COVID Stage 4 “Imminent” as Delta Variant Looms

Austin Public Health reports troubling increases in new cases and hospitalizations

Austin Public Health administers vaccines in March (Photo by Jana Birchum)

Less than a week after Austin and Travis County returned to Stage 3 of the local COVID-19 Risk-Based Guidelines, local health officials are saying that moving into Stage 4 is "imminent," as Austin Public Health reports troubling increases in new cases and hospitalizations. (Update July 23: APH announced Friday afternoon that Austin has re-entered Stage 4; read the story here.)

As of Tuesday, July 20, the seven-day moving average for new hospital admissions stood at 31 – the first time since March that this key metric has risen above Stage 4's threshold of 30. (In early January, it peaked at 93.7; it was at 6.6 a month ago.) Officials are waiting to confirm the trend before declaring a reentry into Stage 4, but recommend that everyone – regardless of vaccination status – wear a face mask while indoors.

Even under Stage 4, Austin Public Health says that fully vaccinated residents may attend private indoor and outdoor gatherings, dine, and shop while masking and observing distancing and hygiene protocols. For those who are partly vaccinated or not at all, gatherings of any kind are not recommended, with or without masks; those individuals should limit themselves to only essential travel, shopping, or dining outside the home.

The move comes amid news this week that the highly transmissible Delta variant accounts for more than 80% of new U.S. coronavirus infections, according to the Centers for Disease Control and Prevention. In a U.S. Senate committee hearing on Tuesday, July 20, CDC Director Dr. Rochelle Wal­ensky called this a "dramatic increase" from the agency's estimate only two weeks ago that 50% of U.S. cases were caused by Delta. In addition to being more transmissible, Delta is more likely to lead to hospitalization than the Alpha variant, which remains the cause of almost all new COVID-19 cases in Austin. APH reported only four Delta cases last week, with one patient requiring hospitalization.

Though Delta is still being held at bay – for now – in Aus­tin, APH is concerned about the impacts of both the variant and continued vaccine hesitancy, especially on younger children who still aren't eligible to receive the vaccine. "We're seeing a larger percentage of younger people being hospitalized in recent days," said Health Authority Dr. Desmar Walkes. "We're also learning that there's an increase in the number of children that are being admitted due to COVID-19."

The trend underscores the importance of children 12 and under wearing masks as they return to school next month, said Walkes. The American Academy of Pediatrics released new guidance this week that all school staff and students as young as 2 years old wear masks during in-person learning, regardless of vaccination status. Texas school officials' hands remain tied by Gov. Greg Abbott's executive order banning them from enforcing mask mandates. (Update July 22: According to Austin ISD officials, the district must and will enforce parents' wishes for their children to wear masks.)

Almost all people being hospitalized in Austin now are unvaccinated; vaccinated people might still get infected but are rarely hospitalized, said Walkes. But the emergence of a more transmissible variant points to the critical role that vaccines play in combating new virus mutations before they lead to breakthrough infections. "People who are unvaccinated have been able to give this virus an opportunity to mutate, to change the way it is able to develop disease in our bodies, and as a result, there are some instances where if you're vaccinated, you get mild disease," said Walkes. "That is indeed what we're seeing."

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