The stats for COVID in Texas were once again mixed for the last two weeks (ending October 16) but the most important indicator, hospitalizations, took a distinct turn for the worse.

Hospitalizations

After the summer spike in hospitalizations, that metric has been mostly flat until about 10 days ago, when suddenly new hospitalizations began to rise by about 100 per day.  By the end of the two weeks, general hospitalizations had increased by 1,080 beds (34%) and ICU beds by 247 (22%).  The only silver lining is that the increase has not been nearly as rapid as we saw in early June and the numbers did start flattening out again at the very end of the two-week period.

For reasons I have been unable to discern, most of the increase (~60%) occurred in the DFW and El Paso areas.  Seven of the 22 reporting areas for the State actually saw hospitalizations decrease.  Thankfully, in the Houston area, we have only seen a very modest increase.  There is no region in Texas where hospital capacity is currently taxed.

Fatalities

Reported fatalities continued to inch down.  Average daily reported fatalities fell from 82 in the previous two-week period to 71 during the last two weeks.

The actual date of death data continues to show that the third week in July was the peak of the fatalities at 275 in a single day.  A month ago, when most death certificates should have been filed, fatalities were averaging about 60 per day, compared to 150 two months ago.

Given the increase in hospitalizations, it seems unlikely that fatalities will continue to decline over the next two weeks.  Historically, about 10% of those admitted with COVID to the hospital have died but that ratio has been improving.  Hopefully, if we do see an increase it will not be dramatic.

Testing/New Cases

I have told you many times what I think about testing and new case data, but with that said, daily new cases increased during the two-week period from about 3,800 per day to about 4,200.  The positivity rate based on the daily reports declined slightly from about 8% to 7%.  The State has begun reporting a positive rate based on the actual specimen collection date, which provides the most accurate picture.  However, because of the delay in getting back test results, it is a lagging indicator.  The State has a seven-day moving average and will update the historical values as test results are received.  This means that the daily value reported is not particularly useful but looking at the curve over time gives us some indication of the course of the spread of the virus.

Conclusion

It appears that the effects of relaxing suppression efforts may have gotten the upper hand over increasing natural immunity over the last two weeks in Texas.  There has been a lot of speculation that the increase in cases in some northern states is being driven by colder temperatures and people spending more time indoors.  I am skeptical about that explanation, but if it is true, we should see the opposite in Texas as the cooler weather may get people out of their air conditioning and outdoors.

I continue to believe that we are seeing the opposing forces of the suppression relaxation and growing natural immunity dictate the course of the epidemic.  Opening schools was a significant easing of restrictions and moving around town you can just tell that there is growing public fatigue with the recommended control measures.  We need to keep watching those hospitalizations very carefully.  If the virus begins to get out of control again, that is where we will see it.