Week 74, 8/9 - 8/15/2021

jpoheim
Aug 15, 2021
4 min read

Updated: Aug 23, 2021

Dr. Hotez, in the latest interview with the Chronicle's Lisa Gray(1), surprised me with a statistic: only 20 to 25% of adolescents are presently vaccinated. This is a part of the population that is out-and-about, working a Summer gig, playing basketball at the park, stopping by the local coffee shop to chat with friends,....Recently, the list includes shopping for school and attending pre-school sports/band/orchestra/cheer/....registration in preparation for classes that begin in next week.

I assume that the Summer has flown by for this group just like it has for me. I usually close out my 3rd Quarter activities with a different routine. The longer days give one the illusion that there is plenty of time to put off paying that bill or cleaning up the desk or organizing my part of the garage. Of course, vaccinations were available for me back in March. So, I had gotten this off my plate well before the humid ennui of the August that is Houston.

But, in the midst of Back-to-School preparations, adolescents need to make vaccinations a high priority. The Delta Variant is not the same as what we experienced in 2020 when they were less vulnerable than their grandparents. I am measuring doubling rates on the order of 10 days while last Winter, with restrictions in place, the corresponding value was between 14 and 70 days. As a result, their vaccination shot-clock is running low on time if they want to avoid another lost year of High School (or College).

Figure 1 shows the latest Covid-19 Hospitalization Rates along with the dates of equal levels during Phase 4 which started at the end of October, included the Winter Holidays, and ended March 10. As shown, the Gulf Coast and Central Texas currently match previous Purple peaks. North Texas and the Panhandle are still looking to double in order to reach

their Winter maxima. The Border is of particular interest since: its two-pronged Winter surge differs from the other four regions of the state. Figure 2 provides a breakdown of the Border total into its Trauma Service Area Components: I-El Paso, U-Laredo, and V-Rio Grande Valley. The counties associated with these are: El Paso, Webb, Cameron, and Hidalgo. These three regions are spread across a distance of on the order of

two-thousand miles crossing three geographical zones: Gulf Coast - with humid, tropical climate, the Sierra del Carmen/Big Bend National Park, and Chihuahua Desert - with dry, arid climate. Given the distance and the change in climate, one would not expect the whole region to behave as one - and the data suggests that the Rio Grande Valley shares more with the Coastal Bend Counties than it does with far West Texas. Its Winter Surge occurred more than one month later than El Paso's peak - and hence the two purple peaks above. Presently, it is seeing higher hospitalization numbers than the rest of the Border despite high vaccination rates (between 69-71%) that match those from El Paso (71%). While the former serves as a vacation destination where the so-called "Snowbirds" from Canada have Winter homes, the latter has a large military base and serves as a East-West, North-South shipping hub. Both affect the population demographics, density, and tendency to cluster vs. mix with others.

Figure 3 is the latest report on Vaccinations. The increment for this week, .8%, is not too different from last week (.9%). I expect next week to be the largest bump in the numbers coming just over three weeks after the Delta variant took over the state's data.

While the Governor's mask mandate ban has been struck down by court challenges from Houston and Dallas, the appeal may go the other way, creating a sense of dread given how high hospital occupancy already is. Once student and teacher cases add to the picture, we will have exceeded 2020 peaks and land out at a plateau which is higher as well unless some kind of restrictions are implemented in the near future.

Figure 4 are the usual 4-plan with Cases overlaying Hospitalizations. Note that the scales for North Texas and Gulf Coast (0 to 4,000 Covid-19 patients; 0 to 60,000 cases per week) are different from those for the Border and Central Texas (0 to 3,000 patients, 0 to 12,000 cases per week).

Interestingly, Central Texas and the Gulf Coast actually show a slight decrease in cases this week. . Whether this is real or simply the result of counties not reporting on weekends or a lag in the testing results which will be corrected by backlogs is unknown. This is why we rely on Hospitalization reports since they are required to provide this data daily and represent the most severe cases (mostly from unvaccinated individuals).

The spike in Border cases comes from Webb County (Laredo). These may or may not translate to higher number of hospitalized Covid-19 Border patients next week. While Border Hospitalizations are well below the peaks from last Winter, this region is out of ICUs. While the Texas DSHS is recruiting additional staff for the state, it is not clear whether such help is available given the present crisis in Florida, Arkansas, Louisiana, and Missouri. Without additional staffing, the Border will not be able to expand back to last Winter's capacity