Among the countless health experts and government officials decrying Gov. Greg Abbott’s March 2 executive order ending Texas’ statewide mask mandate and allowing 100 percent occupancy of businesses is Dr. Joseph McCormick, veteran epidemiologist and founder of the UTHealth School of Public Health in Brownsville.
Abbott’s decision, made without seeking input from three of his four medical advisers according to the Texas Tribune, makes Texas the largest state without a mask mandate. The order, which takes effect March 10, came on the same day 6,000 Texans were hospitalized with COVID-19 in the state, 1,700 of them in intensive care units, and during a week when virus cases stopped declining nationwide and cases in Texas began ticking up again.
The last time Abbott relaxed restrictions, in spring, COVID-19 cases and hospitalizations soared and restrictions had to be reimposed. McCormick worries the same thing could happen this time.
“This is not the time to have done this,” he said. “I don’t know what the rationale is. I don’t know if the governor knows something us scientists across the country don’t know, but to me this was not the time to have done this.”
One reason he cited is that Texas cases are more than 7,000 per day over a seven-day average, up from 4,000 per day during the mid-February cold snap. Another is the relatively high rate of hospitalizations and ICU cases.
“Third, in the Rio Grande Valley our case fatality is twice that of the rest of the state,” McCormick said. “And in fact Cameron County, it’s more than twice the rest of the state.”
Case fatality is the ratio of the number of deaths to the number of cases.
“Case fatality is important because it’s higher for Hispanics (and) it’s higher for African Americans, and Texas now has a majority of those populations,” McCormick said. “They continue to be high risk.”
Meanwhile, every known variant of the virus has been found in Houston and is likely already in Dallas and other large Texas cities, he said.
“One only has to look to see what happened in the U.K. with their variant, which is probably one of the least threatening of the variants that we now have,” McCormick said. “There’s too much unpredictability here to now suddenly say we’re going to reopen.”
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease and chief medical adviser for the White House, called the decision by Abbott and Mississippi Gov. Tate Reeves to lift restrictions “inexplicable” and warned that it could lead to a new surge in cases as highly contagious variants gain ground.
McCormick said it’s possible the population will have to be re-vaccinated for variants that outrun current vaccines.
“Again, coming back to the governor’s decision: The whole point here is to try to keep this thing at bay until we can get people vaccinated, because that reduces the risk of new variants,” he said. “It’s a statistical game. The more the virus replicates, the more likely you are to have mutations that lead to new variants.”
McCormick said there are “a gazillion mutations” out there but that most aren’t viable and can’t replicate.
“But it only takes one or two mutations to get a virus that will outcompete the current ones, and it does that in a way by avoiding the immune response,” he said. “It can outcompete them because it’s not being controlled by the immune response, and so it can continue to replicate.”
As the Biden administration ramps up vaccine availability, meanwhile, Texans should get whichever vaccine they can as soon as they can, McCormick said, noting that both he and his wife, fellow epidemiologist Susan Fisher-Hoch, have received the first and second doses of the Moderna vaccine, which McCormick said is basically equivalent to the Pfizer-BioNTech vaccine.
Both vaccines offer good protection against the virus even 10 days after the first dose, he said. The single-dose Johnson & Johnson vaccine just approved for emergency use by the U.S. Food and Drug Administration likewise provides good protection, McCormick said, adding that there is no reason to think one FDA-approved vaccine is better than another.
According to Abbott’s order, county judges may reimpose COVID-19 mitigation strategies if virus hospitalizations rise above 15 percent for seven consecutive days within their hospital region. County judges may not impose jail time on those who don’t follow COVID-19 orders and penalties may not be imposed for failure to wear a mask, according to Abbott.
If restrictions are reimposed at the county level, they cannot include reducing occupancy capacity to less than 50 percent for any time of entity, according to the order. Businesses are still free to continue requiring masks, as many are including Starbucks, Target and Walmart. H-E-B said employees but not customers are still required to wear masks, though customers are being asked to continue wearing masks.
McCormick said Abbott’s order appears to leave county judges some leeway to respond if case numbers get too high.
“I would hope that the judges will take into account what the situation is here in Rio Grande Valley and make some decisions,” McCormick said. “They could be hard decisions but hopefully they might have a look at that and decide that full-fledged non-masking is probably not the best way to go. … We’re at higher risk, not just for cases but for deaths.”
