Robert T Babbitt PLLC
Issue 1, Article 1
May 2, 2020
COVID-19 WHAT ARE THE CURRENT RESULTS?
Each evening we hear how many cases have been tested as a positive in our city, county, state and nation. Caution and preparation are vital. Fear is not useful. Thanks to the leadership of the Texas Department of Transportation, HTG will each week help you understand the latest developments that help you navigate the challenges ahead.
There are 254 counties in Texas. No county wants this virus. Each county is concerned with the medical personnel and hospital facilities facing immense problems. Italy showed what can happen when the system is overloaded. The data most often reported to keep track of the trends include: positive confirmed cases and fatalities per county. We know that tests have been prioritized for emergency workers, first responders and those with clear symptoms. That leads to important decisions but does not give a random sample to assess the prevalence of the disease.
Fatalities are the tragic result of some cases. The data are not limited by the testing availability rates. The fatality rate news in Texas by county is essentially good news. According to the May 1, 2020 data posted by the Texas Department of State – Health Services there are 165 counties that have not yet had a fatality related to COVID-19. Of the 89 counties that have had a fatality, only 17 have had 10 or more.
There is little surprise in the top 5 counties (Fatalities to date):
- Harris: 114
- Dallas: 104
- Tarrant: 68
- Bexar: 47 (tie)
- Travis: 47 (tie)
There are 5 counties with 0 fatalities and over 90,000 population:
- Guadalupe: Population 182,526
- Parker: Population 159,119
- Gregg: Population 136,671
- Grayson: Population 133,647
- Liberty: Population 90,780
The counties with large concentrations of cases often include prisons or nursing facilities. The five counties with more alarming ratio of population to fatalities are:
- Washington: 2,511 to 1
- Shelby: 7,163 to 1
- Crosby: 7,247 to 1
- Lubbock: 7,300 to 1
- Castro: 8,901 to 1
The fatality rate (population to fatalities) for the entire state of Texas is 37,429 to 1.
Total fatalities in the nation today are 66,621. Three large states have a great deal of variation in total fatalities: Texas 816, California 2,135, and New York 24,368.
This is a dangerous virus that can kill. Keep in mind that the virus itself is dangerous because it is presently not easy to detect. Persons who have been infected are highly contagious when symptomatic. They are also contagious before they realize that they have the virus.
This virus is also defeated by simple strategies. Wash your hands thoroughly and frequently, and hand sanitizer when running water is not practical. Use a mask when in stores and similar settings. Isolate and call the doctor when symptomatic. In 80% of cases, the infected person recovers without any medical intervention.
Texans have fared well in this battle compared to any other large population state. Remember Texas is the second largest population state in the nation. We have the fourth and fifth largest urbanized areas in the nation. We have an international port and two of the largest airports in the nation by passenger volume. We may be fortunate; we must be doing many things right. Remain cautious, not afraid.
Note: For additional details see Texas COVID-19 Fatality Count Data by County
Issue 1, Article 2
May 2, 2020
COVID-19 OPENING THE STATE OF TEXAS
On Monday, April 17, 2020 Governor Greg Abbott announced the plan to open the economy once again. He cautioned all citizens that the potential hospital crisis phase had been resolved by social distancing and quarantine solutions. He reminded us that responsible “back to normal” steps involve phases and data-driven decisions. The governor also announced statewide testing and contact tracing initiatives.
On May 1, 2020 Executive Order GA-18 explained the new rules of engagement. The directives are clear. Retail services may open for pickup or delivery. In-store retail may operate at 25% occupancy. Movie theaters, malls, museums and libraries may operate at 25% occupancy. Counties that have proven to DSHS that the county has had 5 or fewer cases with requisite attestation may open these retail and related operations at 50% occupancy. Limited office (single person office) and government permit processing and related operations may open. Golf courses may open.
Those persons 65 years of age or older are encouraged to stay home, use social distancing and thorough sanitation. Details, including checklists for employers, customers and employees are found at EXECUTIVE ORDER GA-18
Issue 1, Article 3
May 2, 2020
COVID-19 WHAT ARE THE LATEST SCIENTIFIC DEVELOPMENTS?
This week the Food and Drug Administration approved the Gilead Sciences drug Remdesivir for Emergency Use in the battle with COVID-19. The drug was the first of what may be several treatments that do not prevent the infection but minimize its risk and damage to the patient. This drug went to trials quickly because it had already been formulated. It was tested for use in the fight against Ebola. Though it did not meet the performance hoped for in that Ebola test, it had properties that seemed promising for this virus. The small successful clinical trial of the drug in COVID – 19 patients led to average hospital stays that were significantly shorter than those who did not receive it.
In an aggressive move, Gilead is beginning the process of manufacturing large scale production before the full testing regimen is completed. The Emergency Use Authorization category is used when the Food and Drug Administration is convinced by limited scientific data that the drug is safe and effective, even though full capabilities and limits have not finished the longer test processes. It is used when other drugs have not yet been effective.
Two of the 107 potential vaccines under development are moving rapidly through what is normally an 18 month process. This week Oxford scientists and AstraZeneca announced that the Oxford University vaccine that was given to six rhesus macaques a month ago were healthy several weeks after being intentionally dosed with COVID-19. The test group of similar animals given the virus but no vaccine were ill. The test is preliminary, but the results are meaningful and convinced the team to proceed with manufacturing steps anticipating the final approvals. This could lead to large quantities available as early as September, 2020. The human trials with 1,110 healthy volunteers begins now.
Moderna is another of the leaders in the race to a vaccine. The firm announced its submission of request to start phase 2 testing in humans to the FDA this week. In the biggest news from the firm, Moderna and Lonza have announced a deal to ramp up production of the anticipated approved vaccine to one billion shots per year. The announcement indicated the plan to begin batch production in the U.S. as early as July, 2020.
For details on the EAU see: Fact Sheet for Patients and Parent/Caregivers: Emergency Use Authorization of Remdesivir – Food and Drug Administration
Issue 1, Article 4
May 2, 2020
COVID-19 WHERE DO I FIND INFORMATION ON CUSTOMER/EMPLOYEE PROTECTION?
The Federal Transit Administration recommends five important steps to reduce the likelihood that transit employees and customers spread the COVID-19 virus. The steps are in concert with OSHA and CDC guidance:
- Implement procedures for employees and passengers regarding personal protective equipment including face coverings.
- Implement procedures for routine cleaning and surface disinfection of frequently touched surfaces including vehicle handrails, seats, ticket information touchscreens and related equipment items.
- Implement measures to create six-foot separation among groups of employees, employees and customers, or among customers.
- Implement procedures that reinforce healthy hygiene practices and provide sufficient opportunities for the procedures to be used constantly.
- Ensure that transit vehicles and facilities are appropriately cleaned.
- Revise policies and procedures pursuant to Center for Disease Control, OSHA and FTA Safety Advisories.
Many transit systems have added deep cleaning for all internal touch surfaces in vehicles at more frequent intervals. Some have gone to an extra step of using disinfecting wipes on touch surfaces at each instance of the vehicle reaching the transit central station.
For additional details: https://www.cdc.gov/coronavirus/2019-ncov/community/organizations, also https://www.osha.gov/coronavirus