Has Texas stopped trying to contain the COVID-19 outbreak?
In a meeting with Donald Trump last week, Gov. Greg Abbott told a brazen lie to news cameras. Texas, he said, has “been able to contain the spread” of COVID-19.
In reality, the number of daily new fatalities and confirmed cases continues to rise in the state week after week. And while growth is not exponential and hospital capacity remains ample, growth is growth — and certainly not containment.
Containment, as least as the term was originally used at the start of the pandemic, does not mean a dip or a plateau in a state or country’s infection rate. It means employing widespread testing, temperature-taking, and enough contact tracing to identify and isolate remaining carriers of the virus. If the number of cases explodes, containment becomes less feasible and officials apply blunt mitigation strategies, like business closures and stay-at-home orders, to return the number of cases back to a manageable level for tracing.
That’s how countries like China, Taiwan, and South Korea have been able to actually contain their outbreaks, which is to say that new cases are rare or near-zero.
Ideally, if cases are few and far in between, health officials can once again focus their efforts into the labor-intensive process of tracing, surveillance, and case management; strategies that have been likened to a police investigation to stamp out the last (or emerging) pockets of the virus. But contact tracing means little if the number of new cases exceeds what healthcare workers attempting to track and eliminate the virus can handle.
In Texas, the several hundred trained staffers the state is aiming to hire to conduct contact tracing are marching into an uphill battle. The state is already reopening most businesses and the state’s stay-at-home order has been lifted. In fact, the day Abbott allowed the statewide lockdown measure to end two weeks ago, Texas saw its highest-ever peak in daily new fatalities: 50 Texans dead from the virus in a single day.
In routine press conferences updating Texans on plans to reopen the economy, Abbott has shied away from discussing the number of daily new fatalities and cases, which on average, trend only upward. Instead, the governor has focused on the number of tests, hospitalization rates, the state’s infection rate, and the number of Texans who have recovered from the virus.
Those are curious statistics to hone in to justify the state’s reopening.
Keeping a stable rate of hospitalization, a mild positive growth rate, and boasting about recoveries reveals a lot about Abbott’s strategy, which is not containment, but a clever calculation of just how much the state can reopen before hospitals are threatened by capacity.
That much was confirmed in leaked audio of a phone call between Abbott and state lawmakers last week.
“The goal never has been to get COVID-19 transmission down to zero,” Abbott can be heard saying in the recording after admitting that more Texans would surely get infected by his decision to reopen the state.
“It’s simply not either scientifically or mathematically possible to get to zero in the transmission rate, whether it be for COVID, whether it be for the regular flu, whether it be for any type of infectious disease,” Abbott continues in the recording.
As countries like China and South Korea have demonstrated, it is possible to get an infection rate close to zero, or at least below 1 percent, a sign that the outbreak is shrinking. In Texas, the infection rate varies but rarely falls below six percent, the state’s threshold for doing a good job — which again, is still positive growth.
Without a vaccine or sufficient herd immunity, tracing, testing, and lockdowns have all been in the service of what health experts call creating a “new normal.” The virus may not be gone, but with little to no cases, basic social distancing, hygiene, and tracing can do most of the work, save lives, and prevent a second wave of cases as economies reopen.
In South Korea, the shift away from state-enforced social distancing measures and policies has been dubbed “everyday life quarantine.” It only came about after the number of new daily cases in South Korea dropped to around 10, sometimes zero. Most strikingly, the country’s capital, Seoul, saw no confirmed cases for two weeks before the government changed up its pandemic response.
When Abbott privately tells Texas lawmakers that it’s impossible to get COVID-19 transmissions down to zero, he means it’s impossible to do so while trying to reopen large swathes of the economy prematurely. It’s proof that Abbott’s strategy isn’t really containing the pandemic but managing its growth just enough to make executives, donors, and rightwing lawmakers comfortable.
As Texas continues plans to reopen nonessential businesses, there is little doubt Abbott will once again tout the manageable number of hospitalizations and the number of recovered Texans as evidence for how the state is weathering the pandemic. It pays to ask the governor why so many Texans needed to visit the hospital or recover from the virus in the first place.
Photo: Aaron Lavinsky/Star Tribune via Getty Images