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Austin health leaders not likely to move to Stage 5 Thursday, but warn city is on the cusp

COVID-19 hospitalizations have surged in the Austin area.

AUSTIN, Texas — As coronavirus hospitalizations surge and Travis County nears Stage 5 orders, Austin leaders said they will likely not move into a Stage 5 status Thursday, KVUE's Tony Plohetski confirmed.

Health leaders met with experts at the University of Texas Wednesday to review data, and decided that Austin does not need to enter Stage 5 status in terms of risk guidelines. However, leaders warn that the city remains on the cusp of the transition.

On Thursday morning, Austin City Council members will hold a special-called meeting to discuss new ways to enforce state and local orders during the pandemic. That could include creating a penalty for violating health rules meant to prevent the virus from spreading.

Dr. Mark Escott, Austin's health authority, said Wednesday during a press conference that the seven-day moving average for new hospital admissions was 75 and added that the threshold for entering Stage 5 was 70 to 123 new admissions, depending on the trajectory. 

As a result of hitting the seven-day average of 75 new admissions, Escott said he and other City leaders would meet to look at the updated COVID-19 model based on the current numbers so that they could determine if transitioning to Stage 5 is necessary. 

Another determining factor Escott made was whether or not Austin was within two to three weeks from exceeding ICU capacity. 

"Our goal here is to avoid overwhelming the healthcare system," Escott said. "If we are at that trigger point, then we expect that decision to be made within the next 24 hours."

WATCH: Coronavirus in Austin, Texas: Austin leaders hold a live Q&A as county nears Stage 5

Escott urged people to take a number of safety steps, including considering not going to church in person. 

Escott said wait times from getting a COVID-19 test to getting a result continue to be seven to 10 days or longer. Escott said the turnaround time used to be two to three days. CommUnityCare is awaiting results on an estimated 2,000 tests, according to city officials.

“We are getting results after the person is no longer infectious,” Escott said.

Dr. Escott said he supports masks in schools and hopes “that we can open schools and keep them open.”

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MEDIA Q&A:

Question: So first, I want to ask about some of the outreach efforts to vulnerable communities, especially Latinx and Black Austinites wher disparate rates of infections and hospitalizations are seen. So what kind of outreach is being done to make sure people are getting tested, know about isolation options and are taking advantage of other resources like the hotel rooms? How are you measuring, you know, the success of these outreach efforts and what are the results thus far? 

Answer: We are seeing an increase in the number of individuals that are coming in for testing in the Latinx and African-American communities. It has been very important for us. Early on, we established a social services branch. That social services branch has either been City of Austin staff and/or our partners. And those partners have provided information about testing, about the isolation facility, about the importance of ensuring that you get a test and any of your contacts get a test, as well. And so, we know that we are seeing those increases by the individuals that are coming in. But we're also seeing the increase by the number of people that are testing positive. One of the other things that is really important for us is to ensure that our staff and our partners that we contract with, as they are providing additional outreach and information to our community, is making sure that they know all of the risks that are associated. So if an individual is taking a test, our recommendation is that they should assume that they are positive until they receive notification from us that says that they are not. We don't want them to go to work. We have used the rise program with several of our partners and we have been able to provide financial assistance, working through over 40 nonprofit partners, through our community. And through those efforts, a significant amount of the funding has gone to the Latinx and African-American communities. And we feel very confident that that process is working well. However, we are open to communication from our partners to let us know if there are areas we have established to three community sites. Two of them were open yesterday and we're really feeling good about those sites. And we will continue to provide that testing in those communities.

RELATED: Austin Public Health opens 2 new COVID-19 testing sites to better serve Latino, Black communities

Question: Asymptomatic people who tested positive in the last few weeks are being denied a new test to see if they have fully recovered. Some companies are requiring a negative result so they can go back to work. Are you planning to include them for new tests in the near future?

Answer: So, we do not support the two negative testing or three negative testing strategy for clearance of individuals. The CDC also recommends a time-based clearance. And quite frankly, we do not have the capacity in the labs to test everybody multiple times to prove negativity. There is a lot of value in the clinical clearance, the time-based clearance. And we are supporting that effort in our community. Certainly, if employers want to have a negative testing strategy for clearance of individuals, they can work with private labs and offer free testing for their employees if they're going to require that for return to work.

Question: Mayor Adler said Austin is competing for testing supplies and lab results because of increased demand statewide. How is this affecting testing capacity at Austin Public Health and other sites? Is it getting worse, better or holding steady?

Answer: So the lag time in test results is holding steady and perhaps getting a bit worse. You know, just on CommUnityCare's tests from the past couple of weeks ... they're still waiting on 2,000 results and they have a very small percentage of those that have resulted already. And this is what I was talking about yesterday in terms of not being too comfortable with the fact that we saw a decrease in positive tests over the weekend. We are missing thousands of results. So it's really difficult for us to tell if things are getting better or not, because we're not getting the turnaround times that we used to. We used to get turnaround times in the neighborhood of two to three days. Now, it's seven to 10 days, sometimes longer than that. So we are competing. And as Director Hayden said earlier, we don't want people to wait on a test to take action. It's COVID-19 season right now in Texas. If you have symptoms of COVID-19 during COVID-19 season, which we're in, you have to assume that you have COVID-19 and take those protective actions to reduce the risk of transmission to family, to friends and to the rest of the community.

Question: Can you just kind of provide more of an update on testing? How long is the wait time now from getting a test to when someone can expect a result? 

Answer: Again, there's substantial variability based on who's doing the testing and which labs those are being sent to. We have a great partnership with a lab called AIT, and we usually get results in about two days. The nice thing about that is the test results are automated. So individuals are notified via email or text that they have a result as soon as that result comes out. So in that system, we're not relying on a fax coming in to receive the results. We get them relatively instantly. But for other labs, particularly the national labs such as Quest and Lab Corp, we're seeing seven-to-10-day turnaround times. Yesterday as an example, at one time, we received 289 results from one of those major labs. And those tests were done around June 26. So, 11 days between when the person was tested and when Austin Public Health received the results of those tests. At that stage, the test results are relatively useless for us because the purpose of the testing is to identify the contacts, to isolate the positive person their contacts, get their contacts tested to box it in. But, if we're getting results after the person is no longer infectious, that strategy doesn't work. Which is why we need people to take protective action when they become symptomatic. We need people to utilize crowdsourcing for notification of their contacts. So if you develop symptoms of COVID-19, it's important for you to contact those who you know you were in close proximity to during the 48 hours before you develop symptoms and let them know that they need to protect themselves. They need to isolate themselves so that we can break the cycle of transmission.

Question: Schools are set to open next month regardless of what stage public health sets for the City of Austin. Is APH advising local school boards? If so, what is your advice on reopening? What advice do you have for parents, students, teachers, administrators and support staff?

Answer: So we've been in regular contact with the area superintendents for more than a month now regarding plans for reopening. Of course, much of the direction comes from the TEA as well as their school boards regarding the individual school districts and how they will proceed. I do support the concept of offering an option for in-person and for virtual. We have to realize that right now the statistics support the concept that school-age children are less-severely impacted, generally speaking, from COVID-19. But, there are going to be some children and they're going to be some households that are going to be higher risk. We're going to have faculty and staff who we're going to be at higher risk for complications, including hospitalization and death. So the plans have to allow for some flexibility to allow parents and employees to make decisions based upon their individual risk. I will say that I know there's a lot of controversy about masking ... in having school children wear a mask. I was happy to see that TEA made that mandate. I think similar to the discussion we have with keeping businesses open ... if we don't have masking in schools, we are losing the most effective way right now for us to keep schools open. So masking is important. I know it's going to be a changing culture for students, but it's a culture that we'll adapt to. And I'm hopeful that the school districts will enforce that and that we can all work together to open schools and keep them open.

RELATED: TEA says it will ensure remote instruction is available to all; masks to be required at schools

Question: A few weeks ago, APH announced the creation of a special task force to help the Latino community tackle the coronavirus. We have been given weekly updates as far as what this group is doing to assist in educating our community. We also learn of spaces that will allow for people to isolate themselves. PSAs were made. Nonetheless, the Hispanics in hospitals are still leading the charts, and unfortunately, 41% of the deaths in Austin. Is the task force meeting weekly? Are they changing their strategies, seeing that the numbers are changing? Please give us an update on the work this group is doing.

Answer: The internal group that was established on June 11, at the time, the acting assistant director, Adrienne Sturrup, provided some information to our mayor and council about the overall plan to address COVID-19 response for our communities of color. And so there have been several things that we have done. One, we've had a Saturday meeting with the Latinx population to receive information from them about aspects of the response, which will be important for us to provide in response. And so as a result of that, a small team of individuals from Austin Public Health, CommUnityCares and Dell Med and UT have taken the response from Adrienne Sturrup and have come up with another document and come up with a working plan. That working plan, we've sent that out to some partners over the weekend. We are going to provide the information to our mayor and elected officials later on this afternoon. That document will be posted on our website. And our hope is, is that based upon the additional information in that plan, we will go ahead based upon feedback that we receive from the community, that we will in turn continue to do more efforts. So we know we need to increase the level of the efforts that we have started thus far. But we also want to do more. So, that is forthcoming.

Question: In reference to the discussion at Commissioners Court yesterday, what is the update from UT regarding the trajectory of hospitalizations that could indicate the need for a Stage 5 recommendation? How will that trajectory be measured or sized up? 

Answer: So basically, we're meeting with UT at noon today, along with other stakeholders, and they will provide us with an updated model looking at the data from the last week to determine if we're at the trigger point of needing to make further recommendations to dial things down. You know, it's primarily based upon the rate of hospitalizations, the new admissions. But we also realize that right now the pinch point seems to be our ICU capacity. So we're looking at models related to ICU capacity and whether or not we're within two or three weeks of exceeding that capacity. If that's the case, then we'll need to make the decision to have further restrictions. Again, you know, our major goal here is to avoid overwhelming the healthcare system. We really want to avoid having to use alternate sites of care for victims COVID-19. And, you know, if we're at that trigger point, then we expect that decision to be made in the next 24 hours. But again, there are other factors that go into that, including the hospital capacity, ICU capacity, the doubling time of cases, the doubling time of the increases in the hospitalizations. And so there are a number of things to consider before making that decision.

Question: Mayor Adler has talked about the possible need for a 35-day shutdown to kind of slow transmission of the virus. And if either of you could kind of talk about what that would actually look like. Like what types of businesses would close? What would remain open? And then what's the current thinking on the legality of mayors or county judges issuing an order like that? Would they be able to actually enforce that order under the governor's current executive order?

Answer: So my hope is that this would be a dialog with the state. I think Gov. Abbott has been very reasonable in terms of listening to the data and listening to the recommendations of the local city and county officials for the jurisdictions that are being heavily impacted right now. I don't think the governor wants to see people unnecessarily die. And, you know, I'm hopeful that partnership will continue and that if we make the recommendation that we need to dial things down further or dial some things off, that will be a productive dialog. You know, we are looking at different options for turning things down a bit more than we can legally do within the governor's executive order. Part of that discussion will happen tomorrow at city council. But, you know, it's up to all of us. We don't necessarily need to turn things off for people to stop going to those places. If you remember back when we had, right before the shelter in place, we were advising people not to go into restaurants ... to do takeaway and delivery only. You know, we can do that now. Folks can choose to not go into restaurants and to do takeaway and delivery. They can choose not to go into retail stores and do takeaway and delivery of retail items. We don't necessarily need to turn things off if, we as a community decide to turn things down on our own and take action to prevent further spread. None of us, including director Hayden and I, want to make the recommendation to go back to a shelter in place. We know that it hurts people. We know that it threatens people's employment. We know it threatens the economy. And we want to find that balance between a healthy economy and the health of the community. And that's why we're pleading with people today to make the choice to dial things down their own, to act in a more protective way so that we do not have to face that decision of making the recommendation to go back to a shelter in place.

The previous day during a Travis County Commissioners meeting, Dr. Escott said data showed Austin-Travis County may have reached or surpassed an average of 70 daily COVID-19 hospitalizations. This rate could trigger Stage 5 orders, which means that leaders would likely recommend a shelter in place, Austin Mayor Steve Adler said.

According to a joint statement from Ascension Seton, Baylor Scott & White Health and St. David’s HealthCare July 7, there are about 24% of staffed hospital beds remaining and 15% of staffed ICU beds remaining.

WATCH: Criteria met for Austin-Travis County Stage 5 response

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