Health experts talk about the response to the Texas pandemic


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Reports of COVID-19 cases and deaths have declined sharply across Texas since vaccines began rolling out in December. Over the past two weeks, the average number of new cases of the virus reported in Texas has stood at around 1,100 per day. That number at the start of the year was around 20,000 per day. And over the past two weeks, the state has reported an average of 23 coronavirus-related deaths per day, up from around 300 per day in late January.

To a large extent, Texans were able to resume their ordinary routines and social life. Schools and universities have reopened classrooms to students, restaurants are operating at full capacity and employment rates are recovering. As communities begin the healing process, state health experts are examining the scars from the past year to assess what went right and wrong. They wonder: How could governments at the local, state, and federal levels better prepare for the next virus outbreak?

And they also ask Texans to think it over.

Texas Tribune health and human services reporter Karen Brooks-Harper discussed these issues with Dr. Lauren Ancel Meyers, director of the University of Texas at Austin’s COVID-19 Modeling Consortium; Dr Ivan Melendez, the chief medical officer of Hidalgo County; and Dr. John Carlo, CEO of Prism Health North Texas and President of AIDS Arms Physicians.

Hidalgo County had the highest virus death rate in the state for some time, a situation which Melendez says dates back to epidemics that have plagued the region for many years, such as diabetes and the hypertension, in addition to a general lack of access to health. care in the county.

Health experts are approaching the state’s battle with the virus from different angles, but share a key concern: the need for Texas to address health care inequalities linked to demographic and socioeconomic disparities.

Here are some highlights from the conversation, recorded on June 28.

Why is it important to focus on inequality in health care?

Meyers, who is also a professor of integrative biology at UT, said there had been a shift in focus from the state’s urgent needs to finding a way to fill the gaps in health care. health in communities that are also struggling with demographic and socioeconomic disparities.

The university created an online dashboard to show the impact of the pandemic – rates of cases, hospitalizations, deaths and vaccinations – in Austin zip codes, revealing a “very strong correlation” between vulnerable communities and high infection rates, she said.

The tracker also showed that the most socioeconomically disadvantaged communities are two months behind the richest areas in terms of vaccination rates.

“It has disproportionately devastated our most vulnerable communities, and that must be our goal going forward,” Meyers said. “Not only how do we close the gaps, how to fix what is happening because of COVID, but how to make our most vulnerable communities less vulnerable not only to COVID but to seasonal flu, other viruses and future ones. pandemics? “

What made the residents of Hidalgo County so vulnerable to COVID-19, and what can we learn from what the region has gone through?

Hidalgo County, in Texas’ Rio Grande Valley, has one of the highest uninsured resident rates in the country, at 40%, Melendez said; the county also leads the state in rates of obesity, diabetes and high blood pressure. These are diseases that make a person much more vulnerable to the coronavirus.

For these reasons, he said, it’s no wonder the county of around 1.2 million people also had the highest COVID-19 death rate in the state, reaching 5 % at times, despite being what he considers a “sophisticated medical community” with access to a medical school, nine hospitals and 1,500 doctors.

Melendez said that despite these resources, the pandemic has revealed the importance of tackling other chronic diseases in the community and the need for better access to health care.

As of June 2020, the county was seeing nearly 70 people succumb to the coronavirus per day; this rate has fallen to one or two deaths per day. At one point during this summer, around 1,200 residents of Hidalgo were battling the virus in local hospitals; Melendez said that as of June 28, that number had dropped to 48.

Following this traumatic battle with the virus, he said the county now leads the state in vaccination rates, with nearly half of qualified residents vaccinated.

What have been the strengths and weaknesses of the state’s public health system throughout the pandemic, and what structural or financial changes should be made in response?

The power of local authorities to enforce stay-at-home orders was “essential” to mitigate the spread of COVID-19 in its early stages, Carlo said, adding that the motivation of state health workers – nurses, doctors and first responders – is what kept Texans healthy.

As some cities across the state began to run out of ventilators, hospital beds, and space to contain the dead, the state “managed not to cross that cliff thanks to the incredible ingenuity of the system, people on the ground doing all that hard work, ”he said.

The pandemic, however, also showed how “decades and decades” of underfunding local, state and federal health systems have caught up with the state, Carlo said. “This is truly the product we have received when we take for granted the measure of how well we keep our communities healthy.”

How is Texas better prepared for another epidemic or pandemic, and how should scientists and heads of state move forward?

Meyers said the pandemic should serve as a reality check for the country, to show that preparedness is a key factor that could have saved many lives.

Health systems should have been prepared with stay-at-home ordering protocols and contact tracing programs, she said, as well as an adequate supply of personal protective equipment.

In addition to plans on how to protect people from contamination with the virus and be able to treat those who fight it, Meyers said that for the next outbreak, the state should also be prepared to deal with “societal impacts by cascade of how future pandemic threats are going to impact education [and] impact on housing stability, how people will behave and how policy makers [are] will make decisions. “

This conversation is presented by Lone Star College and Texas State Technical College and sponsored by Blue Cross and Blue Shield of Texas, Methodist Healthcare Ministries of South Texas, Inc., Meadows Mental Health Policy Institute / The Hackett Center, Center for Disaster Philanthropy and the Texas Medical Association.

Tribune events are also supported by contributions from our founding investors and members. While donors and corporate sponsors subscribe to Texas Tribune events, they play no role in determining content, panelists, or line of questioning.

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