Will the shelter at NRG return?
Each week, a team of Chronicle reporters fields questions about the COVID-19 pandemic. For this week’s COVID Help Desk, we answer questions about booster vaccines, masks with respirator valves and whether Houston could see another pop-up medical shelter.
Hospitals are overflowing. ICUs are close to maxed out. Will Harris County bring back its medical shelter at NRG?
In the first harried weeks of the pandemic, as hospitals buckled under the first wave of coronavirus patients, Harris County Judge Lina Hidalgo was eager to avoid the dire scenes playing out in Italy and New York: She called for the construction of a pop-up medical shelter at NRG Park.
The $17 million makeshift hospital, filled with camp beds beneath a series of large white tents, was never used. It closed just weeks after it opened, when health officials determined area hospitals could withstand their surging caseload. Few then could have predicted the virus’ trajectory.
More than a year later, hospitals are once again besieged by coronavirus patients. Many children are among them. Will the county re-open its field hospital?
It’s possible.
Hidalgo is ready to re-open an overflow facility “the minute local hospital officials request it,” her spokesman, Rafael Lemaitre, told the Chronicle. “Contingency plans are in place” at several unidentified facilities to add emergency space for local hospitals dealing with the latest surge, he said. NRG Park will not be used this time around.
But the biggest need is not space. It’s staffing.
As of Wednesday, more than 720 patients, 95 of them critical, waited in Houston-area emergency departments for an available bed, according to the Southeast Texas Regional Advisory Council. Meanwhile, local hospitals are grappling with a nationwide nursing shortage exacerbated by high turn-over and burnout among staff.
After area hospitals reported grave staffing shortfalls, the Harris County Commissioners Court last month approved $30 million to send more nurses to Houston-area hospitals strained by the surge in COVID-19 patients, many of whom are unvaccinated. Health officials say it may not be enough to confront the latest wave.
“Throughout this crisis, nurses and medical staff have worked long hours, spent time away from their families and sacrificed so much to help us
pull through this crisis,” Lemaitre said. “The least we can do to help them right now is reinforce them with additional staff, but also to urge residents who have not gotten vaccinated to do so.”
Health agencies are studying the possibility of boosters for Pfizer vaccine recipients. Why are Pfizer boosters fast-tracked?
Earlier this month, the White House scaled back its plans to offer coronavirus booster shots to the general public by Sept. 20, citing the need for further review. The Centers for Disease Control and Prevention then said it would consider whether to recommend boosters only for recipients of the Pfizer-BioNTech vaccine.
Pfizer may come first because it is the only vaccine with full approval from the U.S. Food and Drug Administration, said Dr. Wesley Long, an infectious disease expert at Houston Methodist. The Moderna vaccine and the single-dose Johnson & Johnson vaccine are approved for emergency use, but do not yet have full FDA approval.
The Pfizer vaccine is on a faster schedule simply because there is more high-quality evidence proving its efficacy, said Dr. Peter Hotez, professor at Baylor College of Medicine and director of Texas Children's Center for Vaccine Development. Pfizer is the major vaccine used in Israel, he said, and Israeli academics “have been really out in front collecting the data.”
“Unfortunately, the U.S. winds up being dependent on Israel and the United Kingdom to provide our vaccine effectiveness data,” Hotez continued. “Our CDC has come up small, unfortunately, in terms of collecting vaccine effectiveness data.”
With boosters on the horizon, is it possible to be over-vaccinated?
In short: not likely.
But scientists still need to study the risk of severe complications with any booster shot, said Hotez. They need to determine, for example, whether instances of a very rare heart condition known as myocarditis may increase with Pfizer and Moderna boosters.
“I doubt it. But we want to confirm that,” Hotez said.
For now, vaccine recipients should feel well-protected; vaccine efficacy “is not waning against severe disease,” said Dr. Hana M. El Sahly, professor of molecular virology, microbiology and infectious diseases at Baylor College.
Of more than 173 million fully vaccinated Americans, about 13,000 people have contracted a breakthrough infection that resulted in hospitalization or death, according to the CDC. That puts vaccinated people’s risk of severe disease at 0.0075 percent.
“The booster shot seems to be safe. Is it needed? That is what CDC and the FDA are debating,” said El Sahly.
Are masks with respirator valves as effective as those without?
Masks are here to stay. Unfortunately, not all masks are created equal.
Masks with exhalation valves or vents put both the wearer and anyone in their vicinity at risk, experts said. Filtration units rarely work as promised, providing a pathway for virus droplets to enter and escape. The CDC has strongly discouraged their use.
“If you are letting exhaled breath pass for comfort, that is not gong to stop spread of COVID,” said Long, of Houston Methodist.
Some companies, including many airlines, have taken note, banning the use of any mask that does not fully cover the wearer’s face — including those with vents or valves.
Doctors recommend highquality cloth masks or standard surgical masks that have been proven effective against the spread of coronavirus.
“No need to get fancy,” El Sahly said.