COVID rules kick in
Hospitalizations force restrictions on elective surgeries, restaurants
The number of Houstonarea COVID-19 patients requiring hospitalizations, closing in on summer-like levels, hit a threshold Tuesday that will trigger tighter restrictions on businesses and hospitals.
The rollback, mandated under Gov. Greg Abbott’s emergency protocols issued in October, follows seven consecutive days of COVID-19 patients occupying more than 15 percent of hospital beds in the region. The percentage began gradually increasing around Thanksgiving, then spiked in the last two weeks.
Under the protocols, restaurant occupancy may not exceed 50 percent, downfrom75; bars that have not reclassified as restaurants must close immediately; and hospitals must curtail some elective surgeries. The restrictions remain in place until COVID-19 hospitalizations drop below 15 percent for seven consecutive days.
“Honestly, this is just another milestone on the road to a catastrophe unless each of us acts,” Harris County Judge Lina Hidalgo tweeted Tuesday. “We can’t rely on a small occupancy rollback. Do your part.”
Hidalgo on Monday called the rollback “too little, too late.”
Mayor Sylvester Turner did not respond to a request for comment.
The rollback comes as Texas Medical Center hospitals already had begun deferring certain elective procedures or readying such a managed reduction strategy, the same one they deployed during the summer when patient censuses spiked. The reduction is not the wholesale delay of elective procedures all Texas hospitals invoked in the spring.
Hospital leaders said Tuesday that their systems will continue some elective procedures but suspend those non-urgent cases whose demands on staff and space detract from resources better used to treat COVID-19 patients. Procedures such as mammography and colonoscopy will continue because theydon’t tax needed hospital resources, for instance, but some procedures like heart catheterizations might be better delayed.
Bottom line hurt
Business owners struggling to cope amid the pandemic noted the new threats to their bottom line. Shannen Tune, the owner of Craft Burger who in December closed a location in a food hall downtown that should last until at least February, worried about the effect it will have on a Katy site he just launched. The restaurant was off to a strong start with about 200 people coming in a day.
“For me this is kind of rough,” said Tune. “People have been coming out anyway even with everything that has been going on. So to have to cut down on my occupancy right away is concerning. But the health of my employees and custom-ers come first, so we’ll figure that out.”
The surge of COVID-19 hospitalizations has been relentless. The number of admitted COVID-19 patients in the Houston region has increased for 13 straight weeks, and the 25-county area anchored by Harris County had more than 3,100 hospitalizations on Monday, the highest since July, the peak of the firstwave in Texas.
Houston Methodist was just short of 700 COVID-19 patients on Monday. Methodist CEODr. Marc Boom emailed employees that if this trend holds the system will surpass its peak July numbers in a matter of days.
“This may well be among the most challenging few weeks we’ve experienced during this pandemic,” Boom wrote in the email to employees Monday. “Together, we will get through this, but it will be difficult.”
Dr. James McCarthy, chief physician executive at Memorial Hermann, said his system exceeded 800 patients and should eclipse July numbers by the third week in January. The system’s number of patients has increased threefold over the last month, he said.
Under Abbott’s order, hospitals must postpone elective procedures not medically necessary to diagnose or correct a serious condition “without timely performance of which might leave the patient at risk for serious adverse medical consequences or death.” But it gives hospitals latitude to perform such procedures “as long as they don’t deplete capacity needed to cope with COVID-19.”
Closing clinics
Boom told the Chronicle that hospitals received notice from the governor’s office Tuesday evening that the order is now in effect.
In the email, Boom notified employees that Methodist has started considering what elective procedures or surgeries “might need to be safely delayed.”
McCarthy said Memorial Hermann is a few days away from invoking the same practice. And Dr. Esmaeil Porsa, CEO of Harris Health System, said it began delaying such procedures just before Christmas.
The Houston region becomes the 18th of the state’s 22 regions to have hit the 15 percent threshold. Hidalgo noted the only major metro area that has not is Austin “and they’re on their way.”
The COVID-19 positive test rate statewide is now at 20.53 percent. Methodist’s is nearly 32 percent.
Porsa said Harris Health is about to enter Phase 3 of its surge plans, which involves closing some of its clinics in order to deploy its nurses and other staff at Ben Taub and Lyndon B. Johnson hospitals, both of which are near capacity. He said the leadership is currently determining which clinics to start with.
Hospital officials said they are encouraged that ICUs aren’t being overloaded with COVID-19. They said their staffs have gotten much better, thanks to better treatment options and nine months of experience with the disease, at getting patients discharged faster now compared to early summer.
But with the Houstonarea now averaging more than 3,300 new COVID-19 cases a day — compared to roughly 2,330 such cases at the pandemic’s height in July— it appears the peak won’t come before late January or February, hospital officials said. They also worry a more contagious strain — not yet identified in Houston but maybe already here — poses an even greater threat ahead.
“January and February are shaping up to be our darkest days, given these record numbers,” said William McKeon, CEO of the Texas Medical Center. “Hospitals lag behind in feeling the effects of increases in cases, so expect the numbers to keep going in the wrong direction before things get better.”
Supporting bars
Brock Wagner, founder of Saint Arnold, said the rollbacks won’t affect the brewery that much because its beer garden is classified as a restaurant and it operates entirely outdoors so the order’s capacity restrictions don’t apply to them. But he said he’s concerned about the bars and restaurants to which the brewery sells its beer. “That’ll be our biggest concern — how we can help support them,” he said.
Restaurant owners said it’s been hard to find enough real estate inside their dining areas to space tables 6 feet apart while bringing capacity to 75 percent. Because of that, Chris Williams, owner of Lucille’s, said he’s kept his indoor dining area to about 60 percent capacity. He wishes the political decision-making went more smoothly, but he’s supportive of reducing the number of people inside his restaurant.
“I don’t like the back and forth,” he said. “But I’m supportive of doing what we need to do to get past this.”