will cost more than the food, but that doesn’t make the restaurant a bar, he said.

Emily Williams Knight, Texas Restaurant Association president, estimates that about 1,500 restaurants ranging from steak houses to coffee shops that sell wine were “inadvertently” forced to close when Abbott shut down bars, translating to about 35,000 lost jobs in the state.

The Texas Alcoholic Beverage Commission responded to outcry from the service industry with new guidance in a July 30 notice allowing businesses to either demonstrate that they recently had less than 51% alcohol sales or use alcohol sales projections and apply for a Food and Beverage Certificate, documentation that allows them to reopen as a restaurant.

The certificate workaround requires the business to have a permanent kitchen. It allows bars and restaurants to use projected sales numbers instead of requiring past sales to determine if alcohol sales exceed food sales.

The TABC received more than 600 requests from existing businesses for Food and Beverage Certificates since Abbott’s order took place and granted about 300, according to commission spokesperson Chris Porter. Almost 90 businesses have also requested to update their alcohol sales numbers in an effort to reopen.

The Texas restaurant industry is already struggling, with Knight projecting that up to 30% of restaurants in the state could go out of business.

For those forced to shut down due to the bar order, it can be a death sentence and business owners see these changes as their last hope.

After his Dallas restaurant was closed for a second time, Lava Cantina owner Ian Vaughn knew he’d have to figure out a way to reopen — and fast — for the sake of his more than 100 employees and to save his business.

After three weeks of pursuing various options to reopen, Vaughn updated his sales numbers to include live music ticket sales from concerts, knocking his alcohol sales percentage down to about 39%. This allowed him to resume operations.

“I was highly distressed throughout the entire time," Vaughn said. "I had over 100 people out of work, and I just needed to get my staff back, and I had bills to cover and no idea how we were going to ultimately make ends meet. You feel completely helpless.”

Even some traditional bars can reopen using the same workarounds outlined by the TABC — as long as they have, or will obtain, permanent food service facilities. 

Lava Cantina owner Ian Vaughn reopened his restaurant on July 24 after knocking down his alcohol sales percentage to stay below the state's 51% threshold.

Justin Kaufman, owner of the El Paso Drafthouse and The Rey Muerto, decided to reopen his bars as restaurants by using future sales projections to get a Food and Beverage Certificate.

Functionally, Kaufman’s businesses operate almost the same as before the second shutdown, using the safety measures he implemented when he was first allowed to reopen. He offers the same menus but now requires all patrons to purchase food with their drinks to ensure he stays under the 51% alcohol sales limit. He also hired additional chefs to deal with the increased food sales.

Although he’s happy to be open, finding a way through the state’s loopholes took time and money.

Kaufman estimates that the entire process, from hiring new chefs to deal with increased food sales to applying for the permits cost him around $10,000.

“I wish things have been a little different, and I wish we'd been taken into consideration,” he said. “I've had no choice but to kind of sidestep these situations and do what I got to do to stay open.”

However, the option to reopen doesn't work for everyone. Kim Finch, owner of Dallas bars the Double Wide and the Single Wide, said adding just one kitchen to her facilities would cost about $30,000. A grease trap alone would cost $15,000, she said.

After already draining her savings to keep the bills paid while her businesses are bringing in zero income, adding that expense not an option for her.

“You're just in the dark, you know nothing," she said. "No one’s mentioned a ‘maybe date.' There's not too much longer that we can all just stay closed and keep paying bills.”

Breweries also found themselves forced to shut down by Abbott’s order, with two-thirds of Texas craft brewery owners predicting that their businesses could close permanently by the end of the year under the current closures, according to a July survey by the Texas Craft Brewers Guild.

Hopsquad Brewing Co., an Austin brewery, reopened as a restaurant using a Food and Beverage Certificate with an onsite food truck serving as its kitchen, General Manager Greg Henny said.

He was lucky, because the brewery already had a food truck on site, Henry said. But he thinks breweries and wineries should have their own classification separate from bars, because they operate differently.

Henny said the guidance from the TABC has been confusing and harmful to breweries. To help other businesses survive the pandemic, the agency allowed “retail and manufacturing businesses” to serve and sell alcohol in a patio or outdoor area that wasn't part of its original designated premises, which some brewery owners took as being able to reopen.

However, the TABC later released a clarification saying that businesses with more than 51% alcohol sales were not eligible.

“The circumstances are constantly changing as a result of which way the winds are blowing with [the TABC],” he said. “It makes us feel frustrated. We're fighting tooth and nail just to stay open, and we've shown time and time again that we can operate safely,” he said.

State Rep. Matt Krause, R-Fort Worth, and Texas Legislative Tourism Caucus chairman led the efforts behind the letter sent to Abbott asking for an updated restaurant definition.

“You've got a lot of these establishments — these restaurants — that are kind of in limbo just because of how much alcohol they sell,” he said. “Restaurants that have already been decimated by the first initial shutdowns with the pandemic [and] by some people's reluctance to want to come in and eat.”

The letter asks that any business with a permit or license from the TABC still be considered a restaurant if it has a permanent kitchen that is operational during all business hours, serves multiple entrees, includes an exhaust hood and fire suppression system, only serves seated customers and follows social distancing protocols.

Abbott did not respond to requests for comment.

Krause said he also believes bars could safely reopen as well.

“I'd like to see them be able to open up under certain restrictions under certain guidelines,” Krause said. “They're ready, willing and able to comply with those.”

Angela Clendenin, an epidemiologist at Texas A&M University School of Public Health, said that the rise of COVID-19 cases can’t be attributed to any one factor, including to bar activity, but instead is a combination of many. However, it is likely bar activity did have an impact on the overall transmission rate and some areas saw declines after their bars were closed and the mask mandate was in place, she said.

The typical bar environment makes it easy for the virus to be transmitted, she said. People are typically in much closer quarters, willing to socialize with strangers and can’t wear masks as they’re drinking. Even speaking loudly or singing over music can propel droplets further than usual, she said.

Clendenin said to reopen bars safely, it will take consumers making sure that they are holding themselves accountable and bar owners enforcing social distancing, masking and other safety practices.

“But ultimately at the end of the day, bar owners need to be able to provide for their employees and their families,” she said. “This is a very difficult time for everybody, but it goes back to individual responsible behavior and I can't emphasize that enough.”

Texas A&M University has been a financial 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.

"Restaurants, bars and breweries scramble to reinvent themselves to get around Gov. Greg Abbott's bar shutdown" was first published at https://www.texastribune.org/2020/08/10/texas-bars-restaurants-gov-greg-abbott-shutdown/ by The Texas Tribune. .

Coronavirus outbreak at Houston-area nursing home kills 17 residents

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A novel coronavirus outbreak at a Missouri City nursing home, outside of Houston, has killed 17 residents, according to data from state officials.

City officials issued a press release this week raising alarm over 19 deaths that they said occurred at the Paradigm at First Colony Nursing Home. Nursing home officials told The Texas Tribune that the number is incorrect and declined to provide the correct number.

The city also reported that the facility has 24 infected staff members, and the nursing home reported 11 infected residents who are in stable condition.

“This harrowing development speaks to the severity of this pandemic and how everyone needs to take it even more seriously,” said Missouri City Mayor Yolanda Ford of the outbreak in a Wednesday press release.

The news comes as Texas officials said Thursday that limited visitation at some nursing homes and assisted-living centers can resume, ending a monthslong ban aimed at preventing the spread of the coronavirus among some of the most vulnerable Texans.

Visitors are allowed to see their loved ones indoors through plexiglass barriers in assisted-living facilities where no residents have COVID-19 and there have been no confirmed cases among staff for two weeks. Physical contact between visitors and residents is not allowed, state officials said. In nursing homes, staff must be tested weekly, and only outdoor visits are permitted.

The Paradigm at First Colony Nursing Home has the seventh-highest number of deaths among nursing homes in the state, tied with three other nursing homes, according to data from state health officials. Officials from the nursing home declined to comment on the timeframe during which the deaths occurred.

In the Houston area, the nursing home with the highest death toll is Focused Care at Westwood, with 24 deaths among residents as of July 23.

There have been 83 cases of the virus among residents at the Paradigm at First Colony Nursing Home since the pandemic began, according to numbers from the Texas Health and Human Services Commission.

Ford said she and her colleagues are concerned about the deaths and cases at the Paradigm at First Colony Nursing Home and are continuing to monitor the situation, despite the fact that regulation of nursing homes is under state jurisdiction.

“The lack of City authority is a challenge, especially during a crisis like the COVID-19 pandemic,” Ford wrote. 

So far, there have been over 18,000 coronavirus infections among residents across Texas nursing homes; of those, more than 2,000 have died, according to state data. That number accounts for more than 30% of the state’s total coronavirus fatalities since the pandemic began in March. The most recent data for individual facilities is from July 23, and the total statewide number of infections is current as of Thursday, so it is possible that the statewide infection and death counts are even higher.

Correction: Because of an error in state data, an earlier version of this story stated that Cimarron Health and Rehabilitation in Corpus Christi had 27 deaths, the most of any nursing home in the state. After the story ran, the state revised the data to reflect that Cimarron had seven deaths as of July 23.

"Coronavirus outbreak at Houston-area nursing home kills 17 residents" was first published at https://www.texastribune.org/2020/08/07/coronavirus-nursing-home-texas-missouri-city/ by The Texas Tribune

What losing football to COVID-19 would mean for Texas college towns: "It’s like losing Christmas"

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Local officials and business leaders in some of Texas' college towns are bracing themselves for the possible cancellation of football — a move that could further injure local economies that are still limping from pandemic-related closures and are reliant on game day tourism.

This week, decisions are expected to be made about whether the Power 5 conferences will go forward as scheduled with college football, despite early outbreaks across the nation — including at the University of Texas at Austin — that have already infected student athletes and coaches with COVID-19.

Texas’ five major conference football teams – Baylor University, Texas Christian University, Texas A&M University, Texas Tech University and the University of Texas at Austin — are massive economic drivers for their cities of Waco, Fort Worth, College Station, Lubbock and Austin, respectively, generating a flood of seasonal business for hotels, restaurants and bars in a typical year. 

Economists and city leaders said canceling football would be devastating to local businesses that rely on the huge influxes of cash from home games.

“Forgoing even a single game costs the economy millions. Dealing with the health crisis is essential and must be given paramount priority, but the economic costs of restricting or eliminating college sports are very high,” said Ray Perryman, a Waco economist and CEO of The Perryman Group.

Across Texas, university leaders have supported allowing football to move forward if conference division leaders allow it. Student athletes are already training on many campuses and school officials are laying plans to space out fans in their stadiums. At the same time, many faculty and students have expressed trepidation about returning to campus as Texas remains a hot spot in the nation and hospitalizations and deaths related to the virus remain high.

“We want to play football in the fall,” said Texas A&M System John Sharp in a statement to The Texas Tribune on Monday. Gov. Greg Abbott has also given his blessing, permitting up to 50% of capacity in college stadiums.

 “I support the players. This impacts the players as much as anybody else, and what I am seeing in the Big 12 conference, as well as elsewhere, is that the players really want to play,” Abbott said during a televised interview with KWTX on Monday.

Doug Berg, an economics professor at Sam Houston State University, said towns like Lubbock and College Station would feel the impact of lost game day revenue more than larger cities like Austin with its more diversified business base.

Still, UT-Austin reported in 2015 it had a local economic impact of more than $63 million per home game.

A bigger proportion of municipal budgets in smaller towns is derived from sales and hotel occupancy taxes – both of which typically experience significant hikes during football season. For college towns, “it’s like losing Christmas,” Berg said.

 The toll of losing football is “larger than we care to fathom,” said Eddie McBride, president of the Lubbock Chamber of Commerce.

One typical home game at Texas Tech, with an average attendance of about 60,000 people, pours “millions of dollars” back into the city of Lubbock, McBride said.

“We do count a lot on football,” McBride said. “It isn’t just sold seats…it’s going to people’s houses and buying food and drinks from the local grocery store and the beer store, and then going to the bars and the restaurants to watch the game.”

Many business owners who are living paycheck to paycheck, already hammered by the pandemic, may go out of business without the cash influx they were expecting from football season, McBride said. Lubbock, which has a population of nearly 266,000, is already grappling with a 6.9% unemployment rate — more than twice what it was in January.

Steve Massengale, owner of The Matador in Lubbock, holds the exclusive merchandising rights for Texas Tech’s athletic gear. Massengale, a city councilman, said some home games can generate revenue in the six figures.

The store typically hires up to 35 seasonal workers to work game days, many of them students.

“It would be devastating,” Massengale said. “There's just so many things that depend on vibrant activity on campus and on game day Saturdays. The negative impact is insurmountable.”

In College Station, Mayor Karl Mooney points to a symbiotic relationship between the city of 116,000 and Texas A&M University. By Mooney’s estimates, nearly every household has one member who is affiliated with the university. In the 2008 recession, the university was a steady source of employment that kept the town’s economy afloat.

And according to a 2011 estimate from the College Station Chamber of Commerce, Texas A&M home games generate $20 million in direct consumer revenue. With a typical run of seven home games, the city’s businesses sees upward of $140 million every football season.

“We are impacted dramatically by the university,” Mooney said. “We’re not an Austin, a Houston, a Waco.”

Officials in Waco said they could weather the blow if Baylor’s season was canceled.

According to a 2013 study, Baylor Athletics had a $373.3 million impact on Waco’s economy. Yet while the food and hospitality industries would be hit hard, their losses wouldn’t devastate Waco’s $14 billion economy, City Manager Bradley Ford said.

“If we weren't gonna have football this year or had significantly lower attendance, certainly, you'll see some of that ripple through the local economy and tourism and restaurants and things of that nature,” he said. “But it won't be what I would deem a ‘substantial hit’ to the local economy.”

Perryman, who helped conduct the 2013 study, said visitor spending leads to “in excess of $25 million in gross product each year in the Waco area and over 337 full-time equivalent jobs when multiplier effects are considered.”

Patrick Svitek contributed to this report.

Disclosure: Baylor University, Sam Houston State University, Texas A&M University, Texas Christian University, Texas Tech University and University of Texas at Austin 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.

"What losing football to COVID-19 would mean for Texas college towns: "It’s like losing Christmas"" was first published at https://www.texastribune.org/2020/08/11/big-12-sec-football-texas/ by The Texas Tribune.

$400 in extra unemployment benefits remain uncertain in Texas after Trump's executive order

The amount of unemployment benefits coming to Texans remained up in the air Monday as confusion persisted over President Donald Trump’s weekend executive orders designed to provide economic relief from the pandemic.

On Saturday, Trump ordered that eligible unemployment recipients receive an extra $400 weekly — but only if states administer the funds and provide $100 of that amount. The order prompted bipartisan questions from governors about the administrative burdens and costs for states, along with questions about whether Trump had the constitutional authority to issue such an order.

On Monday, Texas leaders didn't say whether the state would pay the money. The Texas Workforce Commission issued a statement to multiple news outlets that it’s “currently reviewing the presidential memoranda and will provide additional information as soon as it becomes available."

Gov. Greg Abbott, meanwhile, expressed hope that Congress would reach a deal and fully fund the extra benefits, saying he'd spoken with Vice President Mike Pence and Treasury Secretary Steven Mnuchin about the issue.

"The Trump administration continues to negotiate with the Democrats in the U.S. Senate and the U.S. House on a reformed package that would provide full funding for those unemployment benefits," he told KAUZ in Wichita Falls. "I will think that what will eventually happen is that the Trump administration and the Democrats will reach a deal.”

For weeks, 1.6 million Texans were receiving an extra $600 weekly thanks to federal legislation designed to help keep Americans and businesses afloat. Funding for those benefits expired at the end of July, and Congress has been unable to reach a deal to restart the payments.

Trump’s orders on Saturday sought to circumvent Congress, though he’ll likely face legal challenges about whether that's allowed. The order aims to divert money allocated to the Federal Emergency Management Agency for hurricane relief into the unemployment supplement. Trump’s order calls on states to use money from the federal Coronavirus Relief Fund — or other state funding — to pay for its share of the unemployment benefits.

States across the country have been hit hard financially by the pandemic. Texas Comptroller Glenn Hegar projected in July that the state would face a $4.6 billion deficit in 2021 and that revenue for the current two-year budget period would be $11.5 billion less than originally estimated.

But even if it were to hold up in court, it remains unclear how exactly Trump's order would work. CNN reported Monday that the U.S. Department of Labor issued guidance that states could count their existing unemployment payments toward the $100 they are required to contributed. If that were the case, it would possibly lower the supplemental payments Texans receive to $300 per week, according to the report.

Governors on Monday urged Congress to reach a deal to extend the program legislatively.

“The best way forward is for the Congress and the Administration to get back to the negotiating table and come up with a workable solution, which should provide meaningful additional relief for American families,” said New York Gov. Andrew Cuomo, a Democrat and the chair of the National Governors Association, and Arkansas Governor Asa Hutchinson, a Republican and the NGA vice chair.

The Democratic U.S. House has already passed a bill that would authorize $600 weekly payments funded by the federal government as part of a massive and sweeping $3.4 trillion measure. Republican leaders in the Senate meanwhile have pushed for a narrower proposal, and have accused Democrats of holding the extra payments hostage in negotiations. Talks did not appear to be progressing Monday and, while the Senate remains in session for negotiations, it has not scheduled votes.

Neither of Texas’ two Republican senators directly answered questions posed to their offices Monday about whether they supported Trump’s order. U.S. Sens. Ted Cruz and John Cornyn are split on whether they support the additional payments.

A spokesperson said Monday that Cornyn “supports extending an added federal benefit on top of the normal unemployment insurance.”

Cruz, meanwhile, reiterated that he believes the expanded unemployment compensation will only make it harder for Texas’ economy to recover.

“As Sen. Cruz has repeatedly said, Congress should be focused on helping Americans safely return to work and restoring hope and optimism across the country – not keeping the economy shutdown by paying people more to stay at home and not work,” a Cruz spokesperson said.

"$400 in extra unemployment benefits remain uncertain in Texas after Trump's executive order" was first published at https://www.texastribune.org/2020/08/10/extra-400-unemployment-texas/ by The Texas Tribune.

Local health authority resigns in Texas border county battered by coronavirus

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The top doctor advising Starr County on local health policy resigned abruptly Monday, leaving a key position temporarily vacant in a rural border community already battered by the coronavirus.

Dr. Jose Vazquez resigned from his position as health authority after members of the commissioners court rejected increasing his pay from $500 a month to $10,000, according to a press release from the county and County Judge Eloy Vera.

Vera, who brought the pay increase to the commissioners, said the contract would last only as long as Vazquez’s services were needed and had a termination clause that let either party cancel it. It also would have been paid with federal CARES Act funding.

Vazquez has “been working tirelessly for the county for the last six, seven months getting just a token amount for the last six, seven years,” Vera said. “Since COVID started, he has been putting in at least 60 to 70 hours a week… It was only fair that he be compensated for that.”

Vazquez, who is also board president of the county’s only hospital, could not be immediately reached for comment.

Local health authorities provide guidance to city and county officials on how to manage the coronavirus, often play a role in addressing the public at press conferences or hearings and can make recommendations about school closures, in the event of an outbreak.

A press release from the county thanked Vazquez for his “outstanding service” and said the appointment of a new health authority “should be forthcoming.”

County Commissioner Eloy Garza rejected the proposal because he thought it cost too much. He said another doctor, Antonio Falcon, had agreed to serve in the position for free and that the commissioners court was expected to formalize the arrangement Friday.

“I got a call from Dr. Falcon and he told me he was willing to do it free of charge," he said.

Vera said he asked Falcon to start immediately providing him with guidance on medical decisions in an informal capacity.

“I cannot wait until Friday,” he said. “I’m an engineer by trade, know nothing about medicine. So I need a doctor to help me with that sort of thing.”

The other three commissioners could not be immediately reached for comment.

Starr County, population 65,000, is one of the poorest counties in the country. Its residents are more than 95% Hispanic, a demographic that’s been disproportionately affected by the virus. About a third of the county’s population under age 65 lack health insurance.

As the virus has hammered south Texas, workers at the county’s small hospital, which had no intensive care unit, have flown patients hundreds of miles away for treatment. Hospital leaders discussed forming an ethics committee to wrestle with decisions about which patients should go home to die with family and which should be transported elsewhere for care.

Vazquez said in July that “the time of rationing medical care is a time that we all have feared from the beginning but it looks like we are getting to that point now.”

Officials in Starr and other South Texas counties were initially successful in forestalling the spread of the virus. But infections surged in June about a month after Gov. Greg Abbott allowed businesses to begin reopening and overrode local authorities’ ability to take a more cautious approach. Graduations and summer holidays that brought a series of occasions to gather likely exacerbated the spread.

Starr County has had 68 confirmed coronavirus deaths and 2,213 cases as of Monday, according to state data.

Vazquez is not the first health official to leave during the pandemic. The leader of San Antonio’s health department stepped down over the summer saying it was time for a “person of color to lead.” The San Antonio Express-News reported her boss sent an internal memo harshly criticizing her abilities the day before.

Across the country, dozens of state and local public health leaders have resigned or been fired since April, reflecting burnout, hostility toward public health experts and the politics of the moment, according to a review by the Kaiser Health News service and The Associated Press.

"Local health authority resigns in Texas border county battered by coronavirus" was first published at https://www.texastribune.org/2020/08/10/starr-county-texas-coronavirus/ by The Texas Tribune.

Coronavirus testing in Texas plummets as schools prepare to reopen

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The number of Texans being tested for the coronavirus has fallen sharply in recent weeks, a trend that has worried public health experts as officials consider sending children back to school while thousands more Texans are infected each day.

In the week ending Aug. 8, an average 36,255 coronavirus tests were administered in Texas each day — a drop of about 42% from two weeks earlier, when the average number of daily tests was 62,516.

At the same time, the percentage of tests yielding positive results has climbed, up to 20% on average in the week ending Aug. 8. Two weeks earlier, the average positivity rate was around 14%.

On Saturday, the state set a record for its positivity rate, with more than half of that day’s roughly 14,000 viral tests indicating an infection.

Taken together, the low number of tests and the large percentage of positive results suggest inadequacies in the state's public health surveillance effort at a time when school reopenings are certain to increase viral spread, health experts said.

"Opening the schools is a really complicated problem, and the best thing we can do is get the number of cases down so kids can go back to school safely," said Catherine Troisi, an infectious disease epidemiologist at UTHealth School of Public Health in Houston. "There are so many reasons why kids need to be in school, particularly younger kids, but we’re finding out more and more they can get infected, and the concern is them bringing it home and spreading in the community and spreading to teachers.

"I think the worst thing would be for schools to open, then close," she said. "That really makes it hard on parents, that unpredictability, and there’s a lot of costs associated with opening the schools safely."

The decline in tests may be driven in at least some places by a drop in demand. In Austin, health officials say fewer people are seeking tests through the city’s online portal and at local events. Local officials had been forced in late June to limit testing only to people who were showing symptoms of the coronavirus. Now, they are opening it back up to asymptomatic people.

And at sites in Dallas, testing numbers have been declining over the past few weeks as locals utilize less of the city’s capacity.

The number of tests performed in Texas has “never been great,” said Vivian Ho, a health economist at Rice University and Baylor College of Medicine, but “it’s extremely troubling” that the numbers have dipped since last month.

“It’s troubling because we can guess at some of the reasons, but we’re not sure,” she said.

She suggested that some people may have been discouraged by long wait times for test results, or less concerned about the virus’ toll in Texas after a frightening peak in July began to flatten out.

A declining number of tests is a particularly thorny issue for schools, Ho said. "No public school has the resources to do testing under the current circumstances. There are huge class sizes and crowded hallways,” she said.

Researchers estimate that the true number of coronavirus cases could be more than 10 times the number of positive tests. As many as half of the people who contract the virus may never experience symptoms.

State data shows coronavirus hospitalizations declining in Texas, with some 7,500 coronavirus patients reported in Texas hospitals on Sunday. That’s down from a late July peak of about 11,000 — but remains well above Texas’ levels in the spring, when daily hospitalizations plateaued below 2,000.

In San Antonio, health officials last week said that a return to school would lead to new viral transmission and a growing body of evidence shows racial disparities in children’s susceptibility to severe illness from the virus.

“We know that children are less likely to be sick, but not immune,” said Dr. Junda Woo, medical director for San Antonio’s Metropolitan Health District, who said that on Wednesday there were about 80 children with coronavirus in local hospitals.

The role of children as disease vectors is less clear, Woo said. Studies show that children are less likely than adults to have infections severe enough to require hospitalization, but a recent report published by the U.S. Centers for Disease Control and Prevention found that Hispanic and Black children were much more likely to be hospitalized.

Hispanic children were about eight times as likely as white children to be hospitalized, while Black children were five times as likely, researchers found. In Texas, about 53% of public school students are Hispanic, and about 13% are Black.

“Outbreaks will happen” in schools, Woo said. She likened schools to other group settings that have seen significant clusters of infection, such as nursing homes and daycares. “It’s going to seep in from the community as a whole.”

Gov. Greg Abbott said on July 31 that local health officials could not issue blanket orders that preemptively blocked schools in their jurisdictions from opening their classrooms for in-person instruction. That statement, which followed similar guidance from Attorney General Ken Paxton, came after about 18 local health authorities had issued such orders.

The move frustrated some superintendents, who said they were hamstrung in their ability to respond to the pandemic.

Abbott has said that local health officials could shut down schools that have COVID-19 outbreaks after they reopen.

Abbott also said school districts could ask for more time to limit the number of students learning in classrooms, on a case-by-case basis, beyond the current eight-week maximum set by the Texas Education Agency. And he told school officials that they could move their start dates later in the year with a school board vote, as long as they make up the time.

The Texas Education Agency has not yet released any specifics on which districts will be able to receive waivers to limit in-person instruction beyond eight weeks or under what circumstances. But it said it will penalize school districts for unlawful school closures, worrying superintendents who want more certainty of state support while handling an unpredictable pandemic.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters last week that communities with high levels of viral spread may be better off not reopening schools for in-person instruction.

“There are some areas, like we’ve seen over the last couple of weeks … of very significant viral activity,” Fauci said during an Aug. 6 briefing with journalists hosted by the Alliance for Health Policy. “Under those circumstances, you’ve got to use common sense … It may not be prudent to get the children back to school in those areas. So, you got to say, ‘Try as best as you can to get the children back to school, but one size does not fit all.’”

County unlikely to issue order on in-person learning

ANGLETON — With the start of the new school year just around the corner, there’s no telling how the COVID-19 case numbers might be affected across the county, the county’s top official said.

“That’s hard to say,” County Judge Matt Sebesta said. “And I don’t like to do crystal ball projections.”

Instead, he will rely on the Department of State Health Services’ guidance to the Texas Education Agency and to local school boards and superintendents to prepare for the new year, he said.

“I think they are all making very thoughtful plans that they’re putting into place to be able to educate our children, as well as to do their best to protect them and the school staff,” Sebesta said.

The county is not considering issuing a mandate to school districts on whether to remain closed or to open fully online, because they don’t have the authority to do so, he said.

“The attorney general issued an opinion on that a few weeks ago,” Sebesta said.

Attorney General Ken Paxton’s opinion contradicted a previous TEA statement which said school district closures would be subject to decisions from local health authorities.

Across Texas, several local health authorities have issued orders to delay in-person instruction which rely on state law allowing a health authority to control communicable diseases, Attorney General Ken Paxton said in a letter dated July 28 to Mayor Doug Svien of Stephenville.

“But nothing in the law gives health authorities the power to indiscriminately close schools — public or private — as these local orders claim to do,” Paxton said in the letter.

Under the law, local health authorities can quarantine property in some instances, but cannot issue blanket quarantine orders that are inconsistent with state law, Paxton said.

A similar statement from Gov. Greg Abbott on July 31 came after almost 20 local health authorities had already issued such orders. Officials previously believed local health authorities, including Dr. Anthony Rogers for Brazoria County, had such power.

Locally, the number of COVID-19 new daily COVID cases has dropped from a few weeks ago, but it’s important to consider overall, long-term trends that span at least a couple of weeks, over narrower trends or snapshots, Sebesta said.

Officials began the week with fewer than 100 new cases, reporting a total of 94 Monday. According to the dashboard, those cases spanned 15 local communities and touched all age ranges.

Pearland saw the greatest number of new cases Monday with 28. Angleton and Freeport had 14 new cases each, and Lake Jackson added 11 new cases to its tally.

The rest of the communities added single digits to their totals, the largest being seven in Clute, closely followed by five in Alvin.

West Columbia and Holiday Lakes each saw three new cases, while Manvel and Brazoria each saw two.

One new case each was reported for Damon, Brookside Village, Sweeny, Iowa Colony and Liverpool, according to county data.

Two children under the age of 10 were confirmed to have tested positive, as well as one person 80 or older. Five people in their 70s and eight people in their 60s were included in the county’s report, as were 10 people under the age of 20 and 15 people in their 50s. The highest numbers were in people in their 20s (18), in their 30s (18) and in their 40s (17).

“All confirmed,” Sebesta said of the new cases.

The new infections announced daily are from tests taken at least several days previously. On average, it takes two to four days for labs to return results, but some tests could take longer before the findings are reported to the county.

Monday’s report included a resident of Cypress Woods Care Center in Angleton and an inmate of the Brazoria County jail. Sebesta did not know the age range or gender of either individual, he said.

Cypress Woods was the only nursing home to have a new case reported Monday. Creekside Village Healthcare in Clute has not seen any new cases since the outbreak reported Friday, Sebesta said.

Reached by phone Monday, Creekside Village administrator Amy Brieden declined to comment.

Officials also reported 26 recoveries — a number Sebesta thought was low.

“Seemed like the recoveries were a little low today,” he said. “But we’re coming off the weekend, so we’ll just see how the rest of the week shapes up.”

The county has not reported any Sunday recoveries since June 7. They don’t expect recoveries Sundays because there are not as many staff members at work, Sebesta said Sunday.

There were no deaths to report Monday, Sebesta said.

“No deaths is a good thing,” he said.

Since March, the county has reported 6,684 cases in all, of which 3,507 are active and 3,097 have recovered. There are 24 probable cases, which are people exhibiting symptoms and linked to others who have tested positive. County data shows that 56 people have died.

More than 40 cases tied to jail

More than 40 cases of the coronavirus are related to the Nacogdoches County jail as the caseload and death toll continued rising early this week.

The outbreak at the jail contributed to an 87-case spike between Friday and Tuesday when the cumulative case count reached 898 and the county recorded its 32nd coronavirus-related death.

There were 372 active cases in the county as of Tuesday afternoon, with 494 estimated recoveries and 5,231 administered tests. The most recent fatality was a city resident in her 50s, according to county officials.

Sheriff Jason Bridges on Monday announced 25 inmates, four jailers and a jail nurse tested positive over the weekend. County officials confirmed another 11 confirmed cases at the jail Tuesday afternoon. It was unclear if those Tuesday cases were inmates or employees.

At least 50 other inmates housed in a separate area of the jail from those with the virus were showing symptoms Monday, Bridges said. As of 4 p.m. Tuesday, there were 252 inmates in the county jail.

Medical personnel from Nacogdoches Memorial Hospital were conducting more tests Tuesday.

The sheriff’s office has administered antibiotics to inmates with symptoms of COVID-19, the disease caused by the virus. Antibiotics do not fight the virus but can prevent secondary infections.

The employees who have tested positive are quarantined at home, Bridges said. The sheriff’s office has sought advice from similarly sized jails where outbreaks have occurred, he said.

Bridges is considering asking for more medical assistance from state organizations in addition to the jail’s three nurses and a medical technician on staff and has access to an on-call doctor.

“We don’t need it right now, but in the long run I could see us needing additional medical personnel,” he said.

The outbreak has forced the jail to suspend indefinitely all trustee programs including litter collection and mowing operations.

“I don’t know how long this will be shut down. It could take three to four weeks,” he said. “We don’t know yet.”

The outbreak seems to have begun with two inmates booked on July 12 and 13. They were jailed for more than a week before their family members contacted the sheriff’s office to report that the inmates might have been exposed to the virus, Bridges said. Both were tested and immediately moved into isolation when the tests came back positive.

“This is a situation we didn’t want to have happen,” said the sheriff, who early on implemented standards on sanitation and personal protective equipment in the jail.

All inmates have been required since March to wear masks when moving around the jail. Bridges said jail staff are also now required to wear face shields in addition to masks.

He offered some words to the family members of the people incarcerated at the jail.

“I can assure you we are doing everything we can to protect your loved ones,” he said. “We don’t want them to get sick.”

Statewide, there were an estimated 143,939 active infections with 244,449 recovered cases.

As of Monday, officials with the Texas Department of State Health Services announced fatality data from the disease would now be based on death certificate information determined “when the medical certifier attests on the death certificate that COVID-19 is a cause of death.” The total number of death statewide rose from 5,038 on Sunday to 5,713 as a result. The state recorded another 164 fatalities Tuesday.

Locally, hospitals reported six COVID-19 patients on ventilators with an additional 19 available ventilators. There were 40 general-admittance hospital beds available — roughly 54% of capacity — and six intensive-care unit beds open, or about 8% of capacity.

47 cases added between Friday and Monday

The number of confirmed coronavirus infections in Nacogdoches County climber by 47 between Friday and Monday as some 247 tests were administered over the weekend.

As of Monday morning, there were an estimated 343 active cases of the virus in the county with an estimated 494 recoveries and a total of 868 confirmed cases. The disease caused by the virus was a factor in the deaths of 31 people in the county.

On Monday, county officials announced 17 additional confirmed cases, 10 of which were reported Saturday and seven of which were reported Sunday. Two of those cases were from homes where someone previously had been infected.

Saturday afternoon, officials announced an additional 30 cases that were confirmed Friday afternoon, five of which were associated with long-term care facilities and seven of which came from previously reported households, which drove the tally up from 841 to 851.

People between 19 and 29 made up the majority of those infected by the coronavirus, accounting for 150 of the confirmed cases for about 17.2% of cases. People in their 40s had the second highest number of infections, with 134 for 15.4%.

The Southeast Texas Regional Advisory Council reported that, as of 4 p.m. Sunday, there were six COVID-19 patients hospitalized on ventilators in the county, with 14 ventilators available. There were six intensive-care unit beds available.

Coronavirus patients occupied a little more than 23% of the general hospital beds in the county as of Sunday.

Statewide, the Texas Department of State Health Services reported an estimated 147,511 active cases of COVID-19 as of 3:50 p.m. Sunday. The state had a total of 381,656 cases since the onset of the pandemic, with an estimated 229,107 recoveries and 5,038 fatalities.

County, city, hospital district expands fight against virus

As COVID-19 cases continue to rise, especially among a younger population, Walker County expanded its fight against the novel coronavirus Monday.

At a special called meeting, members of the Walker County Hospital District gave unanimous approval to three contracts that will open a seven-day testing site at the Huntsville Memorial Hospital clinic.

The program is funded through at least $1.2 million from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which will be paid from the city of Huntsville and Walker County to the hospital district. The district will contract with Huntsville Memorial Hospital for the staffing, structure, equipment and materials needed to provide COVID-19 testing.

“This is an exciting partnership that has come together very quickly,” hospital CEO Steve Smith said.

The new testing site at 125 Medical Park Lane, behind the hospital, will open Aug. 17 and offer free screenings.

It joins the other testing site at the Walker County Fairgrounds, which plans to test individuals weekly throughout the month of August.

Free testing at the hospital will be available from 4-8 p.m. on weekdays and from 8 a.m. to noon on the weekends. The hospital is also expected to offer 10-12 neighborhood testing locations.

County officials reported at least 54 new confirmed community cases on Monday, bringing the county’s total to 1,239. An additional 2,085 inmates confined in Walker County’s seven state-run prison units have tested positive for the virus.

The state reported 31 new COVID-19 deaths Monday in Texas and 4,445 new cases. The state estimated that 133,584 confirmed cases were active with 7,437 patients hospitalized, 1,382 fewer than the same time last week.

But the rate of positive COVID-19 test results remains high, with a rolling seven-day positivity rate of 20.99%, well above the threshold of 5% recommended for reopening by the World Health Organization.

The true number of cases is still likely higher, because many people have not been tested, and studies suggest people can be infected and not feel sick.

Texas State moves home opener against SMU back to Sept. 5

Texas State is moving its 2020 football season opener at home against SMU back to the original date of Sept. 5, the program announced Monday.

Texas State also confirmed the cancellation of a home game against Ohio on Sept. 26, caused by the Mid-American Conference’s decision Saturday to postpone all fall sports.

Last week, Texas State announced its matchup against SMU had been moved up a week to Aug. 29 to allow greater flexibility in response to the COVID-19 pandemic, breaking up a stretch of seven straight game weeks to open the season.

With the matchup against Ohio nixed, Texas State returned the game against SMU to its previous date while still allowing an open week in September.

“We are pleased that we still have six home games,” Texas State athletic director Larry Teis said in a statement. “We have an open date in September that gives us some flexibility.”

Safety protocols, capacity limitations and gameday procedures for Texas State’s opener at Bobcat Stadium in San Marcos are yet to be announced.

Man charged in juice bottle biting video

An 18-year-old Nacogdoches resident is facing a felony charge in a food tampering incident in which police received a video of someone biting juice bottles before returning them to a store bin last week.

Christopher Grant Lewallen was booked into the county jail late Friday on a single, third-degree felony charge for tampering with a consumer product. By Monday, he had posted bail and was released.

The affidavit filed against Lewallen by Nacogdoches police identified him as the person who recorded a juvenile biting bottles of apple juice inside Kroger on University Drive last week.

Police did not release the juvenile's name or any possible charges against them.

On Wednesday, police were made aware of the video, which had been posted on social media that day.

"(The video) depicted a young white male subject picking up unopened bottles of apple juice, biting into them, and then placing them back into the display bin for unsuspecting customers to come into contact with the contaminated bottles," the affidavit against Lewallen said. "The video was also tagged with a banner mentioning “corona" and inferred he was going to be infected with COVID-19."

Both Lewallen and the juvenile "freely admitted" to the incident, according to the affidavit.

Police removed the bottles believed to have been used in the video, and store managers pulled the product from the display, said NPD spokesman Sgt. Brett Ayres.

"Working in conjunction with each other, the two subjects committed the act of threatening to tamper with the consumer product and causing fear by posting the video of the incident to a social media platform," according to the document.

Police have not released the video and attempts to find it on social media were unsuccessful Monday.

A social media trend of biting bottles of Martinelli's apple juice has gone viral in recent months. When the bottles are partially empty, the sound of biting one resembles that of crunching into a crisp apple.

Under the Texas Penal Code, third-degree felonies are punishable by between two and 10 years incarceration and/or up to $10,000 in fines.

County's latest reported COVID-19 numbers bolstered by surge at Rusk prisons

The total number of confirmed cases of coronavirus (COVID-19) has increased to 1,110 and includes a surge in numbers reported in state jail facilities in Rusk.

According to Grace Mikhail, the Cherokee County Public Health Department emergency preparedness and disease surveillance branch manager, recent figures that appear to have jumped during the past few days actually are due to “mass amounts of labs coming in” from tests performed weeks ago but are now just being reported to the county.

“It's why we're seeing a mass increase in the number of recoveries, as well,” she said.

A release from county health officials Sunday evening – the most current data as of Monday press deadline – shows that 853 of the 1,110 confirmed reported cases are recoveries, while 255 cases are active. There also are a total of 75 individuals who are hospitalized as a result of COVID-19.

The county data also reflects only two deaths – a static number since results data first was released by officials. It is a marked contrast to the seven listed Aug. 9 by the Texas by the Texas Department of State Health Services.

Under new reporting guidelines, “the death certificate is how we report” confirmed deaths due to the virus, Mikhail said.

As a result – much like with the wait for return of lab results for confirmed cases – the county awaits information of confirmed deaths from the virus before officially listing them among its data.

Of the confirmed cases, Jacksonville reports the greatest number, with 506, followed by Texas Department of Criminal Justice facilities in Rusk with 221 – a figure provided by TDCJ.

“We have to wait for the lab report (confirmation) to count that (figure) – we want to wait until we have all the information needed so that we do not double-count any cases,” Mikhail said.

City residents in Rusk account for 160 cases and 75 cases have been attributed to the Rusk State Hospital.

The leading age groups for confirmed cases is the 21-30 segment with 168 (15.1%) cases.

The 41-50s have 137 (12.3%), followed by the 51-60 age group with 130 (11.7%) cases.

“the cases we report as positives are confirmed lab tests of a PCR (preliminary chain reaction that tests for presence of the viral RNA),” she said.

Meanwhile, health officials reiterate that the best defense against the virus is to take simple precautionary measures:

According to the CCPHD, coronavirus most commonly spreads through respiratory droplets, such as coughs and sneezes. Symptoms of COVID-19 include fever, cough and shortness of breath and may appear 2 to 14 days after exposure.

The best way to prevent illness is to avoid being exposed to the virus. Everyone has a way that they can contribute to slow the spread of the virus and should remember to:

• Wash your hands often with soap and water or alcohol-based hand sanitizer.

• Avoid touching your eyes, nose, and mouth with unwashed or gloved hands.

• Avoid close contact with those who are sick.

• Stay at home as much as possible

• Put distance between yourself and other people.

- Keeping distance from others is especially important for people who are at higher risk of getting very sick.

- Remember that some people without symptoms may be able to spread the virus

• Cover your mouth and nose with a cloth face cover when around other people (grocery shopping, pharmacy, etc.)

• If you are in a private setting and do not have your cloth face covering, remember to cover your cough or sneeze with a tissue, then throw the tissue in the trash.

• Clean and disinfect frequently touched objects using a regular household cleaning spray or wipe.

Texas Health and Human Services has launched a 24/7 statewide mental health support line to help Texans experiencing anxiety, stress or emotional challenges due to the COVID-19 pandemic.

This new resource offers COVID-19-related mental health support for all Texans. People can call the Statewide COVID-19 Mental Health Support Line 24 hours a day, 7 days a week toll-free at (833) 986-1919.

Further information on COVID-19 can be found at https://www.dshs.state.tx.us/coronavirus/ and https://www.cdc.gov/coronavirus/2019-ncov/index.html.

Lack of social distancing is killing people in Del Rio

DEL RIO, Texas (AP) — On a sweltering afternoon near the Texas-Mexico border, Ximena Colecio donned a powder blue face-mask before walking to a chain-link fence to hang the hand-made sign clutched in her tiny fingers. Scrawled in bright neon marker, it reads: “For the best teacher. We will miss you.”

There were 27 other such signs hanging at Irene C. Cardwell Elementary last month to mourn the loss of Chavell Gutierrez, 55, who died from COVID-19.

Chavell Gutierrez isn’t the first person to succumb to the virus in this small southwest Texas border town of about 35,000 residents, and officials are certain she won’t be the last, the San Angelo Standard-Times reported.

The virus has stretched Del Rio’s resources to its limits. As both city and county officials scramble to stop the spread of the disease, local healthcare workers are fighting a war on two fronts — a battle to save their patients’ lives, and their own.

“We were at 13 cases for a long time until we got to around June,” said Dr. Jaime Gutierrez who serves as the local health authority.

As of July 24, there were 1,163 positive cases of COVID-19 in Val Verde County and 14 deaths, according to state data. Gutierrez said local counts place the number of fatalities much higher. Freezer trucks to store human remains arrived in Val Verde County on July 25.

“How many more deaths is it going to take before people decide enough is enough?” Gutierrez asks.

No one in Del Rio knew the answer to that question — but so far, it’s not 48. Though many of those deaths are pending review before being classified as COVID-19, all of them died after testing positive for the virus, local officials said.

“These people died of COVID-19 pneumonia,” Gutierrez explained. “My diagnosis on the death certificates says cause of death is ‘pneumonia due to COVID-19’.”

Dressed in a dark suit and tie, Rick Robles looked serene for a man who began his workday abruptly at 2 a.m.

“I got that one and another call from the hospital at around 6:45 in the morning,” he said. “Some people think (COVID-19) is a hoax. They should spend a day with me.”

A lifelong resident of Del Rio, Robles owns and operates Sunset Memorial Oaks Funeral Home where he’s also responsible for embalming the dead. COVID-19 is like nothing he’s experienced in his 30 years in the funeral industry, and he wishes more people would take the virus seriously. It’s 12:28 p.m. on a weekday, and Robles hasn’t had enough time to eat breakfast.

His funeral home averages between 8-10 services a week. That’s no longer the case.

“We’ve had about 18 (funerals) so far this week,” Robles said. “Last week it was 22. It’s a spike, and the difference is COVID. I’ve never seen anything like it. The situation with COVID-19 has gotten out of hand in this area.”

There is data to support Robles’s claim.

Val Verde County’s population is slightly above 49,000 residents. Its positive cases match counties more than twice its size.

By July 29, Val Verde County had reported up to 1,163 positive cases. Counties similar in size to Val Verde include Burnet, Kendall and Lamar. There were slightly more than 1,260 cases of COVID-19 between the three on the same date.

Speaking as a funeral director, Robles said one tragedy he’s witnessed from COVID-19 is how it’s stripped away people’s normal ability to seek comfort in one another as they mourn their dead. Chapel and graveside services are limited to 10 people who have to maintain their distance or risk spreading the disease.

“That’s hard for families,” Robles said. “It’s even harder for them to know their loved one passed on by themselves without having (family) there to hold their hand when they shared their last breath.”

Alejandra Valadez knows exactly how that feels.

“My grandmother was alone when she died. There were nurses, but not family,” Valadez said.

Dionisia Valadez, 88, had been living in a long-term care facility in Del Rio when staff placed the building on lock-down in March. On July 7, she was rushed into the ICU at Val Verde Regional Medical Care Center. Dionisia tested positive for COVID-19 and Influenza A and B.

Valadez was able to see her grandmother in the hospital, but not in person. She had to use an online video conferencing app, and the conversation was brief.

“The last time I saw her she wasn’t responsive,” Valadez said. “I told her I loved her very much, and that we were waiting for her to come home. She never did.”

Five days after being admitted into the ICU, Dionisia Valadez succumbed to the virus on July 12. She was cremated soon after. There was no funeral service.

Valadez said she feels traumatized and infuriated after losing her grandmother to the virus. She wasn’t able to hold her grandmother who lay dying in the hospital, and she’s upset by the number of people who still aren’t wearing masks. She too has a message for those who think COVID-19 is a hoax.

“It’s real. It’s here. And you don’t know who could be a carrier. Wearing a mask could save someone else,” Valadez said. “I don’t wish this upon anyone. My grandmother helped raise me. It’s hard watching someone you love fighting for their life and not being able to do anything about it.”

Valadez continues to urge people to be responsible and do what they can to stop the spread of the virus, a mission shared by city, county, and Del Rio healthcare officials who have likened COVID-19 to a viral hurricane.

One institution that has weathered the COVID storm well so far has been the Val Verde County Jail, which hadn’t reported a single case of the virus as of July 28, and Val Verde County Sheriff Joe Frank Martinez aims to keep it that way.

“People are dying,” Martinez said. “To slow this down, I think people need to be mindful of what’s going on around them.”

Martinez and officials with the Texas Commission on Jail Standards were cognizant of the virus early on. Since February, inmates at Val Verde County jail have not been allowed to see family members in person. They instead communicate on video through electronic devices. The jail has one entrance, and everyone is screened upon entry for signs of COVID.

Fogging machines spray an alcohol-based chemical throughout the facility 2-3 times per week. Border Patrol apprehensions are handled elsewhere and the jail no longer holds misdemeanor offenders. Felony offenders and inmates charged with family violence are placed in a restrictive housing unit where they’re closely monitored.

Outside the jail, Martinez said county and city law enforcement agencies have responded to complaints of people who aren’t wearing masks, which have included food service employees at restaurants.

“I can’t stress enough that we need to be respectful toward one another,” Martinez said. “I think people need to be responsible for their actions, and in my opinion, they need to be held accountable for them. A person who’s not respecting someone’s space ought to be considered a deadly weapon.”

It’s Martinez’s contention that COVID-19 is so prevalent in Del Rio, that it’s impossible to know who’s contagious at this point, and not social distancing or wearing a mask could very well kill someone.

“In the beginning, this community thought that (COVID) was just hype,” said Val Verde Chief Deputy Waylon Bullard. “The majority are wearing masks now. There are still a few who say ‘It’s my right. I don’t have to,’ but they’re becoming fewer and far between.”

One city official said those who insist on not wearing a mask are trying to hold onto some degree of “normal” during a global pandemic, but “normal” is a relative term depending on who you ask.

“Everybody’s trying to find some kind of normalcy. We’re never going to go back to how it was before; it’s not going to happen,” said Del Rio City Mayor Bruno Lozano.

Seated in his office at City Hall, Lozano said he’s worried the reason the city’s positive cases are so high is because people who are asymptomatic for COVID-19 are passing the virus to older, more susceptible residents at an alarming rate.

Visiting family and friends often is part of Del Rio’s small-town culture — something Lozano is now trying to change.

On July 15, he made an urgent request in a video posted to the official City of Del Rio Facebook page asking people to voluntarily stay home for a period of 21 days to limit the spread of the virus.

“We’re currently experiencing an emergency crisis like never seen before,” Lozano said in the video. He encouraged Del Rio residents to shop online whenever possible, use delivery apps to support local businesses, and if necessary, designate only one family member to go to the grocery store.

In his efforts to educate the public, he’s gone so far as to encourage the Del Rio community to tell their children not to hug their grandparents.

“We need to teach our children why it’s important to save grandma and grampa’s life,” Lozano said. “Personal responsibility is everything.”

Lozano is concerned Del Rio residents are ignoring calls to practice social distancing — spreading the virus with little thought for whom it might affect.

On the day Lozano made his urgent plea for residents to stay home, there were as many as 455 positive cases of coronavirus in Del Rio, according to hospital data. A week after his message, the case count had risen to 567.

“There are no secrets in Del Rio. Everyone knows everyone,” said Liz Williams, a waitress at the Malinda Restaurant inside the Ramada Inn. “The mayor asked people to stay home. I don’t think people are listening to him.”

Williams used to serve coffee, toast and scrambled eggs to a group of older residents she said would frequent her restaurant every morning. Williams is worried for their safety; she hasn’t seen them in four months since the outbreak.

“I do know a few are OK though,” Williams said. “I got a text once with a photo. They were eating breakfast at someone’s house. The text said, ‘Hey, could we get some coffee over here, please?’”

That Williams is receiving texts at all from restaurant patrons she hasn’t seen in months underscores how tightly woven the Del Rio community is with itself. Williams said it’s a small town, and people like to hang out no matter what’s going on.

She suspects this is the reason why the coronavirus has become such a problem in Val Verde County.

All the things that make small town living worthwhile: its connections and relationships, handshakes and hugs — like blood in the ocean to a hungry shark — it creates a feeding frenzy for COVID-19.

During April, May and early June, Del Rio’s positive cases hovered in the low teens. By mid-July, there were hundreds of positive cases.

“I live over near Comstock,” Williams said. “Driving past the lake on Mother’s Day and on Father’s Day, the lake was filled with people.”

Local health authority Dr. Jaime Gutierrez and other officials agree with Williams. The lack of social distancing in Del Rio has made COVID-19 worse, and likely cost people their lives.

For awhile, Del Rio was an abnormality. While the virus raged around the rest of the country in March, April and May, doctors and nurses at Val Verde County Regional Medical Center saw few cases. A hospital employee said people in Del Rio took the virus seriously at first.

“There were lines at H-E-B and Walmart with people 6-feet apart. Everybody had their masks on,” she said.

Then in May, Texas began to reopen gradually and things in Del Rio changed over the course of the summer holidays.

“Sure enough, 10 days after Mother’s Day, we started to get a couple. 10 days after Father’s Day, then 10 days after Fourth of July — it started to snowball,” Gutierrez said.

Gutierrez said the summer is when Del Rio adults want to be at Lake Amistad and Del Rio teenagers want to visit San Antonio. In early June, Bexar County reported more than 2,800 positive cases of COVID-19, according to state data. By Father’s Day the virus had ballooned to more than 6,800 cases in the San Antonio area.

“We saw a lot of teenagers driving to San Antonio, getting infected and coming back,” Gutierrez said. “It set off a huge wave of positives and it hasn’t let up. It’s been ungodly. Fortunately, the medical community here has really stepped up.”

The medical community in Val Verde County had little choice otherwise.

The Val Verde Regional Medical Center has become a COVID war zone, with actual soldiers from the U.S. Army and Navy fighting the disease alongside rural doctors and nurses. It’s a battlefield where healthcare workers have displayed uncommon valor, bravery, sacrifice and have suffered causalities.

There are green zones and red zones — places on the hospital floor marked with bright red tape where not even the hospital CEO can walk — not safely, not without a plastic suit of Personal Protective Equipment, and those places are growing larger every week because of the coronavirus.

On July 23, nurses at Val Verde Regional Medical Center were preparing a section of the hospital — its surgical services department — to become another COVID unit. Its fifth such unit in three weeks.

“For about three months, we sat on the fringes of COVID,” said hospital CEO Linda Walker. “We were preparing here at the hospital ...When things ramped up, they ramped up very quickly.”

The Val Verde Regional Medical Center’s initial capacity for COVID began with seven beds. As cases grew, healthcare workers expanded from the ICU into an empty pediatric unit to create enough space for 19 beds.

A third, fourth and fifth unit soon followed. Of the 72 total hospital beds and the 50 patients who occupied them July 23, there were 30 COVID patients. Those hospitalized afflicted with COVID have ranged in age from their mid-90s to 6-years-old.

Walker said many rural hospitals like theirs are struggling not to become “COVID hospitals.” She said as more people infected by the coronavirus are admitted, other patients have to be housed safely in places like the emergency department, which is creating a strain on the local healthcare system.

The toll is also creating a strain on the healthcare workers.

“I’ve had employees in my office sobbing,” said Chief Nursing Officer Jessica Nuutinen. “They say, ‘I’m going to pick up this extra shift,’ and tears are coming down their face. They say, ‘I’m so tired but I know it’s the right thing to do. This is my family, my community. I’m going to pick up this shift.’”

Opening more COVID units has forced many changes at Val Verde Medical Center, and Nuutinen has helped guide hospital staff through the anxiety and the uncharted waters the virus is forcing onto its overtaxed workforce.

“I’m a nurse, and nurses get into this profession for a reason,” she said. “What I truly admire about my staff is how we’re all coming together to overcome (the virus). I’ve never been so proud of my team.”

Still, there have been casualties.

Irma Santellanes worked at Val Verde Regional Medical Center for 43 years. She was a unit secretary, and one of the first people to volunteer to screen those who entered the hospital by taking their temperature and placing a paper armband around their wrist.

“She did it with honor — ‘Whatever you need, Miss Jess. Whatever you ask of me, I will do’” Nuutinen said.

Santellanes contracted COVID-19 and died days later on July 16. She was 62.

“This hospital has never seen anything like (COVID-19),” Walker said. “Most hospitals haven’t, but particularly here in the rural areas. This is not the flu and it is incredibly contagious.”

When hospital staff talk about their work family, they are speaking more than figuratively about what binds them together. Santellanes’s daughter is a nurse who also works at Val Verde Regional Medical Center. Her sister works in the Radiology Department.

Many hospital employees wear a picture of Santellanes on their work badge. A table draped in white with a memorial is set up near the hospital entrance where Santellanes worked before she was exposed to COVID-19. A book with blank pages has been placed on the table to allow her work family the chance to share both their memories of her and their grief in the passing of one of their own.

Walker said of the roughly 570-person hospital workforce, about 32 employees were out sick July 23 with the coronavirus. Seven others had recovered from COVID-19 and returned to work despite knowing they might get the virus again.

One of them is Lucinda Renee Martin, Director of Surgical Services.

Martin said her battle with the coronavirus began on a Monday toward the beginning of July.

“You never think it’s going to happen to you...until it does,” Martin said. “You want to brush it off as, ‘Oh, I have a little itch in the back of my throat — it’s allergies.’ That’s how it started. Just a little scratch, like you need a cup of water.”

Martin said she felt fine otherwise but the scratch continued into Tuesday. On Wednesday at about 3:45 p.m., Martin felt suddenly dizzy, then experienced a heat flash followed by the chills. Her energy quickly plummeted and she needed to rest.

“I sat down and thought, ‘Something’s wrong with me,’” she said.

All hospital staff get their temperature checked before entering the building. Martin said she felt healthy that morning. A colleague screened her again. Her temperature had spiked to 103 degrees. Now symptomatic for COVID-19, she took a swab test and immediately went home to quarantine for 14 days.

Martin is married and has five children, ages 17 years to 20 months old. She told her husband that something was wrong, then secluded herself in a bedroom and went to sleep.

“I pretty much slept for 13 days. It’s scary. It was exhausting,” she said. “I would wake up at 8 o’clock in the morning, look at the time, and then I’d wake up again and it would be 4 p.m.”

Martin lost her sense of taste and smell, both symptoms of the virus. She had no appetite. Her bed was soaked in sweat. Her back ached and she continued to lose track of time. It was difficult to breathe. It was difficult just to exist.

In the evenings, Martin would tell her children “good night” using a mobile phone. Despite never leaving her room, her husband and her children began displaying symptoms of COVID-19 and needed to quarantine themselves.

July 23 was Martin’s second day back at the hospital after recovering from the illness. She said her family is better, and understands the risks of what returning to work at a hospital with five coronavirus units could mean.

“I’m worried about getting COVID again, but I was worried before,” Martin said. “Being a nurse, that’s what we’re here for. What we’re fighting is a biological warfare, and everybody is fighting for their lives.”

To help Martin and her colleagues win that battle is the United States military.

In mid-July, the U.S. Navy Rural Rapid Response Team 1 arrived at Val Verde Regional Medical Center. Their presence has been described as “a godsend.”

Composed of Cmdr. Sean McKay, a U.S. Navy Doctor; Lt. Cmdr. Sarah Jagger, an ICU/Critical Care Nurse; and Capt. Stephanie Corsaro with the 62nd Medical Brigade, they’re providing rural hospital staff with critical knowledge in how to combat COVID-19.

A specialist in the U.S. Army, Juron Toliver, and other service members provide additional support.

McKay works directly with COVID patients in Del Rio. He’s currently stationed in Maryland where he’s served in various hospitals as a pulmonary critical care doctor. He said the Navy developed medical teams around June to support rural communities dealing with the coronavirus.

“We’re being sent wherever we’re needed,” McKay said. “Other Navy teams have gone to New York. We have Navy critical care teams in places like Virginia, Jacksonville, Florida, San Diego, Okinawa, and Guam.”

McKay said everyone has been welcoming and helpful while his team works alongside rural caregivers to slow the spread of the virus. He said his team will stay in Del Rio as long as the Department of Defense feels they’re needed in the area..

Val Verde County Judge Lewis Owens hopes they stay awhile.

Judge Owens is part of what’s referred to as the Val Verde County COVID Task force. He and other locally elected officials and healthcare providers meet often at the county courthouse to decide what actions are needed to stop the virus.

The county recently hired six contact tracers to track how COVID-19 is spreading through the community. With so many positive cases already, Owens said the process is often daunting but that he and other officials are doing everything they can.

Deputies are now serving citations to people in Val Verde County who test positive for COVID-19. If they leave their home, if they violate quarantine, if they do not follow social distancing guidelines, the county will fine them up to $250, which could increase at a later date.

“There’s no book for this,” Owens said. “For a flood, you have a template. For a tornado, you have a template — you have things you follow. But for COVID? Things we thought were right two months ago we’re having to rethink.”

Owens likens COVID-19 more to a viral hurricane, and at the end of the day, Val Verde County will need more funding if its going to weather the storm.

A month ago, when COVID began to skyrocket, Val Verde County had more than $724,000 it received in relief funds. As of July 22, all but $59,000 had been spent. Owens said the court had set aside $200,000, which officials used purchasing supplies to battle COVID early during the pandemic.

“We bought a machine to make disinfectant, purchased hand sanitizer, handed out food. We didn’t wait for these other programs to kick in. We started buying stuff,” Owens said. “We bought masks, N-95′s, and gowns.”

Owens hasn’t crunched all the numbers, but in consideration to staffing and other ancillary needs, said it might take another $1.2 million a year for Val Verde County to effectively deal with the coronavirus. But with so many unknowns, it’s difficult to land on a number.

“I’ve already looked at the budget for the next fiscal year,” Owens said. “We’re going to be fine. The problems is that I’m using my reserves ‘to be fine.’ The problem is also what I’m going to do the following fiscal year, and then the year after that if this continues.”

At this point, no one can say. COVID-19 still feels like a puzzle and it remains unknown how many pieces are missing — even when some of the things Del Rio has lost are glaringly obvious.

San Felipe Creek is a spring-fed oasis along the eastern edge of the city. The water is so clear you can drop a stone off a bridge and watch as it sinks to the bottom of the creek bed.

Ordinarily in July, you would both hear and see Del Rio’s children splashing in the water while parents watch from nearby shaded picnic tables — at least until, like so much else, it was closed by the coronavirus.

Yellow caution tape fastened to park benches flutter in the wind, and San Felipe Creek is now defined by absence — by what Del Rio no longer has because of COVID.

The absence is as real as the virus itself, as real as the teacher who won’t be in the classroom, or the grandparent who will be missing at the dinner table. It wasn’t always this way. And its uncertain when things in Del Rio will start to feel normal again.

Sports set to return in Texas

While school sports remain on the bench, the latest announcement by Texas Governor Greg Abbott has many people anxious for the return of organized sports.

Monday afternoon, Abbott announced a timeline for the next phase of openings in the state of Texas as part of a planned recovery from the COVID-19 pandemic.

According to Abbott’s plan, rodeos, equestrian events, bowling alleys and skating rinks will be allowed to open and resume beginning May 22. On May 31, youth sports and professional sporting events may resume. However, pro sports can only resume without in-person spectators.

Abbott’s decision didn’t come soon enough for some groups. The Del Rio Little League’s board of directors voted to cancel its 2020 season May 14. That came on the heels of Little League International announcing that it was canceling this year’s Little League World Series for the first time in the league’s history.

The Del Rio Babe Ruth Baseball League canceled its 2020 prep division season, for 13-year-olds, on April 14. The league is still holding out hope that it can hold a majors/seniors division season, but it has followed all guidelines from the national Babe Ruth League in regards to how to proceed. Nationally, the Babe Ruth League’s board of directors has asked to forego the league’s regional and world series formats for the 2020 season in order to allow local leagues the chance to play when the go-ahead is given.

Abbott’s announcement immediately brought hope to student-athletes who have been unable to be a part of any organized practices or play since UIL suspended activity March 13. Sports seasons were eventually canceled altogether April 17.

In the wake of Abbott’s announcement, UIL issued a statement indicating a plan to allow limited activities beginning June 8. The full release is as follows: “UIL is aware of Governor Abbott’s May 18 announcement and is actively working with appropriate state officials to allow schools to begin limited summer strength and conditioning and marching band activities on June 8, 2020. As soon as the details of that plan are finalized, UIL will release them to schools to allow time to plan and prepare for bringing students back to campus for these purposes.”

The San Felipe Del Rio CISD has used the summer months to push its strength and conditioning program as well as activities geared toward specific sports, such as open gym for volleyball and basketball. Athletic director Ric Smith has stated that the district’s athletic programs will follow UIL’s lead, so as soon as UIL comes to a decision expect the school district to announce its plans.

Guadalupe County confirms 1 new COVID death, six new cases

Guadalupe County is reporting one new COVID-19 death and six new cases of the coronavirus in the county.

The number of confirmed deaths are expected to continue to increase from 32 as the Texas Department of State Health Services releases new information to country, Guadalupe County Emergency Management Coordinator Patrick Pinder said in a news release.

“Guadalupe County expects the number of deaths to increase due to the Texas Department of State Health Services’ webpage reporting 45 deaths,” he wrote. “Due to the lag in the reporting, we have not yet been provided all of the deaths.”

Guadalupe Regional Medical Center has reported to Pinder that 28 county residents had died in the hospital from COVID-19.

As of Monday, the number of active cases dropped to 256 and the number of recoveries increased to 1,658.

In total, Guadalupe County had 1,914 confirmed cases.

Currently, GRMC has 12 patients admitted to the hospital with the coronavirus.

The Texas Tribune, The Associated Press
 

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