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How Texas Swaggered Into a Coronavirus Disaster

How Texas Swaggered Into a Coronavirus Disaster

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The state wanted to be among the first to reopen. It’s now dealing with the consequences.

Gov. Greg Abbott of Texas speaking about the state’s response to the coronavirus this month in Austin, Tex.Credit...Ricardo B. Brazziell/Austin American-Statesman, via Associated Press

HOUSTON — For one brief, delusional moment in early April, I felt a smidgen of support for my governor, Greg Abbott. Sure, part of me thought his plan to reopen the state after just a few weeks of lockdown was cuckoo. Medical experts warned of a surge in coronavirus cases if Texas did just that.

But Texas is a big state, I told myself, and why should people out in Mentone or Daisetta have to close up shop when the hot spots were many miles down the highway? And yes, I knew the governor’s fevered, ferocious fealty to President Trump made his push suspect. But really, what kind of person would put politics over the safety of his constituents?

It wasn’t as if Mr. Abbott had done nothing. He issued his version of a statewide stay at home order on March 31, following in the footsteps of brave(r) local officials. Uncharacteristically for a Republican state official perpetually at war with the Democratic cities, he allowed the likes of my Houston mayor, Sylvester Turner, and the Harris County judge, Lina Hidalgo, to use their best judgment when it came to protecting public health — that is, until they tried to enforce mask-wearing, which, to Mr. Abbott’s way of thinking, was an infringement of our treasured individual rights.

Maybe you recall the hair-curling fiasco of early May, when a judge sentenced a Dallas area beauty salon owner named Shelley Luther to jail for contempt of court after she reopened in defiance of Mr. Abbott’s shutdown, which included jail terms for violators.

Ms. Luther became a folk hero thanks partly to opportunistic patriots like Sarah Palin and Ted Cruz. Mr. Abbott contradicted his own order, demanding Ms. Luther’s freedom and insisting that “throwing Texans in jail who have had their businesses shut down through no fault of their own is nonsensical, and I will not allow it to happen.”

But while New York and Washington were in crisis, the number of cases and deaths here remained remarkably low. Maybe Texas was being spared because of a lack of density in our cities or because people drove alone in their cars instead of cramming into subways. Maybe our already rising temperatures were killing off the virus.

Maybe, in contrast to the yahoo stereotype, most Texans were wearing masks, socially distancing and washing their hands and so had actually headed the virus off at the pass, or dodged the bullet, or whatever people think we like to say down here.

And maybe for those reasons, Mr. Abbott became infatuated with the idea that Texas would be among the first states to reopen. As he said, Texans needed to get back to work. That was indisputable. The food bank near my house was already overwhelmed with the unemployed and hungry.

Yes, Dr. Peter Hotez, Houston’s internationally known virus expert, warned of the dangers of opening early, but what did he know? The guy wears a bow tie.

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With cases in Texas on the rise, a rural hospital braces for an outbreak while trying to stave off financial ruin.

One of the difficulties in a small rural hospital is we don’t have a lot of resources. We have two ventilators and four anesthesia machines. If we had six or more critically ill Covid patients, we would be overwhelmed. We don’t have the equipment to be able to support that many severely sick patients. That’s why it’s so scary for rural hospitals. Our county has about 15,000 people. But we have another 33,000 people that go through here everyday on the Interstate. And I’m going to have to go get one of them to bring me another test. And we’ll go ahead and do it while you’re here. OK? We deliver the tests to Snyder, which is 40 miles away. They drive them to Lubbock, which is another 100 miles. Or they could be flown to a lab in Austin. Sometimes, we have test results in seven days. Very spotty, very unpredictable. I just dropped two specimens off. I’ve got to go print labels for one. We’ve had four positive patients in our county. The most troubling piece to me is to know that it’s probably still coming. Nearly two-thirds of rural counties are reporting outbreaks of Covid-19. In little bitty hospitals that a hot spot will pop up. In one week, they have no patients. In the next week, they have 300 positives. Rural hospitals are at a disadvantage. We are all barely hanging on by a thread. Rural hospitals are facing a different kind of crisis, which is how to financially survive during the pandemic, as they shut down elective surgeries out of an abundance of caution. Another month or two of that, that would be unsustainable. We have another rural hospital closing this week. How far do we let the economy suffer for protection? And how far do we let protection suffer for the economy? So today, I’m issuing an executive order that outlines how we go about opening the Texas economy. And I know that’s a difficult decision that we individually are having to make— People were ready to get out and grab a drink. and our hospitals’ are having to make, and that our country’s having to make. Twenty states reporting increases in new cases. Tonight, Texas reporting its largest single day in cases ever. Though the virus hadn’t yet reached us, it was already our enemy. It is concerning that, as we start opening back up, that people just quit self-distancing. And then it does get in our nursing home. Hi, Mom. How are you? Get your phone so we can talk. You’re doing OK? Yeah. I guess I’m doing OK. I love you. I love you. I’ll be there every day at her window until I can get my hands on her. I have a concern that she would die alone. I know that many people in the country have died alone. Back in March, we decided to forgo all elective procedures before we were required to do so, in order to save lives. Typically at 10 o’clock on a Monday, usually this E.R. would be full. It’s sort of a curse and a blessing. A large portion of our income is generated from surgery procedures. Restricting those cost us over $2 million. Everyone took a 10 percent pay cut. It’s very personal. Because these people are friends and colleagues. And you hate to ask them to sacrifice. That’s a very tough decision to make. For days, we waited for a significant number of Covid patients. But at the same time, we were moving very quickly towards financial disaster. I could never live with myself if I was the one that got my kids sick. So the kids, they went to stay with their grandparents. If this hospital couldn’t survive, where would we go? What would we do? Our family’s rooted here. We don’t want to go anywhere. Hi, buddy. Hi, buddy. The presence of a pandemic is just one more financial burden on struggling rural hospitals. High numbers of uninsured patients have forced 128 hospitals to close in the last decade, in Texas more than any other state. It’s staggering to think that there are 11 million people who, in their county, cannot go to a hospital. There are a handful of counties across Texas that don’t have a doctor in the county. To drive 150 miles or more to get to a hospital, that’s absolutely the difference between life and death. When Governor Abbott reopened Texas, there was kind of a mixed sense of relief and fear. My anxiety went through the roof. We reopened our hospital for elective surgeries on May the 11th. It was an absolute necessity to get the funds running again. There are certain pieces that I couldn’t have fixed without help. We had to have federal intervention. The Trump administration promised to rush $10 billion for rural health care providers. That’s money that’s going to support the hospitals that gave up elective procedures, which is how they make so much of their money. We knew then that we would have the money be able to keep the doors open. When the state had been opened up for three weeks, my husband and I wanted to bring the kids back home. Happy birthday, Mom! Happy birthday! Mommy! I actually got the best birthday present and went and got them for my 35th birthday. And they had a carrot cake made for me — or a bunny cake, as they call it. I knew you’d be here any minute! I don’t know what the future will bring. I don’t know if we’ll ever hit that storm of patients to come in. And if so, we might end up taking the kids back to their grandparents. We are a very vital part of these small communities. And most of us get paid less than what it costs us to provide care. We need to be paid fairly for what we do. I think you’re going to see rural medicine continue to kind of just dwindle. And that’s heart-wrenching. Because I think that everybody should have care that’s accessible to them. This is Dr. Liedtke with an update from Sweetwater. Covid has finally arrived. We have over 10 active cases in the county, one hospitalized with critical illness, requiring respiratory support.

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With cases in Texas on the rise, a rural hospital braces for an outbreak while trying to stave off financial ruin.

For a short time, then, I wondered if Mr. Abbott had been right. His three-step reopening plan sensible enough, with Phase 1 allowing restaurants, retail stores, movie theaters and beauty salons to operate at 25 percent capacity.

It was life-affirming to see all those “we are open!” banners flapping in the breeze — to go out to a new restaurant and see all the folks inappropriately shaking hands and hugging one another. I even got a pedicure, protected from my technician with a plexiglass shield etched with the words “Customer Safety First.”

On Memorial Day, the Galveston beaches were packed like Carnival in Rio. And out in rural Texas, folks who had no choice were working away in meat-processing plants. Businesses like Target and Wal-Mart welcomed shoppers without masks as if it were Black Friday.

As we now know, that was then. “Ten days away,” a friend who works for Judge Hidalgo told me the night before the June 2 march for George Floyd downtown, when police helicopters were circling over our socially distanced dinner party — 10 days before we would start to see the cases really spike.

That date coincided with the arrival of Mr. Abbott’s Phase 3, which allowed many businesses to reopen at 75 percent capacity on June 12. Shortly after that, the numbers exploded.

The governor knew better than to blame better testing for the increase, because we don’t have enough testing. Instead, he blamed those rowdy millennials: “There are certain counties where a majority of the people who are tested positive in that county are under the age of 30, and this typically results from people going to bars,” he said.

But, no worries, the governor added; Texas still has plenty of hospital beds. And today, we have more than 130,000 cases, up from over 60,000 at the end of May.

And so, here we are, with a jittery populace and the Texas Medical Center’s coronavirus website competing with TikTok. I.C.U.s in Houston are at 97 percent capacity, with “unsustainable surge capacity” predicted for hospital beds in late July. If “this trajectory persists,” Dr. Hotez tweeted, “Houston would become the worst-affected city in the U.S.” He added that it would “maybe rival what we’re seeing now in Brazil.”

Still, taking his cues from the president, Mr. Abbott refused to issue a statewide mask-wearing order. His latest explanation is that he actually had a plan to require masks all along — he just put the onus on business and store owners to require mask wearing instead of a bullying state government. That Mr. Abbott never stressed this brilliant solution in public was beside the point. It wasn’t his fault that no local officials caught on until this week.

“Earlier today the county judge in Bexar County finally figured that out,” Mr. Abbott said after the judge mandated that businesses require their workers and customers to generally wear masks in the county, which includes San Antonio, last week. “They finally read what we had written.” This is government as a game of Clue: Governor Abbott in the Statehouse with the masked mask order.

Now with the numbers climbing, Mr. Abbott has taken the bold step of hitting the pause button on future reopenings, allowing local officials to limit outdoor events to 100 people (down from 500), closing bars and suspending elective surgeries to save potentially needed bed space. But mainly his advice is just to stay put, which has become easier since New York, New Jersey and Connecticut are now requiring Texans to quarantine for 14 days upon arrival.

“We want to make sure that everyone reinforces the best safe practices of wearing a mask, hand sanitization, maintaining safe distance, but importantly, because the spread is so rampant right now, there’s never a reason for you to have to leave your home,” Mr. Abbott said in a recent interview. “Unless you do need to go out, the safest place for you is at your home.”

In other words, we are all in this together. But we are also completely and totally on our own.

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