The very thing that made the holidays great before COVID is striking fear into the heart of the healthcare system – families gathering and being merry.
There’s plenty of reason to suspect that the holidays will send cases skyrocketing. Two weeks after Halloween, the greater Houston area saw an uptick in positive cases, adding an average of 1,270 positive cases a day (disregarding data from an abnormal day when Montgomery County released case numbers from the previous two weeks). That was the first week since September that the Houston area logged a daily average of more than a 1,000 cases – and the cases continue to climb.
Mia Gonzaga, a nurse who cares for COVID patients at Houston Methodist Sugar Land Hospital, said she’s not optimistic for how the numbers will look two weeks from now.
“I was expecting it to get pretty bad after Halloween because people go to parties ... and it has gotten pretty bad,” Gonzaga said. “I'm expecting it to get worse two weeks from Thanksgiving.”
The effective reproduction rate or R(t) is a key measurement for viral spread – when it’s above 1.0, the virus is spreading quickly. As of Tuesday, the R(t) for the greater Houston area is 1.24, up from 1.22 last week.
Harris County remains at the highest COVID threat level and County Judge Lina Hidalgo issued several calls for the public to cancel their Thanksgiving gatherings going into the week.
“Look, right now, we can’t afford for the numbers to get worse,” Hidalgo said in a public statement.
As the COVID positivity rate grows, so has hospitalization. Over the past seven days, the TMC has admitted an average of 161 patients a day into their hospitals; last month, Houston averaged 92 hospitalizations a day.
“Right now, everything feels okay, but if the numbers continue to grow and the virus continues to spread, we'll probably be at capacity pretty soon,” Gonzaga said.
Like many healthcare workers this year, Gonzaga is not spending Thanksgiving with her family – not because she’s working, but because she contracted COVID through her work and is still recovering. Gonzaga said it’s a necessary risk of the job.
“It's more common than we'd like it to be,” she said. “It sucks, but I'm not surprised or anything. It’s part of the job.”
Currently, 92 percent of ICU beds in the TMC are filled and there are contingency plans to expand the ICUs should the hospitals reach capacity.
Although they can increase beds and space by taking over other hospital units, the healthcare system can’t create nurses and healthcare workers out of thin air.
Gonzaga said that even with adequate PPE, having to care for an increased number of COVID patients makes it harder to avoid getting sick.
“The medical system works in general, but when people are gathering and not wearing masks, you kind of overload the system with COVID patients,” Gonzaga said. “We have to take on more patients as nurses and it’s more exposure and more risk for us.”
When Houston’s COVID numbers peaked midsummer, the hospitals hired extra doctors and nurses to help the overloaded system. But with the holidays, healthcare systems across the country are likely to see parallel spikes, meaning there likely will not be as many hands available this time.
“Everyone's kind of scared of that,” Gonzaga said.
According to Hidalgo, the current rate of growth of the city’s COVID ICU population is the same as it was before in early June.
“We were on the edge of a crisis of our healthcare system,” Hidalgo said. “Twelve hundred people died just in the month of June and we don’t want to be there again.”
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