What Happened in Houston

The U saw one of its highest ever increases in cases yesterday, more than thirty four thousand, five hundred new infections, close to the peak in April. New modeling predicts the virus will kill a hundred and eighty thousand Americans by October. It's causing some states that were previously lays a fair about IRIS restrictions to take more stringent measures like face

mask orders and internal quarantines. The virus is now ravaging some states that hadn't been hit as hard in previous months, states that were slow to enforce lockdowns or quick to lift them. One of those states is Texas. Cases and hospitalizations there are surging as a result. Texas Governor Greg Abbott announced and in an executive order today that it was putting the brakes on its phase reopening. While businesses that were already permitted to open can stay open, the

next phases of reopening have been put on hold. The situation is most dire in Houston, where some experts expect the virus outbreak to swamp the city's medical infrastructure by July four, and Houston is the subject of our main story today. Bloomberg reporters and the Court and Joe Carroll report that if cases keep rising at their current pace in Harris County, which includes Houston, they will triple or

quadruple by mid July. I spoke with Emma and Joe today about how the city's hospital system expects to manage the crisis. How did we get to Texas being the new hot spot of COVID? You know, Texas shut down. The governor was reluctant to shut anything down back in back in March and April, as we saw COVID erupting in places like New York and Chicago. Eventually did did did order a lockdown of sorts um you know, and

it seemed like it was it was working. The case load stayed low, relative to what were hot spots at that time. Hospitals were fine. And after after a few weeks so they reopened surgeries to you know, reopened doctor's offices and and and then at the beginning of May just began reopening the entire state. It was phased, you know, you know, if you were owned a restaurant, maybe you

could go to your occupancy. You know, it wasn't a full on reopening, but but the numbers stayed low and and things really didn't sort of explode here until right around Memorial Day, late May, the cases started to really take off positivity rate with through the roof, and that has continued and we we get to where we are now. We're in the Houston area. Anyways, the intensive care units

are all used up. They're going to have to convert some other beds over to to make some space, and the projections are of the case load world, we'll just continue higher. You know, what has been the response of of health workers, of physicians, of hospital workers to this development. We've heard a lot of understandably concerned from medical providers, um, you know, saying we don't really know what the coming days and weeks will bring, and you know, in particular

for them, you know, as for I think everyone. You know, the example of New York City and what happened to our hospitals. You know, that example really looms large and cast kind of a dark cloud over you know, medical providers all around the country. You know, they don't want to see the same thing happening in their own emergency departments,

in their intensive care units. And and yet you know, as these intensive care unit beds fell up, hospitals can of course expand their capacity, right um, But the concern here is really you know, once you start exceeding those traditional I see you beds, you know how much further can you expand capacity? Right? So I spoke with the head of the Texas Medical Center, which you know describes

itself as the largest medical city in the world. It's based in Houston, and Bill McKeon said to me, do we think that we can care for those patients and provide them a bed and provide them and do we have the proper amount of personal protection equipment? Do we

have the proper amount of ventilators? Yes? On all accounts, So in that sense we feel but remember, capacity is like a giant bathtub that at sooner or later if water goes unchecked and the faucets are filling, then at some point any place, even the biggest medical city in the world, will overflow. And Joe, you know, what is the the sense on the ground in Texas? Are people wearing masks? Are people getting a sense that, you know, this pandemic is not over yet? What what is the

feeling in say Houston? For many weeks there was a sort of an undercurrent that a lot of the precautions that have been taken, we're overkilled, that masks were silly, um and and and there's also there is a deep strain of of you know, this this las fair approach where the government doesn't get to tell me what to do. That's very, very ingrained here, even in the metropolitan areas. Over the last couple of days, that has taken quite a hit because the numbers coming out of the medical

center in other places of and so alarming. There seems to be a little more acceptance there. There's there's a lot of fear when you when you know, when you hear that that the all the I c U ben are are taken up, or most of them are taken up. I mean it frightens people, and so the community is

pretty divided. There are still folks who saying, look, mask won't help, you know, who sort of sneer at the formal recommendations, and then of course their neighbors are angry with them because they'd really like to see you wearing a mask. This morning, the governor surprised everybody when he came out and he said, the reopening is on hold.

You know, it had been set to be a phase reopening, and so we're you know, depending on the line of business you were in, you were open to maybe fifty capacity, you're uh, and then on a certain date in the next few weeks you were going to be allowed to go to seventy some to that. So he froze all

of that, which nobody saw coming. Is there any sense from from the medical community that perhaps with the new drugs and the new therapies that have started to become available, like from desevere and whatnot, that even though there is a high or case count, that perhaps you know, the death rate will not correspondingly rise as well in safe places like Texas if you think about it, like in the start of this pandemic, we were talking a lot

about building, you know, creating more ventilators. You know, we're still kind of talking about, you know, producing more testing supplies, things like that. So we've had some time to prepare, and a lot of the hospitals I spoke to in Texas as well as in Arizona, where there's also you know, a rising hospitalizations, have said we are better prepared than

we were before. We have personal protective equipment, Whereas at the start of this pandemic, I mean, there were some really horrifying reports coming out about what, you know, frontline medical providers were wearing to go to work at this with this really highly infectious disease on the loose. But

you know, across the board, preparation is better. But I think what's important to note, and I spoke with a really wonderful doctor and professor in New York UM who said, you know, there's a lot of things you can do to prepare UM now that we have all this information about the virus, but until you're in it, it can

be hard to know if you're really prepared. And I think we've heard that also from you know, hospitals in Texas and Arizona saying we think we're prepared, but reasonably, there's only so much stuff we have, right There's a limit to how many doctors we have. You can't stockpile respiratory therapists the way you can, you know, mask, So

this is just something to keep in mind. You know, there we have a lot of medical infrastructure in this country, and we have the ability to to bring in volunteers or even travel providers from other parts of the country, but there are going to be some serious limits. And I think it's worth pointing out that in some of the parts of the country where we're seeing these cases

take off, it's also extremely hot outside. I'm not a field hospital expert, but I think what we did in New York when putting a field hospital in Central Park kind of most iconically. I don't know how feasible that's going to be in other parts of the country where

it's just so hot outside. What are either some lessons perhaps Texas can take from some of the former hotspots like New York in kind of charting a path forward, or alternatively, what are some new factors that people are going to have to take into account, like the heat in Texas in the summer that is going to necessarily mean a new roadmap that people are going to have to start writing a new guide book of how to deal with a COVID outbreak In a state like Texas,

the heat has been a real challenge and and and there's there's no blueprint for for how to deal with it. I mean, it's it's it's in the nineties fahrenheit here every day now, it's especially in South Texas, and it's extremely humid, and that strives everybody indoors. Everybody's got an

air conditioning running. And the question, the unanswered question, is that actually contributing to the to the sort of the bloom and cases we're seeing because indoors it's transmitted more easily and you just don't stay outside all afternoon like like you might if you were, you know, in Chicago or Detroit or someplace. And it's sort of counterintuitive because when you think about a quarantine, certainly don't think about

you need to get outside in the sunshine. Um when they set up a field hospital here, they did set up one for Harris County. That's the third wild third largest county in the in the country, and it's where Houston is. It was at a at the pro football stadium turned out not to need it because we just didn't have the caseload then. So we spoke with county officials yesterday and they are getting ready to re establish it within forty eight hours when they see sort of

the overflow. I see you beds that we talked about, If they'll start to fill up, then they're gonna they're gonna go open this field house and it is it is air conditioned. You said you could not do it outside and at this climate. Something we're also hearing out of Texas has been this tendency towards you know, the cases that are new are a lot in younger age groups. Are young people inadvertently spreading the virus in the community, you know, thinking that they're young and healthy, not taking

precautions because they don't think that they're at risk. Folks were starved of of of of a social life for more than a month, and so when when clubs and taverns and restaurants started to reopen, especially here in Houston, in places like Austin, Dallas, uh, young people predictably flocked to them. The medical authorities do think that played a big role in our surge here as much as the younger folks aren't tend not to be fragile. They're also

really hard to scare. And so you could talk about this virus being out there and there there is a certain segment of community that thinks, well, that's you know, I get the flu every year and I'm not I'm not eighty years old. I don't need to worry about it. And so it seems that the folks trying to trying to convince everybody to mask up have a challenge on their hands. I mean, what would you say, is is something that can be done or should be done on

the ground in these states right now? I think going forward in the in the next two weeks, maybe three weeks, what we that will determine the path States like Texas take what they're gonna watch. You know, we are seeing the sort of expected rise in in case in caseloads, you know, due to so many weeks after after the state reopened. Question is is COVID nineteen is lethal this time around, as say it was when it when it ravaged New York. We don't know that it's not yet.

We're not seeing those kind of fatality numbers, and I really think that will drive what what the politicians do if we see that sort of tragedy, I think that they will rethink how how hard they want to go on businesses and on residents. Frankly, with the next when we have our next pandemic, if it is not as lethal, I I don't think there'll be the political will to change things. That was Ema Court in New York and

Joe Carroll in Texas, And that's our show today. For coverage of the outbreak from one and twenty bureaus around the world, visit Bloomberg dot com slash Coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Topher foreheads Jordan Gaspore, Magnus Hendrickson and me Laura Carlson. Today's main story was

recorded by Emma Cort and Joe Carroll. Original music by Leo Sidron. Our editors are Rick Shine and Francesca Levi. Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening.