Texas Gov. Greg Abbott said in a television interview Tuesday morning that he expected the state to report an all-time record of more than 5,000 new COVID-19 cases that afternoon -- when the Department of State Health Services finalized that number it was nearly 5,500.
With several major markers on the upswing in recent days, Abbott is continuing to advise all Texans to maintain social/physical distancing, wash their hands regularly and to wear a facial covering when inside businesses.
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On Tuesday, not only did the state confirm 5,489 new COVID-19 cases, bringing the state's total to 120,370, but they also confirmed a record 4,092 hospitalizations related to the virus and another bump in the positivity index upward to just shy of 10%.
Of the hospitalizations, more than 1,000 of the patients were in the North Central Texas Trauma Service Area, which includes 19 DFW-area counties including Dallas, Collin, Denton and Tarrant, those adjacent as well as a handful of others.
The number of people hospitalized locally for COVID-19 has nearly doubled since June 1 when there were 580 people in area hospitals. On Tuesday, there were 1,074 people hospitalized in the NCT TSA; meanwhile, the statewide numbers have grown from 1,756 on June 1 to 4,092 on June 23.
Some attribute the surge in cases to gatherings held just under a month ago around the Memorial Day holiday. With Independence Day less than two weeks away, Abbott is considering if more needs to be done to reduce crowd sizes other than the power already granted to local governments.
"There is an executive order already in place given (to) local authorities to put restrictions on crowds gathering over 500," Abbott said in an interview with Corpus Christi's KRIS-TV. "We did see an increase after Memorial Day. We saw an increase in the early part of June. We need to make sure we have the flexibility to reduce crowds in ways that will reduce the spread of COVID-19."
Tuesday, Abbott amended a disaster proclamation to allow mayors and county judges to limit outdoor gatherings to 100 people. Previously, the cap on outdoor gatherings was 500 people.
The amended order also directed the Texas Health and Human Services Commission to enact stricter standards for child care centers.
In the last seven days, Texas has added 24,035 new cases of the virus, or 3,433 per day. The increase in cases from a week ago represents a jump of 25%. Should that trend continue, Texas could see more than 150,000 cases of the virus by this time next week.
"If we are unable to contain the spiraling spread of COVID-19, there will be more onerous requirements put on businesses including even considering having to ratchet back on the expansion of opening businesses in Texas," Abbott said. "That's the last thing that either I or those businesses want to do. So the best thing we can all do is work on continuing to open up businesses that use safe practices that include wearing a mask."
Abbott, who has refused to mandate wearing masks statewide but has allowed county governments to require them to be worn inside businesses, told KRIS-TV he believed businesses understand that requiring masks is a necessary step to keeping their doors open.
"The primary way they are going to be able to keep their businesses open is by having people wear masks," Abbott said. "They realize they would rather have customers in masks than having no customers at all."
For the second straight day, the state's positivity index, the percentage representing the number of people who have tested positive for the virus, is just below 10%. When Abbott debuted his Open Texas plan, he said should a sustained rate of 10% be seen again that it would be a red flag that mitigation efforts would need to be revisited. Last week the number steadily climbed from 6.71% on Monday to 8.94% by Friday. On Sunday it reached 9.51% and on Monday it hit 9.76%.
Epidemiologist Dr. Diana Cervantes said there’s a balance in public health between protecting lives and letting people live their lives. If the latter outweighs the former, she said the state winds up where it is now. She said the surge could be attributed to the kickoff of summer and Memorial Day activities.
“I think all of those things in alignment really caused people to go out and kind of violate the three important rules of preventing transmission: to avoid crowds, keep distance and watch how much time you’re spending with people,” Cervantes said. “With more openings, there’s more people and when there’s more people there’s just more transmission.”
As an epidemiologist, she said people cannot ignore the recent swell in positive cases -- and it’s not only because of increased testing. But Cervantes said the rise in cases is also attributed to behaviors and people violating recommended best practices.
“Sometimes people may think, ‘Well, we’re doing a lot more testing to more people so we’re going to see more cases,’” she said. “Even though we are seeing more tests that are being done, the actual percent positivity has increased. So, it’s not just the actual number, it’s the proportion of tests that are coming back positive.”
The number of coronavirus patients has nearly doubled since the first of the month. Parkland Hospital Chief Medical Officer Joseph Chang said conversations are ongoing about how to handle the surge.
“We do have two dedicated wards already here at Parkland Hospital for COVID treatment,” Chang said. “We have numerous other rooms that can be converted at a moment’s notice. We are actually, at the moment, preparing a third dedicated ward.”
To keep that from happening transmission must be controlled. Cervantes said there are risk factors to keep in mind.
“Everyone one person that gets infected, you could potentially infect two to three different people,” she said.
If there is just one takeaway, Cervantes said it is that we are still as susceptible now as we were months ago.
After four weeks averaging 160 deaths per week, COVID-19 related deaths in the Lone Star State jumped up last week to 209 deaths -- the most on record since May 17.
On Tuesday, the state reported another 28 deaths, more than the previous two days combined.
In North Texas, Denton County hasn't recorded a death in two weeks and has only had four COVID-19 related deaths this month. It's a similar story in Collin County where officials have not reported a COVID-19 related death in 12 days and have only reported three this month.
Through Tuesday, Dallas County is averaging 4.4 deaths per day over the last week, a slight increase over the week before when there was an average of 3.1 deaths per day. Tarrant County is averaging 1.7 deaths per day over the last week, a slight drop over the previous week when there was an average of 2.1 deaths per day.