Social Distancing Texas update

Reopening of Texas

Because this is important regarding Texas’ policy decisions today.

The reopening of Texas was done in a phased approach. The purpose of this is to, ideally, evaluate COVID19 spread BEFORE going to the next phase. Unfortunately, this wasn’t done in a consistent, data-driven manner and we may be seeing the impact now. Let me explain…

Note: Remember, we have to give policies at LEAST 2 weeks to even start to evaluate their the impact on COVID19.

Phase I: Two weeks after Phase I was implemented, COVID19 spread increased very slightly, but not in a meaningful way. This is okay (it would have been great if this went down). But time to move on to Phase II.

Phase II: This phase gets messy. Within two weeks after Phase II was implemented, there was also Memorial Day and protests/demonstrations/riots. The combination of these three was followed by exponential growth. Parsing out which caused which is impossible. The ONLY way we can do this is IF we had a comprehensive, state-wide contact tracing program. Which we don’t. If we did, we could see who got the disease where and how they spread it. Nonetheless, given this exponential spread, we should have never moved on to Phase III.

Phase III: But we did. It has now been three weeks since Phase III was implemented. We’ve never seen so much COVID19 spread across the state of Texas. Ever. So, we aren’t going to Phase IV (as of today).

Translation: Stopping Phase IV is the right call. However, it’s after a series of wrong calls. The disease has spread and, unfortunately, we may have to go back.

Love, your local epidemiologist

Data Source: DSHS. Graphs created in collaboration with my biostatistical rockstar colleagues, Drs. Yamal and Yaseen.

Deaths Predictions Texas update

Texas Today

And this is my best shot at giving your the most comprehensive picture of COVID19 in Texas today.

Cases: While Harris County is getting a lot of attention due to an increase in cases (and we should be worried about this), it looks like after adjusting for population, Dallas is in even worse shape. Another worrisome county is Bexar (San Antonio) given their recent steep incline. In order compare the severity of COVID across Texas counties, we NEED to adjust for population. I noticed this is missing in much of the news.

Testing: TPR has always been a problem in Texas. Our goal is 5%, and we are over 10% in most of Texas. We need to allocate resources to increase testing. Like NOW. We are not testing enough to get ahead of the epidemic.

Mortality: CFR looks steady in Texas. In fact, it’s decreasing. This is driven by COVID spread among younger Texans, who have the ability to fight off the disease compared to older populations. HOWEVER, this JUST measures mortality. This does NOT account for lifelong complications we are seeing among the young patients that survive. Which is a whole other story.

Future cases: I included classic Epi curves for each county (with 7-day average- blue line). I also included our June 13 projections calculated based on R(t), which takes into account testing, temperature/humidity, social distancing, and population density. Projections in Bexar, Travis, and Harris county are grossly UNDERestimated. We NEED to especially improve social distancing here. Projections for Dallas and Tarrant look accurate so far (but still need to improve social distancing so this projection goes flat).

Translation: We need to increase testing. We need to improve our social distancing. We need to be worried for all of Texas, but particularly the rate in Dallas and Bexar right now.

Love, your local epidemiologist

Data: DSHS. Graphs and analyses by yours truly.

Predictions Texas update

Case Projections

Sorry for bad news on Father’s Day.

A few days ago, I posted projections for a few Texas cities (compared to DC, NY, and CA). Those projections were created on June 13. Now that 8 days have passed, I was curious how accurate they were thus far.

Projections are incredibly hard to estimate. And many epidemiologists are hesitant to post or discuss them amid the risk of being scrutinized and losing the public’s trust. However, while all of this is true, I also think it’s important point of discussion in order to change behavior. So here we go…

These figures include the original June 13 projections. I added cases for the past 8 days in each county (see red dots and lines). The projections look pretty darn accurate so far. Dallas projections may be slightly overestimated (but not by much). Harris and Tarrant projections look like they are UNDERestimated. By a lot.

The only thing that can change these projections are the variables that were used to create them: 1) county-level population density; 2) testing capacity; 3) 3-day average of social distancing; and 4) temperature and humidity over the past 2 weeks. The public can only help through social distancing. A few counties in Texas, including Dallas, have mandated facemasks. It will be another two-ish weeks to see if this had an impact on spread.

We should all keep a close eye on these numbers.

Love, your local epidemiologist