Healthcare workers walking through the Texas Medical Center on July 8 as coronavirus cases spiked in Houston.

Callaghan O’Hare/Reuters

Texas’ coronavirus outbreak has ballooned dramatically since June 1. On average, 9,100 new daily cases were reported over the past week.

Experts say Gov. Greg Abbott started reopening the state prematurely, which backfired, triggering a public-health crisis.

Face masks and social distancing have also become politicized, they said, making the response more challenging.

Families describe the pain of losing loved ones amid the coronavirus’ calamitous impact.

Visit Business Insider’s homepage for more stories.

For 53 years, Betty and Curtis Tarpley were a team.

Their son Tim doesn’t know when or how the pair was exposed to the coronavirus in Fort Worth, Texas — he just knows his mother took ill first. Within 12 days, both of them were in the hospital in critical condition.

As the elderly couple deteriorated, nurses wheeled Betty’s bed into Curtis’ room, lowered the guardrails, and placed the Tarpleys’ arms next to each. Tim’s mother was on pain medication and “out of it,” he said, but Curtis knew his wife was by his side.

“He couldn’t really turn his head or say anything, but he reached over, found her hand, and they held hands,” Tim told Business Insider. “My parents were lucky that they had that moment.”

Curtis and Betty Tarpley at a celebration for their 50th wedding anniversary. The couple died of the coronavirus on June 18.

Handout by Tim Tarpley

Betty died of COVID-19 at 11:05 a.m. on June 18. Curtis followed at 11:52 a.m.

They’re two of the more than 3,250 people who have died of the coronavirus in Texas as the state’s outbreak spiraled out of control. Texas reported its most deaths in a single day — 105 — on Thursday. Its highest single-day tally of new infections came Saturday: 10,351. In total, the virus has infected more than 268,800 people in the state, based on data from Johns Hopkins University.

Related video: 6 months of the COVID-19 pandemic in the U.S.

Experts blame the ballooning numbers on Gov. Greg Abbott’s choice to relax restrictions when he did. People eased back into normal life gradually at first and then began flocking to restaurants, bars, gyms, and beaches. They put aside face masks and forsook social distancing.

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Since June 1, more than 8,600 people like the Tarpleys have been hospitalized in Texas, state health data shows. The following account of what that has looked like on the ground is based on interviews with health experts, mayors, patients, and surviving family members.

The ‘Open Texas’ plan

While the coronavirus walloped New York in March and April, Texas’ numbers held steady, with 1,000 to 2,000 cases a day and sometimes far fewer.

Galvanized by the seemingly low impact of the virus on the state, Abbott kicked off his “Open Texas” plan on May 1. White House guidelines instructed states to reopen only after seeing a “downward trajectory” in cases over 14 days, which Texas had not experienced.

But Abbott relaxed rules anyway, and, initially, cases declined. On May 25, he tweeted: “Today Texas had the fewest #COVID19 fatalities since the end of March. We also had the fewest COVID hospitalizations since the middle of April. And, we have the 2nd most recoveries from COVID in America.”

But then the trend reversed.

Some 2,600 new infections were reported June 16. The number crossed 3,000 on June 17, then 4,000 on June 20, 5,000 on June 23, 6,000 on June 30, and 8,000 on July 1.

From May 1 to Monday, Texas’ total case count went from 29,000 to over 268,000.

Dr. Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine, attributes that surge to three factors.

“One, we opened prematurely, and before the modelers told us that we could be in containment mode, meaning less than one new case per million residents per day,” he told Business Insider. “Second, we did not put in all the public-health infrastructure that we needed to manage the opening. And third, there needed to be a higher level of communication explaining that there was still a lot of coronavirus around and that people needed to wear masks and take other measures.”

Read more: Dozens of drugmakers are racing to develop coronavirus vaccines. Here’s how they see 2020 playing out and when the first vaccines might be available.

‘It was like he knew it was OK to go’

Betty Tarpley became ill in early June, just ahead of Texas’ big case spike. The family initially thought she had a sinus infection or a bad tooth. On June 8, she became confused and left to see her dentist two hours early, then got into a car crash on the way.

“I remember thinking that something was wrong and that this could be the night that she doesn’t wake up,” Tim said.

After she struggled to check her blood sugar — a routine she’d done for over 20 years — Tim drove Betty to the emergency room. She tested positive for COVID-19 the next day.

Curtis told Tim that he was feeling weak two days later. He’d developed pneumonia and sepsis and was admitted to the intensive-care unit. It wasn’t until his third coronavirus test that he got a positive result.

Unmasked patrons at a restaurant in Austin, Texas, on June 28.

Sergio Flores/Reuters

Curtis held steady for his first four days in the hospital. But then he learned Betty wasn’t expected to survive.

“It was like someone flipped a switch and he just declined so quickly,” Tim said. “It was like he knew it was OK to go because he didn’t have to fight and lead the team anymore.”

Abbott didn’t properly calculate lag time after lifting restrictions

What Abbott didn’t anticipate sufficiently, experts say, was how long it would take to see the effects of policy changes.

“I think on paper the governor’s plan didn’t look bad because there’s a rule of thumb in public health that whenever you make an intervention in a community, it takes about two weeks before you see any changes,” Houston Health Authority Dr. David Persse told Business Insider. “So his plan allowed 18 days before they would go to phase two.”

But that wasn’t long enough, since people “did not go from zero to 60 miles an hour” right off the bat, Persse said.

Instead, he added, they “slowly started venturing out, so that two weeks didn’t really start for probably a week or 10 days after he issued the order.”

Residents lined up in their vehicles to be tested for the coronavirus in Houston on July 9.

Adrees Latif/Reuters

On May 18, Abbott further relaxed the rules. At that point, the numbers still “looked awfully good,” Persse said.

But then came Mother’s Day, Memorial Day, and graduations. People went to parties and crowded the shores of lakes and beaches.

“Texans were likely lulled into complacency by the initial low number of additional cases and deaths compared to New York,” Dr. Jaquelin Dudley, the associate director of the LaMontagne Center for Infectious Disease at the University of Texas at Austin, told Business Insider. “Also, inaccurate information at the federal level suggested that SARS-CoV-2 infections might be seasonal, like the incidence of influenza.”

When the pendulum finally started to swing in a dangerous direction, Persse said, “it moved very fast and very far all at once.”

A woman having her nose swabbed as people waited in their vehicles in long lines for coronavirus testing in Texas.

Callaghan O’Hare/Reuters

By June 26, San Antonio had seen a 500% increase in hospitalizations. Houston and Dallas hospitals were nearing maximum ICU capacity. Abbott hit pause on the state’s reopening and ordered people to wear face masks.

‘I’m sick and tired of doing funeral arrangements’

Of Texas’ 55,632 staffed hospital beds, only 12,066 — about 22% — were available as of Monday.

For many Texans with COVID-19, that makes it impossible to seek experimental treatments or transfer hospitals.

Alfonso Morales Rodriguez Jr. told Business Insider that last month he spent hours on the phone for over three weeks trying to transfer family members with coronavirus infections to larger hospitals in Houston for plasma therapy.

His requests were denied.

“Within 11 days, I lost my mother, my father, and my brother,” Rodriguez said.

From left, Porfiria Morales Rodriguez; her husband, Alfonso Rodriguez; and their son Rudy Morales Rodriguez are among those in Texas who have died of the coronavirus.

Handout by Alfonso Morales Rodriguez, Jr.

Rodriguez visited his family on May 23, not knowing it would be the last time he saw any of them. Two days later, his father, also named Alfonso, was hospitalized, followed by his mother, Porfiria, and then his brother, Rudy.

“I’m sick and tired of doing funeral arrangements,” Rodriguez said. “It was devastating to me and my family. None of us could believe what was happening. It was like we were in a nightmare.”

His sister, Irene Soliz, also came down with the coronavirus. She survived, but Rodriguez said Soliz was “all alone in the hospital with nobody to console her” when he called to tell her that Rudy had died on June 8, then Porfiria on June 9, then the senior Alfonso on June 19.

The average age of COVID-19 patients is dropping

Mayor Steve Adler of Austin told Business Insider he thought people grew restless over time, abandoning caution as their yearning for normality increased.

“We believed we could open back up without significant and necessary behavioral changes relative to the way that we operated before,” he said.

A medical worker walking past a row of ambulances parked outside Houston Methodist Hospital on June 22.

Callaghan O’Hare/Reuters

The people who seem to have done that most are relatively young. The average age of those receiving coronavirus diagnoses in Texas has dropped to under 30.

“We’re seeing a significant increase in the people between the ages of 20 and 50 that are becoming infected,” Persse said. “They may not die at the same rate as the people who are over 50 or 60, but you still have a large number of people getting infected — and a small percentage of a big number is still a big number.”

‘We currently do not have a national strategy’

Though Texas’ outbreak has put Abbott in the spotlight, many public-health experts agree that a bigger problem is the lack of guidance on a national level.

“The president should provide a leadership role and lead by example and based on scientific evidence,” Dudley said.

President Donald Trump continues to incorrectly attribute the surge in cases to increased testing, however.

“I think we’re going to be very good with the coronavirus. I think that at some point that’s going to sort of just disappear, I hope,” Trump told Fox Business Network on July 1.

Gov. Greg Abbott of Texas with President Donald Trump in the Oval Office on May 7.

BRENDAN SMIALOWSKI/AFP via Getty Images

Adler said Trump’s dismissal of the virus’ threat was hurting his ability to mobilize the Austin community.

“The messaging coming out of Washington would suggest to people that this is not serious, that the virus is not infectious, that it’s going to go away, that masking is not important or effective,” he said. “That’s harmful and will lead to people dying that don’t need to be dying.”

Hotez, too, said be blamed a lack of clear directives from the federal government for the US’s coronavirus disaster.

“We currently do not have a national strategy,” he said. “What we have is the states being left to make decisions that they don’t have the detailed epidemiologic knowledge to make. These are big decisions and so we need a fundamental strategy.”

‘If you can just save one person’s life, why not wear a mask?’

Rodriguez said it bothered him to see coronavirus-related restrictions conflated with a trampling of civil liberties.

“People don’t take it seriously,” he said. “They think they’re invincible, that they can do whatever they want, and they’re not going to get sick.”

He added that to him, any resistance to wearing masks was outrageous: “If you can just save one person’s life, why not wear a mask?”

Residents of Galveston, Texas, protesting the closing of beaches amid a surge of coronavirus cases.

Adrees Latif/Reuters

The fact that public-health measures like masks have become politicized is embarrassing, Persse said.

“We have got to stop arguing about this like it’s a political issue,” he said, adding: “This is a biologic public-health crisis, and we need to address it as such.”

On Friday, Abbott warned Texas residents that the worst of that crisis was “yet to come.”

“If we do not slow the spread of COVID-19 … the next step would have to be a lockdown,” Abbott told the CBS affiliate KLBK.

Any hope of avoiding that, Persse said, required people to follow the rules.

“If you want your cocktails, wear a mask,” he said. “If you want the schools open, stay 6 feet away from each other. If you want to get back to normal, stop having parties and going to big gatherings.”

Several days after Tim Tarpley’s parents were hospitalized, he too tested positive for the coronavirus. His diagnosis forced Fort Worth’s mayor, Betsy Price, to self-isolate, since Tarpley is her fitness trainer. She did not contract the virus.

Tarpley said he worried about other vulnerable, elderly people like his mother and his father.

He advocated trying to protect “those that want to be protected” but added, “I think until we have a vaccine all we can do is try to lessen the blow.”

He misses his parents, Tarpley added, but is grateful one isn’t left mourning the other.

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