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Austin-Travis County recommends masks, moves to Stage 4 of COVID rules

Heather Osbourne
Austin American-Statesman

Austin-Travis County's top health authority on Friday requested that residents return to wearing masks as the area moved back into Stage 4 coronavirus guidelines, a sign of worsening pandemic conditions in Central Texas due to the presence of a highly contagious variant known as delta. 

Dr. Desmar Walkes, Austin-Travis County's health authority, announced the stricter recommendations after the weekly average of daily hospital admissions reached 35 Thursday night, the highest it had been since late February.

Stage 4 restrictions:Austin's COVID safety guidelines, explained

People wear masks as they walk along the Drag on Tuesday. Health leaders are asking all Travis County residents, including those vaccinated against the coronavirus, to wear masks in public because of a surge in COVID-19 cases.

"In just five months, we have evidenced four new variants of this virus," Walkes, who was joined by five other local doctors during a public briefing, said Friday. "And the last week's data shows the delta variant is more severe and deadly than its predecessors."

Walkes on Friday said she's now recommending that fully vaccinated people again wear masks in any situation where social distancing cannot occur. Those situations include shopping, dining, traveling and sporting events.

Unvaccinated or partially vaccinated residents should no longer gather in groups at all and only shop, dine and travel when essential, the Austin Public Health guidelines say. They should also continue to wear masks in public spaces, especially indoors. 

Children older than 2 should also be wearing masks when indoors or when they cannot socially distance outside, Austin Public Health said in a statement Friday. Walkes said coronavirus hospitalizations have been increasing among children, a trend that continues to worry health leaders and comes about one month before students are scheduled to return to school.

Children under 12 do not yet qualify for a coronavirus vaccine. 

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The latest data from the University of Texas modeling consortium, used by local health leaders to understand the likely outcomes of disease spread in the coming weeks, says Austin is likely to max out intensive care units by Aug. 21 if residents don't start wearing masks again and remain socially distant in public. 

If Austin residents don't adhere to Stage 4 guidelines, UT projections show the area could see an estimated 12,279 hospitalizations and 1,282 deaths by Oct. 1. 

"When I think about when the ICU nurses start hearing that the surge is here and it's coming, I see this look of just, really, they're overwhelmed," said Elizabeth Douglass, an infectious disease doctor at UT Health Austin. "We're tired. They're tired. I just ask that you think about that and wear a mask. That will make such a big difference." 

Austin Public Health's guidelines — ranging from the lowest threat of coronavirus spread at Stage 1 to the highest at Stage 5 — have been used for about a year to help residents understand the level of risk to the community, while offering guidelines to follow to avoid transmitting or contracting the disease.

In addition to the average of new hospitalizations, Austin Public Health considered the increase in the daily average for new confirmed cases of COVID-19, the disease caused by the coronavirus, in the decision to signal Stage 4. On Thursday, the daily average was 148, the highest it's been since early March. 

The pandemic arrived in the region in the spring of 2020 at Stage 3 and reached Stage 5 at the end of the year. The city dropped to Stage 2 a few months ago but has never reached Stage 1.

The guidelines are not legal requirements, but some aspects are enforced as part of the county's health codes.

Businesses encouraged to resume mask policies  

Businesses on Friday were asked to return to masking policies to protect employees and customers. 

The city of Austin's Economic Development Department is now recommending that businesses encourage all customers to wear face masks and post clearly marked signs with mask policies, according to a statement released Friday. Business owners should also consider limiting in-store and on-site capacity, the recommendations say. 

Austin and Travis County earlier this year did legally mandate masks by requiring businesses to have face covering policies in place, but Gov. Greg Abbott in an executive order in May put a stop to local governments imposing mask requirements for businesses or individuals.

Austin-Travis County health leaders ended local mask requirements as soon as Abbott's orders were set in place to avoid a potential courtroom conflict with the governor. 

Abbott also will not allow schools to require students, teachers or visitors to wear masks.

Masks may only be required at state-supported living centers, government-owned or operated hospitals, Texas Department of Criminal Justice facilities, Texas Juvenile Justice Department facilities, and county and municipal jails, according to the orders. 

However, businesses may still decide whether they want to require customers to wear face coverings. 

During an interview with Houston TV station KPRC this week, Abbott said he thought it would be "inappropriate to require people who already have immunity to wear a mask." 

Although fully vaccinated people have about an 88% efficacy rate against the delta variant in preventing severe disease or death, they are being asked to wear masks because they can still be infected with the mutation and may also spread the disease to unvaccinated people, health officials said. 

Partially vaccinated or unvaccinated people remain at risk of severe disease of all strains of the virus until they are two weeks past receiving their second shot, local health officials said. 

Brandon Hodge, the owner of two South Congress Avenue businesses and president of the South Congress Merchant Association, said he isn't surprised Austin businesses are being asked to have mask mandates again. He said he felt the decision by Abbott to do away with mask mandates was premature. 

"Can I just say I told you so?" Hodge said. "You know, it's so frustrating when our officials don't listen. It's bad enough that they don't listen to the experts in the field, but it's worse when they don't listen to those on the ground and in the trenches dealing with this every day."

Hodge said while he's supportive of a move to protect Austin-area shoppers from the coronavirus by requiring masks again, he thinks it should not be left to business owners or employees to have to enforce it.

If a customer challenges masking rules, Hodge said, situations can escalate into confrontations employees aren't equipped to handle. 

"Here we are, small business owners, trying to keep our employees and our customers safe," Hodge said. "And to be vilified for taking these actions is a very difficult thing to do. 

"Unfortunately, I think that this issue has been so politicized that any change on our far right government's stance on this issue would be seen as a sign of weakness," Hodge said. "It will fall on deaf ears. We have businesses to run." 

Large events, in-person learning likely to continue 

Walkes on Friday said she was not recommending any capacity changes for large events and activities such as soccer games, concerts and weekend festivals. She also had no specific capacity recommendations for bar owners on Sixth Street or beyond. 

If the remaining 30% of Austin-area residents who are unvaccinated went in this weekend for a coronavirus vaccination, it would take about 35 to 40 days after the first dose before they would be fully protected against the virus, according to Walkes. As a result, the only way out of rising cases in the short term is for residents to wear masks again. 

"We're making this plea to individuals, citizens, community members, neighbors, loved ones, friends," Walkes said. "We're asking them to get vaccinated, No. 1. And, we're asking them to wear a mask to protect themselves and everyone around them so that we can get everybody vaccinated and protected and decrease the number of cases." 

 Dr. Menna Iyer, chief medical officer for Dell Children's Medical Center, said she supports children going back to school in person to help avoid the increase in child mental illness from lack of social interaction that was seen last year during the height of the pandemic. 

"We really would like these kids to go back into school, work with each other, have social interaction so they can grow developmentally," Iyer said. "So to allow that to happen, we would like everyone to get vaccinated and continue to wear masks." 

Dr. Brian Metzger, who works in the infectious disease unit at St. David's Healthcare, added to Walkes' statements Friday that fewer than 10% of patients hospitalized for COVID-19 in the area are vaccinated. 

"And the vaccinated make up 60% to 70% of adults in our area," Metzger said. "So 90% of the cases are coming from approximately 30% of the population. So you can see that disparity and how much these vaccines work."