At the end of each day, Pranish Kantesaria takes off his sometimes soiled medical mask and drives home from a hospital in Austin, Texas.
Months into the COVID-19 pandemic, the director of pharmacy at Baylor Scott & White Institute for Rehabilitation said his family’s life has changed in ways both trivial and severe. The constant, bubbling anxiety inspired a pivot from wine to cocktails. His wife, a physician’s assistant, switched to the night shift so that a parent can always be home with their children aged 1 and 6. Kantesaria started financial planning classes in case he one day feels he must leave the health-care industry to protect his daughters, one of whom is immune-compromised.
“If one of us brings COVID home, she could end up in the ICU in a couple of days,” he said.
But while Kantesaria, his wife, his 71-year-old mother, and their daughters have adjusted to life under the novel coronavirus, other Austinites have seemingly gone about their business. Kantesaria told The Daily Beast on Wednesday that it’s frustrating to see people at the grocery store or dining-in at restaurants without masks or appropriate social distancing.
That’s a common complaint amid a massive surge of COVID-19 cases in a slew of states that public experts have said reopened too quickly and recklessly, and without following federal recommendations for supplies, testing, and contact tracing. But it’s especially glaring in Texas, where officials reported 5,551 new cases on Wednesday—a new record—after breaking the 5,000-case mark for the first time a day earlier.
Increasingly, residents, medical professionals, and public officials said they worry that Texas faces a new frontier of horror—and that no one at the state level is willing to take the action needed to stop it.
“Sometimes it feels like no matter what you say or do, nobody is going to care,” said Kantesaria. “We’ve become more comfortable living with the anxiety.”
Gov. Greg Abbott, roundly criticized for his aggressive reopening scheme, did little to curb that fear, saying earlier this week that “closing down Texas again will always be the last option.”
Still, on Tuesday, Abbott urged Texans to stay home if they can; gave local authorities the power to restrict outdoor gatherings of more than 100 people; and said Texas would create mandatory health standards for child care centers since the rules were until now voluntary, The Texas Tribune reported.
“COVID-19 is now spreading at an unacceptable rate in Texas, and it must be corralled,” Abbott said during a news conference this week.
Mirroring national trends, it’s worst in urban centers, with the largest outbreaks in Harris County, Dallas County, and Bexar County. The number of Texas patients hospitalized with COVID-19 more than doubled in just 24 days, tallying 4,389 total on Wednesday. Travis County, home to Austin, has reportedly considered local convention centers, stadiums, and other facilities as temporary hospital overflow facilities, if it comes to that.
Kantesaria pointed to the back-and-forth between state officials and local authorities trying to impose masking, social distancing, and other restrictions—a battle that has played out nationwide. To ensure big-city officials proceeded with the governor’s swift reopening plan, the state’s attorney general sent letters to leaders in Dallas, Austin, and San Antonio warning that “unlawful” local requirements more strict than the state’s orders could be met with legal action.
Abbott did, this week, urge Texans to wear masks, and has recently given his tacit consent for local officials to impose masking requirements on businesses, if not throughout their municipalities. He has declined to officially order residents to comply. Abbott did not immediately respond on Wednesday to a request for comment from The Daily Beast.
“It ends up falling on us in the health-care system,” said Kantesaria. “We’re pretty much on our own. There’s no cavalry coming. There’s no help coming.”
Outside of Austin, things are even more grim.
Some hospital officials in other parts of the state have already said intensive care units are near, at, or over capacity. The Houston area has extraordinary capacity, with the largest medical facility in the world at the Texas Medical Center. But hospitals in the area have already started moving COVID-19 patients to a local children’s hospital to help other facilities cope.
Houston Mayor Sylvester Turner said on Wednesday at a city council meeting that 97 percent of ICU capacity in Houston had been filled, 27 percent of it by COVID-19 patients.
In the beginning, during the stay-at-home order, “we really did flatten the curve,” said Dr. Umair A. Shah, executive director of Harris County Public Health, which oversees the Houston area. “But since the reopening of Texas, and Mother’s Day, Memorial Day weekend, the protests, graduations, Father’s Day, restaurants opening to 50 percent, and bars opening and hair salons,” things have gone haywire.
“It’s not just where we are today, it’s about the fact that at some point soon we may need to get into surge capacity, and there comes a point where it’s unsustainable,” said Shah.
And on Tuesday, Talking Points Memo reported that the federal government was winding down support for seven local testing sites in Texas.
The sites—primarily in Dallas and Houston—were coordinated earlier in the pandemic to help local authorities after a series of missteps led to a national dearth in available or affordable COVID-19 tests. But the feds will no longer provide testing kits, laboratory access, staff, and other costs starting on June 30.
Four Houston and Harris County sites, with FEMA assistance, provide up to 2,500 to 3,000 tests per day for the city, said Shah.
“We’re really busy at these test sites right now,” he told The Daily Beast.
In a letter to the federal government over the weekend, Shah asked for a two-month extension from the Department of Health and Human Services, noting that the county is the third-most populous in the country and home to the largest uninsured population in Texas, where 4.7 million people live.
“It is clear our current healthcare system could soon be overwhelmed by this pandemic,” Shah wrote in his letter. As he told The Daily Beast on Wednesday, “Given where the trends are going, this would not be the time to lose any capacity for community testing.” The Department of Health and Human Services did not immediately respond on Wednesday to a request for comment from The Daily Beast.
Meanwhile, hospitalizations in Dallas County have doubled since June 1, Judge Clay Jenkins told The Daily Beast on Wednesday. If the federal assistance dries up, the metroplex and its surrounding area would lose testing capacity by about 2,000 per day. COVID-19 is now the third-leading cause of death in the county, behind heart disease and cancer, according to Jenkins and local health authorities.
“We’ve asked our federal partners to continue the partnership in a different way, to provide us with reagents for our labs,” said Jenkins. “If they’re unwilling to do that, we’d like to keep our partnership going the way it is now.”
But if that doesn’t work, things could get dire. And fast.
“If you get sick and you need a bed or an ICU or a ventilator, we have a bed for you,” Jenkins continued. “But if we continue on the trajectory we’re on, with no real requirements, in a month we will be in very serious trouble.”
Among medical providers, there’s significant fear, Kantesaria told The Daily Beast. But there’s also a kind of increasingly macabre resignation.
As he put it, “Clearly our state has decided, ‘Whatever, it’s in God’s hands. If people die people die.’”
Editor's note 06/26/2020: This story has been updated to correct the kind of mask used at the Baylor Scott & White Institute, and to clarify that the pharmacy there does not treat confirmed COVID-19 patients.