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The omicron variant has led to a surge in positive cases across Texas, and some hospital regions are seeing numbers of COVID-19 patients that rival last winter.
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The variant, which is now known to be more transmissible than delta and the original virus strain, has also led to the state’s highest rate of positive cases with more than 1 in 5 COVID-19 tests reading positive.
In Texas, the positive case rate surpassed 10% by mid-December, which put the state in a "red zone," a rating for which federal officials encourage more restrictions to limit the virus' spread. More than a week later, the rate has more than doubled, reaching its highest point yet with a 22.3% positivity rate.
The high positivity rates haven’t yet translated into more deaths or dramatic numbers of hospitalizations in Texas, but some states that saw a surge in COVID-19 cases in November and early December are near or have surpassed record hospitalizations from the virus.
Michigan, Vermont, Maine and New Hampshire reached their highest hospitalization rates in December, according to CNN, however, the number of patients being treated for COVID-19 in Texas hospitals is still far below the surges seen during the winter of 2020 and this past fall.
On Tuesday, the Austin American-Statesman reported that the Austin area will be returning to Stage 4, which recommends that unvaccinated and partially vaccinated people avoid nonessential activities, including indoor dining and shopping.
Experts that The Texas Tribune spoke with are seeing an increase in COVID-19 patients in hospitals and anticipate they will rise. But this more infectious variant is having a major impact on hospital staffing, said Dr. James McDeavitt, the executive vice president and dean of clinical affairs at Baylor College of Medicine.
“The difference with this surge is because this is so infectious and everyone is getting sick, everyone is calling out sick,” McDeavitt said. “It’s not as much about the number of people in the hospitals — it’s more about the number of health care workers who they themselves are getting sick and need to be isolated.”
And with many hospitals recording persistent nursing shortages, even if there are available ICU beds, they might not have anyone to staff their departments.
Statewide, roughly 1 in 14 hospital patients are being treated for COVID, but the number is a lot higher in hospitals serving the El Paso area and the Texas Panhandle, where at least 1 in 6 hospital beds are occupied by a COVID-19 patient.
The higher rate of hospitalized COVID-19 patients in the Amarillo area is attributed to lower vaccination rates, a lingering delta surge and resistance to social distancing measures, according to Dr. Rodney Young, the regional chair of family and community medicine at Texas Tech University Health Sciences Center in Amarillo.
“About 90 to 93% of our hospitalized patients are unvaccinated,” Young said. “That number is closer to 98% for critical care, and around 100% for those on ventilators.”
The increasing number of cases in the community have also impacted the state’s elder care and Texas’ criminal justice facilities, where infected staff and visitors can transmit the virus into areas where people often live more closely.
The number of active COVID-19 cases at assisted living facilities in the state has more than doubled over the past two weeks, but the 124 active cases registered on Monday are a fraction of the more than 900 measured this time last year.
“We’re at the beginning stages of this wave, we’re really still watching it,” said Carmen Tilton, vice president of public policy with the Texas Assisted Living Association. “I’m not seeing in the data a wildfire of cases in assisted living facilities in Texas.”
Tilton, whose organization advocates on behalf of assisted living facilities across the state, noted that the best defenses against the virus are adhering to mask policies, screening and testing that can identify cases early on and limiting contact between positive staff, resident or visitors.
“We are going to see outbreaks because when you have high levels of community spread in the surrounding community, you’re going to have a positive case,” Tilton said. “You can’t hermetically seal these buildings.”
Positive cases are again on the rise in the state’s prisons, according to Karen Hall, the deputy chief of staff for the Texas Department of Criminal Justice.
“We have seen an increase just as we do when we see an increase when the community cases rise,” Hall said. “Not as drastic, not as drastic as with the original outbreak or with the delta (variant).”
Hall noted that the largest number of cases over the weekend came from prisons in Anderson and Fort Bend counties, which both have seen an increase in cases over the past two weeks.
Vaccination rates for about one-third of the state’s correctional facilities are above 70% for both prisoners and staff. And for another half of the facilities, vaccination rates are above 50%.
The weekend also led to an increase in positive cases among youth and staff members at the state’s juvenile correctional facilities, with 37 children in Texas Juvenile Justice Department facilities having tested positive for COVID-19. That's more youth cases than the agency registered over the past nine months and the largest single-day positive rate since the summer of 2020.
“I think we know that anytime we’re moving into the holidays, anytime that we have new variants out there, there’s a higher risk of infection and spread,” said Brian Sweany, the TJJD spokesperson.
The agency also recorded 23 positive cases among staff that weekend, including 10 at the McLennan County campus where all but one of the youth cases originated. The agency speculates that these are omicron cases, due to how quickly the virus is spreading but how mild the cases are.
At the agency’s request, the Texas Department of Emergency Management is sending members of the Texas National Guard to four of the agency’s secure facilities this week to help with staffing, Sweany said. On Wednesday, the number of active cases among agency staff had jumped to 35, he said. National guard members have been sent to Texas hospitals and other facilities throughout the pandemic to prop up staffing amid surges. At the juvenile facilities, the guard members will be assisting with tasks like meal preparation, transportation and logistics and will not be in direct contact with the residents, Sweany said.
Those guard members will be in place at least through Jan. 9, he said
The sharp increase in positive cases has been at a level most communities had not yet seen in the pandemic, including in the Houston area, where they went from several hundred two weeks ago, to more than 5,000 average daily cases, according to Dr. Esmaeil Porsa, president and CEO of Harris Health System.
“So far, that crazy increase in the number of cases has not equated to a crazy increase in hospitalizations,” Porsa said. “They are going up but they are not going up proportionally to the number of cases.”
Karen Brooks Harper contributed to this report.
Disclosure: Texas Tech University and Texas Tech University Health Sciences Center have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
Correction, Jan. 3, 2022: An earlier version of this story cited a source who provided an incorrect statistic. One hundred percent of patients on ventilators in Amarillo are unvaccinated, not 60%.