Listen to Austin 360 Radio

Why isn't Austin in Stage 2 of COVID guidelines yet? Travis County's health chief explains why

Heather Osbourne
Austin American-Statesman

Travis County residents over the past two years of the coronavirus pandemic have become all too familiar with calibrating their social plans around Austin Public Health's risk-based guidelines, which until recently were largely influenced by the seven-day average of new daily hospital admissions for COVID-19.

Austin Public Health's guidelines come with their own recommendations to help the most medically vulnerable among us avoid getting sick. They range from Stage 1, when the threat of coronavirus spread is the lowest, to Stage 5, when the threat is at its worst.

But public health leaders have started to keep a closer eye on COVID-19 transmission rates, which is a per capita count of infections over seven days. This week, they provided the American-Statesman new insight about how they plan to predict and help prevent future coronavirus surges, a grim reality for many as the pandemic appears likely to drag on into its third year.  

More:Number of Texans in hospital for COVID at 2,720; Austin area remains in Stage 3

Why Austin hasn't gone to Stage 2 yet

The hospital admissions average in the past few weeks dipped below and has stayed at or under 14, the Stage 2 threshold and the lowest number since before the highly contagious delta variant of the coronavirus violently swept through Austin over the summer.

Travis County residents have been expecting Austin Pubic Health to trigger a downgrade to Stage 2, but Dr. Desmar Walkes, Austin-Travis County health authority, explained Wednesday why that never happened. 

Instead of celebrating a move to Stage 2, Walkes two weeks ago announced that she and other public health leaders would adopt the weekly community transmission rate as a key indicator of determining disease spread.

More:UT honors researchers who helped develop crucial component of COVID-19 vaccines

The national Centers for Disease Control and Prevention also uses this method, which tracks new cases per 100,000 people over seven days.

If Austin and Travis County had continued to follow the weekly hospitalization average and dropped to Stage 2 and even Stage 1 as hospitalization decreased, it would have become very likely that another surge could begin before Christmas. 

The University of Texas Modeling Consortium, which tracks COVID-19 data to predict future trends, alerted Walkes to this likely scenario while reviewing data from the months when the delta variant took over Austin. 

The Austin area was in Stage 2 of the risk-based guidelines when the delta variant hit and, while the hospital average was very low, the community transmission rate was high and showing signs that cases were rapidly growing. 

More:Austin health leaders prep for potential holiday COVID surge, urging public to be cautious

Nurse Lola Ogundare prepares Moderna COVID-19 vaccines at an Austin Public Health vaccine clinic at the Delco Activity Center last month.

What the transmission rate can mean

To avoid making the same mistake of mainly following the hospital average to determine risk, Walkes said she chose instead to look to the community transmission rate, along with other previously used factors, to make sure the Austin area didn't give up social distancing and mask wearing prematurely.

"We're now going to be looking at a lot of different factors as we move from one stage to another," Walkes said. "I'm trying to give the community information that will help them protect themselves when they're at indoor public spaces."

The transmission rates fall into four categories that describe the risk of coronavirus transmission:

Low: When the number of new COVID-19 cases per 100,000 people in the past seven days is less than 10.

Moderate: When that number is between 10 and 49.

Substantial: When the number is between 50 and 99.

High: When the number is 100 or more.

"I want them to know that if they go somewhere and they're indoors, like the grocery store, what their risk is of getting COVID," she continued. 

Walkes on Wednesday further clarified that Austinites are not out of the woods in avoiding another surge just yet. 

The community transmission rate Thursday was 49, signaling a moderate risk of catching COVID-19 for those most vulnerable to the disease, which include those with preexisting or chronic medical conditions or those with auto-immune deficiencies. 

Austin is currently in Stage 3, but Stage 4 could be signaled if the transmission average stays between 10 and 49 for more than a week. 

The county on Thursday recorded 15 new hospital admissions for COVID-19. The rolling seven-day average of new daily hospital admissions was 13.

More:Surge in consumer spending is helping drive Austin's economic rebound

The county's highest average for new daily COVID-19 hospital admissions during this most recent surge was 84 on Aug. 11, when the community was in Stage 5, the highest threat level.

Austin Public Health was tracking 106 people in the hospital Thursday with COVID-19, compared with the pandemic record high of 653 patients tallied on Aug. 25.

Only 53 people were in Austin-area intensive care units Thursday for COVID-19. That number hit a pandemic record high of 237 on Aug. 22. The 32 patients on ventilators Thursday remained a significant improvement over the pandemic record high of 174 set Aug. 29.

Vaccine boosters for the holidays

Walkes warned that more than 100,000 Travis County residents still have yet to receive even one dose of a coronavirus vaccine. 

Equally worrisome is that Austinites who are fully vaccinated now have their immunity decreasing after six months from their last shot, and it could put themselves and others at risk if they don't go get their booster shots before gathering next week for Thanksgiving. 

More:Coronavirus still creating worries for the Texas economy

"The big thing is getting vaccinated and testing if you have any kind of symptoms to make sure that when you go home, you're just bringing the fixings for the turkey," Walkes said. 

If residents abide by Walkes' guidance for nonvaccinated residents, which is to keep wearing masks in public and get vaccinated quickly, the health leader said she's confident another surge won't happen. 

However, Walkes said deviating from Austin Public Health's guidelines will likely result in more hospitalizations and death before Christmas.