Here's a rundown of what health authorities discussed.
Question: COVID-19 in Austin disproportionately affects the Hispanic population. Are you seeing the same type of ethnic breakdown at nursing homes as you are in the general public? If you're not, does that mean the impact on the Hispanic community is even greater in the general public than what we're reporting?
Answer: We're in the process of phasing out the nursing home data from the community data so that we can provide separate race and ethnic breakdowns for our nursing homes. I think this is important because, as I've noted before, the majority of our deaths and a substantial portion of our hospitalizations are related to residents of nursing homes. So, we really want to separate that data and look at the trends separately between nursing homes and the rest of the community so that we can answer important questions like that. And so we can direct appropriate public policy to the right place.
Question: Austin and Travis County have appeared to flatten the curve, but at great costs and stress to its resources over time. Reopening puts more strain on these resources as spots flare up at assisted living centers, UT and especially construction sites. How will APH continue to staff and fund the services necessary to deal with the pandemic until a vaccine is administered or the virus is otherwise under control?
Answer: Basically, what we are doing is we have developed a surge plan. The surge plan is based upon looking at some modeling that we have received from Dell Med (Dell Medical Center at The University of Texas at Austin), as well as the information that our epidemiology and preparedness staff have provided for us. As we move through this response, we are able to bring in other City employees that work outside of Austin Public Health, but work for the City of Austin to assist us with this response. We have planned out our efforts through the end of this calendar year and we will evaluate that weekly. And if we need to decrease that effort as far as staffing, we will do that, and if we need to increase, we have the ability to increase. We feel very confident in the plan that we've developed.
Question: Recent reports have stated a very high percentage of the Hispanic population in Austin have tested positive for COVID-19 in comparison to other groups. What measures will you implement to stop the spread in the Hispanic community? Do you have a plan for outreach or possibly creating a task force to address this issue?
Answer: Yes, we are going to develop a task force. We currently have some council cabinets and the task force will be a branch in that council cabinet, where we will put together a team of our community members as well as other partners that we have been working collaboratively with during this response. Our Austin Public Health staff and equity and community engagement division have developed a plan, and we are going to share that plan with the task force and get feedback from them. We have some ZIP codes that we have been following and have noticed that there are some disparities in ZIP codes. Honestly, those are ZIP codes where we see health disparities outside of the COVID-19 response. We are going to put in place this plan, work with the task force, work collaboratively with our community non-profit partners. But we are absolutely going to do everything we can to improve the health among our Latin community.
Question: Following up to that, when do you plan to have the task force in place and which ZIP codes are you seeing that are concerning to you?
Answer: We are formulating the task force. I don't have a date on when that will be stood up. Some of the ZIP codes – and these ZIP codes are definitely aligned with the ZIP codes that we see health disparities in, so they are the same ZIP codes – so when we look at the eastern crescent and we look at southeast Austin and we look at "41" and "44" come across Austin out to the Del Valle area, but then come through Central Austin, "02," continuing up northeast to "24" and "25." And then we have some disparities out in Pflugerville and Manor, 78660, as well as we have some neighborhoods we are looking at in the "52," "53," and "58" area. Those are just to name a few of the ZIP codes that we know we will have to do some targeted outreach. One of the strategies – we set up a hotline for various needs. So, we are setting up a hotline for folks who have questions or are needing additional information. The other thing is we have had staff that have sent our fliers for services. We are looking to do virtual classes as well as some in-person outreach.
Question: What has APH learned from recovered patients about immunity? When will test turnaround times be quicker than three to four days? Will the City start testing for antibodies and will that help learn more about immunity?
Answer: The immunity question is unanswered at this stage. It's unanswered because the disease has not been around for that long. So there is clearly evidence of antibody development in folks who are sick and recover. In fact, many of those individuals have been referred to We Are Blood for convalescent plasma donation, which has been administered dozens of times to individuals hospitalized int the Austin-Travis County area. But the jury is still out in terms of long-term immunity and we won't know about long-term immunity until we have a longer period of time of experience with this disease. We've asked The University of Texas to put together a proposal for what we call a seroprevalence study, which is a study looking at the antibody prevalence in the community to decide what our prevalence rate has been ... what our infection rate has been, but also to monitor the presence of antibodies over about an 18-month period. So we're hopeful to get funding for that study so that we can answer some of these questions.
Question: Please tell us about the APH's use of Abbott Labs Point of Care machine, its accuracy and challenges, if any.
Answer: We received the Abbott ID-now analyzer several weeks ago from the DSHS. We just, on Monday, received the first shipment of 24 test kits, so we have not run any tests on the ID-now analyzer. Talking with some of our partners at local hospitals, they're not seeing the same results as have been recently published. In fact, their results show substantially higher accuracy as compared to the regular send off tests, the RTPCR tests. So there are some nuances of how tests are collected. These are some of the questions that still need to be answered regarding the reported inaccuracies of this test. I think folks should be cognizant of that concern. We know that sensitivity of tests varies between symptomatic or asymptomatic, if they're hospitalized or not hospitalized. There are a lot of factors involved with the accuracy of a test, and I think we need to collect more information related to how to interpret those results.
Question: Quick follow up to that one. So you're still going to move forward with this Point of Care machine, and you're not too concerned of any inaccuracy coming out of it?
Answer: Again, we only have 24 test kits. So generally, what we do when we first validate a machine we have received such as this, is we collect both the rapid test and the send-off test, so we don't rely on the rapid test on its own. Initially, we would send off both tests, ensure that we can validate that machine internally first before we decide whether or not we are going to pursue that as a sole source of testing in the future.
Question: Would you consider reporting the daily percentage of positive tests against the total tests (positivity rate) since that seems very important for the government to decide how and when to reopen the economy? And if we are doing better or worse?
Answer: We actually are posting the number of positive cases we have every day as you can see if you go to our dashboard. It has been revised and includes a lot more information. As we get more data we are trying to share that with the public. One of the challenges of providing percent of positive tests is that we don't get the number of all the negative tests in the City of Austin. Those tests are not reported to us. We only know the number of tests that we have completed ourselves because there are a large number of people conducting testing in our community. So, it makes it a little challenging to get that information.
Question: How can APH deal with construction workers, as well as others, refusing to take the COVID-19 test? With such large numbers of people saying no to the test, Can APH or the City do more to make people more comfortable with the test?
Answer: There are real barriers and perceived barriers to testing. I think there is a perception that people are going to have to pay for the testing. Depending on where they choose testing, that may be the case, but for the Austin Public Health site, there is no charge at all. There is also a concern in our immigrant community, there is concern about them being detected and that somehow that information is going to be shared with law enforcement. That is absolutely not the case. The information we collect for testing comes to Austin Public Health. That information cannot be used for prosecution. The other concern we are encountering that is more difficult, is people's concern that if they test positive, that they will be out of work for an extended period of time. In circumstances where people don't have sick time, that is a huge disincentive for people getting tested. In some circumstances, they would rather not know than be out of work. This is a key challenge for us across the country. I think we do need some federal legislation to protect workers, particularly in this period of time, so we can assure a paycheck and we can assure their job.
Question: Interim Health Authority for Austin-Travis County Dr. Mark Escott said a few weeks ago that he can't envision us having any mass events anytime soon. What is his position on that today? What would be his recommendation at this point about ACL or Longhorn football?
Answer: Mass events are a challenge and as I said last week, the large events were the first thing that we turned off and are the last thing that we are going to turn back on because of that risk of exposing lots of people. We are working on a plan to forecast what we think is going to be reasonable. Looking through the end of December, we don't have any indications at this stage that we would be able to mitigate risk enough to have large events, particularly ones over 2,500. Having said that, a lot is changing quickly. If we identify effective treatment that can be administered early in the case of transmission ... that's going to be a factor. If we find ways to rapid test that could be done at the gates before people go in, that's a potential factor. There are a lot of factors that are just unknown forecasting beyond the next month or two months that are challenging. We will continue to provide advice to the community regarding mass events. At this stage, in Stage 3, the answer is no. Our ability to open things up, in terms of events, are going to depend on how our community responds to the recommendations, that they continue social distancing, and continue personal hygiene. If we continue to keep things flat, more things are possible.
Question: Dr. Escott, if we flatten the curve, but there is no vaccine in time for ACL or Longhorn football, does that matter moving forward?
Answer: It really depends on how flat it is. If we maintain things flat, and certainly if we can decrease hospitalizations, then we'll think about moving from stage three to stage two. Which will open things up a little bit more as far as gatherings are concerned. A small increase, not a big increase. We really have to get to that green level, the Stage One before we are going to be willing to have any sizable events. I think that's incentive for us to work hard at social distancing.
Question: In work session, Community Care pointed out that the eastern crescent of town had clusters of positive tests. Is this simply because more people are getting tested in those areas? Are there aggressive testing efforts in West Austin?
Answer: It's a bit challenging to answer that question completely now because we don't have all the data in one place. We've got Community Care, which has done about 4,000 tests. Austin Public Health has done around 4,000 tests. Austin Regional Clinic has done more than 10,000 tests. And we've got tests being done in hospitals around the region. So it's hard to answer questions like that, which is why we're trying to get that information together in one place so we can identify where people are being tested and where they're not. I will say Community Care has done an excellent job of reaching out to their community. They've done an excellent job at decreasing some of those barriers to people getting tested. They're a trusted resource and we'll continue to support their efforts. But we do need to make some population-based decisions and the best decisions are made when we have all the data in one place.
The lead health authority for Austin and Travis County announced on May 19 that we have effectively flattened the curve in the number of COVID-19 cases. However, Dr. Escott said we need to remain vigilant.
APH will continue holding press conferences every Wednesday at 9 a.m. to answer coronavirus questions.
Austin-Travis County has completed more than 20,000 COVID-19 tests since the beginning of the pandemic, according to the latest figures from the Texas Department of State Health Services, as Austin Public Health (APH) continues to make COVID-19 testing more accessible to the community.
The State dashboard shows the total number of tests at 22,973 as of May 18, while separate State data show that Austin Public Health and health partners have achieved a per-capita rate of 15.3 tests per 1,000 people across the region, with 2,595 positive cases and a cumulative positive rate of 11.3%.
APH provides free tests at a drive-through site to anyone who has been approved after using the online public enrollment system at AustinTexas.gov/COVID19. Criteria for getting a test include the presence of symptoms, exposure to others who have tested positive, as well as other high-risk factors identified by the Centers for Disease Control and Prevention. APH also runs a dedicated testing site for City and County critical staff and first responders.
Earlier in May, the Public Testing Enrollment system was expanded to serve the neighboring residents of Williamson County as part of the continuous effort to protect the health and safety of Central Texans. With access to this technology, Williamson County was able to open an additional testing site in Georgetown and has tested 333 people since May 6. The information collected is accessible between epidemiology teams across jurisdictions to help develop a more comprehensive picture of how Central Texas is being affected by the virus, and inform how to further prevent its spread.
“We are testing substantially more people than we have in the past, and with the expansion of testing sites and our technological resources we have the capability to not only help more residents now, but plan for a future of living with coronavirus,” said Dr. Escott. “This virus does not stop at jurisdictional boundaries, so partnering with neighboring counties gives us the edge we need to combat this virus effectively.”
“Williamson County and Cities Health District (WCCHD) is very fortunate to be partnering with Austin Public Health to be able to offer a no-fee public testing site. We have received multiple comments from the community being tested that they find the online screening system and results portal very easy to use, and they are grateful to be able to have this service available to them for no cost,” said Dr. Lori Palazzo, WCCHD Medical Director and Health Authority. “The more testing we are able to offer in the county will give us a better sense of the spread of the virus and allow WCCHD to contain potential outbreaks.”
Users who fill out the Public Testing Enrollment Form and are approved for a COVID-19 test are now able to schedule a test at several locations – including the one in Williamson County. To complete the Public Testing Enrollment Form and for more information regarding COVID-19 visit AustinTexas.gov/COVID19.
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