For the last two weeks (ending February 6), all metrics have indicated that COVID infections in Texas are steadily declining.

Hospitalizations

Hospitalizations have now dropped by 30% from their peak on January 12 and yesterday they fell below 10,000 for the first time since before Christmas.  For the last two weeks, hospitalizations fell at 2% per day.  At that rate, hospitalizations would be cut in half by the end of the month.  The IHME model is predicting a more gradual decline in hospitalizations, only falling to 8,750 by the end of the month.  

Texas had been lagging slightly behind the national decline in hospitalizations but made up some of that ground last week.  The national rate last week was only slightly ahead at 2.1%.

All of Texas’ twenty-two reporting regions saw decreases over the last two weeks, including, thankfully, Houston.  The largest declines were in northern and western parts of the State, which had been so overburdened just a few weeks ago.  The smallest declines were in the border regions.  

Fatalities

Reported fatalities finally begin to recede, albeit slightly, with average daily reported fatalities declining from 316 to 312.  The State’s actual date of death data suggests that fatalities probably peaked in the current surge around January 9 at 330.  That exceeded the previous peak in late July of 278.

There has been a very close correlation between hospitalizations and fatalities.  If that correlation continues to hold, we should see fatalities begin to steady decline.  My back-of-envelope numbers show we should be down to about 200 per day by month end, which is consistent with what the IHME model is now predicting.  The vaccination of many of those most vulnerable to fatality could significantly accelerate the decline in fatalities.

Vaccines

Texans continue to get vaccinated at a good rate.  As of Saturday, the CDC reported that over 10% of all Texans had received at least one dose and 734,000 Texans are now fully vaccinated.  Texas still ranks second among the states in total doses administered but is falling behind on a per capita basis.

I am increasingly hearing anecdotally from various people that getting a vaccine scheduled is becoming easier, although many in the approved categories are still waiting.  I suspect we are going to continue to see supply ramp up over the next couple of weeks.

On Thursday, Johnson & Johnson filed for FDA emergency use authorization of its one-dose vaccine.  Their vaccine also can be stored in a regular refrigerator.  Because the logistics of distributing and administering the J&J vaccine will be so much easier and because of that company’s enormous manufacturing capability, this vaccine is really going to be game changer.  The FDA’s outside vaccine panel is set to meet on February 22, where the vaccine will almost certainly win approval.  J&J has said it is prepared to start shipping the vaccine the next day.

Testing Results

Texas’ testing data was once again all over the map for the last two weeks but for whatever value it has it, too, confirmed the lower level of infection.  The number of positive test results declined by 14%, while testing declined by 7%.  The State’s positivity analysis based on the date of collection of the sample peaked just after the first of the year at 21% and has since fallen to 12.5%.

Conclusion

The IHME model has moved the peak infections in Texas back from January 21 to January 1 on its most recent run and now shows daily “new cases” will be below 2,000 by the end of May.  Its newest run has hospitalizations coming down faster than it previously projected and, notwithstanding the daily reported fatalities are still coming in at over 300 per day, the model shows the number is more likely in the 270-280 range currently.  It shows that daily fatalities will be less than 20 per day by late in May.

I think it is clear that the cumulative effect of the high rate of infections over the last couple of months and a growing vaccinated population is taking its toll on the virus’ ability to spread.  The only cloud on the horizon is the effect of the variants.  Of course, if you listen to the media the variants will completely upend our ability to reach herd immunity and we are going to be in perpetual lockdowns and masks.  The headline from this Washington Post story would make one believe the variants may completely reset the game clock on herd immunity.  But when you actually read the story, serious experts, like Harvard’s Mark Lipsitch, are very skeptical that the variants will have a dramatic effect.  The IHME model has now broken out the variants as a separate projection and it shows the variants have very little effect.

There is some worry in the medical community that we will see another surge in the fall.  There was a late third surge in the Spanish Flu pandemic in early 1920.  But no vaccines were ever developed in that pandemic and the world was forced to rely entirely on naturally acquired immunity to end the pandemic. Personally, I don’t see how there will be enough people without some level of immunity in the fall to fuel another major surge.  But, of course, only time will tell.